A New Country

Two months & one day from when we left Lomé, Togo, we were setting sail again for West Africa.  This time a little farther north than we’ve been in a while, to Conakry, Guinea.  Guinea has about 10,057,975 people in about 94.981 square miles (roughly the size of Oregon).  Starting just south of Guinea-Bissau, it stretches around Sierra Leone, Liberia & shares a border with the Ivory Coast.  Like most African countries, Guinea is divided up into different tribal areas- 24 tribes in Guinea, with Soussou being the most prominent in the area around Conakry.  The country is about 85% Muslim & only 10% Christian.  


The military band plays during our arrival

This is about $100 US- think I'll need a bigger wallet!

Our tiny dock space

Guinea gained its independence from France in 1958, but a series of one-party dictatorships drove Guinea to become one of the world’s poorest countries.  The currency is the Guinea Franc, but 10,000gnf equals about $1.40.  One of the ways we look at the health of a country is by looking at maternal mortality rate (which is 680 out of 100,000), & the under 5 year old mortality (which is 146 out of 1,000).  Accessibility to healthcare is very difficult in most areas, especially during the rainy season which stretches from May to October, washing out roads & making this unpassable.



Unpacking the OR

Since we’ve arrived, we’ve been pretty occupied in setting up the hospital for the start of the surgical field service.  Our dock space is very smaller then what we are used to, (because we have an agreement with the ports that we don’t pay for dock space, the ports lose money with us being here & are often reluctant to give us a lot of space) we’ve had to adjust the way we normally set up our dock space.  The OR has been in different variations of disarray over the past week, its hard to believe, at some points, that everything will go back to where it used to be, but slowly, it is looking more & more like an OR.  I'll be happy when its complete & ready to use!

Prayer requests:

1)     The people of Guinea

2)     The people on the ship, that we may meet the needs of the people

3)     The cholera epidemic- cholera is very much a threat here, it started in February & has sickened lots of people (so far no one on the ship) & even killed a fair many. 

4)     Screening day is approaching- we need all the prayers we can get for this

5)     Living in a Muslim country is a little nerve wrecking; please pray for peace & guidance.  We are not here to convert, but to show Jesus’ love through our actions.

 

On a personal note, please pray for my family on the loss of my dad’s brother, Ted.  He is at peace now & in a new body made perfect by God.  I’m sorry I won’t be there to celebrate his life with my family, but I’ll be there in spirit.

 

 

Blessings

State-Side

We made it safely to Santa Cruz de Tenerife, part of a group of islands that belong to Spain.  While the ship is in Tenerife, there’s not much for an OR nurse to do.  Instead of wandering around & probably getting into trouble J  I decided it would be nice to go home for a bit.  I was lucky enough to get the whole month of July off & took the opportunity to catch up with life back home. 

I was able to spend the 4^th with my family in Independence, seeing relatives I hadn’t seen in years.  We grilled out, had corn on the cob & even McElroys’ potato salad!  Indee’s parade was in the morning & fireworks were in the park by the river.  

My family at the 4th of July parade

Dad & Uncle Bob canoeing the might Wapsi

Dad rented us canoes to take down the Wapsi, a fun trip even if there wasn’t a lot of water.  We spent a great afternoon on the 4th just floating down the river, getting out to cool off when we needed to & seeing a lot of wildlife (vultures, a bald eagle & some deer)  I got to say though, Iowa is a lot hotter than Africa!   

I spent a lot of time just relaxing & watching the birds at the bird feeders in my parents’ backyard.  Hung out with friends & watched TV- though it was strange, I haven’t seen a commercial in over 10 months.  I took our dog for walks & Dad & I explored one of our favorite places, Backbone State Park.  I even went to this place called a "mall" its kind of like a market, but there's no bartering & didn't smell like rotten fish & fruit- what an experience in itself!  I even got used to being able to drive places again, where & whenever I want!

The family models their new African aprons

After a couple lazy days at my parents’ house, Mom & I drove to Colorado for a week to see family & friends.  I realized how homesick I was for Colorado when the mountains finally came into view & I drove on familiar streets.  I had to keep telling myself that I didn’t have a home there at the moment.  I packed in as much summer-in-Colorado-fun in one week as I could.  I went to a Rockies game (we lost L), spent time at the barn with my favorite 2 & 4-legged animals, went for a hike in the mountains & had dinner with some amazing friends.

Eri & I at the Rockies game

Horsing around at the barn with Steely

We hike up Devil's Head

My time home wasn’t overly exciting or thrilling, but I didn’t need that.  I needed peace & quiet, long-long hot showers, home cooked meals, the opportunity to recharge & gear up for the next stage of this trip.  All too soon, it was time for me to fly back the ship.  I am ready.

Cast Off Your Mooring Lines & Set Sail

 The time has come, we are leaving Togo.  To be honest, when I first heard we were coming to Togo I was a bit skeptical.  Mercy Ships was just there in 2010, why are we going back so soon?  Do they really need us?  I don’t speak French, how am I supposed to connect with my patients?  I really didn’t want to go.  Funny how looking back over the last 5+ months, I realized there was no other place I would have wanted to go. 

Goodbye Togo!

Mercy Ships had done a short field service in Togo in 2010, only 5 months while most field services are 10 months.  We were just returning to finish what we started then.  We were able to provide over 1,500 surgeries to people who would probably never receive care.  We taught 7 local surgeons new surgical techniques, allowing them to provide care to the people.  We provided over 10,000 dental procedures & helped thousands more with our off-ship programs.  Random fact: Togo was the first country in Africa Mercy Ships ever visited back in the early 90’s.

Captain John gives the go ahead

Casting off our mooring lines

I’ve learned through my travels that speaking the local language is important, but not necessarily a deal breaker.  Nursing has its own language that is universal; a kind touch, a smile, a soothing voice is often all that is needed to convey to your patients that you are there to help them.  Plus, I always had our awesome dayworkers there to help with the more complicated things like asking questions & giving instructions.  Kids are also the best teachers when it comes to learning a new language.  They are patient & love to show you new things.  I often go straight to the kids when I meet a new group of people, they accept me & I’ve learned that people begin to develop trust in you when they see how you interact with their children.

Saying goodbye

Leaving Togo behind

Now our time has come to leave.  A small crowd of mainly dockworkers, crew members that were staying behind & the government officials gathered on the dock to see us off.  The last crew member was on board by 0930 & our mooring lines were let go around 1000.  Slowly, we slipped out of the harbor & into open waters, heading west towards Tenerife.

Goodbye Togo, I’ll miss you!

Blessings

Tying Up Loose Ends

The hospital is closed, the ship getting ready to leave Togo, & we have a list of things to do before we leave:

First: Day Worker Thank You

Our awesome dayworkers

The OR team

We held a special celebration in honor of all of our dayworkers (the local people who translated, cleaned, cooked, did maintenance work & taught us about the Togolese culture).  In the OR, PACU & sterilizing, we had 7 wonderful translators, Marie, Thomas, George, John, Gratias, Mark & Holali.  Over the months they provided a bridge between us & our patients, stepping in to hold a hand or explain a procedure.  Not only did they help us in the OR, but they invited us to their homes, helped us navigate the markets & the streets of Lomé.  Our day workers became more than just colleagues, they became friends.

Second: Find local music cds

With Gratias & her family

Ginger at the music store

Heading back to the ship

Jen on a "zimmyjohn"

On the wards, we learned some fun local worship songs.  We loved dancing to them & we wanted to find those songs so we could always remember Togo.  We asked on of our dayworkers, Gratias, if she’d help us.  She agreed & sent her brother to come pick us up.  Now, the main form of transportation in Togo is by motorcycle & motorcycle taxis called “zimmyjohns”.  Her brother helped us acquire a couple “zimmyjohns” & away we went!  He took us to a small music store that was more of a shack.  We spent a lot of the afternoon trying to remember all the songs we loved so much, & drew a small crowd as we sang or hummed what we could remember.  Most of the songs were either in Ewe or French & we didn’t know the names of the songs, or even the words for that matter. I’m pretty sure they thought we were crazy “Yovos” (Ewe for white person).  Once we found the songs we were looking for, we walked to Gratias’ house to meet her mother & family before we said our goodbyes & took “zimmyjohns” back to the ship.

Third: Look for contraband



Checking a ceiling access

In one of the crawl spaces

Checking one of the lifeboats

With the hospital closed, the nurses are reallocated to different departments to help fill the gaps as people leave.  I have been reassigned to security, meaning that I help keep the ship safe while in port & watch for pirates while at sea.  Part of the job required us to search the entire ship for things that don’t belong & stowaways.  We divided up into teams & divided up the ship to begin our search.  We had to look everywhere- behind walls, in the ceiling, we crawled into small spaces & up ladders, we even checked the lifeboats & the ship’s funnel.  It took the whole day & we learned there was more to the ship than just what we saw everyday! 

 

Finally: Relax

Out to eat with friends

Togo offers a lot of fun things to do & wide selection of restaurants.  We spent our last day in Togo relaxing poolside at the Seamen’s Mission- a Christian restaurant/hotel established to cater to the ships in the port by providing clean & affordable services to the men on the ships.  It’s within walking distance of the port & they even offer a free shuttle service to & from your ship in the evenings.  Behind the Seamen’s is the German Restaurant that serves very yummy food.  Eating good food & relaxing by the pool was a great way to spend our last day.

Tomorrow we leave Togo; it’s a 10 day sail to Tenerife in the Grand Canaries.  I guess it’s time to start a new adventure.

Blessings

C'est Fini

It seems like yesterday we were untying equipment, making beds, bleaching walls- turning a normal looking ship into a hospital.  The past 5 months have flown by.  As our last week of surgery came & went, it brought a sense of accomplishment of a job well done, as well as a feeling of sadness that we were done.

We are the Pirates of the OR- Arrgh!

Gratias sporting a very piratey eye patch

In the OR, we celebrate the last week of surgery & a job well done with a party & a little OR humor.  One day the OR was over runned by pirates, who happened to look like doctors & nurses.  No one walked the plank & there was no buried treasure, but I think there was a parrot, it was a great excuse to have a bit of fun & sword fights... :)

One last hug

Saying goodbye to Komla

Saying goodbye to Hougno

Hougno waves as he leaves

The hardest thing about the end of an outreach is saying goodbye to the people we’ve meet & cared for during our time here.  I had made some special bonds with a couple of boys who had been on the wards for months while they healed from their surgeries.  I often spent the evening with my buddies walking up & down the hall exercising, or just sitting & playing games or watching a movie.  We didn’t speak the same language, but that didn’t matter.  They had been with us so long it was hard to imagine the wards without their smiley faces.  When it came time for them to go home, it was heartbreaking.  I helped walk them out & plastered a big smile on my face as I helped them get into the landrovers, & waved as they drove away.  I hate goodbyes.

The ORs are packed

Packing is always an inevitable part of end of outreach preparations.  It requires a lot of time, creativity & elbow grease.  It took about 2 weeks to get the ORs ready for the high seas.  The rest of the ship was right behind us with their preparations.  Tents on the dock came down, containers packed, landrovers were lifted up onto the deck & secured.  Doctors, nurses, crew members who had been with us since we arrived have left in large groups.  The ship feels empty.

The halls are quiet, the beds are empty, the last patients have gone.  The hospital is officially closed.  All good things must come to an end & so must our time here in Togo.  The ship is ready to leave, but I wonder if I am.

Blessings

Impromptu Dance Party

One of my favorite things about being in Africa is the music.  I love to hear the African drums & the shakers & the songs.  They are so different from the music we listen to at home, so beautiful & down to earth.  I’ve learned that drums have an important place in African society, children learn at a young age how to play.  Its more than just slapping the drum with your hand, there’s an art to it.  When the drums start to play, whether its outside on the dock, in the International Lounge, the wards or in a village, it gathers people together, it lifts spirits & makes people feel happy & a part of the community.  Also, its impossible to just sit & listen; drums will have you on your feet, dancing along with the crowd.

One Saturday night not to long ago, we decided to celebrate birthdays out on the dock.  It had just stopped raining & we gathered under one of the tents for a BBQ.  Soon, someone brought the drums out & started playing.  We danced out on the dock, avoiding the giant rain puddles, just laughing, singing & dancing with our friends.  The patients from the wards joined us & a dance party had begun.  I love these impromptu dance parties.

Blessings

From Suffering to Beauty

When I told people I was the OR VVF team leader, I would get blank stares.  “What is VVF?” they would ask.  I would respond with a vague “it’s a fistula caused by childbirth” because, really, I had no idea either.  That was until I found myself standing in the ward surrounded by women who had these fistulas. 

Here’s what I learned over the past month about VVF:

1-     VVF stands for vesico-vaginal fistula which is a hole between the bladder & vagina & is only one type of fistula, there’s also vesico-uterine (a hole between the bladder & uterus), urethro-vaginal fistula (a hole between the urethra & vagina) & recto-vaginal fistula (a hole between the rectum & vagina).  The fistulas cause them to be incontinent of urine & feces.

2-     It’s a symptom of poverty caused by lack of education & availability of healthcare

3-     VVFs are caused by obstructed labor, the women can spend days in labor, often times going to 2 or 3 hospitals or clinics before they find one that would accept them either because they can’t pay or the clinic has no operating room for a c-section.  When they are able to deliver, the baby is dead & the mother is left in ruin.  Fistulas are totally preventable by having access to healthcare & have been eradicated in the Developed world because of the availability of c-sections.

4-     Other complications of obstructed labor include: foot drop, nerve injury, infertility, skin breakdown, kidney disease, prolaspe & maternal death.

5-     The social ramifications are astounding, the women are often out casted because they are wet & smell.  Their husbands leave them because they can’t produce live children any more.

6-     Its not always the young girls (under 17) having babies at a higher risk, most fistulas happen to women of normal child-bearing age.  Its also not always the first baby that causes the problems, the 5^th, 6^th, etc can be the culprit. 

Working with these women & hearing their stories of pain & suffering & yet seeing their smiles, tears, & laughter has shown me a new understanding to the human spirit.  I love coming down to the ward & sitting with the women when they are on bed rest after their surgery, or joining the “VVF conga line” in the hallway, as the ladies go on their daily walks, singing & dancing as they go.

At the end of their time with us, we have a special dress ceremony for them.  It represents their new life, healed & ready to continue with their lives after many, many years of being outcasts.  They are given a new dress, jewelry, & their nails & make up done.  We gather on the ward, singing, dancing, laughing & crying, we go through all the emotions.  These beautiful women stand up & give their testimonies, their stuggles, their hope & their thanks.  We give gifts of soap (to remind them that they are washed new in Christ’s blood), a mirror (to show their beauty), a cross necklace & a Bible.  The ladies are able to leave & start their new life. 

The women on the ward are so unbelievably strong.

Blessings