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.