Saturday, June 30, 2007

also the work of bed 10

on the catwalk

Sitting in a hospital bed can be a bit boring, so the ladies of the faith ward started a knitting club. Michelle, a ward nurse, was their teacher. Some had a hard time, some were naturals. I felt like I was at a senior high event.

Bed 10, my patient, was obviously experienced. She knit a beautiful grey hat for our charge nurse, Laura, in a span of only two hours. As I finished my shift last night she had begun a new project with beautiful red yarn.

"It's for you. I'll have it done tomorrow."

The alarm clock played it's sing song tune at 6:20 AM. Throughout the night I had woken up every hour, scared of sleeping through my soft-spoken travel alarm clock. Rolling out of bed I threw on my grey scrubs and headed up to the cafeteria for some pre-shift coffee. I made it to the ward by 6:45 Am. The 30 foot commute is amazing.

Bed 10 was waiting for me with a red hat in hand.

Of course I made a huge fuss over it.

Later in the morning, when things were settled, I tried my hat on. I stepped out of the bathroom to big smiles and applause. The ladies of the faith ward like my hat.

There is a large aisle that divides the ward beds. Today it was my catwalk. I strutted through ward modeling my new red hat. The woman smiled and laughed. One lady even told my she liked my face.

I love my job.

Friday, June 29, 2007


Are you able to read? No
Are you able to write? No
Did your husband leave you after your fistula? Yes
Number of Pregnancies: 1
Number of Deliveries: 1
Number of living children: 0
Time in labor: 4 days
Fetal outcome: stillbirth
Date of delivery: 1989

This is from an admission history of a VVF patient. It could be any one of them.
There histories are almost uniform. Fifteen seems to be the median age at time of delivery. The baby was stillborn. The husband left.

Many of these woman are thirty or forty now.

Last night I cared for three VVF ladies. We had a hard time understanding each other. I am told Liberians speak English but I don't believe it. Fortunately we have translators in the ward to bridge the communication gap.

There was a distinct stench of urine in their room. A smell these women have learned to live with.

One of my patient's was a little sassy. She tried to trick me into giving her extra towels. I felt at home.

We read stories and it is easy to compartmentalize them into a fictitious part of our imaginations. But theses are people. Individuals. They like to laugh (a few ladies found my miscommunication funny at times). They like watching TV. They get board because they are stuck in the ward all day.

Working with these ladies is wonderful. They have such sweet spirits. My heart was broken as I read their histories and thought of the weight of their past experiences. How broken their hearts must be.

We all pray for their mending.

first day

Today was my first day as a ward nurse. I had a total blast. It is quite possible that I took care of two of the cutest little boys in Liberia. I took the 5 y/o for rides down the corridor in the rolling chair. He had the biggest smile and the most beautiful brown eyes.

My three VVF ladies were equally lovely.

I did however feel my thus far greatest pang of homesickness. Euphoria was running through my veins and I had no one to tell. I was a bit of a sad four year old.

Wednesday, June 27, 2007


I had thought about keeping a written journal this year but seeing that I often cannot decipher my own hand writing, typing just makes more sense. So forgive me if my thoughts meander but you have been fairly warned.

Yesterday was my birthday. I am 24. I am dealing with the wretched thought that in six years I will be (gasp) 30. It may seem like premature dread but 6 years ago I was 18. And I can vividly remember 18.

I have only been in Africa for a 1.5 weeks, so all friendships at this point are seedlings. But you would not have known that yesterday. I am truly surrounded by lovely people. Someone made me a cake. I got cards and little presents. Four friends even endured almost 4 miles of walking on a dirt road during rainy season so I could purchase African fabric at the market. How nice.

The market was an interesting. I love experiencing the culture. During our walk it started to pour rain so we took cover under the awning of a local shop. In Philadelphia we probably would have been told to leave. But here, the owner gave up his seat and scrounged up some plastic chairs so us five white ladies could have a proper seat (as the English would say). It's good to know that chivalry is not completely dead.

As week walked, the streets were lined with people just sitting on the road. Not working. Because there is no where to work. There is very little economic opportunity of any kind. Our pale skin easily distinguishes the crew as Mercy Ship workers. And as you walk through the streets people will often yell with a reflective intonation, "Mercy Ships."The men often make a high pitched pucker sound when you pass, which I have decided is the Liberian equivalent of "Hey Baby".

Tonight I became a bit of a pirate, I boarded the Anastasis and pillaged hangers from the closets of empty rooms. The Anastasis has been Mercy Ships flagship for almost thirty years. It has brought medical care to thousands of people. Soon, it will be making it's final sail to India where it will be scrapped.The ship was originally an Italian cruise line. It's design and character are lovely.

As I walked through the now empty corridors I thought about it's history. I am unsure how long it takes to build a ship, but I imagine it is a long and tedious process. It must be designed, assembled, equipped, and tested. The hands that built the Anastasis thought they were building a cruise ship. They intended to provide rich Italians a delightful place to take a holiday (another English term). In their wildest dreams they could never have imagined the vessel would be taking her final sail from a third world country in Africa. Or that it would provide hope and healing for thousands of the world's poorest inhabitants. Or that her crew would be made of people from over 40 nations and almost every walk of life.

But so often that's what happens.

The things we build in our lives our used for completely different purposes than we intended. We have no idea how God will use today's experiences tomorrow. Our lives could take on an entirely different purpose in a moment and suddenly we see how the orchestrated past enabled a new beginning. God's intentions are beyond our understanding and it is beautiful to watch Him breath meaning and life into our vessels.

I love that we never really know what is going to happened next. It makes life so much more exciting. It makes difficulties worth enduring. It makes the sheep dependant upon the shepherd.

The real beauty of the Anastasis is not found in her frame or design, but in how she was used. The spirit of mercy is the remembered beauty. Likewise, when we reach the end of our journey, it will be remembered how our lives were used .

At a funeral the most touching remembrances are,
"She was a loving mother."
"He had a gentle spirit."
"He had a generous heart."

People don't often remember the dead with
"She was able to fit into size four jeans her entire life."
"He graduated 2nd in his high school class."
"Her yard was always the most meticulous in the neighborhood."

We will leave something behind.
Let us store up treasure where moth and rust do not corrupt.

Tuesday, June 26, 2007


Yesterday the hospital opened. 60 VVF surgical candidates were screened. Journalists and media documented the historical day which was eight years in the making. It was exciting for everyone.

Except for three women.

VVF stands for vesico-vaginal fistula. During a pro-longed labor pressure from the head of a fetus can cause internal tissue to become necrotic. A fistula develops between the bladder and vagina and causes a constant leak of urine. More severe fistula's may include the rectum and feces will leak as well.

Western medicine has eliminated this condition in the developed world. But in Africa at least 2 million women are leaking.

They leak because girls are forced to marry before they have fully developed pelvic bones. They leak because their bodies are malnourished. They leak because maternal care is not accessible. Often, a woman will endure five of six days of unattended labor. Her efforts produce a dead baby and a solemn memorial.

I have watched an American child die. We support bereaved parents.

VVF women are societies outcast's. Husbands leave. Friends ignore. Unable to control their stench they are left to carry their burdens alone. Many become severely depressed.

60 women arrived yesterday with hope. Hope that they might regain their lives.

57 are still hoping.

3 went home.

This morning during our crew meeting we prayed those three women. And we continue to hope for the other 57.

Monday, June 25, 2007


I always have an incontrollable urge to spit from high places. So today, while I was reading outside up on the seventh deck, I leaned across the rail, made sure no one was looking and hacked a wad of spit down below. Gracefully, I watched my spit fly through there air and splash on the water in concentric circles.

In less than a second the rings were assimilated into the still water as if the never existed.

My senses are somewhat overloaded at the moment and I am having to create an entirely new schema to contain my experiences. This weekend I was able to spend some time off the ship and although I was well read and well prepared for what Liberia would be like, you cannot help but be profoundly moved by the present conditions.

The air is filled with stories of rape, war and fear. The roads are broken. The water is dirty. I learned this week that every 12 seconds someone dies from malaria. Every 30 seconds it’s a child that dies. As we walked through the city I had to raise my floor length skirt so that the border didn’t become soaked from the many stagnant pools of water that paraded throughout the residential area. It’s rainy season in Liberia and there is no infrastructure for the rain to divulge in. Although, I don’t think all the puddles were rain water. Either way, the mosquito’s don’t care. Any puddle of cess will do.

Children are everywhere. They smile and wave as we walk by. Many extend a playful hand. I wonder what they think when they see me. White. Tall. Western. Privileged. The innocence of children is one reason why I choose to work with them over adults. Adults can frustrate me. But you cannot withhold your compassion from a child.

A child on the street extends his hand.

My mother was a white American. His a black Liberian. I was born in a hospital. He might have been born at home or in the bush. Maybe his mother was running from the rebel army right before his birth. But none of that matter’s when he reaches out his hand. Neither one of us choose to be born. We had nothing to do with the color of our eyes or skin. And yet such a divide exists between our circumstances.

I grab his hand as I walk by.

The hand of the giver touches the hand of the receiver. Both hands made of the same cell and bone structure. Both hands requiring a specific amount of oxygenation and blood. Both created in the same image and likeness of a loving God. We are really not so different.

As I recalled the day’s experience on the seventh deck I felt paralyzingly humbled. And I wondered where the heck do I go from here. If the world’s problem’s were the sea, my year commitment to the people of West Africa would assimilate into their poverty quicker than my spit in the water. But I am happy to feel that way. I want to be moved. I hope this year ruins everyday life forever.

Sunday, June 24, 2007


It has been four weeks since I quit my job in the PICU and I was feeling a void in my life due to lack of child interaction. Also, I had not been off the ship the entire week. So, when the opportunity to visit an orphanage arose I was eagerly inclined.

I jumped in the back of the land rover which was driven by a member of the church empowerment staff. He and his family regularly visited the orphanage and brought the children bags of rice each month. We would pick up the rice on the way there.

After twenty minutes of driving we pulled over at a local vendor. A price of 22.50 per bag was agreed on. Our driver loaded us up and jumped back in the front seat.
"I'm not sure if that's a good price, but the children need to eat."
I began to calculate. There were 75 children at the orphanage and we purchased four bags of rice. This would last for a month. Each child received one cup in the morning and one cup in the evening. So, for less then 100$, 75 children would have something to eat. This month. There was no guarantee's for August.

It took all my will power to not breakdown in the back of the land rover.

I have heard about extreme poverty. I have googled it. I have researched it. I have written papers about it. But today I saw it.

Before I left home I had joked that I would never want to have a wedding because I would think of all the rice I could buy with the money. Let's say a wedding cost 10,000$. I could feed the orphanage I visited today for 8.6 years. I'm totally eloping. (I assure any of my over-zealous friends that I have no prospects at the's just a cross-cultural example).

The children were beautiful beyond words. I taught them a slew of Coatsville songs. About 15 of them were lines up mimicking the motions for "Sunrise to Sunset". There were a few older girls that had the sweetest spirits. They reminded me of girls in youth group back home. The Liberians are lovely people.

Friday, June 22, 2007

the hospital

remarkable thought

This morning I heard whispers that we were having a ship fire drill in the afternoon. As the appointed time approached the sky began to look as it might bring forth the second flood. Which would not be an unlikely scenario seeing that it is rainy season in Liberia.
I asked one of the long-term nurses if the fire drill would be cancelled if it started to down pour. I was answered by a loud, German voice over the ship's intercom, "This is the captain, we are going to be having a fire drill in a few minutes. Please bring your umbrella." (he sounded remarkably like the California Governor) And so as I joined the rest of the crew on the port with umbrella in hand my question was answered.

Ship culture is very interesting and has it's own lingo and lyrics of which I am beginning to decipher.

All week I have been going to orientation meetings. The ward system is very simple and user friendly. I can't wait for the patients to get here. 16 woman are being flown in from up-country by the red cross for VVF surgery this weekend. The eye clinic will also be starting next week.

The challenges presented by the prospect of working with nurses from around the world has come into a bit of a closer view. Each country has it's own correct way of doing things and I am beginning to understand how much we will all need for grace and flexibility when working on the ward. A few differences include: Nurses from Europe don't assess their patients with stethoscopes. No breath sounds are listened too and no bowel sounds are auscultated. It's the physicians responsibility. This is shocking to an American ICU nurse.
Another difference is that English nurse's push their IV antibiotics. I give zantac over a pump.
The thought of pushing antibiotics is terrifying.

Slowly, I am starting to feel a little more comfortable. I am very impressed with the organization and am convinced that this will be an amazing year. Never before have I been exposed to so many cultures. It is very hard for me to believe that there are many other places in the world that have 400 people from over 35 countries and all ages and walks of life united for a common purpose. As challenging and stressful as that can be, it is quite remarkable. My view of myself in relation to the world will forever be changed. Regardless of culture, dress, sense of humor, dialect or color we were all created in the image and likeness of the same God.
Remarkable thought.

Monday, June 18, 2007

such is life

My stomach is quite acidic from the two large cups of coffee I drank after dinner. Happily I can write "drank" rather than "downed" seeing that Mercy Ships is a recipient of donations from Starbucks. It is the only coffee brewed on the ship. What a pleasant surprise.

As for the food, I can give the diplomatic answer that my mother has set such a high standard during my first 23 years of life that I could never expect it to be met. With that being said, the food is quite palatable but I will most likely lose a few pounds this year.

While everyone is very friendly I do feel a bit like a first grader at a new school. It's not my favorite feeling and something I haven't felt in awhile. But I am pretty certain that the acute awareness of my newness will fade over the next few weeks.

Surgeries are scheduled to start next week. Our first few weeks will be only VVF patients. If I wasn't so tired I would give an exhaustive lesson on VVF, but that will have to come later. In a nutshell, VVF is a condition in which a fistula is formed during a traumatic labor, leaving the woman incontinent of urine and feces. Often the babby dies and the woman is left by her husband. Some women with this condition are as young as fourteen. I was still playing with dolls when I was fourteen. Although, I probably should not have not admitted to that. Perhaps that's why I am a pediatric nurse. It will be such a privilege to work with these women.

Today I found out that Mercy Ships always tries to give the pediatric patients to pediatric nurses. If I was speaking you would hear the intonation of my excitement. While I am willing to be flexible my preference will always be to work with children.

Flexible is a word that will be given new meaning this year. At times I am sure it is a word I may despise. But I cannot help but think anything a small sacrifice in light what has already been given on my account. Already I have met people from Canada, Holland, New Zealand, Switzerland, South Africa, Nigeria, Liberia, England, Australia and Taiwan. This is the first time in my life where I have had to identify myself as an American rather than a Philadelphian. It is amazing to see that while the dialects, accents, and cultures of the crew are incredibly different, we are truly united. Our belief in the same Bible and the same God bypasses the vast differences. And it is possible to share a deep connection with a new acquaintance form the other side of the world. "Kindred spirits are not so hard to find as I once thought."


Sunday, June 17, 2007

taxi ride

Mary Lou started to walk down the crowded dirt road with a hand slighted raised in an attempt to hail a taxi. The four of us followed close behind while in continual observation of our surroundings. The road was fully occupied by small, yellow cars that were fashionable in the early 80’s. After 20 feet of walking and hand raising, a car was persuaded to pull over.
“Two American dollars to take us to Cici beach,” said Mary Lou leaning into the open window.
“Two, dollars, to go to Cici beach? No,” replied the driver.
“Three dollars.”
“Alright, five, but your really making me spend a lot of money.”
“Okay, five dollars to Cici Beach. Get in.”
I opened the rusted, poorly painted yellow door and climbed across the threadbare backseat. Two friends joined me, while Mary Lou and Sandy shared the front with the driver. Our driver was tall, dark and thin. He had widely set, distinct cheekbones which framed two serious dark brown eyes. His soft-spoken African annunciated English was hard for me to decipher.
We joined the parade of yellow taxis on the dirt road and were onward towards our destination. Quickly, we were stuck in a Liberian traffic jam as the road was crowded by people from market, which was lining both sides of the road. As dewy drops of sweat trickled down the sides of my face, I gazed out my window at the vast array of colors which comprised the Liberian market.
Stout, dark women wrapped in African fabrics made of vivid reds, green, gold’s, and blues walked through the dense collection of venders. Some carried babies on their backs who were held there by long, carefully wrapped fabric. Others balanced large cargos on the tops of their heads so effortlessly, it was like a magicians trick.
Dozens of men and woman sat selling fruits, plastic flip-flops, clothes, and bread. Some were fortunate enough to have a shoddily constructed awning to sell under, others carried their goods, some sat it the dirt under the hot sun.
As we sluggishly moved forward, dark eyes peered through our windows. Our light skin made it quite obvious we were foreigners, the small minority. And I was far, far, away from home.

Friday, June 15, 2007

welcome to Africa

This email is being written from an Internet cafe in Liberia, West Africa. Crazy, huh?

After two days of travel I have been tagged with a Mercy Ship ID and given the key to my room for the upcoming year. Already, I have seen a series of Divine intervention as I had at least four near misses with disaster during my travel. For example, yesterday I spent a day in Brussels, Belgium while en route to Liberia. My two traveling buddies (Lyndsy from New Jersey and Kassi from Canada) and I went to the city to do a bit of exploring. I didn't feel comfortable leaving my electronics's in the hotel room so I decided to carry them in my back pack. It seemed like a great idea.

Until then the rains came down and the floods came up, leaving my friends and I to run through the flooded streets of Brussels in torrential rain. Our attempts to utilize public transportation failed and we all ended up looking like we had jumped into a pool. With my electronics.

Fortunately, I had with me the professional rain jacket my parents gave me for my birthday. It was my laptop/cameras/ipod's salvation. I owe my dad a huge thanks.

Overall, I have no complaints. Both flights were comfortable and uncrowded. There were seven Mercy Ships ladies on my flight from Brussels to Liberia and six out of seven were nurses. The African airport was hot and uncomfortable, but we all went through customs without any problems (well, I almost wasn't allowed to take my baggage because I couldn't find my baggage ticket, but that really doesn't count. However, I did break into a cold sweat).

When landing in Monrovia, I sat by the window I could view the city as we landed. However, all I saw was miles of open green land intertwined with dirt roads and a few thatched roof houses and run down buildings. We drove about and hour from the airport t oreach the ship. Soccer is obviously popular as a view six or seven makeshift games along the roadside. There were also interesting signs accompanied by simple pictures with statements such as "Woman can contribute" and "Real men don't rape".

My room is much larger than I anticipated. It is by no means roomy, but I do have more storage space than I did at Bible College.
I love and miss you all. As soon as I set up my laptop I will send some pictures. Have a lovely evening.

Sunday, June 10, 2007

I should be sleeping

My stomach has been hurting for about two weeks. I'm not sure if it's a side effect of my malaria medication or my nerves. The reality of not seeing family and friends for a year is setting in. Although I am sure I will make wonderful new friends in Africa, I am a tad cynical seeing that I am convinced I have already met all the best people. Perhaps I will be proven wrong.
During my 24 years I have experienced more love and kinship than many would find in a lifetime. The realization of how blessed I have been has consumed my thoughts this week. How humbling it is to think of all I have experienced in comparison to the people I will be serving in Africa this year. Any sacrifice looks very light.
However, I will still miss my mom. Terribly.

Friday, June 8, 2007


I tried to get my act together this month so that I would not have to spend my final week in America running around like a crazy person. However, the duration of this week has been spent running around like a crazy person. I'm submitting to the fact that this is just the nature of traveling and perhaps the nature of life. No matter how hard we try, we never have it quite all together. Oh well.

Saturday, June 2, 2007

officially unemployed

As of 8:15 pm tonight, I no longer have a job. My almost two years in the PICU have quickly passed. I have worked with so many wonderful and talented people.

Walking out was a bit sad.

It was also a bit difficult.

I had to turn in my badge and beeper and no longer possessed the authority to swipe myself out of the building. Were it not for a kind-hearted environmental service employee, I might still be trapped in the staircase.