Esther

Esther is a favorite patient of mine. I really just can’t get enough of her. She is a typical 14 year old girl, a fact which drives some of the other nurses “small small” crazy, but makes me just want to hang out with her more.

Today I took Esther to the 7th deck. It was not raining and seeing that we both spend most of our time on the third deck, where there are no windows, I thought we probably needed some sunshine.

Someone gave Esther a princess crown. I make her wear it when we watch the “Esther” veggie tale movie. She let me borrow it today. I got to be the princess.

On the seventh deck there is an assortment of preschool toys. There is an old little tykes house in the corner. Esther and I climbed inside the house and spied on people as they passed by . Just like when I was five.

I let Esther take pictures with my camera. But I had to help her.

Esther can only use one hand. Think about trying to take a picture with one hand. It’s nearly impossible to hold the camera, look through the view finder, and snap the picture with one hand.

I wander how many small things Esther cannot do with one hand that I take for granted everyday.

Someone was worried that I was spoiling Esther because I gave her chocolate. I don’t think Esther has ever truly been spoiled at any point of her life.

I hope she has felt a little spoiled during her time on the Africa Mercy. She deserves it.

Cessee

I am a pediatric nurse. I absolutely love taking care of children. Interacting with kids comes very naturally to me. They seem to enjoy my personal insanity. And I enjoy theirs.

Perhaps it’s because we seem to enjoy the same thing (like princesses and ice cream). Perhaps it’s just because I envy how carefree and spontaneous four year old’s are allowed to be. Perhaps it’s because I get excited over little things and make a mess when I eat.

Geriatrics is the opposite end of the spectrum.

When I got report on Cessee, a 65 year old VVF patient my stomach dropped a little. Geriatrics is not where my gifts lie.

I came to Cessee’s bedside in the morning and found her curled up in a small ball. I had to wake her up so I could give her morning mediations. She sat up and her face broke into a toothless grin. Her skin was old and weathered. Her caving in gum line revealed a mouth that was void of most of it’s teeth.

It was clear as I tried to ask her questions and give her medications that she understood a “small small” amount of my English. But she took her medicine and let me perform her morning care without any difficulty.

I don’t know how old Cessee was when she gave birth to the child which caused her injury, but seeing that she is 65, she must have been leaking for many years. Throughout the day small moments in our interactions gave insight to the fact that Cessee had a hard life. She’d cringe like an abused animal if someone raised their voice. Her eyes were cynical. When I’d sit next to her on her bed she’d lean back away from me. It was obvious she had a hard time trusting people.

About hour 8 of my twelve hour shift, I sat on Cessee’s bed and attempted to give her a backrub. Backrubs are a wonderful example of therapeutic touch and loved by most patients. As I started to gently rub Cessee’s shoulders she turned around in as half funny/half scolding manner and grabbed my hands.
She then used her free hand to start tickling my shoulders. Apparently my backrub felt more like a tickle attack. And now I was the attackee.

For about five minutes Cessee sat there trying to tickle my shoulders. Being sassy. Giving me a hard time.
It was great.

Somewhere in that moment we became friends. Age and nationality did not matter. Cessee was acting like a silly little girl. And I pretty much always act like a silly little girl. I guess we are kindred spirits.

Princess

This is from the Dinsney Insider Newsletter. All I can say is that these are some very bright little girls. And I like Ariel because she has a pretty voice. And I like Belle because she wore her gold dress and had big dreams.

"The Insider decided to talk to young girls to find out what it is that makes Disney Princesses as appealing in 2007 as they were in 1937. Here's what they had to say. Ellie, 4, loves Aurora from "Sleeping Beauty" because she likes "her pink sparkly dress." Her sister Hazel chose Mulan as her favorite because "she is sporty and I like her black hair."
Like Ellie, many girls are drawn in by the sparkly dresses and princess couture. Let's face it, these ladies have outfits to envy! Whether it's Ariel with her crimson hair and pearls fresh from the ocean adorning her neck, or Cinderella in her shimmering blue ball gown and glass slippers, there is a look for every aspiring fashionista.
There is more to these princesses though, than stylish wardrobes. They teach kids to be kind to others, to be true to themselves, and to never stop dreaming. They aren't just living the life any little girl would dream of - they're also great role models.
Ruby, 6, said her reason for loving Disney Princesses is that "every princess is very helpful and nice. Sleeping Beauty helped the fairies and the fairies helped her because she was nice to them."
While all Princesses might be nice, they aren't all alike. Mulan, Pocahontas, and Jasmine are all princesses who show little girls that no matter what culture you come from or what you look like, you can embrace what makes you special and still be a princess. They send the message that "It's great to be unique," both in how you look and what you choose to achieve.
According to Cameron, that is exactly why Ariel from "The Little Mermaid," is her favorite. At 9 years old, Cameron identifies with this princess of the sea because "she believes in herself. If she dreams something, she makes it happen." She says that she likes Ariel because "she's sort of different from all the other princesses because she's a mermaid - and she has a great voice."
It's no wonder these princesses have such a following. In the end, the message the girls are getting is that you don't have to dress in a tiara to be a princess. You can be you and be a princess just the way you are."

outcasts

My patient in bed 6 had waited most of the afternoon to go home. She was from the interior and had been transported to Monrovia on a plane by the red cross. A Liberian social worker from the Red Cross was picking up three of our discharged VVF ladies as well as bringing two new patients.

Matilda, one of our translators, and I had gone through the discharge instructions with her at lunch time and explained the paperwork she was going home with. Now she just had to wait.

Around 4:30 I noticed a foul stench invading our ward. I was obtaining a set of vital signs and my back was turned away from the wards entrance, so I did not notice the three women who had entered the ward.
As I stood up to grab my patients chart and write down her vitals signs the stench became extremely potent. I looked up and saw a 4’10 Liberian lady standing in front of the bed next to me. She was what my nose had been smelling. Presumably, she was one of our new patients.

I then noticed a tall woman wearing a red cross ID and a second Liberian women standing by the ward’s entrance. The Red Cross had finally arrived. Our discharged patients would be going home and our two new patients would be getting surgery.

While the woman from the Red Cross was discussing details with our charge nurse, another nurse fetched gowns for the ladies to change into. Both ladies smelled of dried urine. It was an ardorus stench that surrounded them like a muddy cloud and saturated the airwaves. A large, 2 foot puddle occupied the back of each women’s skirt. They were both asking for pads along with their gowns.

Our VVF ladies are outcasts in their societies. We describe them as “leaking” but I do not think that leaking is a strong enough word. It makes me think of spilling a few drops of water when carrying a full bucket. But that’s not when these women experience. They are sieves. A few drops did not spill from the top of the bucket. The entire bucket was dumped out. They smell and they are wet. Even if they had money to buy pads (which they don’t) they would have no place to buy them from. Instead, they try soak up the wetness with pieces of old cloth, which is highly ineffective. Sometimes they try to stop the urine by shoving rocks into their vaginal area.

Because of their physical condition they are outcasted from society. Many tell us they have no friends. No one ever touches them. Their husbands generally leave as soon as this condition is developed.

The idea of out casting these woman sounds a bit barbaric. A bit inhuman. We would never outcast someone in America for a physical abnormality.

We don’t pressure people to be thin. We don’t call kids with glasses “Four eyes”. If we were to meet a homeless person in a store that carried a foul stench we would treat them with the same respect we treat our brother or sister with.

We would never stereotype someone by the way they were dressed. We would never think ourselves better then someone because we were more educated or had a higher paying job. We would never respect someone more or less based on the car they drive.

In America, a husband would never leave his wife and children because his wife was constantly leaking urine and always smelled terrible. He’d have a better reason. Like that he didn’t love her anymore.

I’m glad our society is not so superficial.

The stories these women share are heartbreaking. We can easily pick out their landmarks of pain. But it is an arrogant thought to think that we’d treat them any better if they were living amongst us in the western world.

We’ve outcasted people for much less.

Windy's Birthday

Windy just celebrated a birthday and some of our crew had a party for him.

Windy

Windy is a patient on Hope ward. He is a fourteen year old boy. He was suppose to go home last week but some post surgical complications have extended his stay. His inability to sleep at night coupled with a low hemoglobin secondary to bleeding that we cannot surgically fixed because we don’t posses the tool to do so has left him looking extremely pale and tired. When I saw him this morning my heart broke for him.

A little boy, Bill, has bilateral cataract surgery today. He is seven, but looks about four. Within 30 seconds of meeting him it was obvious that he has some sort of developmental delay. Developmentally delayed kids are pretty much my favorite kids to care for. They are carefree, joyful, and take the utmost delight in very simple pleasures.

I chased Bill around the ward and tried to get him to play hide and seek with me. He ran around completely carefree and would sometimes explode with belly laughter at simple gestures of humor.
I wound him up to the point that he just started aimlessly running around the ward with his arms extended and voice laughing. To calm him down I lured him on my lap with a proper reading of the Dr. Seuss classic, “Fox in Sox.”

Mid-day I had to step out of the ward for a moment and found Bill was MIA (missing in action). I asked his mama where he had gone.

“Windy carried him to get a bath,” his mama replied.

“Carried” is the Liberian term for “I took”. Windy, who was in the bed next to Bill, took him to get a bath. Windy who looked so tired. Windy who was here by himself. Windy who was getting no sleep. Windy who had every reason to be cranky and selfish had carried little crazy Bill to help him get washed up.

Windy is a sweet boy. He generous nature and content smile is humbling to be around. He’s really breaking my heart.

roosevelt (my buddy)

How sweet is his smile? I'm so sad I'm not taking care of him. So sad. Can't you see why?

the joy and the pain

Today I worked a 12 hour shift. I was sadly taken out of peace ward (where all the pediatric patients are) and placed with the VVF women. I enjoy taking care of these ladies, but a pediatric nurse is a pediatric nurse, I will always prefer children over adults. There are a few kids in Peace ward that I have grown attached too. I missed them today. I am not a crier, but I was definitely holding back a few tears when I received my assignment.



But I did get to see Esther, my favorite 16 year old Liberian girl. We take the VVF patients to deck seven every afternoon to get some fresh air. Esther came along. Today I taught Esther how to spit off the side of the ship. Our translator, Sam, even joined in. It made Esther laugh.


Today I was practicing carrying things on my head again. Always a crowd pleas er amongst the Liberian patient population. I am actually becoming quite proficient. Quite the African Lady.
Esther, one of our translators, wants to teach me how to carry a baby on my back. This is to occur when she works on Tuesday. I am quite excited.

Despite my disappointment in the morning, it was a good day. A long day, but a good day. The VVF patients are really lovely.

When we were outside they sat perfectly aligned with one another and we sang songs together. They would teach me a song, then I would reciprocate. There strong African harmonies and rhythms are amazing.

Living on a hospital ship can be frustrating at times but when i stop and realize where I am and what I am apart of, my perspective is quickly corrected. Human nature lends itself fully to it's own appetites and feels acutely the smallest pain of desire. We quickly become slaves to our desires, whether they be large or small. We are ruled by our own selfishness.

However, facing the reality of extreme impoverishment that is physical, emotional, mental, spiritual, and relational, can for a moment brake such chains, if we allow ourselves to be filled with love.

A love that is patient. And kind. And envies not. And is humble. And unselfish.And not easily angered. And thinks no evil. And rejoices in truth. And bears all things. And hopes all thing. And believes all things.

Where such a love is found, joy soon will follow.

But to love is always a choice.

An excerpt from Hinds Feet on High Places

"I am afraid," she said. "I have been told that if you really love someone you give that loved one the power to hurt and pain you in a way nothing else can."
"That is true," agreed the Shepherd. "To love does mean to put yourself into the power of the loved one and to become very vulnerable to pain, and you are very Much-Afraid of pain, are you not?"

She nodded miserably and then said shamefacedly, "Yes, very much afraid of it."
"But it is so happy to love," said the Shepherd quietly. "It is happy to love even if you are not loved in return. There is pain too, certainly, but Love does not think that very significant."

wearing a bib?

It was Gea's birthday. We were celebrating with box-made cake and nacho chips in the midships lounge. Crystal, who was in charge of the celebration, forgot something in her room. So we both went down to the third deck to retrieve it.

The ward is also on the third deck and we had to eclipse it's end in order to reach her cabins. As I was walking through the large fire door which separates the hospitals from the cabins (My cabin is only two doors way from this door) I heard a squeaky voice call out



"Megee, Megee."



Most of the Liberians I know call me Megee rather than Megan. I guess it's just easier for them to say.



I stopped midway through the door, turned around, and saw Esther standing there. Esther is a 16 year female patient of ours. When she was three, rebels soldiers stuck her hand in a fire. She received a burn contracture release on the ship.



She was standing at the end of the hallway, her right hand carefully bandaged. Her hair was tightly braided against her head in the front but the ends of each braid stuck out of the top of her head, looking like a exploding firecracker made of braids. A spunky hairstyle that matched her spunky personality. She was givning me a large grin which showcased the large gap between her two front teeth. And she was wearing a bib.



I don't know why she was wearing a bib.



I told Crystal I would meet her upstairs and went over to talk to Esther. It was a long day for her, she had her dressing changed. Not so much fun.



I pulled out a nearby chair and we talked about the day together.



At the end of the hall there is a world map that shows where the long term members of our crew are from. I pointed out Philadelphia and showed her how far way I had traveled to be in Liberia. I told her, that God must of loved her very much to send me all the way from Philadelphia to let her know that He loves her. And I told her I loved her too.



This has been a bit of a frustrating week. But if I came, and worked 65 hour weeks, and ate bad food, and lived in an eight foot space, but Esther knows she loved, it's well worth it.



If I was severely maimed at age three by the cruelty of mankind I don't that I would think I was very loved. While our actions cannot undo past wrongs, perhaps we can create a new beginning.

That's a pretty huge privelage.

ballon volleyball

Last night we received an unexpected admission. At home, unexpected admissions are the normal. They are sort of expected. But on on hospital ship in Africa, we carefully screen our patients and give them cards with a specific date to come back for surgery. We are a surgical, not a medical facility, and only have so many surgeons. So our patient population in terms of numbers is rather stable.

But around seven last night, little Angelle was brought into the Peace ward, holding her uncle's hand, by one of our charge nurses.

Angelle was born with a sever cleft lip. It was so severe that it bilaterally extended past her nose, up into both of her eyes. Her uncle showed me a picture of her when she was two. She had a terribly deformed little face.

During Mercy Ships Togo outreach in 2003, when she was 2 1/2, our surgeons performed surgery and fixed her deformity, giving her a whole face. The before and after is stunningly remarkable.

And patch is now covering her left eye. At some point since 2003, a doctor removed that eye. I am guessing it might have been infected. Her right remaining right eye consistently puts out a weepy drainage that had to be cleaned every few hours.

Today she received a cat scan and will be seen by our eye surgeons.

Remember (that is the little girls name) also came to us yesterday. She had a right club foot repaired to day. Last night she was running around the ward with her platted hair and little girl underwear sticking out the back of her pint-sized pink hospital gown. She's adorable.

Both Remember and Angelle are six years old. Both were born with deformities that could make them outcasts. Both were receiving free care from our hospital ship. Both like red balloons.

Last night the two girls gathered from opposite ends of the ward and congregated in the center of the room for some quality balloon volleyball. For almost 45 minutes they happily bounced the balloon back and forth as if they were sharing a secret joy of being six years old that no one else in the room could understand. Neither seemed to notice their gross deformities.

They were having too good a time with the red balloon.

sick

This morning I woke up at 2:30 in a panicked, "Oh my gosh I need to get to the toilet five minutes ago" state. I almost fell off the top bunk, walked the little hallway of our six berth cabin, into the bathroom, and proceeded to violently throw up. After repeating this sequence several times, and nearly twisting my ankle, I got wise camped out in front of the bathroom.

I lay ed my extra blanket on the ground, put my pillow by the near-by collection of dirt-covered shoes (leaving just enough space for the door to open without getting hit in the head), and layed down. For five minutes. Then it was into the bathroom. Again. And again. And again.

Welcome to community living.

We share meals. We share living space. We share workspace. We share germs.

There are a few other nurses sick as well right now. From what I hear, bugs travel pretty quickly on the ship. It's quite inevitable.

Not the best part of this experience, but at least I held down toast at dinner. I would really like a soda, but the ship shop is waiting for a shipment and has none. Such is life on boat.

Emmanuel

Emmanuel is a ten your old boy who came to us with bilateral club feet. His calves were as thin as sticks and his feet severely mal-rotated. He lives at an orphanage. His belly is large and bloated and his hair discolored. Two sings of probable malnutrition. A common occurrence in Liberia.

He had been my patient for a week and a half. During that time I was really able to get to know him and his caretaker, Lucy.

At the end of last week has was always trying to play jokes on me. With a devilish, boyish smile he would tell me he had "plenty plenty" pain or that he had to go pee-pee, and then burst out laughing.

One day, I let him be my nurse. He listened to my lungs with my stethoscope and also took my temperature. I ached and moaned that my leg hurt. I grabbed a pain scale and pointed to a pain score of ten. I demanded medication.

He laughed so hard. It was wonderful.

Yesterday, I knew he was going to be discharged so I walked down to the ward to say goodbye. He was sitting in is bed wearing his clothes, waiting to go home. Lucy, his caretaker asked me how much longer I would be on the ship. When I told her I would be here for an entire year she was very grateful.

"Tell your mother and father thanks for sending their daughter to Liberia."

Lucy put Emmanuel and his crutches on her back, and carried him down the long ward hallway to the patient gangway so they could leave. I grabbed his other bags.

I am going to miss Emmanuel. I promised to think of him when I sang my favorite Christmas song, "Oh come, Oh come, Emmanuel," this December.

I think I'll always think of him when I hear that song.

cici beach

I spent the afternoon in Cici beach for some much needed fun.

going to church

saturday

I cannot believe we are more than midway through August. I hope you are enjoying the last few weeks of summer. Time is passing rather quickly for me in Liberia. Surgeries on the Africa Mercy are in full swing with eye, VVF, and orthopedic surgeries being performed daily. Us Mercy Ships nurses have been busy. Today was my first day off in over a week. An adjustment for a girl who is use to working three days a week and does not believe in overtime. My patients are far less acute than at home, but I am investing so much more emotionally. As a nurse, I get to be the point of contact between everything Mercy Ships does and the patients we serve. It a pretty big responsibility.

All well as being a nurse, I am writing twice a month for the Nursing advance magazine, as well as monthly for the Philadelphia Inquirer. Between the nursing and writing schedule I’ve been “plenty plenty” busy. I’m a little tired.

But it‘s the best sort of tired.

Philippians 2:16 says Holding forth the word of life; that I may rejoice in the day of Christ, that I have not run in vain neither labored in vain.

Never before had I realized how influenced my idea of wisdom has been influenced by my western culture. This experience is teaching me to appreciate the small moments in life. To take things one day at a time. To simply run without intensely calculating the destination. My head is daily filled with about ten new master plans for my life. Following Christ is such an adventure.

Ship life is a constant dichotomy. I get sick of eating peanut butter sandwiches and then visit a hospital full of malnourished children. I feel trapped on the ship (where I am safe) but then think of the translator who told me she’s is scared to sleep in her house at night because of the violence in Monrovia. I complain about working an endless number of shifts but then walk through the streets filled with people who can‘t find jobs. I get tired of being around people (four people have interrupted me while writing this email) but then meet a VVF patient who is an outcast in her community.

There is so much tension. And it’s sustenance is entirely an matter of perspective. The joy and the pain so closely intertwined.

Tonight I hung out with one of my patients, Esther. Esther has been here for two weeks. She’s 16 and completely sassy. We have become good friends. Yesterday, she was sad when I told her I was not working this weekend. So I promised to come visit. My friend, Crystal, and I stopped at the ship shop, bought soda’s, popcorn, and chocolate and headed to the ward. I grabbed Esther. We took the elevator (which I find far to scary to ride in…but for the sake of Esther I did it) to the 7th deck over looking the sea and hung out. It was a beautiful night with a cool breeze. We talked and laughed and ate junk food. Esther thoroughly enjoyed herself. So did Crystal and I. Not the way I would usually spend a Saturday night. But I would not want it any other way. It’s a such privilege to be here.

Eskimo kisses

Roosevelt is a seven year old Liberian boy. Three weeks ago, he was hit by a truck and broke his femur. I have taken care of vehicle vs. pedestrian trauma patients before and can tell you that Roosevelt is very lucky that his injuries were limited to a broken femur and some superficial abrasions. It could have been much worse.

Accidents are the number one killer of travelers to Africa. A fresh reminder to be careful when I'm walking on the street. And to always say a prayer before climbing in a taxi.

Roosevelt is twice lucky. Not only did he survive without any life threatening injuries but the Africa Mercy is in Liberia. He is one of our patients.

For the first 72 hours of Roosevelt's stay, he screamed. Seriously, for the full 72 hours. The Peace ward wasn't peaceful. Despite his scheduled narcotics and rescue doses of morphine, the air waves were filled with

"Oh, my leg, my leg."
"AHHH, I'm dying, oh Lord I'm dying."
"Mama, my foot itches. Scratch my foot, ahh, it itches."

From some of his comments, I had the impression that Roosevelt was probably a very naughty boy at home. The kind of boy who you will hide your teenage daughter from someday.

But last week, something changed.

Now, instead of greeting me with screams, he flashes me huge smiles. His two front permanent teeth are coming in and they currently have the cutest little gap between them. At least four times a shift I lean over Roosevelt's bed, rub my nose against his, and we both yell, "Eskimo kisses."

He loves to watch TV and is always requesting that I put a movie on. His favorite is The Crocodile Hunter. All I can say is "Crikey." I've watched it three times this week. I could probably recite the entire movie for you.

The staff here really goes the extra mile to let the patients know we care about them. It's most often in small, subtle mannerisms, but the message is loudly heard.

Roosevelt knows we care about him. I think that's why he now greets me Eskimo kisses instead of borderline profanities.

I prefer the Eskimo kisses.

boy george

This is a picture I took of My roomoate Michelle and a patient of ours, George. George has had some very sad things happen to him, but you would never know it by his smiles. All the nurses adore him.

caring

It's been a long week. I haven't had entire day off for a whole week. Me, who is use to my three-day a week work schedule. I'm looking forward to the weekend (I have off).

Even though my patients are far less acute then they were back home (I worked in a pediatric ICU) my shifts can be just as tiring. Any nurse would understand.

Being a nurse really requires giving of every part of yourself to your patients. Mentally. Physically. Emotionally. Spiritually.

In Africa, I think we all try to give our patients a little more.

In America, I cared about my patients. My favorite moments at my job occurred when I had five non-task oriented minutes to give someone a little extra TLC. They were five treasured minutes.

But at the end of the day my motivations for working, regardless of how help-oriented my profession, were selfish. I worked for a paycheck. For health insurance. To occupy myself. (which I do think are all valid and good reasons to work)

But on the Africa Mercy, it's a little different. None of us are here for a paycheck. We are actually paying to be here.

Caring is not just a part of our job. It's the reason we came in the first place. It's our motivation.

We care about the physical and spiritual healing of our patients. We care about 16 year old Esther whose hand was thrown in a fire when she was three. We care about 15 year old Teemah who was shot several times as a baby while she was on her mother's back. We care about George, who was mutilated with a pair of scissors when he was two. We care about Mary whose lack of obstetric care left her body constantly pouring out urine.

It takes a little more energy to care. To love. To take those five minutes and run with them. But that's why I came to Africa. Because I do care.

Esther is going to be here for a few weeks while her skin graft on her hand heals. She's already been here for two weeks. Yesterday, three of her ward friends were discharged. Emmanuel's care taker told me Esther cried all night and all morning, but when I came to work, she was happy.

Esther and I are friends. She knows I care about her.

It really makes everything worthwhile.

abstractions from deck 8

I really like taking pictures. Not for any particular reason. Just because I like it. It's a little scary to take your camera outside in Monrovia. You aren't allowed to take pictures in the ward. So tonight I went up to deck 8 and had some fun. Just because.

more abstractions from deck 8

the lines of my earth

a few lines that have been floating through my head this week..

"...Time and place are fluid, and history runs into the present, and the present is always straining into the afterlife so that nothing is only what it seems." National Geographic

"The man who comes to a right belief about God is relieved of ten thousand temporal problems, for he sees at once that these have to do with matters which at the most cannot concern him for very long; but even if the multiple burdens of time may be lifted from him, the one mighty single burden of eternity begins to press down upon him with a weight more crushing than all the woes of the world piled one upon another." A.W. Tozer

Today

Today was busy. A little chaotic. A little crazy. Oh the life of a nurse.

Today I helped change Esther's dressing's on her hand and thigh. She is now 16, but when she was three, rebels took her hand and burnt it in a fire. Since then, it's been permanently curled in a ball. Our surgeons preformed and contracture release and skin graph. We pre-medicated her before we started but it did not stop the flow of tears throughout the two hour process. I felt so sad for her. I bought her a crunch bar and took her to an empty room to eat it as a treat when it was all over.

Today Tarwoe told me she loved me. It was said as I left the room but I think it was genuine. This patient is 20 and went home around five pm. She was expecting to go home at 12 pm, but her mother was running late. As I waited be the gangway for her to leave, she and her mother were in a heated debate. I had a translator find out if anything was wrong. Nothing was wrong. Tarwoe was upset that her mother was late. I think my mother and I have had the exact manner of conversation. Human nature is so uniform.

Today I had my third "African lady" lesson. I'm really becoming a pro at carrying things on my head. Maybe I will start a trend in America when I come home.

Today I took care of a patient whose mother had rubella while she was in utero. She is 2 1/2 and came with her little sister who is 6 months. They wore the same size diapers. The little girl is deaf and blind. We are removing her L cataract. We already removed the R cataract and our surgeons as well as the patients mother are pretty certain she is seeing light and large objects. She had never seen anything before.

Today I never made it outside. It's been raining for 1 1/2 weeks strait. It's peak rainy season. Our Internet, which has been shady all week, was completely shutdown all day.

Today I had instant oatmeal for breakfast. A welcomed change from toast.

Today I was suppose to do my weekly load of laundry but the washers were to crowded.

There is always tomorrow.

block buckets and thunderstorms

Kin Anna and I are learning to carry things on our heads like genuine African ladies.
There was a thunderstorm tonight and it was lovely.

party

Tonight I am in the peace ward without a second nurse. Just me and my eight patients. I am able to be as crazy as I want too.

We had fun tonight.

My friend Stacy walked by our ward, came in, and said
"I saw a party and I had to come in...I'm a little jealous of the ward nurses."

I really don't want you to get the wrong impression. We do work hard here in Africa. But this weekend was a much needed ship holiday (translation: anyone who works 9 to 5 had Friday and Monday off). So we have had no fresh post-ops since Thursday night. Everyone feels pretty good at this point.

The night started with a the movie "The Crocodile Hunter: Collision Course" featuring the late Steve Irwin. The ward is filled with teenagers at the moment and they laughed and oohed at the scary crocodiles and slimy snakes. I sat on my patient Naymou's bed and held her hand as we watched the movie.

Mastering the art of carrying large objects on my head is a skill I am hoping to acquire during my time in Africa. Tonight I had a lesson from Prince.

Prince is a 16 year old boy who is witty, smart, and polite. His entire right leg is casted. His house has burnt down and he has nowhere to live. So he is staying a few nights with us. In Liberia, woman place carefully wrapped fabric on their heads when they want to carry something. Prince wrapped a pillow case for me and put it on my head. I then proceeded to carry a two gallon container of blocks on my head like a genuine African lady.

I walked the entire length of the hospital hallway. Every mobile patient sat at the door and watched. The others were my accompaniment. They all laughed hard at my half-hazard attempt.

So did I.

When I was finished "practicing" my developing skill, I showed them pictures of my family via the computer. Later we sang some Mary Mary songs. Patricia in bed 60 knows them all. I even tried to teach Esther, a 16 year old patient, some swing dance moves.

You always have to dance at parties.

Around 11:30 it was time for bed. Before they went to sleep I told them why I came to Africa. I told them how much God loves them. I read them the 23 Psalm,

"The Lord is my Shepherd, I shall not want. He makes me to lie down in green pastures; He leads me beside the still waters. He restores my soul."

Prince prayed a bedtime prayer and the lights were turned off.

I went to each bed and carefully tucked them in. It's been a good night.

tales of war

Yesterday I went to the market. We walked over that bridge that leads to the center of Monrovia. As we walked by I again marveled at the bullet holes that filled the posts of the street lamps. My friend Lorah pointed out that these holes were caused by missed shots. A significant number of shots had to be fired to produce that many misses.

Mercy Ships has showed several documentaries about the war since my arrival. They show the buildings and city that we walk through everyday before the war. It's filled with buildings that aren't broken down and bombed out as well as street lights and roads that work.

The civil war went on for 14 years. An entire generation has grown up dodging bullets. Liberia's children have grown up as soldiers. Busy fighting wars and using guns rather than going to school.

An orphanage worker was marveling at this fact. That this generation has no remembrance of what Liberia was like before becoming havoced by the war.

Today my roommate was visiting a prison. Liberia's president, Ellen Johnson Sirleaf, stopped by while they were there. She offered our crew her sympathies for the recent loss of a crew member. The prison had been had been her home during Liberia's turmoil and she was visiting her old cell. She seems to be an excellent, smart, and very approachable woman.

I would never want her job.

Rebuilding is going to be a long process. I have been educated about Liberia's civil war in the same manner in which I was educated about America's civil war. Through books and stories. But the people I am meeting have had a different education.

One of our translators told me over lunch that she gets scared whenever she hears loud noises because they remind her of the bullets she use to hide from. A 16 year old in our ward is here having a burn contracted release. When she was 3 the rebels stuck her hand in a fire. Another 15 year old came to have three bullets removed from her body. A man had his arm burnt so severely it needed to be amputated. A woman with VVF delivered her baby while running from the rebels.

They have received a different education.

What we are doing seems very small next to their stories. But it's a matter of perspective.

Seven months of free surgeries won't make a big difference in Liberia's problems. But Mary doesn't leak anymore. Esther can mover her hand. Issac is going to walk on two strong feet. We have shown them God's love.

It's a made a big difference in thier lives. And I think they are worth it.

just do it

Crystal is my new jogging buddy. Today we went for a jog in the Liberian rain.

Crystal runs marathons. My jogging is more of a glorified walk around my neighborhood. It's a healthy challenge to keep up. At home, jogging is a bit of a relaxing experience for me. It's a time to think and to pray. My neighborhood is full of old trees and wide paved roads.

But it's a little different in Liberia.

When I jog here, I feel a bit like I am in a Nike commercial. In spite of the roads condition, in spite of the weather, in spite of the people around me, I just do it (whoa, I am such a nerd).

We run on the shoulder of the road which is completely made of dirt. It takes skill and concentration to dodge/skip over the many large puddles that seem to consume the ground. Any dry area is filled with people. The men often make comments (just like men at home). Sometimes they make the classic Liberian pucker sound. Sometimes they try to be funny by saying, "You lazy girls." Sometimes they try to run with you. Sometimes they tell you that you are their wife. Sometimes they say thank you (I am not sure why).

The roads are filled with an ever flowing stream of yellow, beaten up taxi's. They often pull over to the shoulder to pick up passengers so it's good to be aware of your surroundings at all times. We do have orthopedic surgeons on board, but I really don't feel like getting my foot run over during my stay in Liberia.

Relaxing is not a word I would ever use to describe the experience. But it is fun.

my lovely patients

Kou

Kou is a three year old little girl. Who, by the way, is completely lovely. She likes to smile and laugh and play with blocks. Her dad is completely attentive to her needs and takes very good care of her. Her skin is dark and soft. She’s quite kissable.

Three months ago, Kou fell and hurt her knee. Her grew to the size of a small grapefruit forcing her to walk with an extreme limp. A once active little girl was confined to a small, painstaking movements. Her calf is already starting to whither.
In Liberia there are limited medical resources. Kou was unable to get the medical attention she needed. A minor accident could have caused this happy, active girl to be crippled for the rest of her life.

But the Africa Mercy is in Liberia. Kou won’t have to spend her entire life crippled.

Her little leg is now held hostage by a plaster cast. But she does not seem to mind. She’s actually quite feisty.

Today, I found her hysterically crying. My first instinct was to asses for pain. But Kou wasn’t in pain. She was upset because Tommy, another orthopedic patient, was holding the green car. Kou had the blue car but she wanted the green one. She was basically having a temper tantrum. Like any three year old does. Later she was sitting and eating her lunch, rice with chicken and green sauce. I pretended to eat out of her bowl. As I walked away, her father called my name. I turned around and there was little Kou holding a spoonful of rice. She thought I was really hungry and wanted to share her lunch.

Before my shift was over I was able to hold her on my lap and build with blocks. Nursing can be frustrating sometimes and today had been a bit of a frustrating day. But the last ten minutes of building blocks with Kou pretty much eradicated the previous 500 minutes. It’s pretty great.

the new normal

After two monthes of living on a hospital ship, I have adapted these things into my schema of normal.

The weights in the weight room are in kilograms.
The routine series of beeps on the overhead proceeded by and Arnold-swartzaneger-like voice saying “this is a test of the alarm”.
A translator teaching parents malaria prevention in the ward.
“When did you last have malaria” being an admissions assessment question.
Seeing at least three men a week peeing in broad daylight.
Eating cheese sandwiches. Seven days a week.
Two minute showers.
Having your head hit the top of the ceiling whenever your driving in a vehicle.
Fitting over seven people in a four person taxi.
Drinking coca-cola light (rather than diet coke).
Always wearing a name badge.
Seeing UN workers with large guns outside the window.
Identifying myself as from America rather than Bucks County.
Being very excited about going to the tailor.
Paying 50 cents for a cappuccino.
Sharing a small-small room with five other woman.
Never exposing my knees before 6 pm.
Experiencing a nuetella love-affair.
Hearing the water rush through the plumbing system every time someone on the third deck flushes a toilet.
Never seeing a full length mirror.
Wearing jeans and being considered “dressed up”.
Meeting children who have never seen white skin.
Having people think I am cool. Oh wait, they still don’t think that.

reflections of an over-active mind

I moved today.

I’m still on a hospital ship in Liberia. I am still in cabin 3426. But now I am in the back room rather than the front. I actually sort of have a room rather than a glorified closet now. Exciting.

“Moving” was a bit rushed seeing that our roommate did not leave until 2:30 PM and our new one is going to arrive at any moment. Hospitality was beating down the door to make the bed a 3:00 pm. A girl has to move fast to get what she wants in this world.

I am feeling a bit saturated at the moment. Trying to grasp the dichotomy of being a westernized girl in westernized bubble in a third world country. On the ship you can forget your in Liberia.

We work on a hospital with a cat scanner and x-ray room and wall suction. There is 24 hour internet (even if the connection is unstable an slow). We have a star bucks. And uno cards. And phone lines.

But yesterday I went to church and sat with my little friend who doesn’t have a mom. The building in which the service was held is home 200 displaced people. They stated downstairs while we had church upstairs. One of the members was offered a chance to live in the building but she didn’t want to because it was not very safe at night.

Many of the church children has streaks of gold colored hair amongst their black braids. Some adults had this too. It’s a sign of protein deficiency. Most of the children here are very malnourished. If they do eat, it’s generally simple starchy foods like rice and cassava (a potato- like root). Forget about Flintstone multivitamins.

And here I sit tired of peanut butter and worried that I am going to gain weight.

I think the real struggle I have is not so much with outward circumstances but my inward reflections on my situation. The struggle to find a balance between giving of yourself and enjoying what you have been given.

I am becoming more convinced that life is really about the journey. Our destination is fixed. If we continue to live we will all face death. I think that’s why we often make ourselves so busy. We don’t want to recognize out frailty of consider our own mortality. But at some point it will be considered.

I am so grateful for the perspective I am gaining here. Meeting people from around the world has further convinced me that who we become and how we think is largely determined by the environment from which we come from and the experiences which we have in life. Another reason to not be easily offended . Another reason to give people the benefit of the doubt.
I also feel that the idea of a nine to five life is being forever ruined for me. Not that I think it is wrong. I’m not a fan of classifying people and what they do into “A” and “B” teams. But we only spend a short time here. And we are very frail indeed.

We must choose our paths wisely. I don’t want to have any regrets in forty years.

tension

“Tension is too be loved when it is like a passing note to a beautiful chord.”

Today was a busy day. I feel adequately tired.

Weekends are fun here. They provide a much needed opportunity to leave the confines of our hospital ship and breath some fresh air. Seeing that I am working 6 of the next 7 days I felt it was important to take full advantage of my opportunities to leave the ship.

So I did.

This morning I went to an orphanage. There was 50 kids ranging from 3 months to sixteen. As we walked into the room the children immediately ran to our sides soaking in any physical affection we would give them. I started a huge game of ring around the rosie followed by the clapping game “going on a bear hunt” (except I made a slight substitution- we were hunting for lions).

We sang songs and handed out balloons. I kissed all their faces. African children are just so kissable. I held one little boy, Emmanuel, in my lap for almost and hour. He even passed up an opportunity to receive a hand-crafted balloon sword to sit with me.

When I was a little girl I remember my mom waking me up by rubbing my back. It made me feel safe. There are studies that show the need children have for physical affection. These children crave it. Being at the orphanage made me want to get my NP so I could start my own orphanage. One of the ten master plans I have for my life at the moment.

One of my roommates is leaving on Monday. Michelle B. It will be very sad to see her leave. When I first got here, I was told there were two words you needed to get used to at Mercy Ships, hello and goodbye. I am not so keen on all these goodbyes. And this is just the beginning. It was also I a friend’s birthday. In honor of them we went out for ice cream.
But I am trying to stay away from junk food. Today I was having a “I-am-eating-to-much-bread-here-and feeling-very-bloated” kind of days. At home I am constantly reminded that I am not a size two. It always kind of bothers me, makes me feel a little insecure, makes me think I should skip dessert. In Liberia I don’t have those reminders. There are no full length mirrors. I basically only ever know what my face looks life. The women here have figures. And it’s acceptable.

However, today I meandered on gap.com (just to see what is in style) and I felt the size 2 pressure. So I skipped dessert tonight.

My mind cannot grasp the dichotomy of ship life. Here I am worried about gaining a few pounds while I am surrounded by malnourished children.
There is so much tension in this experience. The tension of living in a western bubble in a third world country. The tension of living and working with people of all ages and walks of life from over 40 countries. The tension of giving what you have while gaining what you need. The tension of missing home while loving where your at.

But tension is not a bad thing. I just wish my mind could grasp the concept of my experiences. I’m going to bed.

kids

goodbye

Goodbye is a frequently spoken word in Mercy Ships. People come. You become Friends. Then they leave. It's very sad actually.

Dr. Ned and Dr. Paul were my neighbors for the past two weeks. They left for the states today. They were both older gentleman who I believe are retired at the moment.

Dr. Ned has a deep older man voice. When they first arrived, at 2 AM, it was heard quite loudly though our cabin walls. I am certain he had no idea we could hear him.

Someday I am going to write a book entitled "Honest, Clear, Communication." I think if everyone read it it might solve most of the worlds problems (*disclaimer* I don't actually think that )

In the spirit of that book, I was obligated to knock on the door the next day when the walls were talking and my roommate, who just worked night shift, was trying to sleep.

Anyone who has ever gone to a retreat or Coatsville with me is probably laughing right now. I promise I refrained from reading them the sleepers bill of rights.

Although there was great hesitation, I made a fist and knocked on the door. I plead my roommates case. The surgeons were so lovely. They had no idea we could hear them. They even apologized for the night before. I assured them it was no big deal.

Another problem solved by honest, clear, communication (wouldn't that be a great book?).

After that greeting, we became friends. I bought them some Liberian donut's. Dr. Ned proofread an article for me.

Our crew consists of people from all walks of life, of all ages, and from all over the world. An incessant stream of hello's and goodbye's.

It's like an international space station. Sort of (not really).

platted hair (braids)

On Monday one of my patients was a fifteen year old girl. She was shot several times during the war. We were going to remove the bullet that was still lodged in her left thigh as well as clean up several other scars.

Being a patient in the hospital can be a little boring. I thought she might find braiding my hair amusing. So I retrieved a comb and rubber bands from my room.

When I returned she got shy. She didn't want to braid my hair. Which was fine. I didn't care about the braids, I just thought it might be nice for her.

But before I could put away my comb, James mom spoke up.

"I want to plat (braid) your hair."

I really like James mother. She was my age and a little sassy in the best kind of way. If we were in school together I am pretty certain we would have been friends. Maybe even kindred spirits.

So she platted my hair. Carefully she divided my hair into neatly segmented squares.

People have been asking me how long the process took but I am honestly not sure. We would start and stop and then start again. After about 25 minutes of platting I generally had some nursing duty to perform. I went to dinner with my hair half-platted. Good thing I don't really care about looking silly.

But at the end of the night my head was transformed into a Medusa-like collection of braids. And it was a hit.

"Your hair looks fine," was the general consensus of the Liberian mothers and translators in the ward. My friend even got hers done the next day. She told me she felt a little guilty having it done while she was working.

I didn't.

It really wasn't about the braids. I would have been fine with my normal afro-bedhead look. It was about friendship. validation. About giving someone the opportunity to do something for you. About letting James mom have something to give me. It made our relationship mutualistic.

It's funny how a very small gesture can mean alot to someone. The next day I wore my African skirt to match my African hair. Three of the translators sat with me at lunch. They had never done that before.

How to reach someone is not something you can find in a textbook. It's something you find in your daily life. We are surrounded by opportunities to validate a person's worth.

Maybe it's a kind word. Maybe it's laughing at a joke. Maybe it's listening to what someone has to say.

Maybe it's having your hair platted.

Collin

A member of our crew drowned on Sunday afternoon. His name was Collin. He was 21. He was my neighbor. His cabin was on the right. Sometimes at night I heard him and his bunkmate laughing through the walls. Once I interrupted a guitar session to ask a dumb question. He didn’t seem bothered.

I didn’t really now him very well. He had just graduated from Texas A & M with a pre-med degree. He was Texan. He was only staying short term. We arrived the same week and were a part of the same new crew orientation.

Living in a small community you kind of know everyone. At least a little. At least a smile or hello in the hallway.

On Sunday morning I thought we would be unable to transport one of my patients to the ward church service down the hall. So I frantically started searching for a gourd shaker so I could sing songs with my bedbound patient. En route to my room I bumped into Collin and his roommate Rob. They were dressed in beach clothes. I asked Collin a question.

“Do you guys have an gourd shaker I can borrow?”

“No, I’m sorry, we don’t have one.”

Then we both went our way.

Two hours later while I was eating lunch on the port, I heard the emergency medical team paged on the overhead paging system. I went to reception and found a flurry of moving medical professionals. Apparently there was a near drowning of a crew member at a local beach. They were performing CPR.

My stomach became completely raw. My heart hit the floor.

Two hours later the captain asked on the overhead that everyone would come to the international lounge. We then learned that Collin had died.

Last week I wrote a blog called Burn out Bright. I think it’s so appropriate to Collins situation.
He Burned out Bright.

There is a lyric in the song that has hit me this week

If we only got one life
If we’ve only got one try
If time was never on our side
Before I die I want to burn our bright

Time is never on our side. When we hold time up to the light of eternity is becomes transparent. We can’t hold onto it. Even if we lived to 80 or 90 years, it’s a only a vapor.

John 17:3 says
And this is life eternal, that they might know Thee the only true God, and Jesus Christ whom thou has sent.

Collin is knowing Christ fully right now. His mind is fixed on the only reality the universe contains.

I have found that so challenging this week. Do I really believe that Christ is eternal life and that this eternal thread can be experienced here on earth? The implications are deep, dividing that which is soulish and that which is spiritual.
But when I die, I’d like to burn out bright too. I’d like to follow Collins example.

Please pray for his family as I cannot imagine the pain they are going though. His service will be on Friday. Also, please pray for our crew members who were with him at the beach. They are traveling to Texas to attend the service. Please pray for their emotional healing and safe travels.