One Single Goodbye……

One Single Goodbye……

One single good-bye is like death by a thousand swords.

Thus ended my last day on board the Africa Mercy. The final lesson learned…there is never enough time for good-byes. I fear I have done an awful job at saying “good-bye”. No time, no energy… no cards left to write in. I feel overwhelmed by the magnitude of my farewell. Several dinners out with friends…a formal thank you at the Thursday night Community meeting (which happened to be a BBQ outside on the dock including the Day Workers)….Frank and George’s families traveling from Sierra Leone to say “thanks”…and then the final wave off!

As one person after another stepped forward to say “good-bye”…I felt like I was dying and my life (at least as it had been on the Africa Mercy) was flashing before me. Alice from the Galley who after waiting three years to become a sterilizer, will be joining out department in my bed space…Ibrahim who was rescued from being denied as a Day Worker in Togo, and who then went on to become crew….Francis who was forwarded a micro credit loan to continue with his Seamen’s schooling…. James who was financially assisted to stay on as crew when his funding ran out, and who subsequently met his fiancée on board-wedding in two weeks…a phone call from Dennis who was back home in Ghana trying to apply for his student visa ( for the  fourth time)… multiple OR Staff members…two male crew members (one a Chaplain, the other an Anesthetist) brought to tears…my three dear cabin mates…John ( whom I did nothing for, but we had such a great “passing in the hallways”-type of relationship…and the BIG one, Frank and George. The pain was deep, cutting and very real.

What has been amazing about being in West Africa is the huge difference that you can make with very little money and very little effort. It becomes almost addicting. One life changing surgery after another…a family helped with schooling fees…another helped when their home burned to the ground…West African Crew supported, cared for and advocated with. And then there is the story of George, the Day Worker from Togo.

I have withheld the story of George Ebbia from all those except close family and friends. I have no idea why. Perhaps it just felt too personal, too close to the bone. I met George in the OR in Togo. If you have been following my adventures, you will possibly remember the story. He invited a group of us in the OR to visit his farm. We ended up planting trees, and I was so impressed with what he had accomplished…yet felt overwhelmed with what he had yet to do. I met with George the following Monday at lunchtime to ask what would make the biggest impact to him with his work on the farm. His answer?  A motorcycle.  Our time was then up…we had to get back to work, but the thought of George and his motorcycle would not leave my brain.
Later that day, a thought flashed into my head.  John had never had a funeral (by request) and there had been an amount of money in an insurance policy for that purpose that had never been used. I would use it to buy George a motorcycle. That night I wrote George a note…telling him about John and offering to help him.

This offer was a seed, which when planted yielded a crop of virtual miracles. At first I told a close friend Jim, who offered to buy a helmet for George to keep him safe. I then emailed my family and a few friends who I thought might be interested in what I had done. Immediately I heard from my sister Judy and brother-in-law Clare who said that they had not had a chance to do anything in memory of John, and wondered if there was anything else George might require for his farm? George and I met again, and this time I asked him to create a list of needs from which they could choose. Judy and Clare chose a custom –made cart which could be attached to the motorcycle in which George could haul supplies to the farm.
Next I heard from my friend Petrea and her husband Paul who choose bags of cement to build his animal shelter. Then Jim got back in touch and said he wanted to email his friends about this project…he was sure they would be interested. That netted a metal roof for the animal shelter…complete with some animals. And so on….and so on. By the time I left Togo, George had everything he needed to set up his animal farm.
I never asked him to do so, but in the end George decided to name the farm after John. ‘The John McIntosh Memorial Farm Animals’. It was at this point that Catherine, the Chaplain on board developed a logo for the farm-complete with a motto scripted by George… Ensemble Aujour d’hui Pour un Bien-Etre de Demain …translated as “Working together today for a better tomorrow”..

Not having a funeral for John left me feeling a lack of closure. When George and his farm entered my life, closure happened. Who would have thought that a solution needed in British Columbia, Canada…could be found in Togo, West Africa? My own personal miracle. As I write this last entry, I received an email from George telling me that his first sheep has given birth to a baby male lamb. I know John (a former sheep farmer himself) must be looking down on the farm in Togo, and smiling with satisfaction.

I owe each of you a huge debt of thanks for all of the emotional, financial and moral support over these past two years. I simply could not have made this journey without each of you. It has been impossible for me to share all that I have experienced in West Africa during this time. I hope that the postings I have written have given you a glimpse of the life, challenges and joys of this part of Africa and her people.

I wish each of you every blessing of the Christmas season, and a new year filled with peace, joy and love.
Ever gratefully yours,

Jane

 

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Greetings From the Africa Mercy!

With just three weeks to go with my life in West Africa, time and opportunity are quickly fading away.

Orthopedic operations are now finished. as we move into the VVF (female fistulae) specialty. This is combined with Max Fax, General and eye surgeries. I am frantically putting finishing touches on the department manual that I have written as a ‘how –to’ book for someone who literally ‘drops’ into the department. Fortunately, that is not our reality at the moment, as we have George, Frank and Juan to keep the department’s gears in motion…along with two very responsible Day Workers, Mark and Amara.

Interviews took place for my position, and George, Frank and Juan all expressed interest in the job. The interview team had a tough decision to make, but in the end, George was chosen to be the OR Sterilizing Team Leader. Alice (from Sierra Leone) who currently works in the Galley will take my bed space, when I leave-and so the department will be left in good shape with a very dependable team.

As always, the best way to connect to the work we do here is to share a patient story. This one is about Memouna.

Go down two flights of stairs on the Africa Mercy, and you’ll find you’ve stepped out of a ship and into a busy buzzing hospital. On the wards you’ll find kids playing, doctors bustling, patients visiting, and plenty of African music. Listen . . . you’ll hear conversations in English echoed by translators in French or one of Guinea’s three local languages – the chatter forms a background like white noise. One would expect that a 13-year-old girl would be among the chattiest – but not Memouna.

Memouna’s pronounced facial tumor began above her left eyebrow, spilling down her face to the corner of her mouth and displacing her left eye. This tumor, a neurofibroma she has had since birth, left her looking like one side of her face was sliding off – like Dali’s famous melting clock in a desert. From behind the curtain of her deformity, Memouna saw the world with her good right eye. And . . . to her despair . . . the world saw Memouna.

For 13 years she was taunted for her appearance. Moreover, superstitions run deep in West African culture, and physical deformities are believed to be the sinister mark of someone cursed. Memouna was not only teased by peers – she was completely dismissed. The drooping facial tumor became the source of a broken spirit.  “She was not happy because in Africa people stay away from her. She would cry because she did not understand why no one liked her,” said Memouna’s 17-year-old sister, Aminata, the oldest of her nine siblings.

“I had so many sleepless nights worrying how to help my child,” said Memouna’s father, who was trying to sell his car to afford her surgery when he learned the Africa Mercy was coming to Conakry. “I was told that no one would be able to do the surgery except Mercy Ships. I had no money to pay with . . . and then God paid!”

On Wednesday, 26 September 2012, Mercy Ships surgeons removed Memouna’s tumor. After her operation, even under layers of bandages, the transformation was profound. Memouna’s profile no longer appeared rough and misshapen. Her face had been physically lifted from the weight of the tumor. Nurses hoped her spirits would follow, but removing years of social isolation is a much more complicated procedure.

In the days after her operation, quiet Memouna said nothing, while her father and sister took turns staying at the hospital and speaking on her behalf. “I’m sorry, maybe she will talk more another day,” her sister would say to visitors. Mercy Ships ward nurse Lynne White said, “It was a long time before I realized she spoke. She was so silent that I didn’t think she could. But I can understand it. She went from spending her life keeping to herself with no friends, and then she came here and was overwhelmed by the attention.”

One night a week after the surgery, Lynne came into the ward to find Memouna listening to headphones, nodding her head to music and mouthing the words. “I couldn’t believe it, so I did whatever I could to try to get a laugh out of her – I started dancing!” Lynne said. “Memouna just laughed and laughed. It was wonderful!”

Two weeks later Memouna arrived on the dock with her father for a check-up. She kept to herself, waiting on the benches. “Is that my Memouna?” Lynne exclaimed. Hearing her name, Memouna glanced around to find Lynne, not walking, but dancing over to her. “It’s you, you’re here!” Lynne cheered, waving her arms in the air. Memouna clapped her hands and covered her mouth, trying and failing to hold back her giggles.

Even though Memouna does not give up her laughter easily, she lets those who show her love see the real Memouna. In those moments, there is a cute teenager in a pink sweatshirt and orange nail polish . . . where a timid, downcast child used to be.

The removal of Memouna’s tumor marks the beginning of physical . . . and spiritual . . . healing.

Until next time,
Jane
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An overdue update from on board the Africa Mercy

An overdue update from on board the Africa Mercy

As the end of my time here draws closer, time in many respects seems to speed up!

Christina, Holali and Christina’s Dad, Dan, left last Monday for Sierra Leone to continue the work of Christina’s sterile processing NGO. Emails from Christina’s Mom indicate that they have had transportation and accommodation difficulties… but I am sure that despite it all, the good work is continuing.

The Friday before Christina left, Volunteer Mercy Ship Surgeons, OR Nurses, Anesthetists and Sterilizers applied elbow grease to the Sterilizing department at Ignes Deen Hospital here in Conakry. Layers of dust and dirt covered counters and window sills.  Rodent excrement, live geckos and clogged drains awaited our attention.  Used needles, razor blades and bloody laundry abounded.
I had the job of cleaning out the toilet which was standing without walls inside the entrance to the department.  It was used to dispose of body fluids and was a mess.  In the bottom of the toilet drain was a tea bag…string attached. Tea time, anyone?
At the end of two hours and with the help of 20 pairs of willing hands, we left a department that was sparkling by comparison.

Sterilizing Room Cleanup

Christina’s discovery that the sterilizing rooms in Guinea are a disaster has been a rude awakening for the OR staff here on board.  They have several initiatives training Surgeons in modern techniques, but to what benefit if nothing is sterile?  What good is accomplished if the infection rate is 90%?  After experiencing the filth first hand, the Mercy Ships OR Staff are committed to Christina’s project.  Christina wants to return to Guinea in March and begin a training course for sterilizers in the city.  Long term, she hopes to partner with a Biomed Tech who wants to teach Biomeds in developing countries.  It would be a project made in heaven to have these two groups of professionals being taught at the same time.  There is one functioning sterilizer in the entire city, but that one is working below temperature.  Hospital sterilizing rooms are filled with broken down equipment, that no one either knows how to repair, or for which there are no parts available.  Brand new sterilizers have been dropped off in local departments by well intending NGOs, without installation or operating manuals. Change is needed.

Unfortunately, we have our own equipment woes on board. For the past almost two years, we have struggled with equipment repair issues in the Sterilizing room, and this time the situation has affected the OR as well. We are down to one working Anesthetic machine, which means that all General surgeries are being done by spinal anesthetic, and Orthopedic and Max Fax surgeries have to share the one working machine. This will result in a 20 hour work day in the Sterilizing room starting tomorrow…with Ortho surgeries in the day time, and Max Fax beginning in the evening. Although the surgeries hope to be completed by 11:00 pm – the work is far from over in terms of the sterilizing room. Now no one person will be working 20 hours per day…but it will most certainly involve a heavier work load for all…and some weird working hours for others. Despite advertizing for a paid Biomed Tech, there have been no nibbles at the offer to assist the one Volunteer BioMed we have-who has been ill and off  work.  A Biomed is scheduled for a short visit to do some urgent repairs, but that individual will not be arriving until November 6th (due to Visas, flights and scheduling).
Note:  A pleasant result has come out of this situation…spinal anesthetics are very well tolerated by the Guineans for General surgery, and are less expensive as well. It will most likely be our anesthetic of choice in these circumstances…a choice that otherwise, would have not been discovered!)

We added to the list of malfunctioning equipment on Thursday when a small lake suddenly appeared on the floor of the Sterilizing room at 7:00 am.  It is just as well a video camera was not running, as I scrambled to get a mop (no mop head was on the pole) and resorted to mountain of small OR towels to sop up the mess.  It was a panic situation, as I was unsure of just how much water would result. If it spilled out from the Sterilizing room into the ORs…all would be shut down until the rooms could be terminally cleaned. The good news is that all ended well! A cracked pipe in the Sterilizer was the culprit.

We almost had a crisis which shut us all down on Wednesday morning, when I opened the department to discover that our ipod was not working. You might think that I am exaggerating, but believe me I am not! Frantic efforts ensued trying to determine if it was the speaker or the ipod itself (it was the ipod). I immediately felt as if I was on life-support, and that the O2 had just been turned down. The panic that crept up inside of me was palpable. I had no idea how dependent I had become on working-to-music in the Sterilizing room!
We started by trying to re-sync the ipod, but no sync option was available to choose. Juan assisted by looking up the FAQs on line for ipod repairs. We attempted to download the most recent itunes software on a system that takes simply forever. (South Penderites: remember the dial-up internet days?…that is high speed compared to our system in Africa!) After on and off attempts for almost 6 hours (we did need to get the work done as well) we were no farther ahead. When the rest of our team arrived at 1:30 pm, I could no longer stand the mournful look in their eyes -and grabbing the ipod, headed on up to our IS (Information Services) Department in total desperation. Grabbing the first IS Tech available, I drew close to his face, and gazed deeply into his eyes, saying…”You know where I work…you know the conditions down there (hot, noisy, cramped)…we have to get this thing repaired..if we don’t, we simply can’t work”.

You never saw 5 Techies debate faster, or more furiously as they tried to fix our dilemma. 2 minutes later, they handed the ipod back and told me to wait 30 minutes and re-start it. The result?… it worked!!! I rushed to the snack bar to buy the IS team a large bar of chocolate. A small reward considering the near disaster they had adverted.

You discover while living on the ship, that things can go along quite smoothly… until one seemingly small thing can tip you right over the edge!

Hope all of your ‘small things’ are sitting solidly, on the correct side of the scale.

Jane

 

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Greetings from Guinea, Conakry

Greetings from Guinea, Conakry

The pace of life on Mercy Ships has picked up with the arrival of Christina Fast, from Canada (no pun intended!) If you have been following these postings, you will recall that Christina came to the Sterilizing room in Sierra Leone, and taught Juan and me the Sterilizing certification course.
After visiting one hospital in Sierra Leone, Christina returned to Canada inspired to create her own NGO, to promote best practices amongst Sterilizing departments in developing nations. She has been aided by friends, family and of course none other than the Pender Choppers.  David Howe has put Christina in touch with a very affordable lawyer for the NGO’s registration and funding has come from wood sales and generous donors from Mayne Island to contribute towards the registration, and her first project here in Guinea.

Christina arrived last Saturday, and did not hesitate to begin her work. Along with Amara, our Day Worker from Guinea, Christina was able to visit three hospitals this past week, interviewing hospital staff, touring departments and assessing the work that was required. To put it mildly, Sierra Leone was miles ahead of the work that is required in Guinea. Findings included: broken machinery; no disinfectants; no gloves or personal protection; rusted instruments; used razor blades , gauze and other biological waste all around; no or few brushes; no Hep B vaccines given to employees; no needle stick protocols…..and on, and on.
Every location they visited expressed a great desire for further education and assistance. They acknowledged their need for better practices, and stated that the lack of sterilize instruments was a huge cause for concern, and a large contributing factor to their high infection rates.

Cleaning Supplies Sterilizing Room - Jean Paul Hospital

Christina decided to pick Donka Hospital – the largest Public Hospital in Guinea, as a focus for improvement. Starting this Monday, Tuesday and Wednesday she will be accompanied on a clean- up mission by Amara, George, Frank and Alice (who will be coming to the sterilizing room from the Galley when I leave in December). They are taking a few supplies with them and a lot of bleach and elbow grease. It is their desire to get the department to an acceptable sanitary standard, and then provide the education and tools to keep it that way. Christina hopes to travel up country next weekend with Amara to visit more rural hospitals.

Christina and I have dinner each night watching the sun set over the islands off shore. We spend our time discussing the NGO and its future direction. I have agreed to be on Christina’s Board of Directors, and to help her as I can in the future.

Christina also brought with her 75 ‘Comfort Dolls’ that were knitted by her Mother’s friend in Calgary, for the patients here in Guinea. Today we walked to the Hope Centre (the step-down unit for the ship) and Christina gave out the delightful knitted dolls to each patient there. The children were delighted with their stuffed toys, and were clearly grateful for them.
We sat for an hour or so, and played games with the children and their care givers. ‘Jenga’ is a huge hit there, and it is amazing to see how skilled the little ones are in getting the block tower to stay standing. There is great excitement shown by all when the tower falls. Some things do not differ by culture!

I was particularly interested in a young man there, who was an Albino. He had a wound on his forehead the size of the circumference of a large muffin paper. The sore was at least a ¼ of an inch deep, and may have been the result of a Noma (an acute and ravaging gangrenous infection affecting the face). I watched as he knelt to say his Muslim prayers in a small, quiet corner. As he touched his forehead to the floor in reverence, his wound touched the floor as well. It spoke deeply to me of his faith and dedication.

I am surprised by how many Albinos I have seen throughout my time here in West Africa. Albinism affects fewer than five people per 100,000 in the United States and Europe. In other parts of the world there is a much higher rate- about 20 out of every 100,000 people in southern Nigeria, for example. Although they fair far better in the West of Africa, than in the East (where rumors of voodoo curses, murders and kidnappings for human organs abound), I feel for them in many ways. Even the healthy ones have such a difficult life – often filled with rejection and chronic un-employment.

My first encounter was not with an Albino, but concerned one. In my early days in Sierra Leone, I was traveling in a van which was stopped in traffic. A little boy came up to the window where I was sitting and grabbed my arm in joyful surprise. I could not understand what he was saying, but his Mother quickly explained that he was so excited to see me because he said, I was like his Uncle. His Uncle, the Mother told me was Albino.
The second encounter involved Gateways friends who were traveling to a beach in Sierra Leone by boat. On the way, they had to stop for gas at a marina. As the fuel tank was being filled, a woman ran towards my friends with a newborn baby in her arms, and pleaded desperately with them to take her child who was Albino. “She should be with you”, the Mother explained.

I am puzzled and saddened by our world where too much or too little melanin- a simple pigment, creates so many prejudices…so many heart aches…so many misunderstandings.

Until next time,

Jane

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September 29, 2012Permalink Leave a comment

Greetings from Guinea, Conakrey

Greetings from Guinea, Conakrey
I will start by including a few facts about this new country we are visiting.

Guinea covers a land mass of about 95,000 square miles –about the size of the United Kingdom or slightly smaller than the state of Oregon.  The nation is ranked 178 out of 187 nations listed on the Human Development Index, and its 10 million residents have a life expectancy of 54.1 years. 43% of the population is under 15 years of age. By far, the majority of Guineans are Muslim-with only 8% of the population being Christians.

The average income in Guinea is about $863 per year, and its literacy rate is only 29%.  Sadly, there is only one physician for every 1000 residents, and there are only .31 hospital beds per 1000 as well. Mercy Ships will be providing general, plastic, maxillofacial, VVF (female fistulae repair), ophthalmic, and orthopedic surgeries. Another 10,000 residents are expected to receive dental procedures, and leadership workshops will be held for about 1,200 church, community and government workers.  At the same time, Guinean professionals will be trained by Mercy Ships in medical, agricultural and mental health professions. Capacity Building is a key focus of each Mercy Ships field service.

Mercy Ships has hired up to 150 local day workers who serve in a myriad of positions from translating to electronics, marine operations, the galley as well as working in medical programs or facilities. Each of these valued day workers are trained with new skills that will benefit them and their country long after the Africa Mercy sails. Capacity building makes a lasting impact- and that’s a very good thing.

For more information on Guinea, check out http://en.wikipedia.org/wiki/Guinea

Screening Line up Guinea

We have been busy in the sterilizing room since our arrival. Unpacking from the sail, set up and re-sterilizing have filled the past weeks. Our team is the same as last year, with the exception of one new Day Worker. George, Frank, Juan and Mark are all back, and Amara is our newest team member. His Mother is from Sierra Leone, and his Dad is from Guinea. In fact, there is a large Sierra Leonean contingent in the OR. Four other Day Workers are from Sierra Leone, which should make George and Frank very happy. These Day Workers moved to Guinea during Sierra Leone’s civil war, and have remained here ever since. When we met for the first time last week, I told them that we have a great collection of Sierra Leonean music in the sterilizing room….so come on down!

It is very difficult to take pictures here. Several crew members have had their cameras confiscated, and had to have the intervention of our security department to remedy the situation. In short, it is simply not worth trying- at least not in the city. I have included some photos taken by our Communications Department which seem to have more grace given to them.

The rain continues to come down, and the cholera epidemic is still going strong. Restaurants are ‘iffy’ for the most part, and expensive. We are having our usual bout of crew bugs….as 450 people from 36 countries most of whom have flown to get here… bring a weird and virulent mix of germs and illnesses.

George and Frank left last week for a nine day vacation back home in Sierra Leone. It is about a 6 hour bus ride to get there. It was fun to see how excited they were. I was in a panic trying to get them the medications they might require with the sudden realization that they have lost their immunity to poor drinking water, malaria and other illnesses by being on the ship for 10 months!  Their bags included a number of gifts for family, friend and neighbours which I had sourced in a ‘Pound’ store in England. Items such as reading glasses, children flip flops, stationery supplies and the like. I think they will have fun distributing them.

Consultation

This past Monday was our screening day. I was relegated to keep sterilizing, but almost all other crew members spent an extremely full day at the People’s Palace where the screening took place. Some crew had to go the night before, and spent the time in security or pre-screening duties. Greta (a Nurse from my Gateway) found the experience to be extremely difficult. She described watching car loads of people arriving through the night filled with children and adults we simply could not help.  People with chronic and debilitating headaches or abdominal pain.  Large numbers of children with cerebral palsy or developmental delay. What made her feel so helpless was that these individuals could have had medicines and/or treatment in the developed world…but not here in Guinea. It was Greta’s job to turn them away. Not easy, by any means.

When the screening ended at 9:00 pm, the numbers fell out as follows. Almost 4,000 lined up to be seen. Almost 1,000 were given patient cards for follow-up and further surgery. On-going eye and dental screening, and some small future surgical screenings will round out these figures. The crowds were peaceful and more understanding of our not being able to help, than we would ever be in the Western world.

As usual, the pictures tell it all. The photographer, Michelle is my bunk mate. We are well matched both in personality, schedule and preference. Thanks Michelle, for your great work.

Until next time!

Jane

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September 8, 2012Permalink Leave a comment

Greetings from Guinea, Conkrey

Greetings from Guinea, Conkrey

We arrived at 9:00 am this morning after a 5 day sail from Tenerife through mostly smooth waters.
We were met by a brass band, the President and his entourage.
The ship has only ½ of one berth space. The bow of the ship sticks way out into the water past the dock.
I am not sure how the patients will fit on the dock, let alone anything else!
We have arrived in rainy season in the midst of a cholera outbreak….got to watch out for those puddles!
We have not been allowed off ship past the dock area, so my impressions of Guinea are few at this point.

Leaving Tenerife

There is however, an amazing view from the starboard side of a breakwater and islands in the distance.
With no imagination at all, they could be the Gulf Islands! Tried to take a picture, but it is too misty. Will have to wait for brighter weather.
Sending you a few pictures contrasting our port in Tenerife, to that in Guinea.

Love to all,

Jane
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Farewell to Togo

Farewell to Togo

Greetings from the choppy seas of the Atlantic – off the shores of Africa!

This past Friday at approximately 10:30 am our anchor was raised as we set sail for dry dock in the Canary Islands. Staying on-board for the sail has been interesting, difficult and fun all at the same time.
The past two weeks have been filled with one good-bye after another. Some are for just a few months – others potentially forever. Three times a week at 7:00 pm, the ship practically emptied as friends hugged, cried and even wept. As the cars loaded with luggage and volunteers made their way through the port gates, the remaining crew formed two lines through which the cars would drive. We cheered and waved the occupants a final ‘good-bye’, then turned to enter the ship once again…our numbers ever smaller. If only we could have harnessed the emotional energy expended during this time…I am sure we could have powered the ship on to our new destination!
Most exciting of all, was the successful completion of the OR sterilizing course by all four of the West African sterilizers. Mark, Holali, George and Frank all did amazingly well, with results from 81-96%.  Our graduation was fun and was attended by 23 OR staff.

Our time was full before the sail. We had to wait until the last of the patients was discharged before we could complete the pack up of our department. Everything in the OR must be padded, wrapped and tied down for the sail. Then the entire department is inspected by the First Officer to ensure it will stay put as the ship rolls. Loading and securing the ship is a huge job for the deckies and technical crew. Every car has to be driven onto a harness and then lifted by an on-board crane onto the ship and secured. All decorations come down from the walls and are stored. All books on the library shelves are turned sideways to prevent the contents from unloading onto the floor. All ship shop products are loaded into boxes on the store floor. All kitchen equipment must be safely secured…and so on…and so on. There are a million ways that sticky tack is used to hold items in place!
In looking back over our time in Lomé, we have accomplished an amazing number of operations for those in need.  794 eye surgeries; 34 cleft lip and/or palate repairs; 281 facial reconstructions (including tumours); 72 releases of limb contractures due to burns; 933 general surgeries (including hernia repairs; tumours and goiters) and 49 VVF surgeries (female fistulae).  With a minimum of one tray per surgery (some take up to 5) these numbers add up to at least 2163 trays to be cleaned, disinfected, assembled and sterilized…not to mention separate instruments.  No wonder the sterilizing team is tired!
Alongside this work were: 9,688 Dental procedures; 14 palliative care patients who received support; hundreds of physiotherapy patients treated; individuals trained in agricultural practices; renovations of community clinics and much more. We have been a busy group!

Two days before we left Lomé there was some significant civil unrest throughout the city.  This resulted in our shore leave being cancelled for 17 hours.  For those of us who were counting on that one last good-bye, this was serious trouble.  We felt as if the jail cell door had clanged shut!  We prowled the decks and rooms like tigers shut in the zoo.  Our angst was raised by the fact that we were soon to leave for a ten day sea voyage –without any stops.  Fortunately, the riots were short lived, and we were allowed ashore for twelve hours during our last day in Togo. The relief was palpable.

We had many sailing and security briefings before we sailed, and received a supply of sea sickness pills at the end of the last one. The night before we left, we had an unexpected surprise with an ‘abandon ship’ alarm sounding at 3:00 am. I jumped from my bed, slipped on my shoes grabbed my ID and opened my cabin door. There stood a crew member who was a room checker during alarms. He looked at me and declared he thought the alarm was for real, and suggested I make my way to the stairs- which I did. At the end of the hall I met the Russian technical crew, who informed me that they had just received notice that the signal was a false alarm. They blushed and smiled at me in my pajamas. I hurried back to bed!

Leaving Togo was a heart-warming experience. The crew of the nearby ships stopped their loading/unloading work to wave us good-bye. One sailor held a large sign and stood at the end of his ship waving enthusiastically. Unfortunately, we could not read the lettering – even with binoculars. We had fun spending time wondering what the sign had actually said… “Good riddance”… “Look out for Pirates” …”I never did put the fuel in your tank” …etc., etc.

Most OR crew are re-assigned to another department such as housekeeping, galley or dining room. I am trying to re-write our department’s manual which is long over-due for an over haul. Too bad that computer work is one activity that can initiate sea sickness. So far I have only had one bout of it. The pills do make one very sleepy, so I will try to cut back or I will never get my assignment finished.
George and Frank have been assigned to the stores department and are busy hauling boxes around the ship. They will have a brand new set of muscles before too long!

I am so grateful to each of you who have so generously supported my volunteer work on the Africa Mercy, as well as that of George and Frank. Your generosity has touched the lives of thousands of patients and their families, and has changed their lives forever. Know the difference you have made in Sierra Leone, and Togo West Africa

With gratitude,

Jane

If you would be interested and able to support Jane’s efforts, you may donate to Jane McIntosh’s Mercy Ship account# 2888 or you can call Mercy Ships at 1-866-900-7447 or mail a cheque to: Mercy Ships Canada Unit 5- 1318 Oak St., Victoria BC V8X 1R1. All donations are tax deductable. Just specify that the donation is for Jane’s account #2888.

 

 

 

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60 Minutes…exams and such

60 Minutes…exams and such

Hello from the Africa Mercy!

Another three weeks have slipped by, and we are going into our last week of surgery.
One week ago, the film crew from 60 Minutes was here doing a feature on the Africa Mercy. They spent a lot of time in the ORs, filming cataract and max fax surgeries. On the Friday morning they came by the sterilizing room to ask when our busy time would be. I responded that that would be hard to calculate due to the timing of the finishing of surgeries…how many trays were used etc. etc. I asked if I could page them.

At approximately 3:30 pm they came back down and filmed the 6 of us assembling the surgical trays. In what is normally a rather rambunctious and noisy workplace, not a word or sound was heard. The videographer commented on how quiet we were…I responded by saying that this was not the norm! Me thinks there was some stage fright going on there.
After he filmed the black, brown and white hands packing the trays, he asked me about the process. When I explained what happens in the sterilizing room, you could actually see a light bulb go on in his head, as he exclaimed, “Wow, I get it! Nothing happens down the hall (meaning the OR), if it doesn’t happen here” We all cheered loudly in response…as usually we are the ones trying to get folks to understand just how important our role really is. It is a little more complex than simply doing the ‘surgical dishes’.
The show will be just 7 minutes long, as it will also feature several other charities. Preview date? October or November of this year.

We lost one of our Day Workers this past week, as Mark had to tend to a sick family member. He came in Thursday to say that it would be his last day. Twenty minutes later he and I were in the library where he wrote his sterilizing exam final. Despite the lack of time to review, Mark (always the top student in the class) got a final mark of 81% – just fantastic. He also was interviewed by HR that same day and was accepted to return as a Day Worker in Guinea in August. Now that was terrific news.
Now that we are down one person, the work is quite busy. Each spare moment is spent studying and reviewing. The exam will be written by the others this coming Wednesday. I feel hopeful that everyone will be successful. We are having a graduation cake and certificate presentation on Friday- the last day of surgery.

Once again, the best way to really experience what is happening here on board is to hear another patient story. This one concerns the condition called VVF.

From down the hall, the drums start to beat as voices begin to sing out in jubilation- for today is a day for celebration. Several women enter the hospital ward with their hands raised in joy. Each one is dressed in bright fabric with fancy head-wraps. Today’s celebration is for them . . . because they have been made well.

The women are all part of the Mercy Ships VVF program. VVF is an injury caused by an obstructed labor. It causes a woman to continually leak urine, feces, or both. Sadly, these women are often shunned from society because of the smell resulting from their incontinence. In their culture, it is commonly believed that the physical problem is the result of a curse or a sin. Many of the women lose their husbands and families. They are completely cut off from society – alone and in despair. In reality, the biggest cause for VVF is a lack of access to emergency obstetric care. When labor becomes complicated, a woman is left to suffer for days as the unborn child continues to push down on the mother’s pelvis. The baby is born dead, and the mother is left with a life time of suffering.

Dr. Lauri Romanzi, a VVF surgeon on board, says, “It is a completely preventable condition that can be eradicated from the world. It takes prevention.” That prevention is access to health care, something that is not available in third world countries like Togo, West Africa. In the western world, if the labor becomes obstructed, the mother is rushed into surgery for a caesarian section. “In the United States, the percentage of births that perform a caesarian is over 30%,” Dr. Romanzi explains. “This eradicable epidemic is a problem merely because these women do not have access to emergency caesarian sections.”

This is why VVF awareness is important – because it is a condition that could affect any woman in the world, but, with proper health care, it is preventable. The women share the emotional pain caused by their physical condition. “If their voice is crying out for one thing, it would be to be normal again,” Dr. Romanzi says, fighting back her own tears in her passionate concern for these women.

As the women stand up to tell their stories, emotions are clearly written on their faces. Chins quiver and words fail them as they try to thank Mercy Ships for saving them from a life of anguish. Today marks a new day! Their strength and perseverance have finally carried them to the end of their suffering, and now they can let go of the past. It means they have the prospect of starting over and re-entering society. It is the start of a new life with delightful possibilities.

Joy wipes away their tears, and they dance out of the ward as they sing. Songs of happiness, healing, and triumph ring throughout the halls of the hospital. Each woman leaves the ship with her head held high in new-found confidence. It is her new beginning!

Trays involved:  Laparotomy – 102 instruments
VVF – 68 instruments
2 cases per day X 4 weeks
Thanks to each of you, for your part in helping to make these great things happen.

Jane

 

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A Long Overdue Greeting From Africa Mercy!

A Long Overdue Greeting From Africa Mercy!

The past two weeks have been over-the-top busy…more work than was almost humanly possible. We had the company IMS from the US here for two weeks sharpening our instruments again…but this year the timing of their arrival was not ideal. The sterilizing department had been extremely busy with the VVF surgeries (for female fistulae). On top of this had been the arrival of the Eye Surgeon Glen Strauss, who can do up to 50 cataract cases per day. Factor in the sharpening guys…and the work was beyond, beyond.

On top of the work load I developed a rather nasty cold, but had to keep going or the work would simply not have been achieved. This included a six day week …10-11 hours per day. Everyone in the department had to work full tilt. When this past Friday arrived, and IMS left, I felt a physical lifting of a huge burden off of my shoulders. The result?? Every surgical tray, OR separate instrument, Ward, Out-Patient, Dental and Physio instrument was sharpened, washed, re-packaged and sterilized.

A highlight of the past two weeks was the arrival of my former bunkmate Anna from the UK. She had been back in Sierra Leone doing training and workshops in the Ponseti treatment method for club feet, and checking up on last year’s patients from Mercy Ships. It seems as if Anna has found her calling, and has chosen her one spot in the world where she can truly work for the betterment of humankind. Sierra Leone has won her heart, and she is busy working to find funding to develop a program to treat what is called neglected club feet.

One in 700 babies is born with club feet in Sub-Saharan Africa. The statistics are only slightly better elsewhere, with even higher reports in India. The actually cause is still a mystery. The Ponseti method of club foot correction involves casting to reposition the foot. It can only be done up to 5 years of age, when the bones of the foot are still malleable. After this point the only treatment is Orthopedic Surgery…an impossibility in Sierra Leone when there are no Ortho surgeons practicing.

While with Mercy Ships and on this most recent trip, Anna was training health care professionals in the Ponseti method. Every time the clinics would advertise for babies to treat, the line ups would also be filled with those over 5 for whom there was no hope. Anna met two Surgeons from Ghana whose hearts became really touched by these neglected club foot patients. At the end of their training these Doctors agreed to volunteer some of their surgical time to help these patients…if Anna could come up with the ways and means to run the program in Sierra Leone.

Anna has been busy connecting to agencies that might help her, and visioning her program in Sierra Leone. In between all of this, we have been able to share many meals and great conversations on board together…and even a movie or two! How I have missed her.

The first week she arrived was the week of her birthday. We celebrated with cupcakes, cookies and African dancing on the dock. It was a lot of fun, and she really enjoyed it.

The first weekend she was here she and my boss Missy went to Ghana for a few days and traveled quite far north. They arrived back Sunday night and by Tuesday evening Missy was having emergency abdominal surgery for a ruptured ovarian cyst, and an appendectomy to boot! There was no better place for Missy to be in West Africa than on the Africa Mercy. One of our General Surgeons performed the surgery and Missy is now recovering nicely.

Now for an update on George and Frank. They have been super busy taking lots of courses beyond the Sterilizing course. They have been taking Word; Excel and Navigator- a platform specific to Mercy Ships. Their computers are used daily for classes and studying…as well as email, Facebook and movies from time-to time! They are meeting lots of people and having many great experiences while on board. One weekend they were able to join a group of kids their age and travel up north in Togo. Exciting for them. Thank you, thank you once more for your generous support of these two great guys.

The Sterilizing course is going well, with our final exam at the end of May. We plan to have a small graduation for the students involved. From that point those that feel prepared will go on in early June to write the on-line certification through IAHCSMM (International Association of Healthcare Central Service Material Management).

A Surgeon was here last month who is planning to build a hospital in either Togo or the Ivory Coast (the location dependent on funding). He approached me to say that he needs to hire 4 sterilizers and wanted to employ the best in Togo…which he described would be in our department! Both Mark and Holaly speak French, and Dr. Andy has taken their info with him. I mentioned that if needs be, George and Frank might be able to access a French emersion course which could make them eligible for this opportunity as well. It is all still a distance away (December 2012), but the chance for this to potentially happen is very exciting.

Both Mark and Holaly have applied to follow the ship as Day Workers. Should they both be selected, our department would remain exactly the same as it is now until I leave in December. At that point Alice (who is also taking the classes) has been scheduled to come into the Sterilizing room from the Galley, and a team member will be selected to replace me as Team Leader.

We are now approaching our last month of surgery here in Togo. The month will be filled with Max Fax, General, Eye and ENT surgeries. We then pack up for the sail to Tenerife and the dry dock period. I will be writing a manual for the department on our sail to Tenerife and will be assigned to another department for our sail to Guinea in late August.

I have applied and have been accepted for a leave of absence to take care of John’s sister and brother-in-law once again in England during the dry dock period. As there are no surgeries during this time period, I am free to return to Reading to help to care for them. David has been placed permanently in a Nursing Home, and Ann is still at home with care givers. My presence there will enable the family (Ann and David’s children) to save some money from the private nursing care, and to take a much needed holiday. They have very kindly paid for my flight to England and back to the ship. I leave the ship June 29th, and return August 12th.

When I first signed up for Mercy Ships, we were supposed to be working in the OR throughout the summer. However, the change of the dry dock period from December to the summer changed that. At first I was annoyed by the change, but now in retrospect it does present a good opportunity to help out John’s family.

Many thanks to each of you for the many ways you have supported me in this journey so far. From emails, cards, parcels, financial support, blog postings …the list goes on and on.

May all that you have given to others, come back to you a thousand fold!

All best wishes,

Jane

 

 

 

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Not Dressed Up…and Someplace to Go!

Not Dressed Up…and Someplace to Go!

Hello!

Adventure after adventure seems to pile up here in Togo.
Last weekend a group of 15 of us ventured to Ghana to attend the wedding of my cabin mate Annika from Germany, to Idrissa from Sierra Leone. It was a big deal trying to get there. First of all, we all had to get Visas, which included:  colored photos; a trip downtown to take in the visas and a trip to pick them up again. Did you know that Canadians and those from the UK get a cheaper Visa fee than the rest of the world?
We left at 6:30 am on the day of the wedding. First we walked to the local taxi stand…then hailed and negotiated the fee for multiple cabs to take us to the border. There we had two check points to cross, photos taken, passports stamped, room after room to fill out paper work etc. How many times does one need to say “I am going to a wedding in Ghana”?

We then entered two vehicles (one of which had been pre-arranged…how did we get so much luggage?), and the journey really began. In Ghana there is about 50 miles or more with huge speed bumps every ¼ mile. Our driver would go incredibly fast…only to screech to a halt…to progress over the speed bump at a snail’s pace… to drive like a maniac to the next speed bump..to screech to a halt etc. etc. I wanted to scream “Stop that”, but clearly that was not the polite thing to do.

The scenery was not that fantastic, but as we got closer to the city (3 hours later) we encountered an incredible traffic jam. At this point, our driver assumed the role of the chauffeur from a James Bond movie…dodging this way and that…changing lanes…squealing tires…back roads…back lanes..onto the highway again etc. We decided the best way to cope was to simply close our eyes. As the minutes passed, the anxious groom kept calling the cell phone of our driver…adding to the angst.
The wedding was at 12:00 noon at the Registrar’s office. As 11:30 approached, we realized that changing our clothes into wedding attire, was simply not going to happen…we would be lucky to make it at all! As 11:55 came, our van screamed into the parking lot, and a sweaty, dusty bunch fell out of the van and into the wedding chapel. Wait…you must be ‘pinned’ with a piece of cedar complete with ribbons to support the entrepreneur at the wedding facility…don’t forget to pay$!

The room for the ceremony was split in the middle by an aisle. I realized with horror that we were sitting down as someone else’s service was going on. When that one was over, we were directed to move to the other side of the room, and our ceremony began. For a civil service, it was impressive how the magistrate ensured that both parties actually wanted to get married….as “This is a serious thing, don’t you know”.  In the middle of our service, the door flung open and the next candidates strolled in. I am sure they wondered what kind of vagrants this mixed marriage couple had invited. When I say that the Africans were dressed up..well there are just no words to describe their outfits.  The African bride herself was in a very fussy traditional western wedding dress. All of the women sported large and fancy head coverings. The fathers of the bride and groom were wrapped in African cloth, similar to a toga- in tribal style.  And us? Well sandals, running shoes, shorts, and T shirts just about sums it all up! After the ceremony we stood gathered on the grounds for pictures, and were serenaded by yet another creative businessman who played “Here Comes the Bride” on his harmonica!

We were able to change after the wedding, and we all cleaned up well for the reception. It was held at a very western hotel. The party was a great mix of western ways combined with African drumming and dancing. There were over 8 countries represented. We stayed overnight at a Baptist Mission house. The next morning the bride’s Aunt prepared a lovely bunch for all of us. It was just so normal to sit in the breakfast area in sunlight and take time over a cup of coffee. To be able to hear the birds singing and not the sound of clacking bowls and loud conversations was heavenly indeed-almost brought me to tears!
We returned to the ship that evening. As we crossed back through the Ghana border, the guard I had seemed very interested in who married whom. When I said it was a German woman that married a man from Sierra Leone, the guard said, “Oh, the man has money now”. I could not resist adding, “More importantly, he has love”.

Since serving on the Africa Mercy is much more than weekend adventures, I share this story of a great re-cycling project here on the ship. It is great to see how many things can be recycled in Togo…not because of environmental concerns, but rather out of need.   Cast away cans are made into crafts, plastic bags into purses and bags, and even tires into shoes.

“Necessity is the Mother of invention”, so the saying goes. Nowhere is it more apparent than in the physiotherapy department onboard the Africa Mercy. When patients’ legs are put in casts, they can’t wear shoes – but they can’t go barefoot, either. The Rehabilitation Team has found a suitable, inexpensive, and easily available way to give each patient the foot protection they need during their recovery. The answer is . . . tire shoes.
Anama Latta, a day-worker in physiotherapy, is responsible for producing shoes from tires in various sizes to accommodate patients. He gathers old tires from motorbikes and begins by removing the wire inside with a knife. Then he measures for sizes – 10″ for large, 6″ for medium, and 4″ for small. Using a box cutter, he cuts incisions to mark where he will use the scissors to cut through. Next, he cuts three holes on each side. Then proper lengths of polypropalene ribbon are used to tie the shoes on. Anama says the tire shoes are stronger than other footgear they might use, and they provide more protection on the sides of the foot. “When I was a child in Togo, I used to wear shoes like these to go to my Daddy’s farm,” said Anama.”They protect better than flip-flops, and the cast doesn’t get wet.”Tire shoes last longer than ordinary shoes, and patients can walk easily in them. Anama says he enjoys making the tire shoes. “This is one way I can help the patients and the Rehabilitation Team, and I’m happy to make them.”
I wonder if Canada’s tire re-cycling tax pays for tire shipments to Togo?

May you always be well dressed for the adventures that await you!
Jane

 

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