Thursday, 26 September 2013

This is Love

Here's the long awaited Patient Selection Day (aka Screening Day) photos. If you read back to my screening day blog My One, you'll see the photos of the ones I noticed and wrote about on that day. See if you can spot them.

I know it's not about numbers- not by any means but here are a few statistics from the day.
The total estimated people (including those turned away outside the compound + potential patients and caregivers who came through the gate): 7,354.
In 12 hours, 4,326 potential patients were screened.
1,326 of those came through pre-screeners for surgical specialties, who then came through registration and then histories (my station!) and then on to the specialty surgeon station and to surgery scheduling.

This is Natacha! She is My One- more story to come.

The amazing thing is, so many of these patients I have already seen in the wards, have had their surgery and been discharged. It is truly amazing to be a part of their journey.
The funny thing is, I am on night shift this minute and my day crew who is my translator is sitting next to me. He has sat here silently while I have scrolled through photos of Patient Selection Day and posting them onto this page. As I worked he commented on the heart behind Mercy Ships being here in Congo, "This is love" he said. Yes, you are right. Because every one person counts.

Monday, 16 September 2013

Abundantly Thankful

Emmanoel was admitted not a moment too soon. His airway was being blocked off by an oral tumour which caused him more and more distress every passing day. When we saw the tension in his body, distress in his deep, brown eyes and the horrible screeching noise from his throat when he gasped for air, we knew that soon his body would not be able to cope with such a huge amount of stress and he would die.

I wrote about him two weeks ago and how he was able to get life-bringing surgery and how he needed to go back to the OR and be put on the ventilator so that his poor little body could rest for a couple of days.

Moments before going back to the OR for ventilation

I wasn’t there when he was extubated but I was thinking about him. I wasn’t working that day but I couldn’t help myself but swing by the ward in the evening to peek at him. When I peeked from the window in the hallway, he was tucked in bed, snuggled next to his mama, who was also fast asleep. He was a new boy from the one who had previously sat in that bed, unable to lie down for the struggle to breathe. His body was completely relaxed and as I watched him breathe, I felt myself sigh and the tension drain away. He was sleeping as any little boy his age should.

Several days later I walked into work in the afternoon and looked around the ward. The usual business was a flurry of nurses handing out 1400hr medications before the new shift arrived. The activity distracted me for a moment and then I realised. Our little boy, Emmanoel, was gone and someone else was in his bed. My team leader told me he'd be discharged home that morning. He'd gone, just like that. He and his mama had been given discharge teaching, collected the appropriate medicines and then been walked out with a translator and caught the shuttle out of the port and then probably a taxi or bus home. There'd been no goodbye ceremony, no trumpets announcing that this precious little boy was now leaving the hospital a completely different boy. He was now loved on by scores of nurses and hospital staff, he'd been cuddled and played with and cherished and will now live a healthy, full life. I can just imagine him as he left the ward, his soft little hand, grasping his mama's as he walked by her side, something he was unable to do when he was gasping so desperately for air. We and you, prayed for him with all our might. God heard our prayers and we danced with joy.  Every time I looked at him I felt abundantly thankful for a God of mercy.

So it was strange that I could walk into the ward and find him gone. But that's how it goes. Each patient who walks into this hospital has their own precious story. Some need more urgent prayers than others, but each need our love in their own special way. So thank you for loving him by praying for him.

And a huge thank you for the outpouring of love and prayer for Baby Girl and her family. I felt so abundantly covered in love and prayer by each of you. The outpouring was truly remarkable.

Monday, 9 September 2013

Dear baby girl,

Today I held you while your mama ate her breakfast. I took you for a walk in the hallway. Two nurse friends of mine swooned over you while you sat in my arms, taking gasps of air. Your eyes were barely open, as you had hardly slept for the last two nights because you were sick.

It was only last week that I met you. You came to the hospital when it opened because the American doctor from the mission hospital brought you and your mama on the plane, hoping we could help. You had a tumour growing in your mouth.

I watched you sitting on your bed with your mama. She said it hurt you when you were eating. You knowingly putting your hand on your cheek, where the tumour hurt you the most. We gave you pain medicine and later you asked for more chicken so I knew you were feeling better.

You didn’t reach for cuddles when we walked by your bed, but you also didn’t cry. Your mama greeted me with a smile every day.

When the doctors saw you during the week, they thought the tumour in your mouth wasn’t one we could operate on and remove. It was growing bigger and you were getting sicker.

A few days ago we gave you a blood transfusion, IV fluids, antibiotics and malaria treatment because you got so sick. We also told your mama that we couldn’t operate on you and we’d try to find you flights back to the mission hospital. Did you see the look on your mama’s face? It broke our hearts. Did you feel her warm tears drop onto your soft skin? We prayed for a miracle.

We wanted to fight for you baby, but this tumour we couldn’t remove. We knew you were dying but we didn’t know when and we wanted to get you home to your family, to your twin sister.

On the weekend you got sicker. You couldn’t lie down anymore because that made it too hard to breathe. You didn’t want to eat or drink much and even though you were so tired you couldn’t sleep because your body had to stay awake to breathe.

This morning when I walked with you in the hallway I had no way of knowing, but as I walked back into the ward, you stopped breathing. Your face changed colour and the tumour that you’ve been trying so hard to breathe around filled the whole space in your mouth. Your limbs straightened out and stiffened for a moment. I hurried to your bed where your mama was sitting and told her through a translator, that you, her baby had stopped breathing. Her face filled with grief and a wail escaped her mouth. She bent over, face to the ground and began to moan, a noise penetrating every surrounding heart with deep sorrow. She hurried out of the room.

I sat on your bed with you in my arms. You’d taken two small breaths but that was it. You now lay limp in my adrenaline shaking arms. I called to the nurse to page the doctors and another to bring a stethoscope. She listened for your heartbeat and shook her head. She put the stethoscope ear pieces in my ears, I put the diaphragm over your heart and it was silent.

Your mother had stepped out of the ward because her heart had broken into pieces, so I had the privilege of holding you in my arms. The nurse put curtains up around us and I sat there alone with you, staring at your face, tears dripping off my eyelashes, soaking into the pretty, white, flowergirl dress you were wearing.

People came in and out of those curtains, checking all was well with me and you, asking if I was ok and did I need anything? Yes, I was ok, because you were in my arms and you were at peace. You weren’t fighting for air anymore. Finally you could rest. Now you are in a place where there is no pain and no sickness. Will you remember me when I join you there? Will we see each other from afar and you will know that it was me who held you as you took your last breath? It was me who held you for the next two hours, in place of your mama who could not bare it. I could hear her wailing down the hallway. She loved you more than words can express and as I sat there holding you and hearing her cries, I thought how raw her heart must feel. I didn’t even want to think how deeply my heart would hurt if you were my child and I had lost you. But I still cried for you. I cried for your mama’s loss, for the hundreds and thousands of mamas and papas all over the world who loose their babies from diseases. I cried for the babies lost in Africa from preventable illnesses. I held you tight.

I stayed with you while the officials came and while your cousin came to see you. She could not bare to see you lying on the bed so still and lifeless, so she didn’t stay long.

When the time was ready I wrapped you up in a patchwork quilt, made with love from someone who knows that the children who need these blankets need something special. I carried you out of the ship and down the gangway and put you on a stretcher to go to the morgue. I saw your mama coming down the gangway in our hospital chaplain’s arms. She was bent over in pain. Agony was written across her face. I thought my heart might split open. The doors shut on the vehicles and they drove away, you in one and your mama in another. I turned my back and walked up the gangway, afraid that the tears would spill over and I would loose composure and fall apart right there on the steps. I will never see your mama again, but I will carry you and her in my heart forever.

So little one, as you rest with your heavenly Papa, I will pray for your mama and your family.

I will never forget you.

Friday, 6 September 2013

Not a Moment too Soon

I walked into the ward last night with my mind prepared for hearing the breathing struggles of a small boy my screening friends had told me about days earlier.
On Patient Selection day there had been an EMT call to the pre-screeners at the very front of the line, for a small boy who had an airway obstruction. He had by-passed registration and histories, where I was stationed, but I heard about it through the radio conversations. I also heard later that he’d been scheduled for surgery in the first week of the hospital being opened.

Yesterday when I walked into the ward, he was sitting in bed 1. When my ears heard the struggle of air passing through his airway, my eyes saw the retractions of his muscles, the tension in his neck, the waving of his hands as he struggled to gasp in the air that his body so desperately needed, my heart lurched and I swallowed back the lump in my throat and blinked back the tears that threatened to roll down my face. At that moment, although he was acutely distressed, he’d been in this position for four months, there was nothing I could immediately do to relieve his stress.
When he was awake it was only for small periods of time because his body was so exhausted from the struggle to get oxygen. When he fell asleep it was only for seconds because he would stop breathing and his body would wake him up to breathe. Over and over and over again, he’d wake up, fling his arms around in frustration and flop back into a restless, teasing sleep.

Today he got his surgery. As I was preparing to head to work I could hardly wait to hear how it had gone. I bumped into his surgeon in the hallway, who quickly filled me in. The tumour was out, he didn’t need a tracheostomy and he’d been extubated about 20 minutes ago.
He stayed in the recovery room for some hours as they woke him up slowly preparing for worst case scenario. He recovered well and so they brought him around to the ward, to the nurse in my team. Once he was settled in his bed, we monitored everything very closely, rejoicing in the sound of his much quieter breathing.
The doctors popped in and out, backing us up by being close by if we were concerned about anything. As time passed by, his oxygen saturation dropped lower and repositioning him didn’t help. His heart rate and respiratory rate increased and so we called the team back for help.
After discussion between doctors and with the mama, they took him back to the OR to intubate him and sedate him for a couple of days to let his body rest.
An hour later he arrived back from the OR. We settled him into the new intensive care bed, on the ventilator, letting his body catch up on the last four months of missed sleep. His little body lay there, the machine doing the work of breathing for him, his chest moving up and down, muscles completely relaxed, so peaceful and comfortable.

In the following days he will come off the ventilator and we will see him breathe on his own, healthy and strong. I can’t wait to see him walk and play and smile.

This is our little boy, days before his surgery. Strangely enough when you look at him here, you could never known how desperately he was trying to breathe before and after this photo was taken.

Tuesday, 3 September 2013

The Real Reason

I had the privilege of being able to work the first shift of the hospital opening for this Congo field service. It was so exciting to see patients lining up while walking up the gangway, 4 short days after they queued up for hours on patient selection day. Did any of them realise that day how soon they would get their impossible dream fulfilled? How were their hearts feeling at that moment of walking up the gangway?
As they filed into our new admissions ward for pre-operative patients, we led them to their beds. The other nurse and I stood with our day crew to translate and we expressed our excitement that they were here. They responded with thanks and one translator told me later how the patients had expressed that they felt very well cared for and welcomed. Perfect!

The following morning I also worked, helping to organise the nurses and new day crew to orient to their jobs, while we got ready and sent the first patients to surgery.
During the morning the hospital chaplaincy team came in. They prayed first with the room full of patients, translators and nurses and then began to sing. The room was filled with joyful harmonised voices and the beat of clapping hands, singing praises to God. It hit my heart so hard with joy that I wanted to burst into tears. I swallowed the lump in my throat, with a wobbly smile and let the music sink into my soul. This is the reason that I love this place. We bring the patients here to give them a free surgery but the real reason is because we want them to know the free love that God has for them and pours out upon them. I am just a vessel for the pouring.

Here's a little slide show from patient selection day put together by our communications team. I hope it works for you.


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