Treasures

Today I went to the HOPE Centre (Hospital OutPatient Extension Centre) to join in with their church service. The covered outdoor area was packed with chairs, filled with patients and their relatives and a scattering of Africa Mercy crew members. Outside of the covered area were more crew members, many with patients or little kids sitting on their laps or by their sides. The weather was cloudy and I had just ridden my bike through the rain to get to the site. My hair, the front of my skirt and shirt were wet with rain. There were droplets of water still sitting on my skin as I walked in with a friend to find a chair.

As instructed we all stood to sing songs in Malagasy praising God, the words and tunes familiar to me after these past 14 months in Madagascar. Looking around the area I saw so many familiar faces, almost all patients I could name, came from my maxillofacial ward and a bunch from other specialities on board. The patients and caregivers were dressed up beautifully for church despite the off and on rain. There were shiny shoes and matching tracksuits on babies, ruffled flower girl dresses on little girls and best dresses for the mamas and papas. Hearing the singing voices of these people, already so dear to my heart, raised in praise to my God, just about reduced me to tears. A wave of emotion washed over me reminding me to treasure this moment, these voices, this place, these people.

Last week while I was writing the morning ward rounds orders in the patient charts, I came across the pre-operative photos of a male patient in his early 20’s who had a massive facial tumour on his jaw. During the first surgery, the tumour is removed and a metal plate is put in place of the missing jaw. The tumours on the mandible that we remove are mostly ameloblastoma, a slow growing benign tumour that eventually cause death by slow suffocation. The tumour is overgrown tooth enamel that, if found in the western medical world, would often be able to be removed quickly without major surgery. This man’s tumour however was massive, I mean, American football sized, coming down off the right side of his mandible. He’d had a successful first surgery and had returned three months later for bone to be put inside the jaw to strengthen it. The bone graft was taken from his hip (iliac crest) and after this healed, he would not need any further surgery and could hopefully go on and have a happy and long life.

I had collected the chart from the end of the patient’s bed as he had just walked into the bathroom, bandage on his face, covering his neat incision line under his jaw, his face perfectly round and symmetrical. When the page fell open with his very first pre-op photos on it, I could barely believe it was the same man. I stared at the photo a while, wondering what he was thinking when the photo was taken. When he came out of the bathroom I showed him the photo. He stood there gazing at it. I grabbed a translator and asked him, “Do you remember how you felt when you had this tumour?” He paused a moment and replied, “If Mercy Ships had not come, I would have died.” I asked him if he remembered how he’d felt when the pre-operative photo was taken. He said, “I was thinking I would probably only have one or two months left to live.” Yet here he stood before me, three months later, with a beautiful, new, symmetrical, tumour-free face. He asked me then if he could give his testimony in church that morning about what God had done. “Yes, yes you can!”

Another patient came over, this one a female, also in her 20’s. She had had the same procedure to remove a tumour on her jaw and had returned also for her bone graft. She also had her pre-op photos in her chart which I showed to her. I asked them both if before they came from their village to the ship if they thought they were the only one in the world with a tumour growing in their jaw. They both said yes. I explained that they’d both had the same type of tumour and the same operations to have them removed and bone grafted. They were not alone.

Several weeks ago we were able to operate on an 8 year old girl who had a bifid nose (see the photo below) and hypertelorism (eyes too far apart). The night before her surgery, I rebraided her hair so that when the surgeons cut her head from ear to ear (across the top), they would not have to shave off all her beautiful hair. As I undid her braids she stayed bent over her brand-new colouring book, enjoying her gift from the Hospital Chaplain team. We talked about her family, her friends and school.

The following day the operation went really well and her new face looked beautiful but as per usual the swelling from surgery forced her eyes closed. The first day post-op, she kept crying, “I can’t see, I can’t see.” She cried whenever someone touched her without first speaking to her and she refused to eat.

As the days passed, the swelling began to go down but her eyes did not yet open. She did begin to eat and we looked for toys that she could play with by touch and not sight. I put new batteries in the toy keyboard, much to the annoyance of some nurses, but I knew if I was that precious girl, I would want something like that.

Eventually the swelling went down enough for one eye to open and we rejoiced! After approval from the surgeon, I took her into the ICU and washed and brushed her hair, removing the clumps of shaved off and matted hair and one of the female day crew redid her braids. She looked so fresh and sweet afterwards.

Waiting in line to be screened, October 2014

 

The surgeons making their rounds

Post-op with her sweet grandpa

It’s each of these stories and moments that I treasure. As we count down the weeks left in Madagascar I want to be counting up the treasures to be found.

 

I'm Leaving

I have thought many times over the past months how to write this blog. Many days I felt heightened emotion and other days I felt neutral, like today. It’s pouring down rain right now and it just seems like the right sort of mood to make this news public. I have decided to end my long-term commitment with Mercy Ships and go back to Australia after this outreach ends, for no other reason than it’s just time to go home. I love the work I do on this ship more than any job in the world and despite knowing I will miss it incredibly, I still know it’s time.

When I walk down the hospital corridors as the OBF women walk and sing, their sweet melody echoing high into the decks above, a lump rises in my throat and I wonder how I will ever say goodbye. When we hug and wave our patients goodbye from the ward, knowing that they can return to their village tumour free or with a new lip or palate, able to become a part of normal society, I wonder how I will cope with nursing at home when it feels so much less significant. When I sit up on deck 7 with my patients at the end of the day, spending time playing games or running around after the kids, making sure they use up their energy, I know I will not be able to give this sort of holistic care at home, but in all of those moments I know that God is in this decision because I feel such peace, despite expecting the adjustment to be tremendously hard.

In approximately three months I will be disembarking from my home and community for six years. I can barely believe it even as I type, that time has disappeared so quickly. It has been swallowed up by the daily loving of new friends, exploring new countries and serving patients with all sorts of conditions. I’ve certainly had some high highs and some low lows, from seeing God perform a miracle in a man surviving when it looked like certain death to having a child die unexpectedly in my arms, my heart and character has been stretched to the maximum and I have grown more in these years than any time in my life.

We are getting closer to counting down the weeks left of the hospital being open for this Mada2 outreach. On May 20^th the operating rooms close down and we will have one week left to recover the remaining patients. It’s the time of year where we get down on our knees praying to see all the wounds that are currently still not healed, to have skin growing to cover them.

Speaking of wounds, my patient Olivia who you have been praying for (thank you!), came back into the ward for a while in the last weeks so that we could give a little more attention to her wound which still hasn’t healed. We have applied the wound vac again in hopes that we can stimulate enough skin growth that she won’t need another surgery. Please continue to pray for her and her family. Her girls are still as gorgeous as ever. Baby Julia is getting so big and able to sit up on her own. Both girls love all the attention that is showered over them in the ward.

This last week I was able to go out with our Mercy Ministries team to the local Hopital Be Paediatric ward. In signing up to join the group that ministers to them, we have to leave our nursing, medical brains behind and just go as someone who cares. The paediatric ward is split up into several rooms with 4 or 6 beds. These rooms are small- probably smaller than your master bedroom. They hold rickety old hospital beds with plastic covered mattresses that were split open from being used for so many years. Each family member has to bring their own bedding, pillows, lapas (fabric), bowls, spoons, food, water etc and then buy the medical supplies that the nurse or doctor tells them to buy from the hospital pharmacy. Since each room is so small and the Malagasy people are a strong relational culture, each of the families speak to each other, like they do in the wards on the ship. They help each other out in ways that you would never see in a western country.

There were such a small number of us going for Mercy Ministries that we were able to just have one translator each and go into the rooms in pairs. We walked in and said hello to the family members and patients inside, taking the time to speak with each family or mother individually before praying for the whole room collectively. Seeing the tiny babies wrapped up in blankets or the toddler sprawled out on the bed looking quite ill, was nothing I had not seen before and not shocking to me, although also a picture you are not quickly able to forget. The eyes of the sickest child I met were so dull, I feared she was closer to death than life but I was not there to be a nurse and so I had to carry on. I met some beautiful new babies, some only hours old, and their loving family members who were caring for them. It was truly a privilege to meet each patient and to be able to stand in that room and pray for them. I also know that walking through the ward, seeing those sick kids, kindles the fire already burning within me. This Africa journey I’ve been on, is not ending.