Goodbyes and Cleaning

I'm down to my last few days in Sierra Leone, and probably won't have much time to blog this week, so here's a quick update.

After an energetic worship service with the patients in the wards, we slowly sent each one of them home last week and shut down the hospital. There have been lots of goodbyes lately - not only are the patients gone, but so are our day volunteers (locals who work on the ship as translators, housekeepers, deck hands, and help in the hospital). We had a celebration on Friday to say thank-you to all of our day volunteers, and there were lots of tears as everyone hugged goodbye. The crew have also been trickling out; every Monday and Thursday a crowd gathers on the dock to send off the Land Rovers full of crew members and their baggage, headed to the airport. We're down to just 3 people in my 6-bunk cabin, and soon Julie will be all alone, as Rachel and I leave this Thursday!

Although the surgeries have stopped and the hospital is closed there is still quite a bit of work to be done before the ship will be ready to sail. This morning all the remaining nurses, about 30 or so, gathered in B ward for a time of worship and devotions before we donned our rubber gloves and got to work scrubbing and bleaching every inch of the hospital. I spent the morning outside on the dock, helping the dental team pack up all their equipment into a shipping container that will now be lifted up onto the top deck of the ship with the crane. Many hands made light work, and we were completely finished before lunchtime! After lunch and another round of goodbyes as more crew headed to the airport, I went down to the ward and joined the cleaning team. We have our own ways of making cleaning fun. Imagine about 8 nurses, wearing scrubs rolled up to their knees and blue rubber gloves on their hands, holding sponges and spray bottles. The main lights are turned off, but the emergency alarm light is on, flashing like a disco ball. "All the Single Ladies" is blaring out of the little computer speakers, and rather than wiping down cabinets or sorting dressing supplies, the nurses are just dancing around the half-empty ward and singing. Yep, that was my afternoon. After the dance party we got back to work, but first put the movie "Grease" on the TV's and sang along to "Summer Days" and "Beauty School Dropout" while we cleaned.

Now I have the evening free, and am trying to get up the motivation to go start sorting my stuff and packing for home. I might just end up in the cafe playing cards with friends instead...

Thanksgiving on the Africa Mercy

A month ago our galley staff cooked up a lovely turkey dinner in honor of Canada's Thanksgiving day, and today we got to enjoy another Thanksgiving dinner for the Americans onboard. All day my American friends and I have been trying to explain to our non-American friends why we celebrate Thanksgiving. It's made for some entertaining conversations.

Brit: "So...the pilgrims, from England, were thankful to the Indians that they didn't starve?"

Canadian: "Yeah, and then they gave the Indians smallpox blankets."

American: "They didn't know the blankets had smallpox on them!"

Brit: "England's such a small country, but it's interesting how we're involved in everything."

American: "We were trying to get away from you!"

I ate dinner with 3 nurses from the United Kingdom, and when we sat down to eat Jess looked at me, the lone American at the table, and said "is there something we're supposed to do? Do we have to sing a song or say something special before we can eat?"

I'd already started eating. Oops. "Um, well, sometimes my family all goes around the table and everyone says something they're thankful for." So we did that, and then I got back to my turkey and mashed potatoes. Yum!

I didn't get very far though before Larry, an older gentleman from somewhere in America, stood up and rang the bell. There's a bell in the middle of our dining room that people ring when they want to make an announcement during a meal. Usually it's an announcement for someone's birthday, and everyone in the dining room sings happy birthday. Today, Larry stood up and said something nice and nostalgic about it being Thanksgiving, and then added "and I'd like all the Americans to join me in singing God Bless America."

What followed was a half-hearted rendition of what sort of sounded like 'God Bless America,' but nobody really knew all the words, and everyone was off-key. Every time I tried to sing I just heard how off-key everyone was, and started laughing, which made me start coughing. I've had a cough for about 3 weeks now. Anyway...the Thanksgiving song fell rather flat, but the meal was lovely. I miss my mama's cornbread stuffing and sweet potato pudding, but dinner was still really good. And a few hours later we all gathered in the cafe and had delicious apple pie and ice cream! All in all, it was a nice Thanksgiving. I have so much to be thankful for right now, I can't even begin to list it all.

Happy Thanksgiving!

You know you're ready to go home when Disney makes you cry

So, I was watching a Disney princess movie with Jess this afternoon before work, and in the middle of the sappy part we looked at each other to find that both our chins were quivering.

Me: *sniff*

Jess: "Does this make you think of Pat?"

Me: "Yes!"

Jess: "I miss Fraser. I think it's time we went home."

Me: "Uh-huh."

Preparing for Goodbye

It's after midnight, and I'm in an eyes-glazed-over-and-contacts-dried-out state of sleep deprivation and should really be going to bed, but the mood is upon me to write, so here I am. Forgive me, I'm in a strange mood.

T-minus-ten days til I pack up my bags, turn in my room key, and walk down the gangway of the Africa Mercy for the last time. Sometimes I accidentally call it the gangplank, not the gangway. But no worries, the captain hasn't made anyone walk the plank yet. I don't think we even have a plank.

I've been on night shift for the past 4 nights. Thursday was the last day of surgeries, so the patients left on the ward have all been here for awhile. That means there was hardly anything for me to do during my shifts. All my patients slept soundly, hardly needed anything, and after I did everyone's vital signs and assessments at 10:00, I had practically no work to do for the rest of the night. I did lots of reading, knitting, and looking at photos on the computer.

My dear friend and bunkmate Rachael said goodbye and headed back to England today. She and I have been through a lot together the past 5 months, and it was definitely a hard goodbye. After wiping the tears away, I went down to my room, saw her empty bed, and started crying again. Another good friend, Kari, went home today also. It's hard to see the crew dwindling away as people leave, and it made me wish that it was me going home today instead so I could just have it all over with. The flight from Freetown to Brussels only goes out on Mondays and Thursdays, and the rest of my Mondays and Thursdays here are going to be full of goodbyes. But that's the nature of Mercy Ships, and really it's the nature of life. Life is constantly changing, people come and go, transitions are made.

We're also saying goodbye to patients, as the hospital is closing for good this Friday. I wrote about that some the other day, regarding Aminata. There are other patients whose wounds haven't finished healing, or who need more surgeries, and it's hard to leave them before the job is done. But I know that even if the ship stayed and the hospital continued operating, the job would never be done. There will always be more people who need care, more stubborn wounds that won't close up, more complications. We just have to do what we can, the best that we can, and leave these people in God's hands. Some of the patients who need further surgeries in the future have been given instructions to travel to Guinea when the ship is there for a field service next year. Others have been referred to local hospitals that have agreed to partner with us in providing follow-up care. And still others simply will be given the best teaching we can, and we'll hope that they follow instructions at home and recover without complication. Please pray for these patients, that their wounds will heal quickly, that the ones experiencing pain would have relief, and that their home situations would be conducive to recovery.

Although part of me wishes that it had been me packing up and heading home today, another part of me knows that the next 10 days are going to fly by. Tomorrow I have the day off, and plan to spend it hiking with friends. Wednesday and Thursday will be my last 2 shifts on the ward, and Friday I'll be working a "cleaning" shift as we scrub down and pack up the hospital. After a weekend off, I'll be cleaning again on Monday and Tuesday. Next Wednesday will be spent completing the checklists and paperwork I have to do before leaving, and packing up and cleaning my room. Then Thursday I'll take the ferry across the harbor to the airport, and wave goodbye to Sierra Leone! It's a strange feeling. Lots of thoughts and feelings and emotions. But I've run out of words for now, so I'm heading for bed.

Our Princess

When I first arrived in Sierra Leone and found out that I would be taking care of both adults AND children on the wards, I was nervous. My last experience in pediatrics was my limited clinical time in college, and I was (and still am, to some extent) very insecure about my abilities as a peds nurse. One of my first little patients way back in June was Aminata, a baby with a big tumor growing underneath her jaw. She was severely malnourished and developmentally delayed when she came to us, so she was put on the infant feeding program to get her healthy enough for surgery. I remember when we were taking care of her in June, Ami was very lethargic and didn't even have the energy to cry or kick her legs. Her arms and legs were much too skinny in proportion to the rest of her body, and her hair was thin and pale.

After staying in the hospital for awhile on tube feedings, she and her mother were sent to live at the Hope Center while she continued to fatten up before surgery. Over the next few months, Ami slowly gained weight and began acting more and more like the 2-year-old she is. Finally she was healthy enough to undergo surgery! All the nurses were so excited to see her back in the hospital, and she quickly became the Princess of D Ward. I remember one day I looked over and saw a group of our day volunteers gathered around Ami's bed, playing the guitar and singing to her. She had the biggest smile on her face, and was waving her arms at them while they sang.

In the operating room, the surgeons found that the tumor was much bigger than they'd anticipated. They had to do quite a bit of "digging" to get it all out, and as a result Aminata had a lot of swelling around her throat after the procedure. She came back to us intubated and breathing on a ventilator, and took up residence in the ICU. She had one-on-one care from nurses with pediatric ICU experience, and lots of visitors over the next few weeks. One evening as I was getting ready for my shift, I heard an announcement come on the overhead speakers: "Emergency medical team to the ICU!" My heart sank when I heard that; I knew we only had one patient in the ICU at the time. When I showed up in the ward for work, a crowd was gathered around Ami's bed. Despite being sedated, she had pulled her breathing tube out and there was too much swelling around her throat to put a new one in. As the doctors and emergency medical team were working, all the D Ward nurses waited nervously next door. At one point our team leader, Natalie, looked up at us and said "Are you guys ok? I think I'm more worried about you than Aminata!" Several of us were close to tears, worried about our little princess. Ami was rushed down the hall to the operating room to have a tracheostomy placed, and she came back to us on the ventilator again.

It was a long, slow process, but eventually the swelling went down enough for Ami to start breathing on her own and come off the ventilator. Her trach site healed up, but she had a pretty nasty respiratory infection after that. Several more weeks on antibiotics and tube feedings had her slowly but surely feeling better. She's been going back and forth between the Hope Center and the hospital since getting her feeding tube out, and is brighter-eyed and happier than ever these days. It's really amazing to see the change in her, since having taken care of her back in June. She's definitely fattened up since then, loves to play with the nurses, and smiles all the time. Her hair is healthy, and her legs are strong enough for her to start learning how to walk!

Despite the improvements, Aminata's tumor may return, and her chest infection never quite went away. And the ship is leaving in December. Leaving Ami before she's completely healed is something we're all struggling with. It's hard to leave before the problem is fixed. It's hard to go home to a country where I have immediate access to whatever healthcare I need, when the people I leave behind don't have enough medicine or doctors or food or clean water. All of Ami's memories are here on the ship; what's she going to think when all of a sudden, we're gone? Her home is probably not a very clean environment; what if her infection gets worse? One of my coworkers reminded me the other day: God brought Aminata to us. He was with her all along, and He'll still be with her when we leave.

Snippets from the Ward

During handover yesterday, we had a little worship time and prayer in B ward. After the nurses finished praying I heard someone behind me calling "Root! come." It was Isatu, and she was gesturing for me to come over, saying "you pray for me." So I went over, took her hands, and prayed for her. Then I said "now you pray for me" and she took my hands and did. It was the best way to start a shift.

We have the cutest little cleft lip baby named Alpha on D ward right now. Since he was born with a cleft lip, he never learned how to suck, so he has to be fed formula with a spoon or syringe. The other day he was crying and screaming for food, and by the time Jess got the formula mixed up and sat down to feed him, he was quite a pathetic little mess. He was hungry so he was trying to eat, but not used to breathing differently yet after the surgery, so he kept choking. On top of that he was mad so he was crying and kicking, and he may have had a dose of lactulose, which was making things get rather squishy in that diaper of his. Poor little Alpha was just an angry, spluttering, burping, farting, hungry mess. In between the gasps and coughs, Jess managed to squirt enough formula in his mouth to satisfy him, and in the end he was content and fell asleep.

Yesterday I went down the hall to fetch something from the kitchen, and heard quite the commotion down by A ward. A few of the nurses and plastics kids were having a bowling tournament in the hallway with a plastic toy bowling ball, using empty pediasure bottles for bowling pins. They looked like they were having a blast.

During some down time when I had nothing to do yesterday evening, I just sat down on a stool and Kadiatu, my wild woman, came and crawled up on my lap. She started nodding off so I carried her to bed. Her dad called me back as I was walking away and said "she needs nappy!" I hadn't realized that she was sitting in my lap for 20 minutes without a diaper on. Glad I didn't find that out the hard way.

Taking care of kids, I've had lots of medicine spit back out into my face. My little 13-month-old patient Esther was quite a surprise yesterday when she saw me coming with a syringe full of her antibiotics. She sat up, crawled over to me, and sweetly tilted her head up with her mouth open. I squirted the medicine in, and she just swallowed it without a fuss! What a nice treat for me - no metronidazole splattered across my scrubs or anything. :)

We have a little girl named Sia who has Burkitt's lymphoma, a nasty cancer causing huge facial tumors. Usually we would have cared for her through the Burkitt's program we have on the ship, but since it's the end of the outreach, the Burkitt's program is shut down and we aren't able to finish her chemotherapy treatments. Instead, we're sending Sia and her mother and little sister to a hospital in Guinea to complete the chemo. Mercy Ships is paying for the medical care, but there was a bit of an issue finding the money to pay for their transportation and lodging, and the patient life team was working to find donations. The other day our team leader Natalie came running into the ward with some great news - she had been talking to one of the patient life people upstairs in the cafe, about how much money they would need to take care of Sia and her family for the next few months in Guinea. A lady in the cafe came over and said "excuse me - I don't mean to be eavesdropping - but are you talking about a child? I have some money set aside from one of my donors that's meant to go to help a child, and I've been wondering how I could find a child to help." The money the woman had set aside was just the right amount to help Sia. Isn't God amazing?!

At the end of my shift last night I grabbed my water bottle, and Kadiatu immediately started waving goodbye to me. She's figured out that when the nurses pick up their water bottles, they're leaving for the day. So cute!

Kadiatu and her dad

Sweet Sia and her little sister

On the Road to Freetown

Last Saturday I got up early and headed to the beach with Rachael, Sarah, Fran, Kari, Julie, and Mona. It was a fabulous day from the very beginning. Usually a trip to the beach starts by walking up Bad Boy Lane, flagging down a poda poda or taxi and arguing for 30 minutes about prices. But Friday night Rachael asked one of the local day volunteers who works on the ward to call and arrange transportation for us. Saturday morning there was a poda waiting for us on the other side of the iron gates at the dock - on time and for a reasonable price. After an hour-and-45-minutes bumpy ride through town we arrived at the beach. Amazing waves, warm sunshine, good friends, delicious food (barracuda and cous cous!), and a little shopping made for a great day.

I didn't take many pictures on the beach, but tried to take a bunch on the way back, of the countryside between the beach and Freetown. Here's what I managed to get out the window of the poda poda:

The ride back through Freetown was highly entertaining. People are used to just jumping into a poda whenever they slow down enough, and our driver had to explain to several people that ours was taken. One person hopped in the front seat and the driver quickly told him that he had to leave. The man turned around, saw all us white women, and apologized profusely. Then he looked at Rachael and said "I love you!" Rachael responded "no, you do NOT love me! And I am not having this conversation." The man left and our driver shook his head, telling Rachael "Ah, you have broken his heart." Everyone had a good laugh over that one. At another point in the drive someone on the street saw us and yelled "Eh! Americans!" Rachael tapped our driver's shoulder and said, "Excuse me, just so you know, I am NOT American. I am British! And SHE (pointing to Julie next to her) is Canadian. So you just tell him that next time you see him." Later we looked out and saw someone in a strange costume making his way down the street. He was wearing a mask and had bundles of sticks coming out his sleeves where his hands should have been. We tried to get an explanation from the driver, but weren't really sure what the occasion was. Some kind of festival or holiday we think. When we were almost home, there was a slight disturbance on the street. A taxi had broken down in the middle of the road and stopped traffic. There was a lot of angry yelling out on the street, and it kept getting more and more crowded as people tried to get where they were going. There was a small space open behind the broken-down taxi where we needed to turn, and the driver just went for it. While we were all distracted by the commotion caused by the roadblock, Fran, who was sitting close to the front, screamed. We all looked out the other window and saw 4 bulls charging down the road, headed straight for us! A man running behind them was frantically beating them with a stick, trying to redirect their path. What in the world - there's never a dull moment in Africa. Thankfully the bulls missed us, and we escaped being gorged by their horns. Fran was a little shaken up for the rest of the ride home, understandably.

By the time we successfully made it back to the ship we'd missed dinner, so after washing off the sand and sea water, we headed to the crew galley to make a big pot of mac-n-cheese and laugh about the adventures we'd had together.

Faces to go with the names

Just a quick post to share a few pictures from work last week:

Enjoying the sea breeze out on Deck 7

The patients aren't the only ones who like to play with the wagons :)

Blowing bubbles is always fun too

Ward worship

Kadiatu, my little wild woman. Note the pretty blue coban wrapped around her hand, to prevent the pulling out of any more tubes.

Bockarie, who got a new nose

"Stockings" up there pulled out Esther's nasal trumpet the other night. Neither one of them is very impressed with their NG tubes.

Princess Royal

I completely forgot to blog about this - then I was looking through the pictures on one of the ship computers today, and remembered. Her Royal Highness, Princess Anne, was in Sierra Leone last week and decided to pay a visit to the Africa Mercy! The ship was a flurry of activity as wards were scrubbed, floors mopped and waxed til they sparkled, and everyone practiced their curtsies. I've never seen this place so clean and shiny. I didn't meet the princess, but some of my friends were working when she toured the hospital...so, I know someone who met the princess. That counts for something, right? ;-)

I think the missionary kids were a little disappointed that she didn't wear a tiara.

In other news, Kadiatu smiled and laughed today. That made me very happy. We have lots of pikins with NG tubes on D ward right now, and they've been kind of fussy the past few days...understandably. But today they all started feeling a little better and having some fun. My little one in bed 9, Esther, pulled her nasal trumpet out last night, but she did not go back into respiratory distress so all is well. At the end of my shift, I learned that she was actually not the one responsible for the nasal trumpet coming out, but her mischievous neighbor, Muka in bed 11 was. I guess the little guy decided he was a nurse last night and that Esther's airway was fine.