Wednesday, 14 October 2015

Surprise

At work in the ward one night shift, it was just past midnight when my co-worker’s patient started screaming her lungs out. It was a 5 year old girl, who’d had a cyst removed from her tongue only a few hours prior. She was writhing in her bed, screaming in the darkness. Her grandma and the Malagasy day crew working with us were both holding her down in the bed. Her nurse went over to her bed in the darkness, behind the blue curtain that shielded the light from the patients. Her nurse had a tiny baby already in her arms, as she was just about to feed her. I went behind the curtain also to see what was going on. At seeing her patient’s distress and not knowing what was causing it, the nurse turned to me and passed me the baby. I looked around for somewhere to put this tiny baby girl. There were no other day crew present as they were eating their midnight dinner, so I hurried back to the baby’s bed where her mama was. I tapped the mama on the shoulder, “Azafady mama” (excuse me) and I dumped the baby into her arms and hurried away.

The screaming and writhing of this 5yo continued and we shone a flashlight into her mouth to see if we could find the problem. There was something in there. Was it a nasogastric tube? I thought, no, she doesn’t have one. OH MY GOSH, it’s a worm! I could see the worm moving around in her mouth as we shone the light inside.
I left the drama at the bedside and went and put gloves on, wondering how on earth I was going to get the worm out without breaking it into pieces since it was so soft and instruments to reach it would be hard and sharp. I called another ward for a third nurse to come for back-up as this little girl was just beside herself, terrified.
I asked God for help as I walked back to the bedside where the nurse, day crew and grandma were struggling to keep the girl in her bed as she fought them, gagging, coughing, screaming, saliva flinging in every direction. When we turned the flashlight back on and shone it in her mouth, the worm had moved from inside her mouth up the back of her throat and was in her nose. In fact, the worm was looped in and out her nose, partly down her throat but part of the body hung outside the nose and so I scooped my gloved hand in and with a swift move, pulled the whole worm out of her nose. I held it gently with my thumb and index finger as we told our little girl, “vita, vita vita” (it’s finished, it’s finished, it’s finished). She eventually calmed down and the wild, terrified look in her eyes calmed and she fell asleep again. The worm died immediately and we left it in a kidney basin for the doctors to view in the morning.

The culprit measured up against a penlight

 

Wednesday, 7 October 2015

Home Visit

Earlier on in the year I wrote about Mioty who was a live wire in our ward. From a very troubled beginning to the sweetest end, she brightened and challenged our lives. One day when I was sitting at my desk in the ward, she came walking up to me singing in English (a language she didn’t know) “Bless the Lord, oh my soul, oh oh oh my soul” It came out of the blue and I barely knew what to do! She climbed up onto my lap and we sang the song together and she joined in the parts she knew. Sometimes she’d walk up to the desk and point at the speakers and say “oh my soul, oh my soul” so we’d play the song for her.
 
A few weeks ago when my ward opened for the first day of this Mada2 outreach, we gathered as a group of evening shift nurses and day crew and prayed together. My team leader then played Matt Redman’s song 10,000 Reasons and we sang it together. As the song played I actually wanted to burst into tears as the ache of missing Mioty was felt so deeply. She was no longer in the ward and wouldn’t be grabbing me by the hand to come and play with her or whisper in my ear or sit on my lap and type with my fingers. It’s hard to know what to do with an ache for someone you love and deeply miss.



Ever since Mioty left the ward in May, my friend and co-worker Heather and myself planned to go and visit her in her home. This last weekend we were able to organise it, along with another co-worker Ria.

After coming off night shift at 8am, I hopped into bed for a short sleep before getting up for lunch, putting the final things into my backpack and heading off the ship. Our small group were very privileged in being able to catch a MAF (Mission Aviation Fellowship) flight to the capital city, cutting an 8-9hr drive of very windy roads down to just 50 minutes of flying in an 8 seater plane. It was amazing to see Madagascar from the air in such a small aircraft. MAF does wonderful things in Madagascar and partnering with Mercy Ships this last year has been amazing for us, helping us reach places far and wide in a country with few main roads and very inaccessible terrain.

MAF plane Madagascar


MAF plane Madagascar

MAF plane Madagascar


The three of us nurses and our translator Anja, arrived outside of Shoprite supermarket and stood waiting. Only minutes later out of nowhere appeared Mioty and her mama. Mama had a wide, almost toothless smile and she hugged each of us. In her quiet, gentle way she seemed excited to see us. Mioty had a cap on her 6 year old head, clasping her mama’s hand tightly, she neither said salama (hello) nor looked up to meet us eye to eye, but as we walked back to her house, she skipped and bounced, excitement showing in her step.

We walked down the dusty pathway through the village, built on one side of the old royal palace on the hill in Antananarivo, the capital city of Madagascar.  We walked past the washing place where Mioty’s mama worked each day washing clothes for her clients. The place was surrounded by half walls of concrete with wide, metal, square-shaped bars to the roof. The wide ‘mesh’ bars had clean, squeezed out laundry hanging on it and the women inside worked and scrubbed to clean their clothes and others.


We were brought into a small, neat lounge room with three couches. This room belonged to Mioty's aunt. We sat and chatted with mama, beside her Mioty played with the pieces of a plastic clock, stubbornly not answering questions but listening intently to the conversation around her.
Ria had visited Mioty a couple of times in the last few months and had told Heather and myself about the tv in Mioty’s house that Mioty had decorated with stickers that she had been given by us in the hospital. She asked Mioty’s mama if they could show us the tv.


Mama led us out of the room and down a small outdoor passage way. She unlocked the padlocked wooden door to their concrete house. Pushing open two wooden window shutters let light into the small room they called their house.

At the end of the room, filling the width of the room was a wooden bunk bed, which slept Mioty, two older sisters and their mama. On the left of the room was a bookshelf and piles and piles of clothes and things. On the right hand side of the room was a giant tv that didn’t look like it worked and it had been turned into a piece of art by Mioty’s stickering anyway. There was also an iron ‘stove’ for cooking which she did inside the tiny house.




On top of the tv was the knitted bear, given to her by the Admissions team on the Africa Mercy, which had been knitted by a kind someone overseas, who will probably never know how far this teddy has travelled and what he has seen. Taped to the walls were some of the art projects Mioty had done on the ward back at the beginning of the year. Even the instructions for making salt water written in Malagasy were stuck high on the wall to see.

Mioty sat on her bed while we chatted to Mama. She pulled out her colouring book and started colouring, she pulled down one of her knitted dolls and played with it, she did head-stands on the bed using the bunk slats above her to climb on, all the while, silent. We asked her if she remembered the song we used to sing and so we sung it to her and as I was sitting on the bed next to her, I could hear her whispering the words along with us.



We asked her and her mama if they would like to get ice cream, our treat. So we left their house and moved to the grassy area outside their housing area and waited for Mioty’s sisters to come. Mioty started playing in the sand, just like any kid. Chickens and baby chicks were scratching around in the area, a few ladies were doing their washing in a tub of water and Mioty found an empty yoghurt pot and played in the sand. A knitted beanie covered her wild, dark curly hair.


video


Both sisters turned up, one was clearly doing mama’s work washing for the day, but put down her load and joined us for the walk up the road to the ice cream place. Orders were placed and ice cream was enjoyed. Despite living only 2 minutes walk from this shop and the ice cream being less than $1 per cone, Mioty’s mama had never been there before. I’m certain her income from washing clothes was never high enough to support treats such as an ice cream.

Back in their home Mioty was a little more lively and vocal than the previous hour. I could see that if we spent several more hours there, or even came to visit regularly, she wouldn’t need time to warm up to us, but we would see the same cheeky, boisterous girl that we had known and come to adore in the ward immediately. It was truly so special to be invited into their home and to see a tiny glimpse of their lives.



Mioty starts school for the first time next week. Her wounds from her surgery back in February, to make her a nose, have mostly healed. The wounds that were still open when we closed the hospital at the end of May, have healed so nicely with the care that her mama was giving her. She told us that Mioty still fought her to clean her face and eye where it was still not healed. We felt so encouraged though that her mama had done such a great job! More surgery could still be done, but for now we will wait and see as the skin of her new nose settles into place and shrinks a little. I certainly hope it was not the last time I see her in her home, but perhaps the first.

I can't even describe how much I love this kid.

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