Africa Mercy - Limping Along: One Nurse's Journey

This is one of Marilyn's parting emails before heading home possibly the end of March. Madagascar was healthier than expected, so it's likely her services will no longer be needed. She reflects on the last two years, and as typical, shares a patient's story. 

Sharon 

(This is a running email post written by a volunteer nurse serving on the Africa Mercy, a hospital ship that travels the African coast).

13 February

We have now done three weeks of cataract surgery since Christmas, and we have enough patients lined up for about three more weeks.We have screened for patients in six cities, but we have not found very many patients overall. That's good news for the Malagasy people...cataracts seem not to be the overwhelming problem here in Madagascar that it is in West Africa.

From a personal viewpoint, however, it has been a disappointing field service. We've worked so very hard to find patients, but we have done relatively few surgeries. Our last screening in Fenereve Est this week was expected to yield about 50 patients--we found 4.

And so, we will most probably be done with surgeries by early to middle March, long before the ship leaves Madagascar in June.  I will probably go home at the end of March, since my job will be done.

But, meanwhile, we have restored sight to some people, and those people are very grateful. Their smiles and words of thanks are payment enough for all our work behind the scenes on their behalf.

I just need to keep my focus on those we have helped, and be     thankful for the opportunity to be here to do as much as we have. My best story for this week is a young man, age 28, who has had diabetes for years and has been blind for two years.  He has a five year old daughter that he hasn't been able to see for nearly half her life.  His prognosis was poor--cataracts induced by diabetes are generally accompanied by other diabetic eye problems. We did the surgery anyway--some improvement is better than none.

Yesterday, when the bandage was removed, he could see almost perfectly!  Imagine, a young father/husband has been restored to a full, productive life, able to work and provide for his family. Now I remember why we're here!

I'll probably write once or twice more before I leave, but I'd like to take his opportunity to say thank you to all of you who have followed my adventures in Madagascar and have prayed for these people with me.  If I have one take-home lesson from these two years with Mercy Ships, it is an increased appreciation that God is interested in the details of what we do, and he gets involved in response to prayer. The splashy miracles that occasionally happen are fun, but I am even more impressed with his consistency in managing the little obstacles that we bring to him day after day.

Last year in Congo, the biggest hurdle to providing surgery seemed to be blood pressures, and we saw God put his finger on them to lower them just below the cutoff point with amazing consistency.

This year, both blood pressures and blood sugars are stumbling blocks to surgery, and once again, in his quiet, behind-the-scenes, non-dramatic way, God is enabling us to do surgery by controlling those numbers.

Blessings,

--

Marilyn Neville

   

[Click here to learn more about the nurses and doctors on board the Africa Mercy.]

Africa Mercy - We Have a Plan...Fluidly Speaking: One Nurse's Journey

This from Marilyn on the Africa Mercy, the first week in September, the week of her 70th birthday! And here she goes again, off on another adventure in a very "far-away land." Sharon


(This is a running email post written by a volunteer nurse serving on the Africa Mercy, a hospital ship that travels the African coast).

8 Sept 2014
"We have a plan...fluidly speaking"

It seems odd that I've been here for only a month--so much waiting and wondering, so many plans changed, and changed again.

Let's see...Since I last wrote, our leadership finalized their
decision not to go to Benin at this time. The situation was just
too precarious, and there was too much chance that we would make the situation worse by inducing people to travel and congregate.

Next, we considered returning to the Congo, where we had our last field service. Unfortunately, the situation in neighboring DRC was also precarious--sources told us that it was much worse than was being reported. The government of Congo preferred that we not come into their port at this time, for the same reason--we are a magnet, and people will travel to get to us.

So, where are we going? The latest plan is...________(I'm not
allowed to say just yet). I must admit, this country wasn't even
on my short list of possibilities. Looking at the map, I discover
that it is very far away! The sail will be long indeed--all the
way down the west coast of Africa, a stopover in South Africa to
refuel and replenish our supplies, and then another sail up the
eastern side.

Usually, it takes months to get a protocol signed with a host
country, even a country where we've been before. For last year's
field service, it took a year to hammer out the details of the
protocol with Congo. It took two months to finalize the protocol
with Benin, a country where we've been five times previously.
We've never been to "country next" before, but with them,
negotiations began one weekend and were finalized and signed one week later. Seems like God has opened a door for us, doesn't it?

Dates...are quite tentative at this point. The target date for
arrival in country next is October 25. We will deploy an advance
team to work with the government and with the port authorities so that at least the legal stuff (protocols, visa waivers...) will be
done and essential services (water, sewer, trash...) will be
available. Much of what the advance team traditionally does will
not be done, of course, because they have only 40 days. It means a slower, more gradual start-up for the field service. We probably won't have an eye clinic building waiting for us, or day crew hired, or screening sites located. Other departments will be
similarly impacted. But, I hear that this is the way we used to
operate, so this is a return to old patterns of arrival, not
complete chaos.

Meanwhile, work on the ship continues. The engineers successfully replaced the O-rings in the propeller shaft, but unfortunately, sea trials to test that repair revealed a second problem, something with the side thrusters. I'm not sure what they will do about that. The delay to fix the propeller allowed time for other repairs, too. They've been working on something electrical--we've had several blackout periods while they worked--and other less critical repairs. Other departments are working on special projects of various sorts, too, so the extended shipyard time has not been wasted.

We are also awaiting the arrival of two containers. We shipped
containers to Benin, our usual procedure...but it takes two to
three months to get a container, and we didn't know what country
next would be in time to send containers there. 

When it rains, it pours. Now, our massive freezer went on the
fritz. That repair is likely to cost $100,000 and take eight days.
Even paying the shipyard workers extra to work the holiday
weekend, this will delay our departure for another two days. So,
our proposed departure date is now September 13--if all goes well.

Once repairs to the ship are sufficient for sailing and the
containers arrive, we'll leave the shipyard in Las Palmas to sail
for Cape Town, South Africa. In Cape Town, the plan is to do some PR work--lots of tours of the ship, etc.--while we wait for the advance team to do their thing in country next.

We may also need to go into dry dock for repair of the side
thrusters. That is a bigger deal than just shipyard repair. You
have to lighten the ship of fuel and water and relocate all the
families with children to somewhere off the ship. We can't do it
here because we've already taken on too much fuel. The problem is, we're having trouble finding a dry dock with space for us in Cape Town. So, as you can see, plans and dates are still pretty fluid, developing and changing daily.

Faced with the prolonged sail, many people who came to help with the beginning of field service in Benin are going home early. Lots of goodbyes, and lots of rearrangements of staffing to cover the holes. I expected to work in the dining room for 2 weeks before transferring back to my "real" job on the eye team. I'm still in the dining room, and probably will be until late October. It is hard work, but not as hard as working in the galley or on deck crew. I get exhausted, but it is a good team to work with, and others do the really heavy lifting and mopping so I don't have to.

I appreciate their consideration!

All these details are not as fascinating as patient stories, but
perhaps it paints a picture of just what a complicated operation it
is to deploy the Africa Mercy to do those surgeries. Usually, all
that preparation happens smoothly in the background and doesn't get noticed, even by those of us who serve on the ship. Watching as these changing plans develop has made me appreciate all the more how many issues must be resolved to make a field service possible.

Now, if all goes according to the latest plan...I will celebrate my
70th birthday on the high seas, on my way to South Africa. My
chair might be rocking, but its not a "rocking chair." I'm on my
way to adventure in a far-away land. How crazy is that?

Marilyn Neville

[Click here to learn more about the nurses and doctors on board the Africa Mercy.]

Africa Mercy - Now What? One Nurse's Journey

August was a a month of unknowns for the Africa Mercy, when and where it would go. Read more about the ongoing Ebola crisis. Sharon



(This is a running email post written by a volunteer nurse serving on the Africa Mercy, a hospital ship that travels the African coast).

25 August 2014

"Now what?"

In the normal course of things, we spend a couple of months in Gran Canaria for shipyard maintenance, and then we sail to Tenerife (another Canary island about six hours away) to restock supplies before sailing to our next field service.  This summer, the ship did in fact get its scheduled maintenance and then sailed to Tenerife.  (That's where I rejoined the ship.).  Plans changed when Ebola hit Nigeria; we delayed our scheduled departure for Benin for a couple of weeks to watch the developments.

Meanwhile, on the sail between islands, we discovered a problem with one of our propellers.  As a result, the ship had trouble going forward and trouble stopping--probably something that should be attended to, right?

It turned out to be quite a puzzle.  For two weeks, the engineers hunted for the problem. Finally, digging deep into the guts of the thing, they discovered that a couple of O rings were defective.  Replacing O rings sounds easy--but we're talking about massive equipment buried in the bowels of a ship.  To repair it, we had to sail back to the shipyard, and they say it will take two weeks of work to dismantle and repair the propeller.  And so, now it will be at least another week of delay. Tentatively, they hope to sail to Africa around September 5th, if all goes well.

If you've been following the Ebola crisis, you know that the problem has been escalating dramatically.  Previous outbreaks have been located in small rural villages, where they were quarantined, stayed local, and petered out. This outbreak is in major cities, in populations that are mobile, and it just keeps growing.  Guinea seems to be leveling off, finally, but Liberia's problem has gone exponential  I can scarcely imagine the horrors going on there. It reminds me of the Black Death that ravaged Europe in the Middle Ages.  (Well, it's certainly not THAT bad yet...)

Lagos just reported two more cases, and they are second tier, one step removed from Patrick Sawyer's caregivers.  I was very much hoping that Nigeria had reacted quickly enough to contain the outbreak to include only those who were initially exposed to Patrick.  Now that it's gone to another level, will they be able to contain it at this point?  It seems very touch and go to me.

Both Uganda and Democratic Republic of Congo have now reported cases of Ebola, but apparently they are independent outbreaks of different strains, not a spread of the West African strain.  Possibly it is "business as usual" for these countries, where outbreaks occur most years in rural areas and are contained with quarantine.  Perhaps it is only our awareness of the problem that is different.

So, when and where are we going?  How will we conduct business once we are "there"?  Will we do mass screenings, or find patients some other way?  Etc., etc.  So many questions...and no answers yet.  And so, we wait and pray.

--

Marilyn Neville

[Click here to learn more about the nurses and doctors on board the Africa Mercy.]

Africa Mercy - How Our Reputation Spreads: One Nurse's Journey

 
A parting post from Marilyn in Africa on the Africa Mercy! She wanted to share one more story before she leaves.

---Sharon

(This is a running email post written by a volunteer nurse serving on the Africa Mercy, a hospital ship that travels the African coast).


How Our Reputation Spreads

17 April 2014

I thought I was done writing for now, but I'd like to share a story I heard yesterday from one of our day crew.  Jean Paul was walking in the marketplace, minding his own business, when a man called his name and proceeded to offer profuse thanks.  Jean Paul didn't recognize the fellow, but the man sure remembered Jean Paul, and others on the eye team, by name.

"I heard Mercy Ships was coming, so I took my blind mother to the main screening.  They turned her away, said that they couldn't help.  But I heard they were screening again at St. Pierre, so I took her there.  The crowd was so large that they cut off the screening two people ahead of me, and she didn't get seen.  I found out when the next St. Pierre screening was, and determined to spend the night waiting in line.  I gave my nephew money for a taxi to bring Mother in the morning.  Sure enough, they saw my mother and gave her an appointment for the clinic, and then for surgery."

We had to wait for the surgery day, of course, but the day came and she had surgery.  The next day, when they removed the eye patch, she could see!  I took her home, and she saw her 15-year-old granddaughter for the first time in ten years.  She knew her by voice, of course, but not by sight.  "Oh, you've grown up!" she exclaimed.  All the neighbors heard her rejoicing and came to hear the story, and now they all want their blind family members to have surgery, too."

Why did we turn her away at main screening?  Who knows?  We processed thousands of people that day (not all for eyes, of course).  It was long, hot, and grueling...I expect we didn't do the job perfectly.  Or maybe we suspected that the cataract was not the whole explanation for her blindness and that she wouldn't get a good result from surgery.  But aren't you impressed with the man's perseverance? I'm so glad he kept trying, and glad that she got such a good result.

Our reputation penetrates the city through stories such as this.  I expect that next time we come, we'll find many more people eager to come to us for surgery.

Marilyn

Africa Mercy - Goodbye Congo: One Nurse's Journey

A parting post from Marilyn in the Congo, as she prepares to come home for a break. Those of you following the Ebola outbreak in Guinea will find this
interesting. .....Sharon



(This is a running email post written by a volunteer nurse serving on the Africa Mercy, a hospital ship that travels the African coast).





Goodbye Congo
11 April 2014

Our time in Congo is fast drawing to a 

close. Because of the long follow-up required after cataract surgery, we have to stop surgery several weeks before the ship leaves the country. In fact, our last day of cataract surgery was yesterday. We will do some pterygium surgery next week because the follow-up is not so long for them, but after that, my job is done. The ship leaves Congo around June 1, but I will be leaving Apr 23rd, headed for the good ole USA and visits with family and friends.

As I was thinking about this email, a band of about 30 minstrels marched slowly up and down the hall outside the hospital wards, singing at the top of their voices, some of the dancing a bit, all of them harmonizing and moving from one praise song to the next without missing a beat. 

They were dressed in hospital gowns, and each carried a Foley bag (collects urine from a catheter). Who was this strange choir? The VVF ladies! VVF stands for vesicular vaginal fistula. This is a condition that can happen to a woman as a result of a long, difficult labor without proper medical attention. The baby's head presses so long on surrounding tissues that some of them die, leaving her internal plumbing a mess.


Many women die, of course. I've heard that one in ten women around here do die in childbirth. Many others survive, but with scar tissue and fistulas between the vagina and bladder and/or bowel. The incontinence makes them social outcasts. Husbands move on. Families put them in a shed out in back to sleep and eat and won't let them come into the house. It's not a nice life. 

Then Mercy Ship comes, and they get repair surgery. Recovery takes weeks, and the women are with us at least until the catheter can be removed. So our wards are brimming with very happy, hopeful, thankful women. No wonder they march up and down the hall several times a day, singing their thanksgiving and praise to God. We give each woman a new dress before she leaves to celebrate her recovery. I'll try to attach a photo of some of our decked-out ladies.

 I think I told you about the edict that we will not do eye surgery on anyone whose blood pressure is over 200/110. This is Africa. Probably half the population over the age of 40 has high blood pressure, and most of them don't take medication for it. We tell them to see their doctors and get on medication before surgery. We call them to remind them to take their medication before they come to the ship for surgery. But, pretty much every day, we have several people arrive with pressures over the limit. We tell them to take their medication if they've brought it with them; we tell them to relax, even take a nap. But mostly, we pray.

An amazing number of times, their pressure will eventually dip low enough to allow surgery...and then immediately rise again once we're finished. It feels like God's blessing, parting the "sea" to rescue these people. I can almost hear him chuckling, "I want these people to get help, so I'll make it possible, and never mind your rules."

One such fellow was our very last patient yesterday. He arrived early in the morning, as scheduled, but his blood pressure hovered around 230/125. He is only 50, but he has dense cataracts in both eyes. He could see hand motion, maybe even count fingers held in front of his face, but he is a teacher, and he needs better vision. He'd taken his medication as directed. He took a nap. Still, his pressure remained above the limits. 

He waited on the dock all day, and every time we brought a patient out after surgery, we'd check his pressure again. It dipped slightly, to about 210/115, but time was running out. We checked about 1:30...nope, still too high. Did he want to give up? No, he'd wait some more. More prayer. Finally, about 3:30, it dipped to 198/110. We rushed him onto the ship and did a fast prep for surgery to get him in as last case, just in the nick of time. It was a beautiful finale to our surgical year. Wouldn't it be fun to follow him home to see what a difference the surgery makes in his teaching and in his life?

As you know, we are supposed to go to Guinea for our next field service.

Now there's an Ebola outbreak in Guinea. We don't know if that will affect our ability to work there or not. Can you imagine a crowd of thousands gathering for our main screening, and then an epidemic breaks out? Ebola is spread by body fluid contact, so that's better than respiratory transmission when it comes to crowds...but hospital wards and surgical patients are abundant sources of body fluid contact. We have up to twenty patients, twenty caregivers, and half a dozen nurses and aides in a single room, and they mingle freely, use the same bathroom, etc. Mix in one Ebola patient... Well, Mercy Ships is studying the situation carefully, including our own on-the-ground assessments as well as WHO and other experts' input. They will make a careful decision and let us know.

Meanwhile, please pray for Guinea. It is quite possibly the most needy nation in our service area. They are too poor and too turbulent to attract foreign capital, but without outright war, they don't get international aide and rescue, either. Jobs are extremely scarce, and poverty is everywhere. Medical care is desperately needed. We always have more patients than we can handle every time we go there. It's like tossing the starfish back into the sea--you can't help them all, but you can make a difference to some. I really hope that conditions will allow us to go there next year. So...stay tuned...

Marilyn  











 




[Click here to learn more about the nurses and doctors on board the Africa Mercy]

Africa Mercy - A Small Piece of Plastic: One Nurse's Journey

Hi. Another post from Marilyn in Africa, my dear friend on board the Africa Mercy. Some of the blood pressure readings and sugar counts for diabetes are "pretty generous," she writes. In the United States they would be disqualifiers for all the surgeries the doctors do, but apparently, the medical staff has little choice. It's hard to fathom. As typical, Marilyn is positive and optimistic through it all.

I was also reading in the newspaper this morning about an Ebola outbreak in Guinea, where the ship sails next. The article said that the outbreak may be headed for Pointe Noire (Congo), where they are at present. Marilyn writes about the Aids epidemic and some of the tumors that result they are dealing with, but I worry about the Ebola virus headed their way. Those of you who pray, please remember Marilyn and the Mercy staff in your prayers!
---Sharon

(This is a running email post written by a volunteer nurse serving on the Africa Mercy, a hospital ship that travels the African coast).



(Pointe Noire, Congo)
 21 March 2014

It has been a long time since I've written. Time seems to melt like

Marilyn in front

butter around here! We have only 3 1/2 weeks of cataract surgeries remaining because our surgeries need to stop well before the ship leaves to allow time for proper followup. The ship leaves Congo the end of May, so our eye surgeries end mid-April. For myself, since the surgeries are done mid-April, I plan to leave for home shortly after that, and then return to the ship in early August, in plenty of time to sail for Guinea, our next port of call.

So, what have I been doing, week in and week out? In one sense, every week is about the same--preparing patients for surgery starting at 0645, sending the last one home around 4:30 or 5:00, on Monday through Thursday. Then, I am working with the field team and having meetings on Friday. On weekends, I do whatever personal chores need to be done, but mostly I rest.

But...that description is deceptive. It sounds regular, steady, predictable...but in reality, it certainly doesn't feel that way. It seems that every day brings unexpected twists and turns. Perhaps it will rain, destroying any "timetable" we think we have. Perhaps six patients will not come and we need to find substitutes...or two extra patients will show up on the wrong date and expect surgery. Perhaps the surgeon will go fast and have no complications, and we struggle to keep up. Or perhaps he's training another surgeon, and they go really, really slow. Or they suddenly start running two surgical tables simultaneously without telling us, and we can't get enough patients ready in time to keep them busy. We think they'll be done by noon! Oh, wait, complications pile up, and in fact they are not done until 6:00 PM. (Yes, we did have such a day...)

Our patients range from 14 to 98. Many younger children also have cataracts, but they require general anesthesia instead of a local nerve block, and this year, we do not have that capacity. In addition to having a surgeon skilled in working with children's cataracts, we would also need an anesthesiologist who works with children. The ones that we have are fully booked for other types of surgery this year. Perhaps, next time we come to Congo, we can help the children, too. I hope so.

We've tightened our policy concerning blood pressures and blood sugars. Our blood pressure limit is generous--200/110--but now we have to send patients home if their pressure is higher than that, instead of just giving them medication to lower the blood pressure temporarily for surgery. We tell them at screening to see their doctor and get it under control, and then we call them (if their phones work...) and remind them, and still, some days we have four or more people arriving with blood pressure over the limits. Sometimes, if we let them sit on the dock and wait a couple of hours, the pressure will come down. If it does, I sure don't take it again! If it doesn't, I eventually send them home to get better medication and return to the clinic for a recheck before we reschedule them for surgery. The procedure is the same for blood sugars. Our limit is 200, pretty tight control for a diabetic.

Uncontrolled diabetes really wrecks eyes, though, so maybe in the long run we do them a favor by demanding that they figure out how to get good control before we do surgery.

Actually, I've been amazed at how many blood pressures do drop to just barely within the limits, allowing surgery. We pray, of course, and it certainly looks like answers to prayer when their numbers drop from 254/125 to something like 198/110 or 200/106. Just barely under the wire feels like God puts his thumb on the number and pushes gently down.

If it happened once in a while, I'd think coincidence, but it happens so often that it feels deliberate. In my life, anyway, I find that God often does "just in time" and "just barely enough", almost like a fingerprint, so that I do see his hand at work in the situation. It's not the big, splashy answer...it's the still small voice.

Normally, we do two types of surgeries--cataracts and pterygiums. Pterygiums are growths of tissue caused by irritants like dust and sunlight. They grow gradually from the edge toward the center of the eye, and eventually obscure vision if not removed. Lately, however, we've done several patients who have a cancerous tumor that looks a lot like a pterygium, but isn't. This particular type of tumor is strongly associated with HIV infection, so we offer these patients a blood test if they want to know their status. It's a delicate situation because a diagnosis of HIV/AIDS can be socially devastating, and yet, anti-retroviral treatment is available for free in this country, so not telling them of our suspicions could deny them the chance to get early intervention and longer life.

Two of these patients are heavy on my heart tonight. One was a young pregnant woman we had last week. Her test came back positive. I wonder what her husband will say, and I wonder if the baby will be all right. We did get the tumor off her eye...but that pales in the light of her greater problems.

This week we had another young woman with an even larger tumor. It was so large, in fact, that the surgeon felt he couldn't remove it under local anesthesia. It took quite a bit of negotiation, but our team leader got her scheduled for general anesthesia next Tuesday. Alas, her blood test also came back positive, and her counts revealed that she has full-blown AIDS. Her counts are so low that I'm not sure they can proceed with the surgery--but again, that's the least of her problems.

I can only imagine what it must be like to think that someone is going to remove a small growth on your eye...well, no, it's too large... and it's not just a growth, it's cancer...it's not just cancer, it's associated with HIV...oops, you are not only HIV positive, you have AIDS and are too sick for surgery. Her world has crumbled step by step over the last week or so as we deliver one piece of bad news after another.

Meanwhile, many people are receiving their sight. If I have a stressful day, or if I focus too long on those we can't help, it is good to come back to that bottom line. Many people have their lives transformed by something as simple as a small piece of plastic cleverly lodged in their eye. Every once in a while, I try to walk down the hall with my eyes closed just to remember and appreciate the incredible blessing of being able to see. Hundreds of people in Pointe Noire are receiving this blessing, and I get to be a small part of making it happen. Now that's job satisfaction!

Marilyn


[Click here to learn more about the nurses and doctors on board the Africa Mercy]

Africa Mercy - Natural/ Supernatural Events: One Nurse's Journey

 
More from Marilyn in the Congo! Life is never the same, one day to the next.




08 Feb 2014
Natural/Supernatural Events

Greetings, my friends
T'is a weekend, and I am thankful for it. We've finished another week of surgery--where did the time go? The days ranged from "normal" (whatever that is...), to very stressful, to frustratingly unproductive--in other words, a typical week. No two days are the same, and they are all unpredictable. I live in a place where rain causes the city to grind to a halt for hours at a time, and it is the rainy season.  I work in a culture that views time and appointments differently--if you tell patients to come at 0630 on Tuesday, some of them will be there, but some will straggle in by 10:00 or 11:00, and a few will come on Monday or Thursday instead.

 If you tell them to take their blood pressure medicine before leaving home on the day of surgery, maybe half of them will do it. I haven't figured out why that happens. Are we not saying it correctly? Can they not afford the medicine? Have their doctors convinced them that they are cured of blood pressure problems with two weeks of medication? Is the word out that Mercy Ships will give them medicine to lower their blood pressure enough to allow surgery, so save yourself a pill? (We do that, usually.)

 So, a day like Tuesday happens now and then. It rained all night, so streets were flooded. The surgeon was eager to get an early start...but by starting time, we had only two patients qualified
for surgery and two with sky-high blood pressures. The other twelve patients hadn't come yet. We made multiple trips to the dock in the rain to bring in drenched patients as they gradually arrived over the next several hours. At one point I had four with elevated blood pressures, three or four that the doctor hadn't seen yet due to late arrival, two pterygium surgery patients (always  scheduled to be the last surgeries of the day), one or two whose cataract surgery was expected to be difficult and so scheduled for later in the day...and no patients qualified to send for surgery.

 The doctor was having to make compromises on who he would do next...and I was jumping this way and that trying to predict which ones I should be preparing for surgery in what order. Some I dilated early in anticipation that he would take them next, only to have them set aside. Others I had to scramble to get ready, and even sent them for surgery not fully dilated. Two patients never did arrive, but we did eventually manage to get the surgeries done on the rest. All's well that ends well, but it was a stressful day.

 Meanwhile, glorious things were happening down the hall. We have a  dental program. They do fillings and cleanings, but they also do a lot of extractions for teeth that are too far gone to save. They did an extraction for one man who had quite an abscess under that tooth. The infection spread quickly and he became deathly ill.

 They admitted him to the hospital for treatment, but he quickly deteriorated to the point of needing intubation and life support. He had aspirated pus, and was in dreadful condition. They actually had to cancel a day of surgery so that the anesthesiologist could attend him 24/7, and even at that, he was not expected to live.

 The hospital administrator later told us that it was technically impossible for the man to recover. His death was so certain that the administrator had already begun the paperwork required for a death on the ship. But, a call for prayer went out, and many prayed, including the kids in the academy. I think the Lord listens to the prayers of children with special attention. At any rate, it seems that He did intervene, interrupting the normal course of this man's crisis. 

 Imagine the administrator's surprise to find that not only was the man not dead the next morning, he was off the ventilator, out of  bed, and sitting in a chair, dramatically recovered. It doesn't happen that way very often, but when it does...hallelujah. 

So there you have it, the lows and highs of the week.

Marilyn


[Click here to learn more about the nurses and doctors on board the Africa Mercy]

Africa Mercy - Ravette's Story: One Nurse's Journey

 

From Marilyn in the Congo! A nice story about a girl named Ravette. 



Mercy Ships newsletter--Feb 2014

Look what I discovered! Mercy Ships puts out a newsletter for us to use to tell you folks about what goes on around here. After all, the Mercy Ships story is bigger than just the cataract surgeries I am involved with. So, here’s a real-time story of a different surgery that happened here recently.

Step By Step to a Brighter Future:  

The plane’s shadow followed the trail of the Congo River to the wide Atlantic – to the ship, they said, that offered free surgery. Vivianne held tightly to the two government-purchased travel tickets as she prayed for her wide-eyed, beautiful daughter, Ravette, who sat beside her and stared out the window with fascination. Maybe, just maybe, the ship would save Ravette. And, in the process, it would save Vivianne, too. The two have travelled light. They left much behind – the disappointment over the lack of medical care; the brutal breaking of Ravette’s legs by the traditional medicine man; the lifelong ridicule; the helplessness; the hopelessness – all of this was too heavy to pack.

Ravette has lived her eleven years of life with a deformity known as genu recurvatum, which loosely translates as “backward-bending knee.” It is a congenital dislocation of the knee. Ravette     struggled to walk, to sit in a car or chair, to climb a staircase, and even to attend school. The most remarkable thing about Ravette, however, is not her deformity. It is her beautiful, ever-constant smile. No matter what goes on, even if it’s painful or tedious, Ravette is always smiling. This glowing smile illuminated her face when she met Dr. Frank Haydon, a Mercy Ships volunteer orthopedic surgeon from the United States. 

Dr. Frank smiled back as he cast an expert eye over her legs and made his assessment: “At this age, the knees are now deformed and won’t bend normally, but we can make them straight.” Ravette and Vivianne were shown before-and-after images of a boy  named Abel, who came to the ship during the Togo field service. Abel had the same severe case of genu recurvatum. They watched a video of Abel walking down a hallway with straight legs. “It was then that I believed my daughter could really be saved,” said Vivianne.

Prior to surgery, Ravette’s legs were placed in the first of a series of specialty orthopedic casts that would gradually stretch her legs. This process would increase the bendability in her soon-to-be-straightened legs. Surgery has since come and gone for Ravette. Hobbling around the wards with her crutches, she is always finding ways to have fun. Whether she’s playing with the
Paint program on an old computer or mimicking her crew friends’ English in a singsong voice – “I’m fine, ow are yooouu?” – she creates smiles and laughter.

Ravette

There are many more steps ahead on Ravette’s road to recovery. Gradually and progressively, casts and braces will be removed until the bones are strong enough for Ravette to walk with straight legs  and no assistance. You may be wondering what’s next for Ravette and her mother as they board another plane to go home. Ravette is clear about her plans for the future, as she states firmly, “I want to find a job in an office working on a computer. I will be a boss!” And then she adds, “But, first, I will tell other people who suffer to come on the ship to be saved like me.” Her mother smiles and replies, “Yes, and so they can be saved like me, too.”

Yes, step by step, cast by cast, Ravette is making her way to a brighter future. I couldn't figure out how to give you the newsletter intact, so the words are above, and the picture of Ravette is attached (I think). Hope you enjoy the story. I did. 

Marilyn
 
[Click here to learn more about the nurses and doctors on board the Africa Mercy.]

 

Africa Mercy - Square Wheels: One Nurse's Journey

Hi....another email post from Marilyn in the Congo on the Africa Mercy! The challenges continue, this time with a large turn-over of personnel and translator problems, but the beauty of Mercy's mission to aid those who otherwise lack access to health care has not changed and God continues to provide.

Marilyn is now on Facebook and I urge all of you interested in her  journey to connect with her there. She has posted some new photos. You might want to mention you discovered her at my blog, so she doesn't think you are some spammer. For now, I will continue to post her letters.

(This is a running email post written by a volunteer nurse serving on the Africa Mercy, a hospital ship that travels the African coast. In your charitable donations please remember this worthy organization).


January 19, 2014
Square Wheels

 In honor of the new year, I've started something new--facebook! Not that I know what I'm doing... Anyway, if you want to "friend" me and I haven't found you to ask you yet, maybe you could let me know how to find you on facebook, if you are there. Hopefully, the more savvy folks around me will help me to figure out privacy settings, messages vs. timelines, and so forth. And maybe facebook will help me to know what's going on in your worlds, if I can figure out how to navigate it without spending all my waking hours poking around.

We've had three weeks of surgery since the Christmas break. They have been difficult weeks, in a way. There's a large turnover in personnel at the end of the year, a problem that seems to have affected the OR particularly hard. Not only did we have a new surgeon, we had a new team leader in the eye OR, new nurses to assist and to scrub, and new translators. They had to reinvent the wheel back there, it seems, and that slows things down. Then, they were having a lot of difficulty with the new translators not showing up for work on time and taking unseemly long breaks when they did show up. Our eye patients only get a local anesthetic, and they need to be able to cooperate with instructions during surgery. The whole system breaks down if we can't communicate.

The OR solved that problem by borrowing one of our translators from the peri-op room. Ordinarily, that would have been a hardship for us, but the OR was working so slowly that we didn't have any trouble keeping up with them.

Because of the difficulties in OR, our work in the peri-op room was tedious, with long hours of boredom waiting for patients. We start more than an hour before the OR does, preparing the patients, and we stay half an hour after they do to discharge patients, so we were "working" eleven hour days, but accomplishing little, with only ten patients per day. After a couple of weeks of this, our day crew got restive. The harmony of our little team started breaking down. When we keep them until after 4:00 or 5:00 PM, it becomes difficult and expensive for them to get home; they started demanding changes. We are looking at some options, but haven't solved the problems yet. It has been a bit disheartening to see the camaraderie of our team fraying at the edges.

One obvious solution is to do fewer surgeries until the OR team gets up to speed. That is not a good solution for a couple of reasons: 1. fewer patients receive their sight (this is the reason that resonates with me...), and 2. we are under a tremendous amount of pressure to reach our target numbers to keep both the donors and the Congolese government happy. (sorry, my gut reaction to that isn't very nice.

Maybe it's a good thing I'm not the manager who has to deal with these realities.) Compounding the problem, one surgeon scheduled for two weeks in February just canceled, and last-minute efforts to fill the gap were unsuccessful. So, that's another 100-120 surgeries not able to be done. Our team leader is trying to make up some of the difference by pushing the surgeons she does have lined up to do more surgeries each day than originally planned. In the peri-op room, it feels like we're between a rock and a hard place...

Have you ever contemplated the mystery of life? For an organism to survive, every single function of the body must be in working condition at all times. If the heart misses 6 beats, you're toast. If the liver, if the kidney, if the brain... Have you noticed that even when you have something as minor as an infected toe, it affects the whole body? So it is with organizations trying to perform complicated tasks. If you haven't got a translator, if someone in the home office fails to order supplies, if a surgeon's family member gets sick, if, if, if... you have to have it all, or you have nothing. 

While not as complicated as what even a single cell must do to stay alive, still I find it a marvel that Mercy Ships can keep on functioning despite the obstacles that arise. When everything is functioning smoothly, we're traveling on nice round wheels. These last few weeks have felt like square wheels most of the time, and one day, I declared we even had triangular wheels. Not a smooth ride! And yet, still I see the Lord's hand of provision. Patients continue to receive sight. We do still function as a team despite the challenges. The mission of Mercy Ships goes forward, pretty much on course. 

Blessings,
Marilyn


[Click here to learn more about the nurses and doctors on board the Africa Mercy.]

Africa Mercy - Heartwarming Stories: One Nurse's Journey

Just in time for Christmas, here are two heartwarming stories from Marilyn in the Congo. Learn more about the African people this amazing ship serves, and how faith in God is behind it all. ---Sharon


(This is a running email post written by a volunteer nurse serving on the Africa Mercy, a hospital ship that travels the African coast. In your charitable donations please remember this worthy organization).

December 20, 2013

Greetings, my friends,

I like to share two stories with you, stories that make me smile, stories that make me grateful to God not only for my own blessings and good health, but also for the privilege of being here to help extend God's compassion to the people of Congo.

Earlier this week, our field team conducted a routine eye screening at a small out-of-the-way church in one of the residential neighborhoods of Pointe Noire. What wasn't routine, however, was the appearance of one of the first people in line. A twelve year old boy stood there with his father, his face disfigured by a large, weeping tumor covered in bandages. Nothing wrong with his eyes? Good, go home!  Next!...No, that's not how it played out.

He wasn't a candidate for cataract surgery, but he sure would have been a candidate for maxiofacial surgery, had we been screening for that. So, stop the presses. What can we do? Ask more questions.

It turns out that the boy lives far away, and they only heard about    Mercy Ships last week.  Filled with hope, father and son traveled for ten hours to reach the ship.  They couldn't find a screening for tumor surgery (that was done last September...), but undeterred, they sought us out anyway by coming to the eye screening site. How they found us at that little church, I'll never know.

It took a few phone calls, but we got clearance to bring the boy to the ship for further work-up on that very day.  He and his father rode to the ship in the eye team vehicle after the screening was done. That boy was radiant with joy, and full of hope. By the end of the day, he'd had a CAT scan and lab work done; he'll most likely have surgery sometime in January.  What a different life he'll have without that tumor on his face. What initiative and perseverence his father showed to give him that chance.

My second story concerns a young man, age 19, who has been completely blind for many years with dense cataracts.  His mother was afraid for him and refused to allow surgery by the local surgeons. (From what I have seen, she was probably wise in that decision...) Sadly, his mother died a year ago, so now he lives with his aunt. Mercy Ships came to town, and together, they decided to risk surgery. He had his first cataract surgery a week ago. He was brave, but during surgery, he called out to mama...her dreams for his future, grief, and hope all intermingled in that one word.  Well, her dreams and his hope were rewarded--he had nearly perfect vision in that eye even on the day after surgery.

A week later, we operated on his other eye. Oh, oh. According to the measurements, he needed a very different lens in that eye--four diopters different, which is huge. That's not usually the case--people's eyes tend to come in a matched set. What to do? Were the measurements wrong? Dr. Wodome, a very competent and confident surgeon, was in a dilemma over which lens to implant, one that matched the measurements, or one that matched the other eye, since that one had worked so well? The team stopped for prayer, and the surgeon chose to match the lens to the measurements. Results? Nearly perfect vision in the second eye also. His two eyeballs really were different lengths. It's good to work with a surgeon who seeks God's guidance in making decisions.

A new year is soon here, and what blessings will we find awaiting us? I feel like I'm living in a wonderful pagaent of God's grace. It reminds me of the Exodus miracles--not so dramatic, of course, but clear evidence all around me of His compassion and His active involvement in the affairs of men. I am blessed every day just by being here, in my ringside seat.

Marilyn 



[Click here to learn more about the nurses and doctors on board the Africa Mercy.]

Africa Mercy - Christmas and Cataracts: One Nurse's Journey

Still aboard the Africa Mercy in the Congo, Marilyn talks about Christmas in Africa and on the ship. As the crew members come from nearly 30 different nations, you can just imagine the variation in customs. Meanwhile, the eye surgeries continue . . . and she shares a typical day. ---Sharon

(This is a running email post written by a volunteer nurse serving on the Africa Mercy, a hospital ship that travels the African coast. In your charitable donations please remember this worthy organization).

Dec 7, 2013

Christmas greetings, my friends

Christmas in Africa.  What is that like?  From outward appearances, it seems like it isn't a public event here, despite the fact that this nation is overwhelmingly Christian. There are no decorations around the town. There is no Christmas music playing in stores (they're just stalls, without electricity, not proper stores). There is no blitz of advertising, urging me to shop 'til I drop. In fact, I see no evidence of preparation at all. When we ask the Congolese day crew about their plans, it sounds like most of them plan to go to church that morning and then spend the rest of the day with family, maybe have a nice meal together.

Christmas on the African Mercy. What is that like? For a while, I thought maybe it was going to be a low key event. Then, a week ago, the ship suddenly blossomed with decorations--artificial trees (we have room to store those all year???), door decorations, cloth wreaths, trimmings everywhere you look. No candles and no live evergreens--it is a ship with maritime regulations, after all, and we are in Africa. The crew comes from about 30 different nations, and it seems we've all brought our cultures and traditions with us. The Dutchies had their version of Santa Claus last night--all the children had to do a trick for Santa, and then they got treats. Other nations will have events on other nights. This evening they  had a Winter Bazaar--it seems that quite a few crew members make craft items to sell, and tonight was the carnival to show their wares. I'm told we'll have a very nice brunch on Christmas morning, and of course we have our religious celebrations throughout Advent. I even hear rumors of a candlelight service Christmas eve--on the dock, of course, fire regulations being what they are. What is pleasantly missing, however, is the constant advertising, the obsessive shopping, the obligatory parties, the secular songs that celebrate everything but Jesus, and the frantic pace that so often blurs the holiday at home. I think that I'll enjoy Christmas quite a bit this year.

 Also missing is winter weather, something that is strongly

associated with Christmas in my head.  Just after the decorations went up, a friend exclaimed, "it's snowing!" She meant it was snowing at home, of course, but for just a moment, I really expected frosty air and snow flurries outside. I was almost ready to go see for myself--and then I remembered, I'm in Africa. It is hot even when it rains, and I doubt they've ever seen frost or snow here. It's just not Christmas weather, to me.

Meanwhile, we have started cataract surgeries in earnest. This year was slow starting because we lacked surgeons for several weeks, but now we have surgeons coming nonstop through the end of field service next May.  Each surgeon comes for two or three weeks, and then we get another one.  Each surgeon has their own specifications and quirks, so it seems like we are always on a learning curve, changing things to suit them. Never a dull moment! But it is certainly rewarding work.  Each day brings 12-20 people with dense cataracts to receive life-transforming, sight-restoring  surgery. It still thrills me to think that I can play a small part in this great blessing.

Every day is different, but let me describe a "typical" day. I usually wake up before the alarm rings, which is good, because my bunkmate doesn't need to get up as early as I do. I get dressed in the dark, having carefully laid out everything I need the night before. Breakfast starts at 06:00 so I grab a quick bite, because I need to begin the work day by 06:45. Fortunately, the "commute" to work only takes a minute or two (and no scraping my windshield or shoveling my driveway...) After a quick prayer, the team goes out to the dock to fetch our patients on board.  That's no easy task! They are blind and usually old. Walking is difficult, and they need to walk up the gangway (42 steps), into an unfamiliar  environment, down two flights of stairs, and down the hall to the peri-op room. Some of them are really, really slow and need lots of help.  Once the first batch of patients arrives in the room, we get their name bands on, their eyes checked, their vital signs done, their dilating drops administered, the pre-op teaching done, and take the first three to the bathroom--all before the surgeon comes to examine patients around 0745 or 0800. It takes all five of us working at top speed to get the first patients ready for surgery on time.  I feel like I've done a day's work by 0830 or 0900, when the pace finally slows down a little.

After the initial surge, I have time to deal with the little problems that come along--the diabetic with a blood sugar of 400, the three or four people who have blood pressures of 230/120 or thereabouts, the one with a fever, the patient or two who are missing vital measurements of their eye that the surgeon uses to choose a lens. Often, it seems, there's a media team from somewhere who just have to have a story by following one or more of our patients through the whole process. They bring their big cameras and microphones and generally get in the way and slow things down. But, telling the world about what we do brings in the finances so that we can keep on doing it.

Eventually, we hit a steady state--taking patients down the hall to     the bathroom, taking them to surgery, and receiving patients back from surgery about every twenty minutes or so. Naturally, when they come out of surgery, we need to check them over, give them meds and instructions, and walk them back out to the dock, which is just as difficult as bringing them into the ship initially. Once we reach steady state, we have a little time to spare. Often, we engage the patients in singing worship songs.  The whole mood of the room mellows out. Most of the patients smile and sing along readily. You should see their delight when I get them up to dance with me while we sing!

The surgical team breaks for lunch at some point, which interrupts the steady state flow. We don't get a break, of course, because we still have a room full of patients to tend to. We need to finish with the last of the morning patients and escort them off the ship, and we need to begin the prep for the afternoon patients, to have them ready for when the surgery team gets back. We do get to eat lunch, of course, by taking turns, but it is eat and run so that the next person can go to lunch, too.   

Somewhere between 2:00 and 4:30, we get the last patients off the ship, and we're done for the day--except to prepare for tomorrow. We get the room cleaned and ready, supplies restocked, and charts checked.  Statistics, ordering more supplies, dealing with emails...all the usual stuff. I'm seriously dragging by suppertime. I tend to work to exhaustion, not realizing how tired I am until I stop moving for a moment--and then it's too late. I am trying to learn to pace myself, take proper breaks, delegate tasks appropriately, and be less of a perfectionist. I need to think like a marathon runner, not a sprinter. Well, that's the goal,    anyway.

One of the really good Christmas traditions we have, in my opinion, is the annual "Christmas letter." I look forward to hearing from many of you about your fortunes in the year gone by and your dreams for the year to come. I wish you all good health and peace as you pace yourselves through this holiday season. 

Blessings, Marilyn

[Click here to learn more about the nurses and doctors on board the Africa Mercy.]