Monday, 30 March 2015

An Innocent Man

I woke up in a sweat, heart pounding, an awful feeling hung in the dark room.
I had just woken up from a dream where I had murdered a good friend of mine and buried his body in the sand at the beach. There had been no motive and I had never, in real life, ever had a single problem or issue with this friend, so I had no idea where this dream even came from.

After he had been thrown into the sandy pit and covered in sand, I realised his name was written on his shoes and so went back and dug up his feet, pulling off his shoes and taking them with me to dispose of somewhere else. Terrible I know. No wonder I woke up with a terrible feeling. I lay in bed, looking around the familiar sights in the darkness of my bedroom and called on the name of Jesus as I had been taught to do from the time I was a child. Focusing my thoughts on The One who holds my life and thoughts in his hands, I asked for peace to still my pounding heart and to fill the room. Although it took time and faith, He came, but I never forgot my dream.

I can still picture each scene of my dream in my mind. An innocent man was murdered by my hands. Surely I would be incapable of doing such a thing, but this week I’ve been reminded of the man who was killed brutally even though he was completely innocent. The man was not only innocent even though he faced every earthly struggle and temptation, but he lived a life of perfection, hardly deserving to be brutally hung on a cross to die.

The fact is I was born into a world of free choice. I could chose to live life any way I wanted. God created it that way so that if we chose to love him, it would be genuine, our own choice. 

I met Jesus when I was a small child. I have no memory of not knowing him. Like a friend you have grown up with, someone who has been a part of every memory, happy and sad, he knows everything. There have certainly been things that I’ve held back from him, not wanting to listen to his instruction. I made my own decisions, stubborn to do what I wanted, but they didn’t turn out well. When I turned around and sought comfort in his arms, he opened them wide and didn’t say “I told you so.” He carried me and spoke gently, singing over me his delight and love, despite my bad choices and sin in disobeying.

In his great love for his children, God sent his son to earth to live among us, to experience a fleshy life of joy and sadness, blessing and hardship. In the greatest act of love Jesus let himself be sacrificed and take the world’s sins upon him.
Think about the sins of the world, the constant war, the shootings, the murders, the lies, the greed, the conflict. Now, imagine having the weight of all of that sin on YOUR shoulders, knowing that God says the penalty of sin is death. (Rom 6:23)

It was my sin that hung him on that cross. He was willing to hang for me. 

He was willing to hang for me.

I try to imagine my heart if I was standing at the foot of that cross, staring up at Jesus hanging there. My heart would just explode with pain watching the agony of him trying to breathe as his arms were stretched up high above his head, blood dripping from the lashings that ripped his flesh wide open, making puddles on the ground beneath him, his life slowly draining out of his body before my very eyes. The crown of thorns digging deep into the flesh of his head creating trickles of blood that flow past the eyes that had captured the hearts of thousands.

Insults were hurled at him as he hung there. As much as I’d like to think I would not have been one of them, I have.

But death could not overcome him.
After he took our sins to the grave, forever removed from us, he rose from his grave. Did you hear that? Death could not overcome him! That means he can never be destroyed! He has ultimate power. Not only does he have power over death but he has given us eternal life with him because of his great love for us, his children. His death brought us life.
It also means despite sickness and the hardship of this life, we have hope in him. We have hope that no matter what we face or do, we can never be removed from his sacrificial love for us.

No longer does death have a hold on us; we are forever set free by the death of an innocent man.

Sunday, 22 March 2015

Dry Skirts

I walk into the ward. It’s still dark, as it’s only 7am and the curtains are still drawn around each bed. After we pray together as a group, the day crew set to work as the nurses hand over the patients from night shift to day shift. The patients stir and the lights are switched on and curtains pulled back. In each of the 20 beds are 20 women, all who have come for this Women’s Health specialty.
It’s actually been many years since I’ve worked as a nurse in the VVF (vesico-vaginal fistula/obstetric fistula) specialty, but I’ve always loved attending the Dress Ceremonies for the women who come through surgery now ‘dry’. However, I have never left a dress ceremony with dry eyes.

Each woman’s story has its own heartache. Today I read the histories of my patients, most of them pregnant by their husbands by the age of 16 or for some, earlier. The people of Madagascar in general are quite small. Many of the adults weighing in under the 45kg mark, but these women are tiny. It seems quite obvious to me why they have fistulas, but the point is that they do and for many of them, they have lived with the stigma of it for years. Facing the reality that 99% of them will never have a chance for treatment.

For those of you who might not have heard of the obstetric fistula, it is a hole between the vagina and the bladder or rectum, that is caused by prolonged obstructed labour, leaving a women incontinent of urine or faeces or both. Sometimes an obstructed labour may continue for three days or even up to seven, by which time the baby’s head has caused such pressure and restricted blood flow to the mother’s soft tissues that the tissue dies creating a hole which leaves the mother incontinent of urine and/or faeces. During the obstructed labour the baby most often also dies, leaving the woman childless and with uncontrollable and unending flow of waste.

In underdeveloped countries such as Madagascar, many women have very limited access to medical help or healthcare and when in need, either for an ‘at risk’ pregnancy or in active obstructed labour, help can be either too far a distance or too expensive to be used.
I have heard that WHO estimates that there are 50,000 women in Madagascar with obstetric fistulas and more than 2,000 women who develop fistulas every year.

The workload is huge and when I look at the numbers, I wonder how we could ever put a dent into it, when in fact we are treating the end result of lack of medical care and so the number will not change if the healthcare system doesn’t move forward, but it does matter to that one woman. A woman having her fistula repaired means she is no longer leaking urine and can live in a normal society again, no longer rejected by her family and friends.

Just see this story from a beautiful woman in Congo during last outreach’s Women’s Health specialty.

So, as I worked amongst the women in the ward today, my heart sort of expanded in my chest. They are dearly loved women, precious and vulnerable, holding hope so tangibly. Many of them have already had a successful surgery and are now ‘dry’, no longer waking up in the morning in a wet bed, who can walk the hallways with dry legs and can rise from a chair with a dry skirt. Isn’t that one of the most beautiful things you’ve ever heard?! That’s life restored!

Unfortunately they aren’t all happy stories. I had one of those women under my care today. In fact I had to send her home ‘wet’. There aren’t really words to explain how sad it was. This particular one has lived 19 years out of her 35 years leaking urine. She travelled for three days to the ship for help and we looked and said it wasn’t possible. There is not enough tissue to close the hole.

I wonder so many questions about these women. How does their heart feel sitting in the ward, knowing that they are not the only one in the world who has been leaking urine for years, who has lost a baby in labour, whose husband abandoned them after she lost the baby, who hasn’t been able to work in a good job or walk through the market without people saying terrible things about them?
The hope in that hospital ward is so high and yet, it feels as though it could be crushed in the single word “wet” or explode with joy at the word “dry”.

The first of the successful surgical repairs discharged from the ward today. They will come back for their celebratory Dress Ceremony in the coming week and oh how we will clap and dance and sing, bursting with joy for each of their dry skirts.

Wednesday, 4 March 2015

Through My Window

 Through my window I can see the end of the white two story warehouse that houses our Admissions, Outpatients, Infant Feeding Program, Screening and Rehab areas. I can see the end of the dock space past the warehouse that has a container full of tools for the mechanics team. I see a tent with a Landrover being washed by the mechanics day crew. Beyond the tent, the dock ends and I can see the ocean and the beach front. I can see fishing boats any time of the day, paddling out and dropping fishing nets and then bobbing on the ocean as the tide comes in and out. On the beach people walk to and fro. Each day you can see men with a small herd of zebu (the type of cow here) grazing on the grass along the sandy beach. There are people that live on the sand in small shelters made from sacks and pieces of corrugated iron.

During the day from my window, only metres in front of me I see all sorts of people and patients coming and going from the warehouse to the ship gangway and back again. One day I saw a teenage girl with club feet being led towards the gangway with a small group of patients for admission into the hospital. She was scurrying to keep up with the group. Her feet so bent underneath her that keeping shoes on looked very difficult. One in the group in front checked behind them and saw that she was lagging behind, finding it difficult with the pace and so stopped to let her catch up. As the girl with club feet disappeared out of sight up the gangway, the thought crossed my mind that she’ll probably never step foot on the dock again with her feet at that angle.


Early in the mornings Day Crew wait on the chairs under the cover of the warehouse, waiting for the clock to tick to the minute they are allowed to board the ship and begin their day’s work. As they arrive in the mornings, they greet each person sitting in the line of chairs with a handshake.

During the day delivery trucks come and go with fresh produce being unloaded and carried up the gangway by strong men and women. The DHL truck comes every couple of weeks delivering boxes of beloved crew mail from all over the world.

The shuttle bus from Antananarivo arrives in the late afternoon carrying new and returning crew, having wound it’s way through a beautiful, scenic, eight hour journey from the capital city airport. You can almost hear the sigh of relief through my window as they step out of the bus and look up at the ship floating before their very eyes.

About the same time, people begin emerging onto the dock from their day in the office or around the ship. They are dressed in exercise clothes and brightly coloured shoes, ready for a run on the streets or a game of ultimate frisbee or soccer on a nearby field.

In the evening I see people in groups leaving for dinner together. Sometimes just two people, ship couples perhaps. Others are in large groups attending birthday dinners or the never ending goodbye dinners.

Every evening there are mums that walk laps of the dock while their kids play on their bikes and scooters, riding back and forth on the dock space that is bigger than any space we have been in for years. Sometimes I see children playing in the pouring rain.

Late in the evenings it is quiet with barely any movement, except for the odd security guard making his round. The dock is lit up all night long, waiting for the sun to rise and the day to begin all over again.

Tuesday, 3 March 2015

Can You Imagine?

I met this man several weeks ago now.

He had the largest tumour I had ever seen. It had been growing for 19 years. Hearing his medical history I thought his chance of being healthy enough to have surgery on our ship with limited complications would be slim, but as time progressed, to my joy, he proved my doubts wrong. He was approved to have this enormous, life-changing surgery. We told him that he could easily die on the operating table because of a whole range of complications. He said without surgery he knew he would die, but he already felt dead inside because of the way he was treated.

So we prayed and prepared.

The day of his surgery came. The laboratory had already bled a lot of my friends and crew mates for blood donations and had people on standby for more.
As the day wore on, the operating room team continued the mammoth operation. It took more than 12 hours of surgery to remove his 7.46kg tumour. Post-operative he went into the ICU and stayed on the ventilator overnight, but by morning he was well enough to be extubated and look at himself in the mirror. Can you just imagine what was running through his mind?

These are a few of the crew members who gave their blood to him.

Over the following days he struggled a little as his body re-adjusted to life without an enormous tumour, but before long he was walking around the ward taking care of himself like every other patient in there with a dressing on their head. He blended right in to the mix of patients in the maxilla-facial ward, to the point that you’d never even believe, apart from seeing the photos, that his body had ever endured such stress.

His story of survival and endurance is nothing short of a miracle. It has been a privilege to be a small part of his story in looking after him on the ward and managing his care. What an amazing story!


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