Straight Legs and Healed Hearts

WARNING: Long and picture heavy post!

Here on Mercy Ships, we're in the business of healing and offering hope. In the case of our orthopedic program, sometimes that means we're in the business of "breaking" bones... well, of altering the alignment and making them straight, in order to improve function and quality of life.

About a month ago now, we had our orthopedic evaluation day, where we assessed our ortho patients from last year. This process involved an in-depth nursing interview, as well as evaluation by the physio team and Dr. Frank. The warehouse was packed, filled with the laughter of children, old friends meeting again, and voices lifted in worship. There is always such joy in being able to come together with our patients from the last field service--it is a rare opportunity. No words can express how full my heart was at seeing the progress these patients have made in the last year. I'd like to share this progress and a couple of patient updates here with you now. You may recognize some of these faces from a few posts last year.

Sandrins
This beautiful little girl's right foot was turned in from a quinine injection that was incorrectly administered (sadly, this is not an uncommon case here). She was with us on the ship for several months last year, and then in the HOPE center for much longer while completing her physical therapy. I went to visit her there often, and we developed a friendship. The communications team did a home visit with her earlier this service, and she sent them back with a beautiful weaved basket specifically for me. (It may be awkward to pack, but you better believe that that basket is coming all the way home to California with me in a few short weeks.) So I was very eager to see her on our eval day. She came dressed in her finest, with the biggest smile... and walking without even a boot on her leg!

Before surgery, with her sister.

Progress in the warehouse last field service.

Visiting together at the HOPE Center last service.

Eval day with Dr. Frank.

Catching us up on all the latest news. Ino vaovao?

Romino
If you remember some of the Mercy Ships Christmas posts from last year (or my blog post), then you'll remember this precious little boy. He was the face of our orthopedic program and it's easy to see why. He had an infectious giggle and the sweetest smile... and was very clever in finding ways to avoid taking his medication. Beginning with dramatically bowed legs, he spent his time with us on the ward in bilateral casts. It was difficult to imagine what the end result might be. So when he literally came running into the warehouse, I stopped still and simply stared. Throughout the course of the day I would feel a little touch at the back of my leg, only to turn around and see him skimpering away giggling. This game was endless. And it brought a smile to both of our faces.

At home, before surgery.

Playing on the ward.

Checking his legs on eval day.

Look at that squat!

Getting ready for school!

Louiahna
Oh, this girl. When I first saw her on eval day, it took me just a moment to recognize her. With her frilly skirt, dinosaur hoddie, cute hairdo, and little pink loafers, she looked almost nothing like the girl we referred to as "The Sheriff." On the wards, she wore a little star badge the nurses made her, had a very serious face, and her casts made her walk with wide "I just got off a horse" steps... Smiles from her were well earned, and worth the effort. I could hardly believe that this little girl, taking such dainty steps with her little straight legs and holding my hand as she walked, was the same one!

Walking her hopper and some extra special glasses.

Serious face on the ward.

Having fun with her friend, Erissa.

Suspicious of the camera on eval day.

Our orthopedics program holds a special place in my heart, not only because of the wonderful patients I've had the opportunity to care for, but also for what it represents. My lovely friend Gigi is the team leader for the program this year, and she always reminds me that ortho is a special time because, while we are seeing physical and spiritual healing in our patients, we also see that healing in ourselves and each other. These kids come to us, some able to barely hobble along. Some can function, but not as well as they should be able to. These cases can be helped with a surgery where the bone is cut and re-aligned, held in place with pins while the body begins to heal. Still others may require more drastic intervention. But this is just the beginning. After surgery, they may have pain. They may have months of physical rehab to re-learn how to walk on these new legs. They may have weeks, some even months, walking around with the heavy burdens of these casts on their legs. It is not always an easy process. But then, the casts come off. They see the fruit of their efforts in rehab. Their bones have healed and they are stronger than before. And they walk, even run, with straight legs. 

Many people in the world go through this process, although they may go through it inwardly rather than physically. There may be things that are broken inside of us, things that require healing. To work through that healing process may be a daunting task. John 15:2 says, "...and every branch that bears fruit he prunes,that it may bear more fruit." Pruning is not easy business. It means that the unhealthy parts must be cut back so that new, healthy growth can occur. It is this pruning, this process of cutting back, that allows the healing to begin. It allows our "bones" to be re-aligned. To set things straight within our hearts. It leaves room for extraordinary hope and kindness to grow between the gaps. And just like our patients, we can walk through the world with newly straightened "legs." What a beautiful sight.

Love

I don't have any pictures today. Instead, I want to talk with you about love. Not the passionate, changes with the tides, type of love. But the kind that is sacrificial, unconditional, enduring. The kind of love that a mother has for her baby, a sister for her twin, a father for his son. It's a bit of a long post, but try to bear with me.

   Shortly after opening the hospital doors, I was orienting two new nurses. Halfway through our shift the nurse in charge came to us and asked if we would be willing to take a seven-month-old, failure to thrive baby as an extra patient. A heartbeat passed as the three of us looked at each other, all considered adult nurses without previous pediatric experience, before I said, "Sure." That is the day that I met little Baby Girl H. At seven months, she weighed a scant 2.2 kilos (about 5 pounds). Due to her bilateral cleft lip and cleft palette she was unable to get enough suction to breastfeed, and had actually lost weight since her birth. Over the next few weeks I started calling her by nicknames, "Little Bird" for her long, thin fingers; "Popeye" for the way she squinted her eyes when we fed her formula via a syringe. With constant feedings every two hours, she quickly began gaining weight and is now at the HOPE center putting on her "Mercy hips" (just like the rest of us on board) until she weighs enough and is healthy enough to have her first surgery. I cannot wait for that day.
   But what really impressed me in this situation was this baby girl's mama and the obvious love and care she showed for her child. Desperate for help, she came to one of our rural screenings. Recognizing the dire situation, our screening team offered to fly her back to the ship with them. Without going home or telling anyone that she was leaving, she boarded that plane with her precious cargo. She flew across the country to a boat filled with vazas (foreigners) hoping beyond hope that we could help her child. For a woman who has lived in her same village all her life, this was an incredible step of faith and courage. And then she let us hold her baby, feed her baby, love her baby. She let these strangers help her. This little baby, although being painfully underweight, came to us in surprisingly good health. This was due to her mother's love and care, and obvious dedication to supporting her child. When we first started feeding Baby H formula, mama would return her right back to the breast to try to keep feeding her. It was clear that in the last seven months, every waking moment was spent trying to just get her baby enough nutrition to survive. She told us that she was so grateful for our help, that it was the first time she was able to sleep at all because she had other people to help her with her baby. Little by little, mama began to relax as Baby H offered up her first smiles with squinting eyes, no longer plagued by a seemingly eternal hunger. She patiently learned how to administer the formula to her baby herself and prepared to continue waking up every two hours once she was on her own at the HOPE center. This mother's love for her child is the reason that Baby H is alive and with us now in Tamatave.

   If you read any of my blogs last year, then you know how much I love our plastics patients! They have the most beautiful souls. This year I have been lucky enough to take care of our little girl Zoeline, assisted of course by her twin sister Rosalina. At the age of six, Zoeline has come to us to release a burn contracture in her foot. She hops around the ward on crutches now and is a total ham, falling back to the bed and pretending to snore when the nurses bring round her nutritional supplements. She has an infectious giggle and wide eyes that are filled with mischief. And her twin is her constant companion. Standing a bit taller than Zoeline, Rosalina is constantly running around the ward making us laugh. But her sister is always her highest priority. On those days when Zoeline is not as comfortable, Rosalina is the one who comes to the nurses telling us marary (pain), malale (itching). She is the one who cleans up their plates after they finish a meal. When they come over to visit me at the nurse's station, Rosalina always makes sure that Zoeline has a place to sit down before anyone else does so that she does not tire from standing with her crutches. When the occupational therapist comes to take Zoeline to her session, Rosalina is standing at the door to accompany her, as many of our patient's parents do. She says "rahavavy (sister)" and points back and forth between them, expecting us to know that that means where Zoeline goes, she goes. They are each other's caregivers, and a beautiful example of what sisterhood really means.

   We have a precious little boy who's been in the hospital with us for a few weeks now. And he is joined by his father, which is unusual in itself. Most of the time the mother is the parent who comes to stay on the ship with their child who is receiving surgery. But these two are thick as thieves, always playing games in their corner of the ward, laughing together, father following son around the ward as he wobbles unsteadily after picking up too much speed. Natolotra came to us with a tumor that made it difficult for him to breathe as it partially obstructed his airway. While he was awake he seemed just fine. The trouble began when he would fall asleep and, depending on his position, the tumor would begin to block his airway. As a nurse on the ward, it was always nerve-racking to see him fall asleep, to listen to the heavy rattling begin to emanate from his chest, and have to constantly be monitoring him for the moment when we would need to wake him up to make sure that he kept breathing. But we had the best helper in this care, Natolatra's own father. If his son slept, he did not. Instead he sat at his bedside, calmy repositioning his son as needed to make sure that he was getting enough air. It was easy to see that he had a good deal practice in assisting his son to breathe through the night. Patiently and gently he would roll him  a bit to the side, careful not to wake him, but listening for that sudden relaxation in his breathing. He learned which numbers on the monitor we were assessing, and monitored it himself. I would glance over to check the number creeping down, start to walk across the room, and then stop myself as his dad made the necessary adjustments. It is easy to see why God gave Natolotra the father that he did. After a long surgery and some time under close observation in the ICU, Natolotra is now awake and back on the wards. As the inflammation from surgery decreases, breathing will become easier and easier for this little boy.... and for his father as well.

   Nurses have the incredible gift of being invited into the most intimate moments of people's lives. However, sometimes the things we see in these situations are not so pretty. We see neglect, abuse, people left to spend their worst moments alone in a cold hospital. We see situations that reflect the kind of love that we, human kind, have come to expect from others. But these patients show us the beauty in relationship, in truly  caring for one another. They are a reflection of the way that I believe we are loved by God, and they show us how we were intended to love each other. While they are by no means perfect, they are perfect in this. They love without artifice, wholly, sacrificially, joyfully. I can only hope to show others this kind of love. It is a lesson that I am continually learning.... but I have great teachers.  

Kick Off

Welcome back, my friends & family! It's been quite a long hiatus on this blog as I've been traveling around the globe and back again. The time away from the ship was refreshing - seeing my friends and family at home was such a balm to my heart after being away for so long. I also had the opportunity to travel, with friends and family, around France, Ireland, Botswana, and Namibia. Add to that a final stay in Durban, South Africa as the ship was still in dry dock, and I think I've met my traveling quota for the year! That special time with loved ones has given me the energy and passion to come back to the Africa Mercy for "Mada 2" and get to work! There is still much to be done here, and I'm excited to be a part of it for the next few months.

After a delayed start from Durban, we made quick time sailing back to Tamatave, Madagascar. It was a beautiful sail, much easier than last year. There was a seemingly endless supply of wildlife to watch, calm seas, and lots of sunshine. At one point we were able to set up our hammocks on the deck and enjoy the view. Here are a couple of photos from our sail and arrival in Tamatave. The advance team and other crew members who came ahead were anxiously waiting for us on the dock.

We arrived here in Tamatave only a little over a week ago... and things are already in full swing. The Land Rovers are all prepped for service. Over 100 new crew have boarded. New nurses and hospital day crew are being oriented. The ORs officially opened with a prayer to start surgery for the service. It is all starting to come together! My role looks a little different this year, as a "returner". This means I get to help more with set up, patient selection, and training the 60-some new nurses that arrived on the ship last week. In the past few days we have been reviewing previous surgical cases from last service and screening our new patients for admission. It is so wonderful to see so many familiar faces; patients and their families who have touched my heart. So many of our plastics patients returned (Lixia, Dyllan, Rosa, Hosni, Landrino), and we had a sweet time visting with one another. At the same time, there is a lot of excitement to meet our new patients and begin forming relationships with the people we will treat this service! Patients have started walking up the gangway to begin their journey here on the Africa Mercy, and today will be my first day back on the ward! I'm thrilled to get to work with the patients once again, hear their stories, and start building new friendships as they heal.

Here's our entire hospital team! Ready to kick off the surgical season for Mada 2!

I also want to mention some very special people who do not get nearly as much recognition as they deserve: our advance team. They are the ones who set everything up and make it possible for us all to be here and do the work we do.  This summer, while the ship was in Durban for dry dock, they remained behind in Madagascar working on new buildings, signing contracts with the government, arranging for crew to arrive and be transported to the ship, dealing with visas, visiting patients, and maintaining important contacts for our service. Last week they gave us an update on how the advance went and what they were able to accomplish. One of the team members was in charge of renovating buildings for our new fistula clinic and for educational purposes. I wish I had a photo to show you of the buildings before and after renovations. A dilapidated building from 1904 was completely transformed! Now, maybe it's just because I'm a girl who grew up in a construction family and can appreciate a good renovation, but the visuals of these buildings brought a tear to my eye. Here is something that will last, something that will be left behind to benefit the people of Madagascar. It is such a tangible gift. Our patients come to this ship and leave looking, and hopefully feeling, different. We hope that they are better able to perform daily activities, that they find acceptance that they did not have before. We hope that they are healed and know that they are valued; and that this makes a permanent change in their lives and how they contribute to community. These buildings, similarly transformed by the loving hands of many people, will hopefully do the same thing for the people of Madagascar. They will continue to provide a safe place for the treatment of patients and the education of healthcare professionals. They will remain, even when the ship is gone. They will help to make a difference in the lives of so many Malagasy, here in Tamatave, and beyond. Simply put, they are a beautiful example of what Mercy Ships is all about. When the pictures from communications are loaded up, I will post some for you.

Don't worry - I won't leave you waiting so long next time for another post! I'll be sure to write again in the next couple weeks as we settle into the surgical service!

We're All in the Same Boat

Last Friday was the final day of surgery, for this field service, on the Africa Mercy (AFM). Quickly the patient beds have emptied, those who have been in rehab for months are heading home, and the wards are getting prepared for "pack up". My friends and crew members have started trickling out the doors, leaving empty pockets around the ship that was so bustling and crowded just a few short weeks ago. And in just two days' time, I will be one of those walking down the gangway to start my journey home. There are so many things I can't wait for: seeing my family, taking a shower that lasts more than two minutes, eating at any time of the day I want & whatever I want, driving! At the same time, there are many things here that I'm sad to leave. Since I am returning for the beginning of the next field service, there are not quite so many losses for me this time around. I will still be coming back to this incredible community, still working with our Malagasy patients, and seeing many of our same day crew. At the same time, I am saying goodbye to many patients and friends who have touched my heart.

Being on the Africa Mercy is a unique experience that's difficult to describe. In fact, it seems almost daunting, but I'll do my best. Instead of being asked "Why would you want to go live on a ship in Africa?", you are surrounded by people who want the very same thing, who are here with the same desire to serve. And we live with, eat with, work with, and travel with these same 400 crew members day in and day out.  While we deal with the typical problems that happen when you live in such a tight community (gossip, finding anywhere to be alone for five minutes, following strict rules, "laundry rage"), there is also a lot of grace and understanding that I think would be difficult to find anywhere else. We have lived through this experience together, faced and overcome the same challenges... we are *lit'rally* in the same boat. Although the people who actually keep this boat running would like to ensure that I let you know it is actually a ship, not a boat.

Crew having a special dinner on the dock.

We had our final, in port, fire drill last week, with a simulated mass casualty situation. All the nurses were called back onto the ship to help triage and care for the "patients", while the fire crew, reception, and other crew members carried out their functions. In the midst of all of this, I was impressed by the teamwork that I saw. Everyone was working to ensure the safety of the crew and hospital, even in a drill situation. A popular phrase on the ship goes, "You come as a _______ (fill in the blank: nurse), and leave as a crew member". No statement could be more true. Everyone works to fill in the gaps to make this work. Nurses clean floors & count inventory in containers, chaplaincy members work extra hours in the cafe, deckhands works as volunteer firefighters, and our communications team travels days to return patients home. And when we have a patient who needs a miracle, the whole crew steps in... to provide blood for transfusions, to physically take care of them, to clean up after them, to visit on the wards and keep patients entertained, to cook meals for them day in and day out, to pray for the patients & the staff looking after them. It takes a village to do this work, and I have been so very blessed & grateful to be a part of the crew this field service.

In the spirit of wrapping things up for the field service, I'd like to give you a couple little updates on some patients who have been a special part of this service:

Sambany is home! After several months with Mercy Ships, our comms team made the several day journey with him to his village.... even running into his wife along the road! They shared the whole story with us tonight at our community meeting, and I cannot wait for them to put it all together so that you can view some of the footage after following his journey all this time. Seeing him climb those mountains on the way home, it's difficult to believe that he had to be carried over them by six people on his way to the ship. What an incredible transformation!

This beautiful girl is Lixia! After five months on the ship she, along with her lovely older sister who cared for her, left today with about twenty nurses standing on the dock crying and waving them off. She was one of our burn patients with an arm contracture, who had a difficult time healing. At one time, the surgeons weren't even sure that her graft would heal... we had her on a wound vac, yet were not seeing progress. Now, against all odds, she is almost completely healed, and able to head back home to where she lives with her aunt & uncle. During her time here, Lixia practiced her writing, we listened to a lot of "Call Me Maybe", she learned more English than I thought was possible while also teaching us Malagasy, and we celebrated her birthday. She was one who definitely captured our hearts, and will be missed.

The little girl sitting on the bed next to my friend Heather, and in the midst of all that confetti, is Mioty. She lost her nose after an animal bit her when she was just a baby, and so Dr. Gary has made her a new one. The nursing staff on D ward did incredible work with this little one. When she first came she wouldn't let any "vazas" near her, screamed during every treatment, and was generally distrustful of everyone. But over time, with care & lots of love, she has opened up. So much so, that while I was working a shift as charge on the ward this week she came and sat on the stool next to me and pulled out a sticker book. As she looked at me very intently, she began to sing her favorite song ("bless the Lord oh my soul, ohhhhh my soul") in her girlish voice before picking a sticker, kissing it, and placing it on my forehead. It is a moment that has been ingrained in my heart.  

This service has been full of little moments like that, that have been such a blessing to me! Thank you everyone for the support, encouragement, and donations that have made this field service possible. See you all soon!

A Crown of Beauty

My original intent for this blog was to write about "ship life" (don't worry, that's still coming), but it has been heavy on my heart these past weeks to share about our VVF/women's health program and the incredible women who have been marching up and down the halls in the hospital this month.

VVF is an abbreiation for vesiculovaginal fistula.... essentially an opening between body parts that means the woman leaks urine continually. Besides the physical consequences of the condition, these women suffer social repercussions as they are ostracized and are cast out from their homes and families for being "unclean". Madagascar has a huge population of women suffering from this condition, with over 50,000 known women on a wait list for surgery and repair.

You may wonder, how do so many women in Madagascar suffer from this condition and we rarely, if ever, see it in the States? Actually, VVF used to be common in the US as well, until C-sections became common practice that is. This allowed for quick rescue of both baby and mother from the dangers of obstructed labor. Typically what happens is that a woman is in obstructed labor for a prolonged period of time (sometimes DAYS), and the pressure against her bladder/vaginal tissue causes it to lose blood supply and creates a hole. Many Malagasy women are very small in stature and have difficulties with child birth. Without an emergency C-section, the woman usually loses her baby and is then left with a fistula that means she leaks urine continually. At times the emotional struggles of this complication can be much harsher than the physical. They come from all around the country, some of them having suffered for years of their lives, looking for hope and healing... however unreachable it may seem.

A couple of weeks ago I attended our first dress ceremony for five women who were "graduating" from the program. It is a special time of celebration for women who are now considered "dry" after successful VVF repair, and are ready to begin their journeys home. Each lady is gifted a new dress and hat, and is pampered by having her hair and makeup done (all of this comes with the approval of the local Malagasy chaplains that we team with in the hospital to make sure it is culturally appropriate). Then we all gather together, share in some music and worship, and then host a "graduation" ceremony. Each woman is invited to the front to collect their graduation gift (typically practical supplies that they can use, but that also have a symbolic meaning) and share a few words with the other patients and crew members.

These stories touched my heart deeply and reflect the individuality of each woman's journey. One woman had her fistula for only months, but was so withdrawn you could see how alone she felt in her suffering. Although she had heard rumors that maybe the ship would kidnap her and take her away, she felt the risk was worth it for the chance that she might be healed. I can't imagine how desperate you must feel to voluntarily travel across the country by yourself, to a big white ship that may either offer you hope and renewal, or may take you away from your loved ones forever. Despite that initial fear, she laughed when she told us her story.  Another beautiful woman shared that she had been leaking for over 30 YEARS, had been abandoned by her family and husband, and had been completely alone in her suffering for that time. That is just a little longer than I have been alive on this earth.  Finally, she is dry and can return home to her loved ones. It was a joyful celebration!

In the midst of these individual stories, is a feeling of sisterhood among the ladies. For the first time, they are together with other women like them. They realize that they are not alone in this situation. Although they are generally quiet when they first arrive on the ship, we soon see them gathered together in the wards, giggling over something our day crew has said or holding knitting circles. We see them walking down the halls, singing at the top of their lungs. We see them laughing at the "vazas" (us, foreigners) who do silly things just to make them smile. And while at 5'4" I tower over these petite ladies, their presence fills the hospital. While there are many emotional struggles to work through, and while surgery is not always successful after the large amounts of damage their bodies have suffered, there is so much more work being done in these women. Here, they come back to themselves, discover hope, and build community. Although challenging at times, it has been such a blessing to work with these women... here are some of their beautiful faces.

Walking out of the dress ceremony in a dance line! 

Group photo.

Hanging out with the ladies on B ward.

Me, Joceline (recovering after surgery) and Deborah.

Joceline, at her dress ceremony! So beautiful!

Our VVF team leader Steph, shared Isaiah 61 as her hope for these women, and I'd like to share a piece of it here with you: 

He has sent me to bind up the brokenhearted,

to proclaim freedom for the captives

and release from darkness for the prisoners...

to comfort all who mourn,

and provide for those who grieve in Zion-

to bestow on them a crown of beauty instead of ashes,

the oil of joy instead of mourning,

and a garment of praise instead of a spirit of despair. 

They will be called oaks of righteousness,

a planting of the Lord for the display of his splendor.

If you are interested in learning more about VVF, I recommend watching "A Walk to Beautiful". It's a short, touching documentary about the lives of these special ladies.

I'll be posting again, hopefully next week, to give you some updates on our long term patients... and lots of photos!

Everyday Miracles

A few weeks ago I was assigned to help the screening team on the dock. It's one of my favorite nursing assignments, despite the fact that it means spending hours in the warehouse in 90 degree, 85% humidity, weather. With my scrubs rolled up to my knees and my burlap TOMS on, I headed down to the dock, wondering what the day might bring. Working with screening at this stage means you get to be part of the team that introduces the patients to our ship, to the surgeons, and the incredible crew on board. You help draw blood work, do patient interviews, escort patients for CT scans and XRAYs, and entertain restless kids with a seemingly endless supply of bubbles. And while screening is not always a "happy" job since there are those we simply cannot help, it is certainly a meaningful one. After all is said and done, the patients who have been selected for surgery receive an appointment card with their admission date and instructions on when to return to the ship. Some patients will even be admitted to the hospital right then and there, to have surgery the next morning. On this day we were wrapping things up when I sat down with a man to give him his yellow patient card and admit him directly to the hospital for surgery the next day. He had a baseball sized growth on his neck that had been there for over ten years. Since he spoke a little English he had learned years ago in school, we had developed a rapport throughout the day. After I told him that he was scheduled to have surgery the next day, he broke into a smile and thanked me. As I wrote down his admission information, he said to me in his broken English, "Ten years I have had this, I have suffered. Now, tomorrow, new face, new day."

I will never forget those words. We are at the point where there are only three months left in the field service. We have gotten into a routine. Monday, screening and new admits. Surgery through Friday. Discharge patients home or to the HOPE center. Empty drains. Do patient exercises. Deck 7 time from 2:30-3:30. Neuro checks at 8 and 12 o'clock. Crafts with the kids. Check your charting. It is easy to get caught up in the activities and nursing tasks, it's easy for this unique hospital to become normal. And then I remember my friend's words... "tomorrow, new face, new day". Nothing we do here is normal. In the space of one day, we are able to offer hope that people have lived without for so long. And while recovery may take longer than that, the healing process begins in that space of time. During this time we have the opportunity to not only offer physical healing, but support our patients emotionally and spiritually as well as they recover from, potentially, years of suffering from pain, difficulty breathing, frustration, and social ostracism. I live and work in a place where miracles happen every day, where they become ordinary, and it is easy to take them for granted here... they've become everyday miracles. Each patient here is special in their own way, teaching us important lessons, and leaving imprints on our hearts. But today I want to share just a few more patient stories with you all, to represent these incredible, everyday miracles.  Some of these have been patients that I've taken care of directly, while others have been stories shared ship wide.

"Doctor" Daniella
This little girl captured my heart. During her time on the ward, she helped me check the crash cart, learned how to use my stethoscope (and how to clean it with alcohol swabs), how to find my pulse, and even how to take her own vital signs. When I brought music to the ward, she would always ask for "Boom,Clap", shouting at the top of her lungs in a straight monotone voice, "Boom, clap, the sound of my heart, the beat goes on, onononononon." I will forever hear that little voice in my head when that song comes on. She loved dance parties, and providing manicures to the nurses and other little girls on the ward. After having surgery on her foot, she progressed from hobbling around the ward with a crutch, to running up and down the halls with me chasing her shouting "mora, mora!" (slow down!).

Olivier
They do patient interviews prior to surgery, and when asked why he wanted his syndactyly on his hands fixed, you will never guess at his response. So he could count to 10 without the other kids making fun of him, and so that he could wear a wedding ring! This little one always made us laugh, he was quick to smile, and it was a joy to have him on the ward! It's easy to see why in this photo.

Mariette
We've recently started doing our goiter surgical service, and we are loving it! Although men are also affected, we've met so many amazing women during this time. We love our goiter ladies! Mariette had a large goiter that made it difficult for her to breathe. She was such a sweet, quiet, presence on the ward during her time with us.

Sambany
Sambany has become the face of the Africa Mercy this year, and many have been following his story on the Mercy Ships Facebook page. For those of you who haven't... here's a quick synopsis. After a four hour car ride and then three days of walking an incredible distance with his grandson, with just the hope that Mercy Ships could help him, he arrived at our doors. Due to the size and nature of his tumor, the surgery planned was very risky. When asked if he would still like to proceed, Sambany told the team, "I know without surgery I will die. I know I might die in surgery, but I already feel dead inside from the way I'm treated. I choose to have surgery." After 12 hours of surgery, and multiple blood donations from crew members, he was free of the 16.45 pound tumor that had weighed him down! For the first time in memory, he is able to choose which side to sleep on instead of using his tumor as a pillow. He was a patient on our D ward, where my wonderful nursing friends took amazing care of him, and the entire ship prayed for and supported him. During an interview with our communications team after surgery, he told them "...I am very happy, because I am saved. God helped me to become like this. God saved me." Amen.  

Seeing himself for the first time after surgery with my friend Marta holding the mirror!

Here he's on the left playing cards with new friends.

Although I am missing home and my loved ones, it is such an incredible honor and joy to be a part of these people's lives, if only for a moment. We have little time left in this field service, and so much left to do, so many people to reach and to learn from. Please keep our crew and patients in your thoughts as we enter our next surgical service with our VVF (vesicovaginal fistula) patients this next week. I'm sure I'll have many more stories to share! 

 

Scars

Scars. Marks left upon the skin (or heart, or mind) from a healed injury. In the States, we do everything we can to avoid getting a scar. Special creams, medical ointments. And if a scar does remain, after every effort to erase it, it is usually a minuscule mark that we brag to our friends about, or conceal with makeup... turning our injury from a sports match or our own tripping clumsiness into a measure of how brave we are. These minor scars do not make us targets for ridicule or for ostracism.

Scars here have taken on a new meaning for me during my time here in Madagascar,partly because of how they originate. It may be simply that I've never worked in trauma or in a burn center before, but the scars I've seen here have had a great impact on me and have changed my perspective regarding their significance. I've seen a man in the local hospital who was attacked with a machete for the fruit he was harvesting, who will bear the scars of those slashes for the rest of his life. Children who rolled into the fire pit in the floor of the one room hut they live in with their families. Adults scarred from childhood diseases that don't even exist anymore in the developed world. Scars are a measure of survival. They are a measure of strength, of endurance. And while the people here hide these debilitating scars and contractures on their bodies with scarves and giant floppy hats, while parents bring their scarred children to us hoping that we will have the ability to erase those scars - to us they indicate a courage and will to survive that very few posses. We are just starting the plastics portion of the field service, working with patients with physical deformities, tumors, or severe burn contractures. These patients come in to the hospital downcast, hiding their faces or different parts of their bodies, hiding their scars. As they spend more time with us though, it is a gift to see them begin to open up, laugh, and build relationships with us and the other patients on the ward.

When we first started our nursing orientation, one of the nurses shared a quote from Chris Cleave's book,Little Bee, with us. Although I read this book myself several years ago, this quote has taken on a much more significant meaning for me during the last few weeks of plastics:

"On the girl's brown legs there were many small white scars. I was thinking, Do those scars cover the whole of you, like the stars and the moons on your dress? I thought that would be pretty too, and I ask you right here please to agree with me that a scar is never ugly. That is what the scar makers want us to think. But you and I, we must make an agreement to defy them. We must see all scars as beauty. Okay? This will be our secret. Because take it from me, a scar does not form on the dying. A scar means, I survived.”

I'd like to introduce you to just a couple of the patients that we are currently working with, who bear these scars of survival. 

Windy! He suffered from these burns when there was an explosion in his home a few years ago. The burns radiate down the side of his body, limiting his ability to turn his head or straighten his arm. He's also one of the cheekiest, and smartest, kids I've ever met! The first night I met him before his surgery, I started to count to ten in Malagasy, proud that I could say all the numbers. "Iray, roa, telo..." He quickly cut me off and counted, in English, "One, two, three, four, five, six, seven, eight, nine, ten!" Then he started giggling at me. In the middle of a game of Jenga, when I asked another nurse to please bring me something, he looked up at me and clearly stated, "Please. Clean the blackboard, please." Someone's been getting in trouble with his English teacher! And despite everything he's been through, he is always quick to smile.

Mamisy! This is a truly incredible teenager. As a child, he suffered from a disease called NOMA. NOMA is a disease that affects mostly children in third world countries, eating away at the flesh. It has a mortality rate of 90%, meaning that survivors are very rare. It thrives in areas of poverty. The last time this disease was seen in the Western world was in the Nazi concentration camps (Auschwitz). Mamisy is a survivor! And Dr. Gary is in the process of building him a nose and upper lip. It's a total of three surgeries, so it's quite a road to travel down.
Here is his before picture:

And here is his latest picture. He has one more surgery to do on his lip before it will be complete.

And just for fun, here are a couple pictures of some other wonderful patients who have captured my heart in plastics:

Narcisse. He is great at entertaining the little ones on the ward. He just left to return home, and although we are so happy he has healed so quickly, we are all missing him on the ward!

Ezra. If you ever want to play a challenging game of "Memory: Spongebob Squarepants Edition"... find this kid. I beat him by one pair this week, and it was a major accomplishment for me.

Fandresena... although he likes to be called Clemmens. He has become one of the poster children for plastics... how could he not with that infectious laugh and giant smile??

I never imagined that I would get to be a part of something like this. The patients are truly incredible, and I am so blessed to be able to spend so much time with them on the wards. Even on my days off, I find myself wandering through to say hello and check in with them. I've truly seen miracles here! Healing that shouldn't happen. A nose being built from a piece of scalp. The nurses and medical team I work with encourage and challenge me to grow in my faith and become a better nurse every day. I can't wait to see what the rest of this plastics service holds for us!