One Determined Man

Meet Sambany.

I do not know every detail of Sambany's story, but what I do know is quite inspiring.  Sambany's tumor has been growing for twenty years.  Despite living in a remote village, he heard about the first-world medical ship offering free operations.  He did not let the distance deter him.  Having nothing but hope and a very little bit of money, Sambany and his son set out for Toamasina using the only mode of transportation available to them - their feet.  After three or four days of walking, they ran out of money and stopped in a village to earn some more before continuing on.  I am not sure for how many more days the two men continued walking.  They showed up exhausted and disheveled, but hopeful, to the Hope Center.  Immediately, the surgeons onboard were paged, and Sambany was brought to the ship for examination.  The lab results showed he had a dangerously low hemoglobin - only 3.5; the normal is about 13.8 to 17.2.  He was given three or four units of blood during his first week onboard.

The tumor is so large, he was able to use it as his pillow.  The results from the CT scan came back.  The surgeons determined that the surgery was feasible, though risky.  The risks were explained to Sambany and his son.  Sambany felt the odds were better with surgery than without.  He even stated that he would be dead without it.

Sambany had his surgery on February 3.  The surgery took approximately 12 hours; the 16 pound tumor was finally out at 9:17 pm.  Our photographers captured his joy as he got his first glimpse of his face without a tumor in twenty years.  Sambany is recovering well.  Praise God!

Sixth Month Check Up!

Okay, we have been here for six months.  Literally.  We arrived onboard the Africa Mercy on August 2nd, and it is now February 2nd.  I have written quite a bit about my job and the patients.  But I have not written much about us.  About how we are doing and where our heads are at.

Well, we are okay.  Adjusting to life onboard was and is very difficult.  The only thing that does not change is change itself.  People and places have constantly been changing.  We arrived to Las Palmas, sailed to Tenerife only a day later, and then back to Las Palmas.  Then, we had a long sail to Cape Town before heading through rough waters to Toamasina, Madagascar.  We have been to four countries - US, Spain, South Africa, and Madagascar - in the last six months.  The language has changed.  Food has changed (I miss those gorgeous Spanish avocados!).
We have been in Madagascar for three months, and I feel only somewhat settled.  Only somewhat because I still feel so oddly out-of-place in town since I do not know Malagasy.  Of course, I can ask someone if they have pain, feel itchy, or if they want a balloon.  However, these do not help when we are at market.  We have been going through the phases of cultural adjustment - honeymoon, hostility, humor, and home.  I first described these when talking about the culture aboard the ship, but we also go through these phases with each new country we are in.  The ship's culture changes in each country.  For instance, in Spain, the curfew was 1am.  Here, in Madagascar, the curfew is 9pm.  In Spain, there were fewer people onboard.  Now that the hospital is running, there are twice as many crew members and a couple hundred day workers.  These details, and so many others, affect the culture onboard.
I passed through a brief honeymoon phase.  My hostility phase lasted longer.  I had high expectations for this organization.  Its motto called to me - "Mercy Ships follows the 2,000-year-old model of Jesus to provide hope and healing to the world's forgotten poor." However, I was disappointed.  I expected too much.  I forgot that the organization is comprised of humans.  Humans are fallible.  Humans make mistakes.  Humans are Christ-like, not Christ.  I have not always been the most gracious to my fellow crew mates nor the organization.  But I have expected graciousness.  I have been looking around thinking about how others should act, become better Christians, instead of looking at how I act and could become more like Jesus.  I sulked because this life, despite all the amazing opportunities it presents, is more difficult that I imagined.
I eventually found my sense of humor.  And now I am working on feeling at home.  There are days I want to pack my bags and leave, though those days are far less frequent than a few months ago.  Most days, I feel content.  I am not in love with this ship, but I do believe this is where God wants me right now.
I do not know what the future holds.  As of now, we remain committed to serving a full two years.  I have been thinking of Genesis 22 for many months now.  God tested Abraham.  God told Abraham to take his only son, Isaac, to a designated location and sacrifice his son as a burnt offering.  On the long three-day journey, Abraham remained committed; he would kill his son as God asked.  He was going to sacrifice Isaac.  As he built an altar, he remained committed.  He arranged the wood so that the sacrifice, his only son, would burn.  He still remained committed.  He tied Isaac to the altar.  Abraham remained committed.  Only when Abraham took hold of a knife, intending to slay his son, did God intervene.  God was pleased with Abraham's love and obedience.
I can only imagine what thoughts raced through Abraham's mind as they rode.  Perhaps he said something similar to what Jesus said just before being arrested - "Father, if you are willing, take this cup from me; yet not my will, but yours be done" (Luke 22:42).
I do not claim that what hardship I have endured remotely compares to the anguish Abraham or Jesus felt.  Indeed, my troubles seem petty in comparison, yet I have found myself asking God to let us come home.  There are many ways in which I fall short of Abraham, but, like him, I remain committed.  

That is where we are right now.  We are committed to serving God here on the Africa Mercy.  We pray that we remain in His will and that He continues to give us strength for each day we are far from our loved ones.  Please pray for us as well.

Meet My Patients

I would like you to meet the people who keep me so very busy.

This is Salestine.  She had an epulis tumor which is a tumor of the gums.  The tumor had grown so large, she was unable to put food into her mouth.

She was quite malnourished.  She very likely would have died within the year without this surgery.   While Salestine was in the OR for almost two hours, the surgery, from first incision to last suture took only 18 minutes.  The rest of the OR time was spent intubating her for general anesthesia.   It was a very difficult task, putting in a breathing tube.  Here she is post-op, eating one of her first solid food meals in a very long time.

 And here she is at her outpatients visit, about a week after surgery, looking so healthy and happy.

This next patient has been with us since around December 12th.  A noma had completely destroyed his nose and upper lip.  A noma is a type of gangrene or tissue death that generally effects the mucus membranes of the nose and mouth.

During his first surgery, his scalp was cut from his skull and brought forward.  A portion of the scalp was used to create a new nose.  The scalp was used because of its terrific blood flow.  A skin graft taken from his thigh or groin was placed on the scalp to replace the skin used for the nose.  A tracheotomy tube was inserted so that he could breath.  A feeding tube was also inserted into his esophagus.

In his second surgery the scalp was pulled back to its original position.  The skin graft, as seen here, is located on his left side.  The edges are still healing.  He will have a third surgery to reconstruct his lips.  Right now, his still has his tracheotomy and feeding tubes, as seen in his neck.

The doctor literally created an entire nose for Mamisy.  It is amazing.  Although the ship brings many first world, medical advantages to Africa, we do not always have the exact implants necessary for every possible surgery.  What the doctors do with the resources we have is simply miraculous.

This little girl is Hermina.  She had a teratoma removed from her bottom.  She has been with us since late November.  The surgical wound was quite significant - both long and deep.  About one week after her surgery, she fell down while walking and opened her incision.  She is just under two years old, and, as an active toddler, she took off when her mother turned aside for just a moment.  Hermina fell down when her little legs could not quite keep up with the rest of her.  She was rushed into surgery to repair the damage.  Afterward, her mother held so firmly to her arm or gown wherever she went.  The doctors have kept her at the hospital to ensure that the wound heals well and without infection.  She was transferred last week to the Hope Center.  This is good news and indicates she is healing well.

However, having been here for so long, she made friends with other children.  It was sad to see her leave.

This young man's name is Venance.  A noma destroyed his lower lip.  The doctors removed the infected tissue during the first surgery.  In his next surgery, the doctors will reconstruct the lower lip.

This little one is Jida.  She came from the capital with her uncle.  She stayed with us for over a week before her surgery.  She was shy and distrustful of us at first.  After one week of friendly overtures, we finally won her over.  This is Jida before her surgery.

And here she is after, gazing at her new face.

And cuddling with her stuffed bear.

This next little girl is Mitia.  She also traveled quite far to reach us.  She was a very happy 6 month old. She was also quite chubby, thanks to a diet of sweetened condensed milk.  The nutritionist worked with the mom to ensure Mitia will get a better diet post surgery.

This young man is Thomas.  He had his cleft palate repaired.  Another organization repaired his cleft lip many years ago.

He really enjoyed playing with the Jenga blocks, though he did not play with them in the usual manner.

This last week, I cared for Ezra, a rambunctious 7 year old boy who was born with a foot deformity.  The surgeons repaired the foot so that he could walk normally.

In the bed next to him was a 17 year old young man, Largisse.  The surgeon released a burn contracture of his right elbow and placed a skin graft over the site from his thigh to increase function and appearance.  He is a typical teenager, always trying to bend the rules.  God has surely used Largisse to increase my patience.

And, finally, on the containers, the new special nipples for cleft palates arrived!  Here is one infant that benefitted from the new arrivals.  Although she was never my patient, I met her and her mom during a meeting with the nutritionist.  At ten months old, this infant was less than 5 kilograms (11 pounds).  She joined the Infant Feeding Program.  We provided formula and rice cereal.  The baby came to the ship several times a week for weight checks and to receive new supplies.  The baby continued to lose weight over the next month.  So, our nutritionist admitted the baby to the hospital.  With the nurses overseeing the feedings, the baby gained weight.  About a week before her discharge, the new nipples arrived.  It made the feedings much easier, both for us and the baby.  The doctors have scheduled the cleft lip repair for the end of the month.  Praise God!  Her cleft palate repair cannot be repaired until she is older.

I have enjoyed my work over the last month.  Nursing is much different here.  Sure, I still perform nursing tasks.  But I also play with the patients.  My particular favorite is a Sponge Bob memory game, though I also enjoy Dominoes - the games can get quite intense.

I hope you enjoyed meeting my patients!

However, it has not all been fun and games.  This little girl, Genesca, came to us hoping we could help her.  We performed a CAT scan and biopsy.  The results were not good.  The tumor is cancerous.  When she returned to the ship for her results, she was quite ill.  She had an infection.  We tended her through the infection but were unable to help her further.  We are not able to care for cancer patients.  We do not have chemotherapy nor radiation therapies.  The surgery would not prolong her life but would make her susceptible to infection.  With very heavy hearts, we told her family the news.  She is now back at home, though once again quite ill.  Her family is with her, loving and supporting her.  Please pray for her and her family.

Belated Wishes

Joe and I want to wish you all...

Merry Christmas…belatedly...

and a Happy New Year…also belatedly.

Christmas was both wonderful and difficult.  Difficult for the obvious reasons - missing people and traditions.  Wonderful because we felt very loved.

There were many events held over the last month.  Here is Christmas by Candlelight:

 

Even our patient's joined in the fun…

 We did receive a few gifts from our friends onboard.  (Notice the mac & cheese…a friend remembered that it is my comfort food.)

On Christmas Day evening, we opened our door for "Open Cabins."  Couples and families opened their doors for more than two hours for anyone wanting to visit.  The event is meant to encourage a more familial feeling of Christmas.  Here I am, with a bowl of homemade ice cream from a neighbor:

I was worried that Christmas would be awful.  I did not feel at all festive, not even on Christmas Eve.  I spent over six overs baking on Christmas Eve evening.  However, when I awoke on Christmas Day, I found presents and goodies outside my door.  Nothing lavish, but the gifts were thoughtful.  Of course, this was followed by amazing food and fellowship.  It was a good day.  God truly blessed us this Christmas.

A total non-sequitur: I would like to make a request for prayer.  My migraines have been increasing in frequency, duration, and intensity over the last three months.  I have had five in less than four weeks.  I do not wish to go back on a preventative medication for a number of reasons, though I am not even certain if that could be easily done from here.  I have an appointment with our crew physician on Friday.  Please pray that the migraines diminish and that the physician and I are able to find a helpful treatment plan.

Thanks!  I love you!

My Thanks

(November 27 - December 6)

Happy Thanksgiving! (belated)

I am thankful for all you!  My loved ones back home - family, friends, supporters.  Thank you all!  Your encouragement - in all forms - is so vital to what we are doing here.  Just seeing the numbers of people reading this blog is incredibly encouraging to us.  So, please, keep reading, keep praying, keep loving.

The ship hosted a Thanksgiving celebration this year.  Usually the ship does not celebrate an individual country's holidays.  However, the ship decided that giving thanks is appropriate and worthy of celebration.  Despite its American origins, the concept is universal.  Many individuals onboard came together to create an incredible Thanksgiving experience.  There was a joyful air everywhere…

About 200 dinner places were set up in our International Lounge.  Dinner was served family style.  We had turkey, stuffing, cranberry sauce, mashed potatoes, baked sweet potatoes and plantains, and gravy.  The galley staff did a remarkable job preparing these dishes.  The Lounge was decorated with beautiful bouquets and also many, many Malagasy hats.

A local band entertained us.  They were wonderful.

Our own Dr. Gary Parker carved the turkey.  As a Max Fax surgeon, he often has to make delicate cuts.

There is a story behind the many hats...Our Managing Director's wife is Malagasy, and she wanted to give us something of her country.  She purchased hats for each of the 200 participants.  The hats hung from the ceiling in glorious array.  Each hat had a specific name written inside.  After dinner, the hats were cut down and presented to each participant.  However, each person had to say what they were most thankful for before receiving the hat.

I am thankful for Joe, who having never been out of the country, decided to start with a two-year commitment to places unknown.  I am thankful for Megan who has become a great friend.  She has made this place seem like home, such is the strength of her friendship.

I wanted to share with you some of the specific patients that I have cared for during the last few weeks.

Vololonirina…you met her last time.  Here is her before photo:

 Here are the doctors working diligently during the long surgery (which lasted over five hours!):

Here is Vololonirina about seven days after the surgery:

Finally, here she is at her follow up, outpatient visit:

She was so thankful, she wrote a letter to us.  The letter is beautiful.  Here it is, translated from Malagasy:

This little boy is Mario!  He is an absolute flirt, blowing kisses to all the nurses…

 

This is my friend Hermina who had a teratoma removed.

Here is a photo of the entire A Ward one day.  Those in blue are the nurses and translators:

Here are two patients who have had hernia repairs:

Yolanda's daughter had come in to our orthopedic ward in the first weeks (in fact, you can see the casts).  Yolanda is still breastfeeding and noticed a problem with one of her breasts.  During one of her daughter's outpatient visits, she asked the doctor for help for herself.  The doctors found an abscess.  We were able to admit her as a patient and surgically drain the abscess.  

This is Jean.  We removed a 13-pound tumor from his upper right leg.  He came from Antananarivo, the capital, which is an eight to ten hour drive.

Here are two of our general surgeons Dr. Abel (on the left) and Dr. Olupot (on the right) working together in the OR:

I cared for Mikael several days after his surgery.

Here he is taking a break with a fellow patient before challenging her to a race!

And here is another Mario, who like all our children, is very possessive of his balloon.

For those of you who were paying attention, you may be wondering why I was caring for ortho patients when I am part of the General Surgery Ward.  Well, due to low census (or lack of patients), I spent a few days working in the very busy Orthopedics Ward.  Most of our patients in General go home the day after surgery.  Most, but not all.  Most of the weekends, we close A Ward from Saturday after lunch until Monday afternoon.  Our patients who had surgery Friday usually go home Saturday by 2pm and the new patients arrive Monday around 3pm for surgery on Tuesday.  Instead of calling off, or giving the day off to, the same nurses, the charge nurses decided that A Ward nurses would sometimes float to other wards so we could spread out the extra days off.  

I love this idea!  I have enjoyed working in the Orthopedics Ward.  The patients are all children no older than sixteen years…Again, balloons are a valuable commodity.  

Each child receives a teddy bear upon admission.  Some like to snuggle...

This little girl strapped her "baby" to her back, just like the mamas do:

The nurses play games, pass out stickers, take the patients for walks…

Mariette learns how to play Go Fish!  Anyone have a seven?

 We also use every available means to distract patients…not only from pain, but also from inactivity since they are on bed rest the first few days after surgery.

Sometimes, a distraction is simply the chance to make a new friend.

The hospital also plays movies…twice a day only…and the children become so enthralled...




























Sometimes, one will surprise you with what they find to keep occupied…

However, we've found that bubbles are the best distraction.

Our Hospital Chaplains visit every day, every ward.  Marc, shown here with his guitar, is a pastor of a local church.  He heard about Mercy Ships and wanted to be apart of what we are doing.  He still acts as pastor for his church, but does miss some Sundays when he takes his turn working weekends.

Some patients are still hesitant to reveal themselves even amongst people with similar afflictions.

Here is one patient wearing sunglasses indoors…

But we do our best to help them love themselves by loving them…

Here is the patient after surgery:

And again on the day he left us - already the swelling has decreased significantly!

Here are a few patients from our Max Fax Ward:

And, here is one of our youngest patients:

I enjoy going through the photos.  I also enjoy sharing them so you can see exactly why we are here.  There will be some changes to my ward in the new year, and I look forward to sharing those with you!