Visiting old friends

This is the evidence of our date night yesterday

We had the whole day planned, but it rained and suddenly the hour walk to the craft market was less appealing. We still wanted to go out for supper though, to celebrate the end of a long weekend. We made a little detour to the Hospitality center to visit some of our friends. For Giles, it was the kids, and for me, the ladies. I had hoped to find one particular lady who was discharged earlier in the week, I didn't get to say goodbye. Instead, I found another dear one who smiled and clapped her hands when she saw me walking up the path. All in all, it was a lovely afternoon!

"Merci Sista"

Here i sit in my whirly chair, counting the minutes until another night shift is over. Funny, as I spin round and round, watching the clock with one ear open for the 'tist' noise I have now trained myself to hear (the African call bell system), I start to think of the lessons I've learned throughout the week.

Tonight's ramble, as I call it, has everything to do with nursing. I truely didn't know what to expect when i arrived here. I had spoken with a variety of people who had worked with Mercy Ships in the past, each with varying degrees of recommendations. I was assured that given my work experience, that i would be fine here. And, it's true, I am, skills wise. One of the last parting comments made to me before we left by a friend of mine was, 'Adrienne, be forewarned, it's a much slower pace than you're used to.' Little did i realize how great an impact this would be.

During my first few weeks here, the words of a senior nurse i used to work with at home came to me. 'You young nurses are great. You're so enthusiastic about starting IV's, running for this and for that. But, you all forget about your patients. You forget to talk to them and walk with them. You forget about the nursing part of nursing. Nursing sure isn't what it used to be. We never used to have to write that we walked a patient, it was assumed.' The conversation that started as a result of this comment was long, and obviously impacting because i remember it. Largely because she's one of the best nurses I've ever worked with. She absolutely hated it when we refered to a patient by their room and bed number and challenged me to get to know them. "There is a way to know your patients, care for them and not let their stories keep you up at night." I never believed her until this week.

We have fun on the ward. There is much laughing and giggling that goes on as we nurses make our way around to see the ladies. I usually stumble over something at least once when the ship makes a lurch to one direction, or one of the patients does the same thing. Perhaps one of the largest learning curves I've had to climb is the one of teaching. There is so much to be taught here, and not all of it is easy. Often I will try the same lesson with three different translators at different times and it is amazing the different results. It makes me nervous sometimes as I am never 100% sure the message is getting across. That in itself has been a lesson learned.

Probably one of the most impacting lessons I've learned here on the ship, is what nursing a person can really accomplish. I admit I was pulling my hair a little too tightly the first few weeks, looking for something to 'do.' At home I'm used to running nonstop. I prided myself in my efficiency and ability to keep straight one hundred little details. I could tell you at a drop of a hat the names of patients from room 1-30, and on the days I was the charge nurse, I could tell you one hundred other little details most could care less about. But here, the world is different. The atmosphere is different, and the work is so much calmer and peaceful.

I think I'm finally starting to get the working environment here. I've moved beyond the smiles and handshakes to conversations with my patients. It's hard to explain what a milestone that can be here. But, I'm glad to say that I've finally accomplished that. There are some wonderful translators here who are more than willing to sit with me and be the in between. When these few gems are working, I've taken every opportunity to get to know the story behind the smiles and the handshakes.

Tonight is one of those surprising night shifts. There are three small children on the ward, babies of the VVF ladies who are still breastfeeding. I had to tell one Mama not to breastfeed her child until the morning due to the drugs in her system. After finding a translator and waking up another lady to help, we had a chat. But, it was about far more than breastfeeding and figuring out a way to appease her rambunctious 2 yo. should he awake wanting food. It was a brief glimpse into her hurting heart. She told me how she was an orphan for as long as she could remember. She was abandoned twice by her husbands due to her condition. The conversation went on for sometime while the lady across the room consoled her before the message was relayed to me. This lady, only 10 years older than me just walked into my heart tonight. Her quiet words, "merci sista," trying not to wake her son, as she grasped my hand firmly, have echoed in the night.

My new found resolve to get to know my patients beyond their medical chart has come with a cost. Tears. I fight them every day, at the end of every shift. Some sad, some happy. These are marvelous ladies. They've fought hard to get here to the ship. Their stories have slowly been edging themselves from my brain where all of them lay arranged orderly and systematically, to my heart that aches for each one. "Wet for 30 years, wet for 13 years, wet for 28 years, abandoned, cast out, left alone, my baby died, nobody wants me,.... wanted to kill myself." Soon after though, come smiles. I've just walked up and down the hallway carrying a very angry 2 yo as his screams cut through the silence of the night with an ear piercing squeal. But, with each step, his cries became more and more of an effort as his little body falls asleep again. Now, here i sit in my whirly chair, rocking from right to left, mimicking his Mama's walk. He's asleep, pouty face wedged into my chest, and calm peaceful breathing fills the night once more.

Some moments are harder than ever, and others are getting easier. I've just tucked in that little boy, his Mama rolled over in their small shared bed, eyes closed, and clapped her hands silently for my achievement. For tonight, she lays in wait, hoping and praying that the day's surgery was successful. I have by no means reached perfection in my nursing. I have a long ways to go before I'll be satisfied with the job I've done. But, I hold on to those little moments of victory, marking the long path. Tonight my job is to watch over 8 ladies and one little boy. Perhaps these night shifts aren't too bad after all.

Ordinary Days

I must stress the fact that we do have ordinary days here. Those kind of days where there are no earth shattering epiphanies, no tear jerking stories, or deep thought provoking moments. Some days are just ordinary. Here, i was forced to pose for a photo that is now posted on the wall down in the hospital. There is a world map glued to the wall, the ward nurse's faces and names are a-fixed to their countries (or close by).

I thought I'd share a few glimpses into the day by day happenings here on the ship. I can't do too many as it takes forever for them to load, but here are a few of my favourites!

This is Giles' special friend, though he does have many.

Here Dad and I are sitting on deck 8, watching the fishermen come in for the day. This is a gloriously windy corner with shade for Dad. It is perhaps my favourite place on the ship.

Giles has found a local orphanage recently, and is helping coordinate the building of new bunk beds for the kids. He was dropped off here one Sunday afternoon while i was working, and played soccer for hours. This set of twin boys are his newest Benoinese friends!

These are some of the fabulous nurses i work with. I have no idea how many countries are represented in this picture alone, but i know each one of them is passionate about helping their patients and are terrific at their jobs. There couldn't be a better lot of them!

Giles plays soccer every Monday & Wednesday evening. They've joined a league here in Benin starting last weekend, and they even won!!!

There you have it, a glimpse into our lives. I spent the afternoon walking through the markets searching for fabric to have an African dress made, and I am frankly too tired to write anything more !!!

Gratitude

Dad is on his way home now. I had the day off today, and decided i would tag along with him. I spent the morning in the OR while he finished his last two cases. After lunch, we headed off to a local hospital called Bethesda which will be a story for another day.

I wish I could describe the feelings I had as various people said goodbye to him throughout the day. Pride was definitely one of them. Joy was another, as well as a strange and surprising peace. My Dad spent 4 weeks working with me as I fulfilled my dream of working on a Mercy Ship. And did he work! He worked long hours here, serving the children of West Africa. How many people can say their parent participated alongside them as they fulfilled a dream? I venture to say not many. I will never forget these four weeks, and will treasure them always. I know they were as meaningful to him as they were to me in ways that words cannot express.

Farewell Dad, and have a safe journey home. See you in 5 weeks. I'm so proud you're my Dad.

Operating on Faith

"Now faith is being sure of what we hope for and certain of what we do not see."Heb. 11:1

It's hard to believe that my Dad will be leaving on Friday. It's already been a month since we greeted him on the gangway. But, sadly, the time is drawing near when our trio will soon be down to two. It has been an honour to have him here, to share the same dream and vision with my Dad. No words can describe it. The last few afternoons, my Dad and I have been enjoying the view and breeze off of the top deck. We've been able to talk about our experiences on the ship. That in itself has been a highlight of this trip. We work in very different capacities on the ship, but the people we help are the same.

This afternoon in conversation he said, "so many times we have operated in faith..." I have been thinking about this phrase ever since. Limitations. Doesn't matter where in the world you are, we will always run into that word. We are limited in our ability. We are limited in our supplies. We are limited in our knowledge. We are limited by our own exhaustion. We are limited by the abilities and weaknesses of others. The list is endless. This 10 letter word has been the topic of our conversations as of late. To quote him, "If you put a sick child in my arms in the middle of a Western children's hospital many things can be done. But, put a sick child in my arms in the middle of the dusty roads of Cotonou and I may as well not be there." This ship is limited by the people who volunteer, the supplies that are donated, and by so many other things. In comparison, yes, this is a first rate hospital compared to anything inland and has many modern amenities. But at times, so very illequiped. It is in these very challenging times that we must all operate in faith.

Our experience here in Africa on the ship, is not easily translatable. We try to give you a taste through our blog entries, but the truth is you will never meet the people in the pictures. I have been struggling with this reality lately. The one and only thing I so desperately want to communicate is that these people are PEOPLE, they are human beings, created for a purpose, created to be loved and to love. But in this world of mass media and world vision commercials, you are immune. There is very little I can say that will shock you, truly. We live in a world that reads about bombs and mass casualties during breakfast. During lunch, we learn about the latest murder trial, 3000 dead in [enter place of your choice], flip channel...blink... I can say all these things bluntly because I'm guilty of it too. I've been there.

My hope is that your heart can be softened just a little, to think twice about the blessings in your life and to be thankful for them. Oh, but do i wish you could meet our patients. Sadly, you will not see them smile, hear their hearts beat, shake their hands, give them huge hugs or share in their tears. You will see them, but you won't know them. You will know their stories, but not see their faces of celebration, or their faces of sadness. You will not really understand that these are people, worthy of the BEST this world can offer. Worthy of clean water, adequate nutrition and properly trained health care professionals.

It is the knowledge that there is a worldly possibility for better lives that troubles Dad and I. That thought in the back of our minds, "now, if only they were in Canada ____ could be done" that eats away at our consciences. The medical equipment, people, you name it exists, we live in the place where it exists. We live where, now thinking about it, limitation is a very unfamiliar word. But we are here in Africa, on this ship, and a child is sick. That word may as well be lit up in fluorescence on our foreheads. No amount of hoping and wishing will make her better.

Here, we operate on faith... faith that this person, this child will see another day, and that the little we can do will help. Faith that our limitations will not limit their little lives, faith that God is bigger than we are, bigger than medical supplies.

These people, these children are alive, they live, they breathe, they feel, they love. They are not merely an image on a screen.



Please never forget that.

"So we fix our eyes not on what is seen, but on what is unseen. For what is seen is temporary, but what is unseen is eternal." 2 Cor. 18

Love in any language!

What does it mean to love? What does it feel like to reach out to someone in need of a friend? How much does a smile cost? A hug? What about time? What does it cost someone to spend their time? How do we spend our time? Can we do more? How much is enough? What about the ones that we can not help? What about those we had to turn away? What about the person who cries out to you on the street in hunger? What about the injustice? The pain? The suffering? When does it end?

Questions: raised but unanswered.

I struggle as to what to write and have avoided the blog for too long now. I look around me, I smell the air, I feel the sea breeze and I hear the constant noise around me. But do I see, do I feel.... how can I walk through the streets of Africa and not be crushed by the injustice? How can I say to a hunger man I will not give you money... How can I shake my head to the vender and say I will not buy from you..... eyes plead with you..... voices cry out to you...... you do not go unnoticed... every step you take through the streets of Africa someone notices you.... eyes follow you where ever you go.... many wave happily and give you genuine smiles... others glare at you with accuzing eyes.... many look at you and put out their hands: expecting, requiring, demanding money... some eyes plead with you for mercy, with outstretched hands of need, genuine suffering as they walk on their hands down the streets with what should have been their legs dragging behind them. The blind reach out, somehow knowing you are there.

Where is the end to the suffering? How does one cope in this world that surrounds us? A world of injustice..... a world that believes there is no hope. Just two weeks ago Mercy Ships had a screening that was booked months ago. They thought there would be more spaces for surgery, more doctors and nurses and staff to support them. They told the people to come and be screened for surgery.... since then the beds have been full, the operating rooms booked. They tried to send out word that they would not be able to take more people. The day neared... they asked for staff to come to the screening day. They asked them to come and pray for the people because they would have to say no. They would have to stand there and look a desperate person in the eye and tell them that they will not be able to have surgery. They would have to hold them as that last hope faded away. The chance to be healed stolen from them, possibly their last chance.

The night before, reports came in that there were already people lining the streets near the screening center. People were there to sleep overnight in the streets in hope that they would then have a better chance of getting surgery. They may have traveled for days to be there. There would have been no way for them to hear the news that the answer to their life changing question would be No! One thousand one hundred and fifty people came that day. They lined up for hours and hours. Mercy Ships staff served them water and smiles. How can one smile though? How can one say it will be okay?

Announcements were made and translated in many languages. People were told there was no more room. Yet they stood in line, hoping amongst hope that they would still have a chance. People who came through and were told they would not be able to have surgery even got back in line for hours more in the glaring sun, standing despite their pain, carrying their child, hoping, waiting.... desperate.

How do you say to someone we will not be able to help you? How do you look them in the eye, amongst their pain, their suffering? How do we then go back to our little comfortable world and turn off our eyes, close our minds, silence our hearts to the cries and the tears?

It is hard, harder then I had imagined.... harder than I would ever have thought......

But there is a way.... so simple.... yet not perfect... the tears and the cries will never leave us... and I hope that we do not forget...... but what about the ones we are helping? What about the woman crying out for joy because they are healed? What about the child who walks for the first time? What about the man who's painful tumour is removed and he can stand tall, free from the deadweight of suffering that grasped him for so long? What about the boy who for the first time can speak clearly because a tumour that consumed his face has been removed? What about the mother who will see her baby nurse for the first time because the babies cleft palatte has been repaired?

We shout for joy! We see the smiles! We lift them into our arms and hold them tight! For these people we have made a difference.... we have changed their lives! We have shown them that God does love them and He knows them by name!

Watch a child enter mishapen, shunned by his community, children may run from him, adults turn away from him. He may survive only because of the immense love of his parents. He is blessed to have parents who love and protect him. Many children that are born with cleft pallete's and tumours are shunned by the vodoo community and sometimes cast out because of their beleifs. Left to die, alone. Thrown aside, unwanted and unloved.

We may not be able to help everyone but we have helped so many. People flow through our hospital wards every day. People flow through our dental clinic every day. People flow through our eye clinic every day. We make a difference!

We connect... we love... what more can we do!

Celebration and Tears

You cannot tell someone to look at a camera and smile like these ladies are doing. It's impossible. These are faces of pure joy. Faces of women whose prayers have been answered. You've already met these women over the last few weeks. I've told you their stories and now you've seen their beautiful faces. These celebrations occur on a weekly basis on the ward now. 25 of our approximate 50 beds are allocated to the VVF ladies now. We have 3 more weeks of VVF surgeries planned, and many more shining faces to see. I thought it was important you see a glimpse of them yourselves.

I've just come off of a stretch of night shifts and can genuinely say I still don't like working nights. Sure it's quiet and there's less work. But, those are two terrifically good reasons for me to not like them! I tuck the ladies in for the night, and spend the next 8 hours watching them sleep. They're all in one room with no curtains dividing them, so it's a fairly simple task to do. The ladies scheduled for surgery the next day get woken up at 5:30am for special showers and baths. Then I'll spend a good half hour emptying their drainage bags and refilling water bottles. At 7am, the day staff come in and wake up the remainder of the women.

It's really that simple, not like at home where a call light goes off every 5 minutes, most of the time for little ridiculous things. Rm 29 puked, Rm 14 is anxious, Rm 46 needs kleenex, Rm 46 needs a cotton swab.... oh wait, Rm 46 wants the light on (remember the person in Rm 46 is independent and can reach all these things herself but feels that the healthcare system owes her the luxury of having someone else reach them for her). Remember this room 46, because she is exactly the person that i have been thinking about during my last few nights while i looked after a different bed 20, now struggling to survive.

The general view point of the Room 46ers:

"The healthcare system owes me _____."
"I've paid my taxes, give me what I've paid for."
"I'm not satisfied with the level of care here, I'm writing to my MP."
"I have a right to this surgery."
"I want a second opinion."
"Where were you, I've waited 5 minutes for you to come refill my water, it's warm!"
"I am not satisfied with this healthcare system"

I am in no way talking about one particular person, so those of you reading this from work can stop racking your brains for who was in room 46. This could be anybody. I am merely generalizing what some of the patients i have looked after at home think and believe, and to some degree what all of us who live in a first world country think we deserve; what we think is our right as a person to expect of our world and health care system.

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She's younger than me and has had a few children. Her story is just like the others, she's been wet for some time. She came to Mercy Ships with hope, and for the first three days after her surgery, seemed well until 2am. She was in incredible pain and her temperature was climbing. She settled later in the day with some medicine though. Her fever left, but something still was not right. 6pm the next night her fever came back, 40 degrees, rigoring with the sheets soaked with sweat. Delirious with fever and pain, things started to change for the worse quickly.

I had a busy night that night, and discovered along with the doctors once again, that we are in Africa. Since we arrived here almost a month ago, there have been 4 ICU admissions. Two very young babies who are doing well thankfully, recovering on the wards. And two adults. The first did not survive, the second is still there. We do not have the diagnostic capabilities that a standard north american hospital would have including the simple ability to do a portable Xray. Benin does not have dialysis machines nor does the ship, let alone a nephrologist. Where the majority of the transportation occurs on the zimmyjohn (aka dirt bike) and traffic accidents/fatalities are extremely high, Benin does not have a neurosurgeon. We alone on the ship do not have half of the resources including medications and supplies to do what could be done in Canada, let alone the local hospitals who have even less.

So what do we do?

She was tiny, less than half the weight she should have been (only 2 kilos). Her little smile was adorable except for a huge tumor protruding off the side of her neck. Her parents, like so many others, came to the ship as a last attempt to save their baby's life. Without the surgery, she would die. It was just a matter of time. But, as the doctors explained to her parents, she could die during the surgery. "She is so tiny and frail." Her parents agreed to the surgery, and while she was being carried into the operating theater, the medical staff worried with the knowledge that we have limited resources to help her if something were to go wrong.

So what do we do?

I wonder what happens to our patients when they leave the ship. Do they remember to clean their wounds, do they do it properly? Do these women who's VVF's have been repaired remember to do their exercises or do they now leak due to stress incontinence, but think it's because the surgery has failed ? Do they understand the importance of what we are teaching them? There is no long term followup here. We will follow them for 3 weeks at the most, but there are no specialists to see them.
I wonder how many of the debilitating tumors come back? There is only one kind of chemo here and nobody can afford it. No such thing as radiation. How long does the "hope" last ?

Sobering thoughts, the kind i come up with when i'm staring at the floor for hours on end during the middle of the night. The kind i come up with after sorting through boxes of rejected medical supplies from hospitals at home searching for anything i could use to make a makeshift somethingorother.

The injustice of this world is so much greater than room 46's luke warm jug of water. If only she'd understand. If only the world would help and stop exploiting the poor. Who decides who gets what ? Why does the 60 year old woman who's abused her body all her life get to live another 15 years on dialysis when an innocent young person dies in africa because she doesn't have the luxery of the North American medical system ? As one Africa Mercy nurse, Ali, wrote on her blog, "where you were born is so often exactly what decides how you die."

The little baby girl lived, despite the complications that arose. I saw her yesterday in the arms of one of the nurses being fed. The young woman is doing better, she'll make it though we still don't really know what's wrong. Her tests should come back today.

Truth is, we do what we can, with the best of our ability. We hold onto the smiles, and celebrate mightily with the successes. Later in the night, we try not to let the tears defeat us.