Pray for Healing

Maurice and Chara both have had surgery a few weeks ago with expectations of minimal complications. The surgeon has since left and both of them have had complications and are leaking cerebral spinal fluid (not a good thing at all!). Both have been taken back to surgery since then. The poor mamas have had to deal with often daily dressing changes, fussy babies who cannot eat because they will be going to surgery, or needing a lumbar puncture almost daily. Both mama’s are tired and scared as we are nearing the end of the outreach and both kids are not healing.

Surprisingly, both little ones have been doing amazing despite the set backs. The last few days I worked last week Chara was waving, smiling, and quite interactive. Three month old Maurice, who came in on the feeding program at 3.53kg (7lbs) is now finally gaining weight (4.19kg), smiled, cooed, and moved around more Friday than I had ever seen him.  I needed to do some dressing changes but just could not find it me to stop cuddling the baby and give him back to mama. We are praising the Lord for how suprisingly well they are both doing! At one point Maurice was the only male on D ward so there was much laughter when another mama said that Maurice was the biggest man on D ward. Such a tiny munchkin but since he was the only male, he got that title!

Despite the two kids doing so well, I would pray that you would lift them up in prayer! We do not want to leave them without them being healed. There is only one more week of surgery left and at one point there was hope of flying in a German neurosurgeon. This has seemed to fall through. So….Dr. Gary and Dr. Mark, our 2 amazing max-fax surgeons will be doing their best to heal these babies. Tomorrow, Monday, Dr. Gary will be putting a VP shunt (device that shunts extra CSF from the brain to the space around the abdomen) in Chara. He has done this before but it is definitely not his specialty. Chara also has had increased complications with infection and poorly healing head wounds. Right now we have a make shift shunt for the CSF fluid which is comprised of an IV canula, IV tubing, and a small empty saline bag as seen in the picture. Please pray for supernatural wisdom for the doctors and supernatural healing for these 2 precious kids so that when the ship leaves, they are healed and the mama’s can have peace about their precious kids.

As one of the common African songs go… “Great things HE has done, greater things HE will do. Unto the Lord be the glory, great things HE has done!”

Chara




Maurice "Biggest man on D ward"





Smiles with Maurice and Mama



Home Again

It has been almost a year since I have left the ship. It is so good to be back! There is something about the ship..and Africa...no matter how long I am gone, it always just feels right to be back...like I am coming back home. I love that about this place. It has been great catching up with old friends. And since I was in Togo for the 2010 outreach it has also been fun to see all the translators and watch their faces as they do a double take passing me in the hallway followed by a big hugs. One of my really good friends, Ali (Wilks) Chandra was supposed to leave this past Friday to go home for maternity leave, but is staying a few extra days to be interviewed by 60 minutes so I am loving having some extra time catching up with her!

As for being back on the ward, it has been an easy adjustment and I am loving actually doing patient care for awhile. I enjoy doing charge nursing as well, but it has been a long time since I have just been a ward nurse and I have to say it has been quite refreshing! It is so good to be back to a place where we pray for the patients before each shift and has also convicted me of not doing this enough at home, even if it isn't with all the staff. I love being reminded of our limitations here with medicine and having to truly rely on our Maker and the One True God for wisdom and healing. In fact the first day back on the ward one of the patients went for surgery and came back to recovery in an odd state. She was jerking and not coming out of anesthesia as she should be. Five hours passed and she still was not waking up! It was now shift change and we bowed our heads and prayed to the One who has no limitations. Within5 minutes one of the recovery nurses cameo the ward with a big smile saying she has woken up and is completely fine. I think God often does this to remind us who is Really in control around here.

On a different note, one of the patients, Joseph, has had a tumor that has been operated on twice before. It is benin, yet keeps coming back. The doctors have decided surgery will do more harm and incur more risk than benefit, so we had to break the news to him and his grandmother that day. Clementine who is a ward disciples from Africa has been with the ship a long time and is the one who usually breaks this kind of news. The African culture is much different than r western way in this area. We are very straight forward about things and ethically this is the right thing to do in our western culture. However, as Clementine was saying, "In western culture, you take hope away. In Africa culture you give hope, not take it away.". In other words, even though the doctors do not think chemo will help at all, we sent them home with a letter for a local hospital to do chemo. It is better to give them this hope and not tell them it wil not work. Even if the boy dies in the meantime, they have that glimmer of hope to keep them going. If we had just told the boy there was nothing that could be done than we would have killed the boy and the grandma before they even left the hospital as Clementine said. I had gone to lunch and was told when I got back that Clementine had spoke to the patient and I could do the dressing change and they could leave. As I was doing the dressing change and teaching the grandma about doing dressing changes at home I soon realized there was a misunderstanding as I reminded her they were not getting surgery. The grandmother started crying along with the 12 yr old boy. She said, "what are we to do? He will just go home to die?". Talk about heart wrenching. Turns out Clementine had been called away and had not gotten to tell them yet. She was able to talk with them later, get them the chemo letter and they were doing much better with that extra hope. But still, it was hear trenching to see that emotion, so real, rightin front of me. Saying goodbye knowing unless God provided a miracle, that the boy was eventually going to die. Here, we have to live on the hope and encouragement we get from helping so many, because on days like this it is so easy to be discourage and ask why. In times like these you have to hold strong to the truth that God is faithful, he is in control and we will never understand certain things. This is why He is God and I am not. I am reminded of Lamentations 3:32, "Although he brings grief, he will show compassion, so gratis his unfailing love. For he does not willingly bring affliction or grief to the children of men.". We live in a fallen world and sometimes it is harder to be reminded of that than others. In the meantime I will continue to pray for them as they journey home back to Ghana. In the meantime, we focus on the patients we have on the ward and continue to love each and every patient that comes into the ward. Some outcomes are much better than others, but God has handpicked each one to be here at that specific time. God continues to move and work, and it is such an amazing thing to be a part of!

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:)