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.