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.