Blessing(s)

When I heard Blessing was coming back to this ship this outreach and out on the dock I got so excited! Blessing is one of my favorite patients from Liberia back in 2008...she has had several surguries from us at different stages for noma on her face. Noma is the flesh eating bacteria that can leave gaping holes in the flesh. We made a new lip for her in Liberia. I can still remember her and Marthlyn trying to teach each other how to talk. One had no lip and one had a cleft lip repair. It was quite funny and rediculously cute!



I finally got down to the ward to see her and her mom today. She is so big and hardly recognizable. I brought a picture with me of her and I in case she was too young to remember. Her mom gave me a big hug and I think Blessing seemed to remember me, but she had just gotten out of surgery and a bit groggy. It's so fun to see how well she is doing from the last time I saw her...and hear some Liberian english from her mom (Blessings lips were out of commission after surgery again).:) She looks so good! Below is a picture of her on a chair next to me on deck 7.

Another patient from Togo last year was also flown in for further surgery. Afi had a huge neurofibroma on her face. Quite a bit was removed last year but it could not all be taken care of. We sent her back to her village last year after instructing a family member how to do her extensive wound care. You always wonder how those situations will turn out...if there will be healing or infection. It was great to see her back and looking fabulous. Her face had healed up great. She had surgery Monday here and things went well. She did lose alot of blood and ended up in the ICU for a day but is doing great now. She is still super shy because of her deformity and probably being in a new place also, but we will keep working on that;)

Tani is another favorite from last year who is supposed to come back for more surgery but there are visa issues...so we can keep praying her her to make it here.

It is just such a joy to see patients return and see how well they have done since the last surgery. God is good!

I SPY

So now you can see why we need divers going down 2 times a day to keep the intakes clean or else we lose air conditioning and power -mission critical. It is quite a bad situation with all the trash that gets put in the water along with the crazy currents. We are currently frantically looking for a full time diver. Right now we only have a handful of divers that volunteer and 3 of them happen to be nurses which we also need to work full time on the ward...so Timo and Dan have been doing both. Many people have been putting in lots of extra time and effort. The diving conditions are less than ideal and down right scary at times with visability about 1 foot! Keep them in your prayers!

If you look closely you can see Olly...one of my favorite mates whose family is my family on the ship. I believe the other one pictured is Dan...one of our ICU nurses. It does not always look that bad in the water, but down below always seems to be quite dark and trashy.

One of my friends who was diving said that as he surfaced once he realized the sewage tank was getting emptied......onto him. MMM. Those divers are amazing..and pretty miraculous they are all still healthy more or less.

Stuck Between a Rock and a Bronchus

I just want to update everyone on a story that is a bit overdue about God's continued faithfulness here. A couple weeks ago through an unusual circumstance we had a small girl come to the ship with "an object in her throat". This little girl has supposedly inhaled a rock a couple weeks before. We usually do not do any type of "emergency surgery", but in this case the patient was brought to the ship. A local ENT surgeon was brought to do the surgery, they just needed anesthesia which we could provide. When I first heard about this, I kind of groaned because I feel like often when we allow special circumstances to happen that we usually would not do we often set ourselves up for problems.

This was supposed to be a simple surgery that turned into a 6 hour long operation. You know it's hairy when even the orthopedic surgeon on board eventually goes in to check up them. During community meeting that Thursday night about 4 or 5 hours into the surgery they had us all pray. In my mind I was dreading the worst. I was envisioning a little girl losing her life here and having to process this with all the new nurses and justify what happened. The surgery was finished after 6 hours with the rock still stuck in the little girls bronchus. They tried everything...even a last ditch effort of super glue to get it out only pushing it down further. Little Josephine came back to ICU not doing so hot. I have to be honest that I really did not feel good about this supposedly simple operation turning horribly wrong.

I can proudly report though, that God worked in some amazing ways to allow this girl to be discharged last Friday with a great prognosis! Here are just a few ways God is amazing.

1. The first night Josephine got back from surgery intubated one of our adult ICU nurses was taking care of her. At around 2 am my roomate who is a pediatric nurse and was charge nurse in a ward down the hall decided to go check on this nurse and patient. At about the exact same time a pediatric ICU nurse was feeling restless in bed and could not sleep so decided to get some tea. She could not stop thinking about the ICU so decided to meander down to check on the patient. Both my roomate and this other nurse walked in at the precise moment the little girl was going down hill. The adult ICU nurse is used to leaving the airway in no matter what so she did not think to pull it out. The pediatric ICU nurse came just in time and said to pull the airway. Sure enough, they pulled it, and the airway had gotten clogged. They were able to reintubate the child and save her life. This happened very fast, but the fact that God orchestrated the two pediatric nurses to come in at that exact moment was a miracle and saved her life.

2. We do not always have pediatric anesthesia providers on board...but during the several days the patient was hospitalized and in ICU we had an AMAZING pediatric anesthatist - Michelle White- here to help provide care for this patient when she was doing very poorly and she was able to help run the code at 0530 one morning when the girl was struggling again.

3. God also orchestrated a cardiothoracic surgeon to fly in from Kenya on less than a days' notice to do a thorocotomy and get the rock out of the lung. This is not a surgery we do on the ship, but again, God provided. That weekend when we all of the sudden needed a pediatric ICU nurse, a couple of our few pediatric ICU nurses happened to be the ICU nurse cover for the weekend. We even had an ICU nurse who worked on a thoracic unit back home scheduled to be the ICU nurse a couple days later which was perfect when the patient had a chest tube!

All of this to say...God continues to blow me away here! So many times I have seen God provide the exact right people at the right time. When we have patients with specific issues it seems God always provides a nurse with that specialty who happens to be volunteering here at the specific time we need it. He provides the exact right ICU nurses and anethetists for the exact time we need it. He even provides the right surgeons at the right time for example when my friend had his finger chopped off last year and an orthopedic surgeon who has a specialty in hands happened to be on board to sew his finger back together. I do not know why I even consider doubting God any more. I am human so I still feel myself in that place at times, but absolutely LOVE it when God continues to work miracles and provide for dim situations right in front of my eyes. May HE continue to get the glory for what happens here. So many times situations are beyond our control, expertise, knowledge...but God continues to prove that HE is so much bigger than our limited resources and knowledge.

After the second surgery, Josephine did very well and was discharged less than a week later! She is coming back for a follow up appointment tomorrow actually. Here is a picture of this precious little miracle baby.

On a side note...this mom and dad lost their other little baby earlier this year, so it was awesome that we could be a part of giving their only child left another chance at life. To God be the glory!

Screening, Water Shortage, and Electricity Outage

One of the views from deck 7 looking into Freetown...a beautiful site!

So once again I am behind on my blogs. It has been a couple weeks since our second screening day. If you have not already heard, it went super well. Thanks so much for all the prayers. God even granted us cloud cover! We got to the site around 0500. A few friends were on the overnight security team. They made sure things did not get out of hand and even did a little pre screening. We finished seeing everyone around 2pm. I am sure there were not as many people there as were at the original screening. It makes me sad that some people that came from far away for the original one did not get seen. I continue to pray for God's faithfulness in the situation. I think part of the reason the line was not as long was because we had so many pre screeners...who went down the line to get the obvious ones out-ex. dental and eye who get seen at our clinics in town and the usual illnesses that we cannot do anything about. I did see some large tumors and many little ones with crooked legs. The last patient who barely made it in the gate is the cute little boy pictured with me below. We had packed up, but managed to find the appointment cards to get him one:) The surgery schedule is not quite filled but we got a good start on it. Not sure if we will need to have another screening later in the year or not. So you can join in praise to God with me for the safety of all those involved and the success of the day.

On another note...we are continuing to just have a rough start here. It is getting better, but every time we seem to be getting somewhere we have another set back. This past week the power went out unexpectedly for a little bit. There were four patients on different operating room tables. The generators did kick in as they should, but made us a bit nervous when the flickered a few times. All the patients were fine and surgery was able to continue. God is good. It is cool in times like these when we can stop what we are doing on the wards and pray together for the outcome:) One of the return anesthetists, Dr. Heinz, laughed later when I asked him how it went when the power died. He said, "I finally got to use the headlamp I keep around my neck instead of feeling silly for always carrying it around with me!" The simple things you take for granted:)

We are also now on a water shortage. Apparently a water main in town broke last week and we have become quite short on water. It has gotten so bad that in order to prevent us from having to cut the surgery schedule short we are not allowed showers and the laundry room is closed. This ship could become quite smelly soon:) So far everyone is handling it pretty well and getting creative with keeping clean..or lack there of;) I used water bags to rinse off after my hike this morning...seemed to work ok. I have to say a bunch of us chuckled when a group returned from the beach yesterday covered in red dirt from head to toe from the poda poda (bus taxi) ride....only to get onto the ship to read on the captain's board "no showers". Hopefully we will be back up to capacity in our water situation within the next few days so we can shower again! We have been using water trucks to bring in water in the meantime, but the water is dodgy so will take even longer to clean before it is usable for the ship. I hear it was a problem for the city also as hotels were having to pay large sums of money to haul in water. All this while they are trying to prepare for the big 50th Anniversary Celebration April 27.

A Picture or Two Will Do

Here are just a couple pictures I have taken. I hope to get one soon of the veiw of the town from the ship. It is quite beautiful, but it is often dark by the time I have time and think about it...

Reminder that screening day is this Saturday. Please pray! I will be back on the pre-screening team. Which means saying no to lots of people...and praying for wisdom to say yes to the right ones. Although me saying yes only means they will get screened for surgery, but still please pray for wisdom as we try to work through thousands on Saturday...also pray for stamina emotionally, spiritually, and physically...for the whole crew! May God be glorified Saturday and the right people be present for us to help!

The 500 year old cotton tree downtown Freetown. Beautiful big tree with the most unique huge trunk! This tree has seen soooo many things...if only it could tell stories.

Frisbee with the locals. As you can see my light grey shirt is dark cause I dove and caught the frisbee in the ocean as a wave crashed over me. Probably my one and only sweet sports move in my lifetime:) Of course the next day we got an email not to be barefoot on the beach and not to swim here...oops. Water felt woderful and it was so good to get off the ship a bit. So far I have not become deathly ill;)

Of course their endurance way outlasted us but it was great fun. Hope to play them regularly. The best part was at around noon when we had played 2 games to 10 and us Mercy Shippers were exhausted thinking it was over...when their coach said, "ok, 10 minute break before final game." Haha...we crawled onto the field for one more but convinced them to only play to 7 for the last game:) We actaully starting winning the last game..at which point they put in all their best players:)

"Wake Up and Eat"

One of these days I will get around to actually updating the country I am in on my blog...one day:)

In the meantime I just wanted to write since I have not updated since we opened the ward on Sunday. It is SO exciting to have patients...especially REALLY cute little bowed leg ones running around! Im not going to lie though. The first few days have been maddness! I could make a huge list of all that we have dealt with, but I will spare you and only tell you a few to give you a feel. I find much of what I say is hard to translate without having experienced the ship and the hospital ward, but I will do my best to relay that. One of the first obstacles included getting 22 patients right from the start (as a result of the failed screening - we brought some from up country). Many were meant to be "hotel" patients not needing care but we had about 6 with malaria, 4 with scabies to name a few. So now we have 22 patients and trying to staff for it when we were not prepared. We more or less have all new nurses on the ward with LOTS of questions. They have had an orientation but no precepting like nurses get later in the outreach when we have experienced nurses to do this (Don't get me wrong, this is how it usually is and it's great...but just adds to the chaos). Then on top of that we have new local translators we are responsible for training as they start this week. This is just the very small list. So as you can imagine as we work we usually get 4 questions for every one that we answer;)

The new nurses have been AWESOME and really have stepped up to the plate. I think after these first 2 weeks of training everyone things will calm down a bit. God has TOTALLY provided though. Every moment I think about all that needs to be done or all the issues and think there is no way this is going to pan out...I know deep down God is in control and will be faithful and provide in the moment for what needs to be. And He has done this every day. It is amazing how things have come together. I always wonder why I ever underestimate God;) You'd think by now I would have this figured out. Yet I often find myself doubting again...only to be proven wrong by God. He always ends up showing up..maybe not as soon as I'd like, but faithful every.....single.....time. In his own timing and his own way.

So before I bore you any longer I just wanted to let you know I am doing ok and surviving my new role as assistant ward supervisor. It has been very busy but God has given me the strength, wisdom, support I need when I need it.


A cute story for the road:
In the midst of putting in another 12 hour day today and the chaos of again moving beds around to accomodate constant change I just had to laugh and got to enjoy the kids and some fun moments. At one point we had just moved a few patients into B ward along with some new arrivals. The 3 caregivers were asleep on their beds in the empty ward and 3 little ADORABLE kids (2 with casts on both legs) were sitting on the floor shoveling food into their little mouths. At one point the kids were telling their parents all to wake up and eat. One by one the parents woke up, streched and realized it was dinner time. I just loved how the little ones were running the show. Maybe you had to be there, but it was the cutest thing. Times like this make me smile and keep my mind focused in the right direction - not stressed but enjoying life's little moments. Oh, to have a childlike view on life...and not take it too seriously!:)

National Clean Up Day

Well, it's national clean up day here in Sierra Leone today. I find it a bit amusing. From looking around in town when I had been through I think it will take more than one of those days to get this city looking nice and no trash everywhere. Although, I was impressed when a friend of mine dragged me off the ship today for a bit in between work. There were actually large trash piles everywhere. A friend of mine works in the engine room and said apparently it is all getting dumped into the river and causing problems for our ship and clogging up vents down below.
So I guess national clean up day here is also national pollution day as well:) It was soo good to get off the ship for a bit though. People here are so friendly and I have to say it is refreshing to be back in a country with english signs and english speaking people so you can have a conversation longer than, "hi, how are you."

The wards are finally looking ready for opening tomorrow. I did panic a bit on Friday when I walked through Friday evening and there was still nothing in many of the cabinets. Many of us worked hard today including the central supply team and got the wards stocked, yeah! Sure will be an interesting day tomorrow and week this week. God has been so good and faithful though! We are all excited to have patients. Getting off the ship into town today and being around the Sierra Leoneans was very refreshing too...a good reminder of how much I love the people of West Africa and why I am here. Sometimes you get so caught up in the busyness of your own work you forget what it's all about and need a bit of a reality check.

Opening Soon In A Ship Near You!

Sorry I have not had a follow up post for a few days. It has been rather hectic around here!

As for the screening day...we did not have a second screening day after Monday. It was too risky and we did not want more damage done. The captain is still reviewing tapes and notes as to what happened. Two men were arrested Monday for contributing to the chaos. And what we have heard from those around town is that they are ashamed of how the people here acted and hoping we don't leave. So at least there are no hard feelings, but I feel sad for the people here that they feel that way. The plan is to try for another screening day within the next couple of weeks so please pray for that!

As for the hospital here...we are set to open Sunday. We did get a couple patients at screening Monday and we actually have many patients from up north who had already been screened by the advance team so we will bring them down early to fill the first couple weeks of the schedule.

Since we had a long dry dock and had to empty the wards completely it has been quite hectic starting back up again. I am in a new leadership position as well and feel quite overwhelmed, Im going to be honest. Please pray for efficiency and wisdom the next couple days as there is still lots to do before Sunday. We have a great team of nurses and God has been great! Please pray for leadership on the ward and on the ship, especially this next week. We are all running a bit ragged!

One of my good friends pulled me aside at one point during the ward open house Wed. cause she knew I was stressed and said, "Liz, look in the ward there (there were 4 nurses dancing to 80s music)...how can you be stressed when you have such a great team." It's true...the team of nurses we have have been amazing in helping us get ready and I know it will all work out!

2 Corinthians 4:7
"But we have this treasure in jars of clay to show that this all-surpassing power is from God and not from us. We are hard pressed on every side, but not crushed; perplexed, but not in despair; persecuted, but not abandoned; struck down, but not destroyed."

Screening...Freetown.

I do not even know where to begin this post. I think I will try to keep it on the shorter side just because I and each one of us here are still trying to process things in our own mind and don't know where to begin to express today's events.
For starters...here is the official report from the Mercy Ships blog:
www.mercyships.org/blog/entry/screening-day-update

We knew there would be thousands of people waiting for us at the national soccer stadium in Freetown when the first crew arrived after 4am. And yes, this was definitely the case. The line that NEVER ends is always a heartbreaking thing to see, yet encouraging in that we get to help many of them. Almost all of the ship was present to help with this huge day. Usually there is some unrest in the crowds and our team of security is able to handle it. Today however, this was not the case. By 0930 events started to unravel that caused people to storm the gate. People were pushing, shoving, and literally trampling each other. People began to climb the fence and our team turned from screening patients to triaging those who were getting hurt and attempting crowd control. Many crew have memories now of patients being trampled several people deep, and pictures that I am not going to even describe in this blog. Several of our cars started taking people to the local hospitals and one man lost his life. To say today's events were tragic is an understatement. We shut down screening by noon at which point we packed up and left quickly. About 20 of us stayed around and tried to do some pre-screening of those that were in the stadium already to get a few more patients. This worked for about 45 more minutes until the situation got unsettled again at which we piled into the back of the pick-up and landrovers and left also.
It is a very somber atomsphere here on the ship tonight. I think we only put 150 patients into the computer database for surgery before things got out of hand.
The whole thing breaks my heart. People here have no money. Many of these people have traveled from LONG distances to stand in line since yesterday morning for hope...probably not having anything to eat or drink in the meantime. Africa is full of poverty and people are desperate. It can definitely be a rough place sometimes. We are used to seeing many difficult things, but this is a whole new thing. My heart truly breaks for those who were hurt today but even more to all those who really need us and need surgery who we could not see.
Please, PLEASE, pray for the leadership of the ship as they deal with government, families, staff, in dealing with the situation. Pray for wisdom and peace. We are trying to figure out a way to do more screening in a safe manner but it is proving to be a very difficult sitation. Please pray that we can reach those who truly need us. We saw so many people in line with huge tumors but it was not safe to go out and get them. Pray that God connects us with them somehow.
Praise the Lord that all the Mercy Ships staff are safe as things could have gone much worse. God protected us! Also, we are thankful that more people did not get hurt. We have followed up with the ones taken to hospitals and they should all be ok.
I know at times like this we cannot even begin to know why this happened or why God allowed it. I do know I serve an awesome, mighty, sovereign God though. I know he will bring us through this and I know his ways are greater than ours. May we trust and rest in that.
Please pray for the crew as well as many have grave images carved into their mind. A couple of my good friends helped take care of the body of the man who passed away and will always have those images with them.
We are continuing to press on, but need ALL the prayers we can get. Thanks for all the love, support, and prayers!

Back On Board My Floating Home

So I am wiping the dust off this blog and starting it up again. Not much to say yet, but I finally arrived safe and sound last night after a flight cancellation in Brussels...but free hotel and 600 euros cash, so cannot complain. I was quickly brought back to my new reality when I sat next to a gentleman from Liberia on my flight from Chicago. He left during the civil war and has not seen his wife and some of his kids in 15 years since! I cried tears of joy and sorrow listening to his story. I have been around people like that quite a bit in my life now but will never grasp or imagine the reality of that. I think that is a good thing.

The hour water taxi ride to the ship was amazing. Felt good to have an ocean breeze against my face again. I do have to admit that I had my escape route planned if the boat capsized though. It was a bit rocky at times and the engine never seemed to stay going for any amount of time:)

Today I was able to relax a bit and have breakfast with old friends. I sure does feel like home. I need to head to bed soon here as tomorrow is screening day. THE big day. Lines of thousands of people will line up with high hopes of life change. Surgery often means being accepted and having a life again and being told no is devestating. I will be leaving at 0530 to head to the big soccer stadium in Freetown. This year I get to do data input (put their names and info into a computer). I am excited as this means everyone I see will be happy and getting surgery. Last year I did pre-screening which means I had to turn many people away. That really wears on you emotionally, spiritually, physically!

So if you are reading this in time please pray for Monday and Tuesday (March 7,8)....for wisdom, discernment, empathy, strength, etc. for all involved. Pray God will give wisdom as to who we accept and who we don't. It is an exciting day but also very, very hard. More to come later....