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.

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.

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.

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.

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.

My One

We moved out, under the cover of darkness in landrovers, bound for a school prepared and ready for thousands of people to walk through in search of fulfilled hopes and finally healing.
The people came. About 7000 of them, lining up along the road in the place we had prepared. The government closed off roads and the people waited.

As we opened the gates, we let the patients trickle in through a filtering system. The pre-screeners ask the patient why they have come and they decide, based upon what Mercy Ships surgeons can do, whether we can help them or not. It is not possible to describe how it feels to tell someone that their last hope of a normal life and healing, we cannot give them.
The 'no' patients are walked all the way to the back gate via the prayer station, always so reluctant to step outside the compound where they hoped so desperately to be helped. The 'yes' patients are escorted to registration and from there to History where I was standing, radio plugged in my ear to listen to all that was going on, answering questions of the nurses, sorting out problems and directing patient traffic.
My co-leader and I had an amazing team of nurses who worked so tirelessly throughout the day. But within the first hour of screening I helped out a nurse with the heartbreaking task of telling a young girl of about 12 years that the surgeons on our ship couldn't help her. She immediately burst into tears. My heart had already sunk to the depths of my chest when I had looked at her through my medical eyes. Her abdomen was massively swollen, she was thin and drawn, her skin colour not quite right. It was a stomach tumour the doctor had told them, but he would not help because they had no money to pay him. All because she lives in a world of very expensive or nonexistent medical care this one precious child might just miss out on life, if not for a miracle. So seeing her burst into tears just about dissolved me. The mother looked at me, explaining again, but we have no money and she needs help and now you are here. I looked her in the eye, hoping the compassion in my heart was written across my face, I'm sorry. Even as I write this tears stream down my face for this one child who needed help that we, as Mercy Ships, couldn't give. We can help so many, and I rejoice in that but who is here for this one? Who is here for the hundreds of others like my friend Ali met, facing this moment over and over again in the pre-screening line.
In moments like this it is not my strength that I stand on, for I do not have the strength to stand telling another that his hopes for us to bring healing are dashed.

 
In the midst of our busy rooms, I stood in the hallway, next to a line of patients and caregivers stretching to the end of the building and far behind me and around the corner. The three rooms I am running are full. One has 60 people waiting, the other two are full of nurses, translators (our day crew), patients and caregivers. I look towards the waiting area and see one little boy out of line. I can stare straight through his bowed legs. Although he is only small the legs are remarkably bowed, creating a little circle that comes together at his shoes.
I turn around with my back to the doorway and am face to face with a woman whose whole jaw is one great tumour, jagged teeth pointing towards the sky. After working on the ship in the maxillofacial ward for the last 18 months this sight is certainly not unfamiliar. I greet the woman and ask her name. It is Natasha and I tell her mine. In the next ten months she will be my patient on the ward and I will have the pleasure of knowing her.
I look down the line and see cleft lips on small babies, little children and even older adults. So many cleft lips in one day I have never seen.
It is this reason, bowed legs, mandible tumours, cleft lips and so many more that make my heart happy and full. Each of these patients will become a part of our lives. I say 'our' lives because the nursing and hospital team is really one big family. We share with abundant joy each other’s triumphs and pray with all our might for every patient.

At 4pm we had been working for 10 hours and after questioning one patient, they told us they’d been waiting outside the gate since 7am. They were tired too. I greeted one lady who had an orthopaedics abnormality and her little girl, who walked with windswept knees down the hall in her striped stockings with no shoes. The woman smiled at me, replying in French, we are tired. Yes I understood.

2pm they had closed the line off outside the compound to new people joining it, but it still held about 1,500 people. Hours later they were still coming through. Knowing we only had limited daylight left we switched to just taking patient details and giving them a screening card for a select date for their specialty. And still the patients kept coming. The whole hallway was filled with people, each holding their precious coloured mercy ships paperwork, a symbol of hope.

It really was ordered chaos but there was never a time out of order or dangerous, despite the number of people in one place. They waited, eager to move when they were called but otherwise willing to wait patiently, like no people in the western countries.
Darkness came and we kept giving out cards, seeing with the light of head-lamps, barely able to see the reason for the patient coming. They will return soon. Actually they already have. There are 60 max fax patients sitting on the dock waiting to be screened.

The numbers are overwhelming. 4236 people came through those gates and this was our first screening day. There will be more in other cities upcountry. More people will come looking for help. Sometimes I feel overwhelmed at that thought, not only for the sheer exhaustion of screening day but because there are so many.

They say you have to start with one, because every single one counts.

Natasha will be my one.

(more photos will come in the next weeks)