The hospital so far this year...

Here is a look at some of the work God has accomplished so far this year. 

This first two individuals are returners from last year…Dyllan underwent surgery to release burn contractures to his neck and side.

This year he has returned for a second surgery to further release the contractures to his neck and his other side.

I know it is difficult to see the difference between last year and this year.  His neck did not heal as quickly or as well as we had hoped the first year.  The surgeons made additional z plasties this year.  A z plasty is a z-shaped incision is made in the scar tissue to release a contracture, or a tightening of the skin which often prevents full range of movement.

Fenohasina was here last year for a VVF repair.  Sadly, the repair failed.  Fenohasina is mentally disabled.  She did not always understand everything we said to her, particularly the medical stuff.  Thankfully, God gave her a great Mama.  She stayed with Fenohasina through both surgeries and recovery periods.  Mama was so helpful to the nurses.  Fenohasina was always sweet and smiling, even after the first surgery failed.  She is pictured here with her mother and two of our ward nurses:

She returned this year for a second surgery.  This one was successful, so far.  Prayers would be very welcome for her continued healing and surgery success.  Here she is, recuperating after being among the first patients to undergo VVF surgery this year:

Miadantsoa is another VVF patient that has fully recovered.  She received surgery in September and participated in the Dress Ceremony in November.  She is so beautiful!

Just like last year, we were counting the milliliters of urine after surgery:

And also celebrating the healing.  This is from the very first dress ceremony we held this year, in October.  Once the ladies meet certain criteria, they are release from the ship's hospital to the OBF Clinic located in town, on the grounds of the local hospital.  This ceremony happened right outside the OBF Clinic.

The OBF Clinic will remain open once we leave.  There is another organization that will take over the running of the clinic.  We are training local nurses and surgeons to staff the clinic.  The nurses spend time on the hospital ward as well as the clinic.  The goal is to turn over complete control of the OBF Clinic to local staff in April.  The patients will be able to have the surgery at the hospital on which grounds the clinic is located.  One of the ship's Capacity Building Projects for this year is the renovation of the hospital's OR Rooms.
The local nurses are fantastic.  Most are learning more quickly than anticipated.  In fact, in January, the OBF Clinic will not need as many ship nurses since quite a few of the local nurses will be able to take patient assignments without a mentor.  Of course, there will still be a ship charge nurse on site until the nurses are fully trained and comfortable.  Two local nurses below are learning the particulars of VVF surgery.

I have worked quite a bit with other specialties so far this year.

This is Mariette.  I had the pleasure of taking care of her for the few days she was on the ship.

The surgeons removed the large lipoma from her back.

After surgery, she wore a pressure garment, a shirt that fit snugly, for a period of time so that the lipoma would not return.  You can see the the shirt peeking out from her regular clothes.  She is pitcured here with her grandchildren:

This is just a sampling of some of the patients that have received care this year.  I am blessed to be his hands and feet to these awesome people.

Where will the ship go next?

And the answer is...

BENIN

For the 2016-2017 field service, we will be going to Benin.

Joe and I are currently committed to Mercy Ships through November 2016.  The plan is for the ship to arrive in Benin in August 2016, so we will have a few months in West Africa.  We look forward to the experience, though we will be sad to leave Madagascar.

Goodbye Grandma Rita!

In September, Joe and I received a phone call from home.  Joe's grandmother was ill.  She was in the hospital.  Doctors determined that she had heart failure and would likely not live long.  They recommended hospice.

Hospice is recommended only for those needing end-of-life care.  Hospice is only for those with a prognosis of less than six months to live.  Estimating how long a patient may live is very difficult.  The doctors said she may only have days.

Grandma Rita lived for almost two weeks and died on 3 October.  She was ready.  For years, she told Joe's father, Skip, that she was ready.

The family made it possible for us to return home.  She would be thrilled to know that her entire family was all together for even a short time.  Even if it was for something as sad as her funeral.

Joe and I took a 9-hour bus ride from Toamasina to Antananarivo (the capital) to catch a flight out.  We flew to Mauritius to Paris to Chicago.  After 44 long hours, two teary-eyed mothers greeted us in the international terminal of O'Hare Airport.  We have since spent time with Joe's family, supporting and helping as much as possible.  Skip and Aunt Marianne, Grandma Rita's two living children, have been so strong.

It was a blessing to have this time with our family - though I am sorry it was brought about by such a sad occurrence.  We had not planned to return home until our time had ended on Mercy Ships, in November 2016.  This extra time is definitely a gift.

It is weird to be back in the States.  That is the best word I have.  Weird.

It is also healing.  We met our youngest nephew, Ben, who was born just weeks after we left last year.

We return soon to Madagascar, back to the work God has called us to do.

My Summer Vacation

Writing this, I feel a little bit like a elementary school child.  At the beginning of each year, almost every teacher requires the students to write a "what I did on summer vacation" report.  In kindergarten, you get to write a sentence and draw a picture.  By fifth grade, you have a one page, typed report due on day 3 of class.

Though the hospital was on vacation, I was not.

Joe and I were asked to be the Advance Team Durban.  Basically, we arrived on 13 May to Durban in order to prepare the way for the ship to safely and legally enter the country.  We had meetings with Customs, Immigration, Port Authority, and Dormac shipyard, to name a few.  We had people from 30 different nations on the ship, sailing in.  Those from certain nations require a visa prior to travel.  The majority of nations, however, were able to get a 60 or 90 day visa upon arrival.  For instance, those from the US just show up in South Africa and are granted a 90 day visitor visa.  Those from Sierra Leone would get deported if they tried to do so.  In fact, our entire ship would not be allowed to dock if any individual needing a visa did not have one.

When we did not have meetings, Joe and I worked mostly out of the Mugg and Bean at the local mall since our internet at the guest house was incredibly slow on the rare days the computer detected a signal.  Mugg and Bean is the South African Starbucks - only with more menu options.  But many people meet up for coffee there.

To be honest, it was difficult.  But I loved it.  I love South Africa.  I had not spent time in Durban before, and it is unlike the other South African cities I have been to.  There is a large Indian population so there is a lot of curry - good curry.

The ship did arrive on 15 June as scheduled.  There was some worry as to whether it would leave Madagascar on time - a small whole was found in the chain locker a few days before sailing.  Our Deck and Engineering Departments worked together to temporarily patch the whole.  A permanent fix was completed here in Durban.  In fact, a number of repairs have been completed.

However, the propeller is still undergoing repairs, but according to the latest news, we should be back in Madagascar at the end of the month.

I have been acting as Operations Assistant since the ship pulled in.  Basically, the job is about 50% Advance Team and 50% Transportation.  Although our time as "Advance Team" ended once the ship arrived, Joe and I had made the various contacts and we have been called upon to use those contacts as needed.  For instance, Joe and I located a company that repairs commercial floor cleaners.  Once the ship arrived, we scheduled maintenance and transportation of the cleaners.  Random, right?

There are about 250 crew on board now - many people returned at the end of July in anticipation of sailing out.  We were supposed to sail out in the first few days of August, so we have been delayed a few weeks.  The ship has gone from a ghost town (about 130 crew) to a bustling city of twice that many.  There are a lot of extra nurses floating around doing extra jobs, similar to how I worked in the galley last year at this time.

Thank you for the support we have received during this crazy time.  Shipyard has been an interesting experience, but I am ready to get back to Madagascar - back to the patients.

Wonky Bones

Our orthopedics program is nearly completed.  Though the surgeries were done during the first six weeks of our time in Madagascar, the patients have only started to be "healed."  The bones take many months to heal during which time the patients are in casts.  The casts are changed several times throughout the months.  For most operations, the patient must be less than 17 years old since adult bones take longer to knit back together.  Adults require longer medical care, and we are not in country long enough to oversee the medical care.  Neither are we are able to ensure adequate care from local doctors.  This is not a slur against local doctors, we simply do not have the time to determine if the doctor is adequate nor do they keep detailed records of past surgeries.

The surgeries performed help individuals look normal, but also restore normal function to the limbs.  The following are some of the most common surgeries performed on the Africa Mercy.  I have also included before and after pictures of patients who have undergone the specific surgery.

BOWED LEGS:
Bowed legs can occur for several reasons.  The most common reason in Africa is Rickets, which is bone disease due to lack of calcium and Vitamin D in the diet.  Most often both legs are affected though not always.

Erissa before:

 

Erissa after:

 

Delias before:

 

Delias after:

 

Louianah before:

 

Louianah after:

 

Wendy before:

Wendy after:

Mikael before:

 

Mikael after: (pictured here in in a partial weight bearing cast…the blue bandages around the cast protect "windows" that are cut into the cast to give us access to the pins placed into the leg which are later removed)

 Tonny before:

 

Tonny after: (His now straightened left leg makes his right leg look crooked in comparison though his right leg is fully functional)

Bernadette before:

Bernadette after:

KNOCKED KNEES:

Just like bowed legs, knocked knees occurs because of Rickets and usually affects both legs.

Brundi before:

 

Brundi after:

 

Leonce before:

 

Leonce after:

 

Larissa before:

 

Larissa after:

 

TIP TOE WALK:

This deformity causes a person to walk as if she is wearing high heels even when barefoot.

Brenda before:

Brenda after:

Sandrins before:

 

Sandrins after: (pictured here in her last "cast"...though it is actually a brace)

OTHER SURGERIES:

Here are a few surgeries that are less common.  I am not even sure of all the medical names.

Vanya before:

I have to admit that these before pictures look fake, but I can assure you that her legs really did look like this.

Vanya After:

 

This is Vanya back at home, looking so normal.  Her family was so amazed and so happy.

Judicael before:

The toes point inward and the arch comes off floor more than normal.  His weight is resting on the outer portion of his feet.

Judicael after:

We will be back next year to help God do some more amazing transformations!