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.

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.

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.

Questions to God

Sometimes I ask God questions out loud. Yesterday the question was quite simple. We were standing in the hospital laundry room, “God, where is the green bonnet?” We needed this bonnet so badly, for the patient who owned it was missing it and hiding her face and her heart from life.

The day before when I had come into work, she was lying in bed, a blue towel covering the whole right side of her face, her body buried in a pile of blankets. Her eyes were closed.  The nurse told me she had refused to eat lunch. She was also requiring high dose painkillers for the surgery that she’d just had the day before. She had so far been unable to move from her bed and walk to the toilet since the pain she felt from the wound on her thigh. She was stubborn about not moving.

Her name means Help in Malagasy and as she lay in her bed, face covered, still as a statue, my heart broke for her. The situation is all too familiar to me. The facial flesh eating disease, noma, was the one who ate away her face. Like so many other patients I have cared for and fallen in love with in the past, she too needs patient, constant, unconditional love. She has clearly been rejected and shamed in her community. Only God knows the awful things that may have been whispered about her as she went about her daily life, her face hidden in shame.

My years of nursing in this place has made me soft and cry more than I ever thought I would but also one of the toughest, unafraid to push the patients to return to a normal rhythm of life despite being in a hospital. Yesterday I pushed her gently and was actually rewarded with an unexpected smile!

Our mission now, if we should choose to accept it, is to sing love over her until it seeps into the very depths of her soul. She has a long road ahead, but being constantly bathed in God’s beauty and goodness is sure to change her.

When I look at my own life, sometimes I shield my face from others. Well actually to be honest, living in such a close community like the ship makes me shield my face often, from those who care, but aren’t the ones that I would choose to share the intricate details of my life with. I think many of us cover our face and stubbornly lay waiting for God to heal our hearts or make our daily life better. Sometimes when your heart is broken and laying on the floor, all you can do is lay in God’s arms, but I think that’s when we need to ask Him for strength to face the new day and to draw off his strength. In that moment we feel carried on his shoulders and He is made strong in our weakness.

There is a lot of sadness in the world at the moment. You don’t need to look very far to see the massive need of the Syrian refugees, the wars that still rage, natural disasters, the friend who is struggling, the patient lying in her hospital bed struggling to accept the road ahead of her, my neighbour who just lost his battle with cancer or the loss of friends who were killed in a car accident over the weekend.

I have asked God all sorts of questions lately, not just about finding patient’s bonnets, but about the plan that he has for us. He says He has plans to prosper us and not to harm us, to give us a hope and a future. (Jer 29:11) But what about all those who are suffering harm? The next verses in Jeremiah carry on by saying that when we call upon Him and come and pray or talk to Him, He will listen and when we seek Him with all our hearts, we will find him. In my experience, in the moment we call out to God and find Him, the pain doesn’t just vanish, but as we learn to lean into Him and let Him carry us, He’ll also carry our pain.

As I was reading the news articles about the Syrian refugees and just feeling so discouraged for them, I was asking God, “How do they know that you are a good God when all they have known is war for the past four years? How do they know that you love them?” I didn’t hear an immediate answer, but the next day as I read more articles, they were about people in Europe standing by the border crossings with banners saying Welcome, passing out free food for those walking on the highway from Hungary to Austria, new shoes provided for those who’d walked and walked and families who’d welcomed strangers into their villages, God whispered to me that he showed these people he loved them through the people who reached out and showed kindness and love. It was a strong reminder to me of the different ways that God shows His love and also to remember to listen to God’s spirit whispering to me to be the one who hands out love in the form of a batch of cookies for a friend who needs encouragement, a bunch of flowers to a family member who has lost a loved one, an extra moment to sit with the patient who is struggling to interact and receive love.

Let the outreach begin

I asked if I could hold him. She nodded her head and handed over her one and a half year old baby boy to my open arms. His eyes were open but he did not see or focus on my face. His hands were in continual rhythmic motion. His mouth made baby sounds and noises. His soft skin and chubby body filled my lap. He smelt strongly of urine and I wondered if my lap was getting wet from his damp shorts, but I didn’t care. This little precious one was in my arms.

We were talking with his mama about the surgery that he’d had months ago in the previous Mada outreach. She was ‘very satisfied’ with his scar as it was hid amongst his curly black hair. She said he was ‘more accepted’ in society now, but she was saving up finances for a surgery to ‘fix him’ because he wasn’t walking yet and wasn’t doing things other children his age were doing. I think a little piece broke off my heart when I heard that. It was a comment that I have heard so many times in different countries throughout Africa. Yet again, I explained to his mama that her precious little boy could not be ‘fixed’ with a surgery. It was just the way he was and that in my country we also have boys and girls the same as hers, who cannot be ‘fixed’ with a surgery. The most important thing that she could do for him was be a good, loving mama and I already knew she was because I had seen her care for him in our hospital with my own eyes. My heart yearns for her, knowing the hard road she will continue to walk in a country without government help or even support groups for disabled children.

~

Little girl J was brought to the chair next to me. She sat down timidly, keeping her head down, feet swinging because they didn’t touch the ground. Her grandmother sat down on the chair beside her, rubbing her rough hands together nervously. Her feet were bare and it was clear to me that she was a woman who knew how to work extremely hard. The translator told me that they were from a village far away. We introduced ourselves and we asked them a few questions.

Little J has a tumour growing from the right side of her face. It had been growing for one year and had already split the skin on the surface, causing fluid to occasionally leak out and run down her neck. At 11 years old, J is small with no body fat to speak of. Despite her young age she sat so still and bravely while I stuck a needle in her arm so that she could have a scan. Even when the doctor looked at her and poked around the tumour, she was so brave. My background knowledge tells me that the results we’ll get back from the tests will tell us that she is not a candidate for surgery on the ship, but my heart screams for the opposite.

 

~

At the end of the day in the screening tent I turned around and saw a large stack of envelopes sitting on the table. It looked like fan mail. I asked Jas what it was. She told me it was the pile of photos and referrals that the day crew at the patient assembly site in town brought back to the ship EACH DAY. There would have been more than 60 photos of all areas of people’s bodies that had a problem or pain, that they would like a doctor to see and remove the lump or cure the pain. We looked through each photo and put them in piles of problems we could potentially help and those we couldn’t. There were some photos that were really heartbreaking. Among them, a baby with hydrocephalus that needs a shunt placed that we cannot do and neither can any other hospital in this country and a young girl with terrible scoliosis who needs a spinal fusion which we cannot offer. The pile of photos went on and on; a pile of papers that cried out ‘Help us!’

~

We arrived in Madagascar on Sunday 30^th August after further unforeseen delays at sea. My last post was about waiting and I had a bit of a laugh because I got further practice less than 24 hours after it was written, when I thought we were finally on our way!

The M/V Africa Mercy in port, Tamatave.

Since we’d been so delayed, we hit the ground running and had cleaned and set up the whole hospital in 5 days, with many thanks to our alumni Malagasy day crew and 60 brand new nurses.

The last couple of days I have spent with the screening team or doing maxillofacial evaluations. I have seen patients waiting for surgery and patients who have had surgeries. I have seen the faces of those who are daring to hope that this is the chance they have been dreaming of or prayed for and I have seen the smiling faces of those who have had successful surgeries and despite some still facing challenges say that they are now accepted in their community and are satisfied with their surgeries. Many of them still do not look ‘normal’ and require further surgery for improvement, yet they are not complaining. I am just amazed at these Malagasy people who continue to flaw me with their selflessness.

Mercy Ships hospital team 2015 Mada2

The first surgeries of the Mada2 outreach began yesterday. The patients were outnumbered by the nursing staff as a handful of the new nurses got to work their first shifts in a place that many of them have dreamed about coming to. I love watching the new nurses in their new environment which is so normal and comfortable for me (it should be after 5 years!) I love watching them fall in love with the people and patients in the ward, knowing that they will never be the same after this experience. Mercy Ships is a place that you just can’t walk away from and be the same person. Despite the fact that this is now my 7th outreach with Mercy Ships, working and living here continues to change me, stretch me and mold me into a better person. So, I say, let the outreach begin!

Waiting

Do you enjoy waiting? I never mind waiting in a shopping line for the check out. I sort of go into a day dream while I stand there, but waiting for a red light to turn green when there’s no one else around?! That makes me impatient.

When I left Australia on August 1^st, I expected to arrive to the ship and sail away from Durban, South Africa only a couple of days later, but when I arrived the ship was still in dry dock and not ready to be back in the water. We were delayed a minimum of 2 weeks and some days it sounded so bad that it looked like we might be there much longer.

DORMAC dry dock

DORMAC Dry dock

Full hard hat policy in the shipyard

I’m all about mental preparation. I’m okay with being spontaneous but if I get called up last minute for a shift at work, it throws me right off. If I’m mentally prepared for a long run in the afternoon, I can do it, but don’t spring it on me, I can’t handle it. So arriving at the ship and hearing that we could be in Durban for weeks more was a big mental shift. Many nurses have been re-allocated to other departments and are working in the dining room or galley, but I have stayed in the hospital department working on a resource project. It’s been great for learning and growing my knowledge but I find it extremely hard to sit in front of a computer all day reading research articles and writing documents. So it’s been hard. Each ship meeting that I have been to, we have heard new challenges and set-backs and all sorts of problems. So last week our managing director called an impromptu prayer meeting at 0745. My community gathered together and sat before God before our day started and we asked and listened to what He had to say.

Trying to make the most of hard hats becoming every day wear.

The waiting period this year has been very small in comparison to the months the crew on the ship spent last year when the Ebola virus hit the hardest and we had to change our course. During that time I was at home, lapping up the luxuries of my family and friends while my ship community were challenged and stretched. This year I have had a small taste of it and I have learned to make the most of the situation before me.

The waiting wasn’t all bad. I managed to squeeze a few adventures into my weekends. We made a trip up into the Drakensberg mountains and traveled into the country of Lesotho for the day. We took a hike among some pretty mountains and spent a weekend meandering through the midlands, checking out waterfalls and cafes.

Lesotho

We found some snow!

And had to have a snowball fight

Can you see who's face this is?

I’m thankful that we were able to find such great things to do during our time in Durban and that in the end the waiting wasn’t so bad.

It also highlighted to me just how much I love my job as a nurse. I have walked into D ward a few times since we packed it all up and tied it down for the sail. Each time that I walk in, I am hit with a thousand memories of a place that I have poured my heart into. I have carried lives of people who have walked in and out of that place, but who will stay with me forever.

Today we finally set sail for Madagascar. Right now we are bobbing around on the ocean, sighting whales left right and centre (it’s whale migration) and I couldn’t be happier.

Three whales. Captured from my bed! (With a long zoom)

Whale tail