Thursday 30 June 2011

A little fighter

Osman, aged 9, came to the Africa Mercy in May 2011.  He presented with a right knee burn contracture with a wound after hurting his knee from falling out of a tree.  The family sort medical advice from a witch doctor who poured boiling water on the wound to heal it.  Unfortunately, it caused 3rd degree burns to most of his right leg and didn’t heal the wound.  His first two surgeries were to clean and debride the wound before a skin graft and contracture release would be possible.
Osman was a bright boy, understanding English and responding to the nurses politely and clearly, unlike any African patient I’d ever looked after.  One morning at 5am, while I was still quietly going about my night shift duties, he called me over, telling me in plain English, “I need to change my sheets.  They have not been changed in three days!”  My response was to think, What!?  Osman, since when do we change sheets here every three days if they are still clean?  Where did you even get the idea that they need to be changed so often?  Instead I replied, “Osman, it is 5 o’clock in the morning!  Let’s wait until people are awake!”
Osman was very particular about the tablets or liquid medications he would take, often telling you to wash his cup out and refill it with fresh, cool water before he would take his medication.  Still, he would always say thank you and try to remember your name.
The third surgery he was able to have the skin graft and contracture release of that leg.  I looked after him in the following days, keeping up the pain relief and keeping an eye on the leg, noticing that his foot was very swollen and he was unable to wiggle his toes and he had no sensation present.  His foot was also like this pre-operatively, but we were hoping for an improvement.  He was a trouper, not often complaining of pain and cheerfully sitting in bed keen to interact and participate in whatever was going on in the ward.
On day three post-op, his leg began to bleed profusely and he was rushed off for an emergency surgery for a popliteal arterial graft (behind his knee).  The surgery was completed but we were still unable to find a pulse in his foot.  Over the following days, even with antibiotics, and a lot of prayer, his temperature rose and we hoped he wasn’t turning septic!  His foot turned black and looked awful.  I didn’t see him much of those days as he was moved to ICU where a paediatric nurse could watch over him.  He seemed relatively cheerful, despite the circumstances.
As things weren’t getting better, we heard the devastating news, “Osman is going to the OR today.  He is having an above knee amputation.”   We all thought, Oh Osman, above the knee!  I’m so disappointed for you!
But like the trouper he is, immediately after the operation he asked for a balloon!  He coped with the change remarkably well, asking the day after surgery when could he get out of bed on crutches.
Osman with a fellow nurse.
He is still on the ward now, more than one month after his admission, while we wait for his stump to heal well enough for him to go home.  He hops about on his crutches like a little champ.  He’ll play balloon soccer in the hallway, standing on his one leg and waving his crutches in the air to hit the balloon.  He is also quick to wack someone with a crutch if they are out of line.  He is hungry for affection and love too, quick to hug you, sit on your lap or even give kisses (I had to tell him to only kiss on the cheek when he went for the lips!).  He is such a beautiful child, also adding to the nursing prayer time by praying himself.  Any fears that us nurses may have had for his future without his right leg, have been washed away by his determination for life.

Tuesday 28 June 2011

Love

How busy I have been in the last few weeks!!!  I have said goodbye to countless friends (or so it feels) and sent them on their way home with a hug and the hope of keeping up to date with their lives via Facebook or email.
The ward I have been mostly working in lately is plastic surgery.  We are now down to just 13 patients, all waiting for their wounds to heal enough to leave the hospital and come back to outpatients every couple of days for dressing changes.  The patients who are in the ward currently are mostly children.  I looked around the ward the other day and saw about 10 boys all between 1-12 years old.  It is the noisiest place in the hospital as you could imagine.  These boys have a special place in my heart, each coming with special needs and the desperate want to be loved.

At handover the other day, the group of nurses were all sitting around in a circle, listening to announcements and hearing happenings in the hospital.  Almost every nurse had a patient sitting on her lap.  When it came time to pray, one nurse asked one of the boys if he’d like to pray.  He said yes!  So we bowed our heads and heard the beautiful words flow out of his mouth thanking Papa God for the nurses and Drs and everyone in the hospital.  After this prayer another little boy prayed, offering his thanks to Papa God.  And again, a 12 year old girl in a nearby bed also prayed for us all.  Those whispered words from the hearts of the children lifted my heart so high I could fly!  What a sweet, sweet feeling.

Each patient knows every nurses name.  They want to sit on your lap, to be carried around, to be hugged, squeezed, loved.  And we give it to them with all of our hearts, and feel the same in return.

Wednesday 8 June 2011

Little Josephine

Here's a recent story written by one of our Mercy Ships writers on a gorgeous little girl called Josephine.
 
Two-year-old Josephine inhaled something that affected her breathing. Her parents took her to a local clinic which sent them to an emergency hospital . . . which sent them to a government hospital . . . which sent them to a satellite clinic . . . which sent them back to the government hospital.  After five days in the government hospital, specialist Dr. Karim Kabineh told them that Josephine was so tiny that she would die if he performed the necessary operation. He needed a pediatric anesthetist, anesthesia equipment, and a critical care unit with 24-hour nursing care – all unavailable at that hospital.
         After eight days of hopeless searching for help, the desperate parents took Josephine to the office of the Minister of Health, where the father, David, hoped to plead his case and find someone who could help. At that moment – in the miracle of God’s timing – Ann Gloag, a member of the Mercy Ships International Board who is well-known for her charity work in Africa, was meeting the Minister.
         She put in a call to Dr. Gary Parker, Chief Medical Officer onboard the Africa Mercy docked a short distance away in Freetown Harbor. After explaining to him what appeared to be the problem, arrangements were made to use an ambulance to transport Josephine, her parents and Dr. Kabineh to the ship.
         Dr. Gary examined Josephine, took x-rays and discovered a small stone lodged in the little girl’s bronchus. A virtual think tank was begun to find a way to remove the stone from her tiny body. Dr.Gary approached engineering to see if a medical device could be fashioned that would be the right shape to fit into the bronchoscope and retrieve the stone.  Every plausible idea was examined and eventually rejected. 
         Dr. Gary and Dr.Kabineh worked for five hours trying to remove the stone without success. Dr. Gary called Ann back to explain that what Josephine needed was a cardiac thoracic surgeon, and there wasn’t one on the ship. David was devastated. Mercy Ships was his last hope. But crew member Clementine Tengue encouraged him, saying, “God will find a way.”
         Josephine was admitted to the intensive care unit with 24-hour care. About 3:00 am, ICU Nurse Melissa Warner was working the night shift when Josephine lost her breathing tube.  Her vital signs were crashing.  Dr. Michelle White, the pediatric anaesthetist/ anesthesiologist, was paged, but it would take her several minutes to respond.  Melissa said, “In my mind I said I need help.”  “And when I looked up, there was Corina Buth standing in the doorway.  Corina, a pediatric ICU nurse, had been restless and couldn’t sleep.  Corina did CPR, and Josephine’s vital signs returned to normal. Then Dr. Michelle arrived and replaced the breathing tube.
         Josephine’s condition was deteriorating rapidly. Analysis was made of the hospitals nearby.  Ann Gloag phoned a professor friend in Nairobi and explained that she needed a pediatric cardiac thoracic surgeon who could fly to Sierra Leone right away. The professor knew just the right man – Dr. James Munene, head of cardiac surgery at Nairobi’s Kenyatta National Hospital. 
         “I was a bit reluctant,” said Dr. Munene. “I had never heard of Mercy Ships. I had no information on this case, and it was the middle of the night” Ann called back with information on his flight. “Be at the airport at 6:00 am,” she said. 
         “It was a little difficult to say no to the lady. I told my wife I guess I’m going to Sierra Leone in the morning,” Dr. Munene said.
         Dr. Munene was overwhelmed by the Africa Mercy, the more than 400 crew members volunteering from 35 different countries, and the concept of bringing hope and healing to the forgotten poor. He couldn’t believe such a mission could have been in operation for so many years, and he didn’t know anything about it.
         Teaming with Dr. Gary, Dr. James operated on Josephine, fishing the stone out of her
bronchus with ease. Because Josephine was so tiny, it was a vital requirement to have a pediatric anesthetist as part of the team.    Josephine woke shortly after the surgery and sat up all the way to the Intensive Care Unit, looking around and asking for a glass of water. To everyone’s surprise, she was anxious to eat right away. After a few days of recuperating in the ICU – and enjoying the attention of the nurses and other crew members – the little girl and her grateful parents left the ship
         Dr. James was captivated by the mission and hopes to return to volunteer his services. “Really, it’s a privilege to come and see what people are doing while others are sleeping and doing nothing,” he said.
         And God never sleeps – miracles still happen every day.  Sometimes we are blessed to be a part of them.

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