Monday, 24 June 2013

A quick clip

I woke up this morning and as I scrolled through my FB page I found this interview of myself pasted on the Mercy Ships Australia page. I don't even remember the interview, but it's nice.



Friday, 7 June 2013

An End

When Steph and I returned from Masanga to the Africa Mercy, the ORs had just closed and the hospital wards were only open for one more week. I happily worked day shifts that week and watched as we discharged and said goodbye to every single patient.
One of the last nights before most patients left, we had a ridiculous, but very fun, party in the ward where, at her own suggestion, one of the patient’s caregivers decided to have a pretend wedding to one of our day workers. We all dressed up for the occasion and had a hilariously fun time pretending.

Just like we do for our crew member friends when they leave, we also stood on the dock to say goodbye to two of our beloved patients. They have been with us for a longer period of time than many of the nurses who came to serve on the wards where they were being cared for. There were truly special goodbyes and prayers said that week.

Then on Friday we had a Thank You party for our day workers, who have so lovingly worked alongside us for the last 10 months. It was a bitter sweet time of celebrating what we have accomplished together, that we could never achieve without them, but also saying farewell before we left.

My D ward team

The last week in Guinea was spent cleaning, packing and tying down what was left of the hospital. We made our last trips to our favourite parts of town and restaurants and for some, prepared to leave Africa for the last time. It also held a lot of sad goodbyes to precious friends.

And then we pushed off from the dock and began to sail. (This is where anyone who has sailed, erupts in squeals of excitement! The excitement of sailing for me is probably 5 out of 5!) I love staring at the blue ocean. I love to watch the open skies, blue and stretching for as far as you can see. I love the golden sunlight on the water. I love watching flying fish. I love the anticipation of seeing wildlife and screaming in excitement when dolphins come and swim with us at the bow. I love hanging over the railing and feeling the wind in my hair. I love looking overboard and waiting and then seeing the unexpected, like four turtles in the water. I love sitting on the bow singing praise songs, while staring out at nothing but sea. I love the brilliantly lit starry skies. I love the time with friends and community that is built through this common experience. And I love that I got splashed and soaked with sea water while standing on the bow. All these things and more makes sailing so exciting to me.

Photo credit: Ruben Plomp

Photo credit: Ruben Plomp

Photo credit: Ruben Plomp

And now it’s over. We arrived in Las Palmas, Gran Canaria yesterday afternoon and last night we hit the streets and marveled over the cleanliness of the streets, how fast the cars were driving, that there was green grass and flowers in the trees, how big the supermarkets are and the fresh produce they were selling, how many white people there were walking around and how we would never be able to spot our Mercy Ships friends now that we blended into the crowd. We sat down to enjoy the gorgeous view of the beach and admire the Spanish buildings, while drinking Sangria and eating fresh cheese and garlic bread. It’s such a stark contrast to the world we have been living in and sort of hard to wrap your mind around.

There are many more goodbyes to be said. Ones that will be some of the hardest of my life to this point and I’m not looking forward to them at all. But for now I will continue to soak in the presence of my friends and enjoy them, for this time shall very soon come to an end.

Sunday, 2 June 2013

Masanga- Fallen mangoes and tears

Day 9's first memory was the sound of rain pounding heavily upon the tin roof, occasionally accompanied by the thundering of a mango hitting the roof, loud enough to make me jump out of my skin.
I checked on Steph after breakfast, by which point she was awake but feeling worse than yesterday, hardly able to sit up without holding on and feeling the earth spin around her. While she sat up, with her eyes closed to try to keep from feeling nauseous, she ate a fried egg for breakfast and we discussed the possibilities for the days to come. Should we wait for her to get better before we leave Masanga or could she tolerate traveling for minimum 8 hours upright in a car?
By the time I walked down to the hospital in the rain, rounds were almost finished so I discussed Steph's case with our doctor friends and then headed back to take her some meds and do a quick pack up of our things to move rooms later that day. The thing about having a sick friend is that there's only so much you can do and then there's nothing. They feel bad that they can't do anything and you feel bad that you can't help them feel better and that's where you are both stuck. So I lay on the bed beside her, her sick of laying down but unable to get up and me, wanting to lay down because I'm tired of constant activity and the constant heightened emotion.
After a review by the doctors and not much else discussed except the possible diagnosis of labyrinthitis and that there's nothing to do about it, I headed back to the hospital.
The path on the walk down to the hospital was littered with ripe mangoes, dropped off the trees after the heavy rain.

The hospital was quiet too, with rain pouring down intermittently. Patients were mostly staying indoors and out of the wet. There were hardly any admissions as the rain keeps the patients from traveling.
I did see some very nasty wounds though. I looked at a wound on a man’s foot. He is one of many patients who have had leprosy and now have terrible ulcers. This man had had an ulcer on his foot now for 7 years. The wound had a terrible odour and after the gauze came away we could see why. His foot bones were completely exposed. You could see at least 4 bones staring back at you, not covered by anything. There were no tendons, no muscles, no skin, just dead bone. The patient actually had no feeling in his foot from just above his ankle to his toe. Next week they will amputate below the knee. There are many wounds here that I have seen like this to varying degrees.
I also helped plaster cast a man’s leg who had been hobbling around on this badly damaged leg after an accident two weeks ago, using a thick stick as a crutch. He had a complete fracture of his tibia and fibula. The poor man could feel the bones grating together as he moved around and as we put the cast on, you could clearly see the leg bend and move where it should have been solid and straight. After the cast was set and he’d rested from the pain, he had a smile of relief plastered on his face. Every time I walked back into emergency where he was resting and we caught each other's eye, a giant smile spread across his face.
We casted another kid’s leg for a fractured femur and then I walked back to the hostel to check on Steph and move into our new quarters for the next two nights.
Once I was back at the hostel for an unknown reason, frustration peaked and overflowed inside of me. I closed myself off, turned the music on and dowsed myself in cold water, washing the sweat of the past day down the drain. As I sat down, refreshed and clean, the unshed tears of the past week reached my eyelids, but somehow still didn't fall.

We ended the day with dinner, a nice group of friends, candle light chats and precious pieces of dark chocolate. I thought that that would be it for the night and I would fall asleep, but as I settled in, hearing the sounds through my open windows of the outdoor wildlife, as though they were in my very room (perhaps some were) I couldn't sleep, as words and thoughts poured through my mind, eager to reach through my fingertips to paper and the cry in my heart became desperate to feel something other than just numb. And then in the pitch darkness they came and trickled down my cheeks and into my ears. But not nearly enough for the emotion dammed up, for the sorrow of lives lost, the sadness of disease and the hurt and pain of sickness. Not one heart can carry such a burden. So in the warm glow of candle light I gave it back to Him. Him who holds all things and keeps all things together. He will carry my burden.
Day 10 was the final day for me working in Masanga. I left Steph sleeping off her sickness, praying that she was improving and not getting worse and I headed down to the hospital.
Every day on the walk down to the hospital I meet people on their way to pump water at the well near the hostel. The children always stop and say, What is your name? To which I would also stop and tell them and ask theirs in return. Occasionally I would see the same child again but not very often. Most often the women and children walking past had buckets full of water on their heads or mangoes that they had collected from the ground.

After the morning meeting, I rounded with  Dr David and the students in emergency, then ducked into the paediatric ward to say hello to my pikins (Krio for children) and then I wandered into maternity and ended up finishing the round with them and finding fetal heart beats with the doppler and feeling for the baby positions.

Back up in emergency there were some new paediatric admissions with malaria. These kids come in very sick with haemoglobins of 50-60 (5.0-6.0 for those in the US), blood glucose levels between 0.9-5.0mmol/l ( 16.2-90mg/dl), most often fevers up to 39.0 C (102.2 F), tachypneoic and tachycardic and sometimes seizing. After now seeing many, many of these cases I know what to do and how to help and better assess and look after the patient. Today was another day of practicing what I'd learned because in the later afternoon these admissions started pouring in and before I knew it every bed and more were filled with children ranging from 5 months - 3 years old, all positive for malaria, all with burning fevers, lethargic, pale and barely crying when poked with needles.
After getting things under control, blood transfusions running, fluid boluses, IV lines inserted, NG tubes placed, my friend Dave and I walked out after 6pm. Sadly that was the end of my days working in Masanga hospital. I’m sad because I have truly come to love it here. Although I don't know in which capacity I might work here for a longer period of time, I loved the friends I made in the patients, nursing staff, doctors and students and I will truly miss them. Perhaps there is a seed planted here for the future. I will let in sit in good soil and see what comes. For now though, there is still plenty to wrap my mind around in all the things that went on while I have walked my flip-flopped feet around this hospital.

Saturday, 1 June 2013

Masanga- Fishing for mangoes

Day 7 began again with the report of a death of a child we'd tried to save but had unexpectedly taken a turn for the worse overnight. The previous day, he’d been restless on his bed and lifted his arms to be cuddled by me when his mother was not present. As I held him I had wondered what his life would hold, but hopes were dashed at the news that it was cut short by malaria.
At emergency, patients were discharging home or transferring to paediatrics which was all good news and not so many admissions walking in. I wondered when the storm of admissions of malaria sick children would hit, like it had every other day.
Just before lunch one very malnourished boy arrived, sick with malaria and anaemia and like every other child needed a blood transfusion, quinine injection, IV fluids, NG feeding of F100, a nutritious milk substitute for those needing extra calories. Just like the other sick children it was also hard to get an oxygen saturation reading on him and his pulse rate as the heart beat so fast and the perfusion so poor. But unlike some children this one hung onto his life during our lunch break, in which I lay down for a minute and then was out like a light for a good hour. After lunch when I reappeared in emergency, he was still fighting, looking a little improved after a blood transfusion was given.

While the emergency department was under control, I wandered around the other wards saying hello to my friends in the surgical women's ward. One sweet lady called out to say hello so I sat down with her. She started fanning me with her sturdy piece of cardboard and we chatted about the hot weather, the seasons in Africa and the seasons in the UK where her cousin was living, about her family tribes, about the war in Sierra Leone and how it affected her life and those of the people here. It was very interesting and such a sweet time of interaction.

Back up in emergency I checked up on a few patients, cuddled a very anaemic, pale, sweet baby before heading back to the hostel to bucket shower, change and enjoy dinner with new friends and goodbye drinks with another.
Day 8 began with Steph getting out of bed and being so dizzy she could not walk straight. So after eating breakfast and sending her back to bed, I walked down to the hospital alone for another day.
I missed the morning meeting but otherwise the day unfolded in a similar manner to every other, rounding with the doctors between paediatrics and emergency and playing with the kids.
Unlike most other days at the hospital, this one was actually fairly uneventful for me which was nice because I was beginning to think that every day would hold some sort of intense drama.

I watched the doctors put a chest tube in a lady and drain out over 700ml of pus from her pleural cavity and we had a patient come in from a car accident with suspected multiple fractures, but all turned out to be fine. I made sure I was back 'home' at a reasonable time to check on Steph and have a cold bucket shower before dark.
Steph and I took a light stroll and ended up with a couple if small kids and a very long stick, trying to fish the ripe mangoes out of the trees. There were a couple of mangoes so high in the tree I just couldn't reach! So we enlisted the help of a friend, Alpha, who kindly obliged. He did it expertly of course, as he has probably practiced for years. He tugged the mango out of the tree and then caught it as it fell to the ground! We were very impressed!

It poured rain during dinner and the outdoor area was lit every few seconds by lightening, while the thunder roared. Steph still wasn't feeling well enough to be upright for long so we retired early and watched a movie thanks to the generous lending of a friend’s computer.
Only two days left at Masanga.


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