Agustine

A group of Mercy Ships crew left the ship on Saturday for a day trip to an area in Liberia called the Bong Mines. A local train allows us to strap our Land rovers to empty cars of the train and enjoy the 2 1/2 hour train ride through Liberia. The trip ends at a beautiful, large lake. It's a great day trip.

Last weekend the crew arrived back to the ship with one person more than they left with. That same weekend 11 year old Augustine, who was from the Bong mines area, had fallen off a truck and broken his jaw. He was lucky to not have any major internal injuries but unlucky to live in a country that currently has no health infrastructure. There was no where he could go to proper treatment.

Somehow, he was able to contact a member of Mercy Ships and arrange to join the crew on the train ride home. On Monday, he had surgery to correct his broken jaw.

After spending a day in very bad pain, he had a much better day today. This is a photo if him outside on the 7th deck. I'm glad we were able to help him.

more Tamba

I just love this little boy and his parents. They are the type of family that makes you happy your a nurse.

Tamba

Tamba is a special baby. He is three months old and from Sierre Leonne. He has two lovely parents and a few siblings.

He was born with an encephelocele,

which, according to Wikipedia is

"Encephalocele, sometimes known by the Latin name cranium bifidum, is a neural tube defect characterized by sac-like protrusions of the brain and the membranes that cover it through openings in the skull. These defects are caused by failure of the neural tube to close completely during fetal development.[1]There have been studies and evidence linking NTD's to folic acid deficiency. The severity of encephalocele varies, depending on the location. Currently, the only effective treatments are reparative surgeries following birth. The degree to which they can be corrected varies greatly on where and how big the encephalocele is"

His parents traveled for two months and spent all there money trying to find a way for him to receive corrective surgery. Finally, when they had almost completely given up hope, someone placed them in contact with Mercy Ships and arrangements were made for Tamba to come to the ship.

When he first arrived her was difficult to look at. He had a huge sack/tumor like protrusion from his head. It looked painful, uncomfortable, and dangerous.

He was in surgery for almost 8 hours. It took several surgeons and nurses, performing complex neurosurgery, but when he was wheeled into the recovery room his large protusion was replaced with a turban of bandage and gauze. A nice exchange.

I recovered and took care of him immediately after his surgery. He did amazingly well. We were able to bring his parents into the recovery room only fifteen minutes after he left the OR. He was breastfeeding after only spending a 1/2 out of the OR. It was really amazing.

His parents were almost in tears when they walked into the recovery room. They were so happy and thankful that there son had received surgery. It was a beautiful moment to be a part of.

Dr. Gary Parker, our chief surgeon (and an amazing, humble man), told me that in his 20 years of experience he has never seen a West African adult with an encephelocele. They die before they reach adulthood from infections or other complications.

Tamba is doing well. Tonight he was laughing, cooing, kicking, and grabbing my finger with his tiny black hand, like any 3 month old would. He is very popular and often has visitors (I decided that he knew what he was doing when he came to a ship filled with nurses that has a 10 to 1 female to male ratio..he knew he would receive plenty of female attention :) . His parents are absolutely lovely. They are the kind of people that make you appreciate being a nurse.

I'm so happy we could help sweet little Tamba.

Levi

Today I had the most enjoyable shift. Everyone was happy. All my patients were children. I worked with my roommate Dorothy and we wrote a few ridiculous songs about the daily routine's of the ward (like the "Pupu song" did you want that dose of lactulose? Wow..I am such a nerd)

Levi was one of my charges. He's a ten year old boy that weighs only 20 kg (about 44 lbs.). He had a large facial tumor debulked that is suspected to be cancerous, probably Burketts lymphoma. It took only five months for his tumor to take over the right side of his face.

Tomorrow we are transferring him to a facility where he may start chemotherapy. I have taken care of many newly diagnosed cancer patients and it breaks my heart every time. I wanted to cry in report when I heard Levi, who I had never cared for before, might have cancer and need chemotherapy. Chemo is not fun for kids and you hurt for the patient and family because you know the road they will be traveling down.

As I was getting report, Levi came by and began to ask us for cow meat. He is on a soft diet that apparently was not satisfying his appetite. Immediately it was apparent that he had an extremely sweet demeanor. He was happy, friendly, shy, and polite.

And so skinny.

It's always sad to see a child be sick. But there is an extra element of sadness here when you think of the very limited resources available in this country. Levi lives in a country that has no electricity or working plumbing. His hospital experience will not include specialist, air conditioning, nutritionist, complex medical equipment, or a single bed hospital room. He'll get chemotherapy and hopefully clean water.

I'm going to keep his sweet face in my prayers this week.

kids at Fatima

update

Hello friends!

It’s been a awhile since I have communicated via email…I have been busy climbing mountains, taking care of patients, and trying to keep my 7 by 8 foot cubicle space in my six birth cabin in a state of somewhat organization (like that‘s actually possible).

It’s hard to believe that we are on the verge of November. The past two months have flown by and we are quickly approaching the end of our outreach in Liberia. The ward will be closing in only four weeks.

Life on the ship can be surprisingly busy and I have found myself somewhat exhausted. Perhaps it’s a side effect of an indecisive wisdom tooth that caused my right gum to become entirely inflamed or maybe it’s just my inability to get to bed before 1:00 am, but either way I am looking forward to our looming sail and spending the holidays in the city of Brotherly Love.
I have been on the ship for almost five months now and there is a long list of bizarre things which occur on a regular basis that have been normalized. But while ship life is becomes “normal” it could never quite feel like home and yet when I think of the experiences I am having in West Africa I doubt that home could ever feel completely like home again.

Feeling somewhat displaced has really made me question my idea of reality and ultimately realize once again that, “Those things which cannot be shaken may remain”, (Hebrew 12:28), and Christ alone is that which is immovable.

At the end of the day, at the end of myself, at the end of my pride, at the end of my sanity, at the end of my strength, I am simply being beckoned to assume my position as the privileged daughter of the Most High (a God’s princess as Gil trusty would say) with no strings or demands. I am simply asked to walk in love.

It’s very freeing.

I will say good night with two things that have resonated with me this week

Hebrews 11:13-14
These all died in faith, not having received the promises, but having seen them afar off, and were persuaded of them, and embraced them, and confessed that they were strangers and pilgrims on the earth. For they that say such things declare plainly that they seek a country (homeland).

"If I find in myself a desire which no experience in this world can satisfy, the most probable explanation is that I was made for another world."C. S. Lewis

a day off

Today is the first of three days off. Days off do a body good, I am convinced. At home I work three days a week of and regularly have long strings of days off which I very much enjoy. Here, often only have two consecutive days off every two weeks. Our shifts are shorter than at home but they can still be quite tiring and you sometimes don't feel like you have adequate time to recover. And we are a little short staffed and my right gum line is swollen and infected due to an indecisive wisdom tooth (ouch, I'm on a steady diet of antibiotics and painkillers).

So I am really excited about a few days off.

Sadly, I had to arise at 7:00 am this morning to attend a mandatory ship safety meeting run by the captain. But I must say, it's been kind of nice to be awake and accomplish something with my day. I was able to spend a good chunk of the morning reading on the dock and the bulk of the afternoon editing my video from Nimba mountain.

Life on the ship can be intense if for no other reason than that you simply can't ever really get away. For example, at home, if I am a little burnt out from being a nurse, I could go spend the day at the park or the bookstore. There is plenty of time to simply think, meditate, and pray, whether it be during a long commute or an empty house. But when your commute is less then 30 feet and you live in a six birth cabins these opportunities are non existent.

So sometimes things feel a bit more intense then they are or they should be, simply by the sheer factor of close proximity.

But the end of yourself is not a bad place to be.

Isaiah 42:5-6

"Thus saith God the Lord, He that created the heavens and stretched them out; He that spread forth the earth, and that which cometh out it; He that giveth breath unto the people upon it, and spirit to them that walk therin; I the Lord have called thee in righteousness, and will hold thine hand, and will keep thee..."

It's so good to be reminded of how small, how incapable, how weak, how unable I am. Sometimes I trick myself into believing that I possess something of worth. It's a very draining notion; if strength were mine, I'd have to groom, feed, and maintain it. If strength comes from Christ I simply must accept it and relish in my position as a Kings daughter (a God's princess as Gil Trusty would say).

Being surrounded by people always reinforces the fact that you can't please everyone. There is always some flaw, some misdoing, some miscommunication, some reaction, some breakdown that someone will find and hold in the light. But how good it is to know that I have no one to please. Christ is my righteousness and grace is my fixed position and eternal security.

While I, along with the rest of the world, daily uncover and rediscover my flaws, Christ gently whispers

"Thou art all fair, my love; there is no spot in thee."

Amen.

plenty plenty tired

I have been on the ship for over four months now. Mercy Ships has been in Liberia since March. The ward will be open for only four more weeks. We are all tired.

I am exhausted.

My schedule has been filled with plenty plenty shifts and I feel my patience wearing a bit thin. Living on hospital ship filled with people form so many cultures carries with it a unique level of intensity. It is an amazing experience, one I do enjoy and do appreciate, but my body is tired and I am ready for a break.

The sail will be nice.
Philadelphia will be cold and lovely.

joy

On Monday night I found a note on my door asking that I would work an evening shift, rather than a day shift, on Tuesday because there was a possibility of receiving an ICU baby. Normally any opportunity to not wake up before 8 am is an opportunity I readily take, but I had not worked a day shift in almost three weeks and was looking forward to it (sometimes working evenings and nights is a little sad because you don't get to see anyone. Everyone is working while your off and everyone is off while your working).

There was a three month baby boy on the ward who had a encehplolphele (that is probably grossly misspelled). From what I am told a some measure of brain tissue abnormally protruded from his skull during development leaving him with a large tumor-like mass on his face. Dr. Gary Parker, an American maxio-facial surgeon who has lived on the ship with his family for twenty years (amazing!!) , said he has never seen an adult West African with this condition. They generally die from encephalitis or some other complication before reaching adulthood.

The baby was in surgery for over ten hours. I helped bring him back from the OR and stayed with him in the recovery room (not many people here have pediatric experience and kids, understandably, make them nervous, so they like to have a pediatric nurse around). The baby had his head wrapped in a large turban like dressing and was screaming as soon as he was out of the OR. A lovely healthy screams that says, "my lungs are working just fine," and is always appreciated by medical teams.

After we had gotten him settled we brought his parents in to see there baby. It was a beautiful moment. The joy, excitement, and gratitude that oozed from their faces was completely beautiful. There baby had been given a chance at life.

black and white (photos)

Bathshe is a crazy four year old boy who had a burn contracture release done. He's crazy; giving you kisses and hugs one minute and throwing complete tantrums the next. He also is a bit of a flirt. I feel certain he will be a little mac daddy during his teenage years.

I love hands. You can see Bathshe's little burned skin.

Musu has been here for over two months. She is the one who always tell's me my but is big and that I should marry her brother. I platted her hair for her on Sunday. It was amusing.

Sarah is a VVF patient. She is the smallest cutest thing you will ever meet. She was here for her second surgery, which was successful. (yeah!!)

brunch

My Bunk mate, the wonderful Michelle, and I.

Yesterday was Sunday morning.

Going anywhere in Liberia is always associated with some kind of stress. There is the stress of trying to catch a taxi (and the awful rejection of standing on the side of the road with your hand waving and watching the parade of empty cars drive pass as their engines whisper the sinister growl of "I'm not stopping to pick you up). There is the stress of finding an appropriate sized group. There is the stress of trying to assemble the appropriate sized group in a timely and efficient manner. There is the stress of trying to talk to everyone in the appropriate sized group. There is the stress of haggling for a decent taxi fare. There is the stress of deciding who gets to go into the Land Rover and who takes the taxi. There is the stress of sitting in traffic and having a ten minute drive take over an hour.

But Sunday mornings aren't stressful because I use to go to African church, but now I go to Sunday brunch. A lovely Sunday brunch.

Breakfast has always been one of my favorite outings. My enjoyment of going out for breakfast far surpasses my love of eating a noontime cup of soup and whole grain bread or enjoying a crisp Cesar salad for dinner. There is something so simple and nice about ordering a fresh vegetable omelet, a strong cup of coffee, and side cup of fruit (Especially when your sitting at Pat's in Newtown).

Sunday brunch is a very relaxing and nice experience. It's a buffet style breakfast that provides a happy time for my taste buds and lovely fellowship for the soul.

Michelle is my bunk mate. She is lovely, patient, kind, and understanding. She shares a 7 x 8 foot bunk space with me, God knew she needed all those qualities :). I have shared my love of brunch with Michelle who now agrees that brunch at the Royal is the only reasonable way to spend your Sunday morning.

Yesterday we went to brunch and we caught a taxi to get there. The relaxationess of the experience was almost ruined by out taxi driver who, "wanted to be my friend''. When a man wants to be your friend, he doesn't want to be your BFF or join you for a casual cup of coffee. He generally wants you to bring him back to America and marry him.

"White girl, White girl, you be my friend", is the commonly sung and slightly obnoxious mantra that no girl ever enjoys hearing. This particular taxi driver was quite aggressive. He took "the long way" to brunch, while telling me he will be visiting America in December while accusing me of not being friendly because I refused to give him my home phone number in the States (I wasn't being "friendly"..that was the whole point).

I arrived to brunch a bit flustered and moderately annoyed. My frustrations were calmed by a hearty omelet and smooth hummus, but next time I might try harder to mooch a ride in a Land rover.

I really am getting excited about the possibility of being anonymous again. It's impossible to blend in here. Your white skin is an immediate give away that your aren't Liberian. The only native light skinned folk are those who are Albino. Being in a culture without much (any?) diversity has made appreciate the diversity which America possesses.

I'm really looking forward to anonymously obtaining a good cup of coffee, a good book, and a very comfy chair. It will be so nice to not be noticed.

a few favorite's from my Nimba trip

tears

Bed 1, K.O., is a RVF/VVF patient who was here in August. At that time her RVF (rectal vaginal fistula) was repaired but we were unable to operate on her VVF (vesico vaginal fistula) . She had surgery on Friday to repair her VVF.

Dr. Steve is back on the ship. This is the third time he has been here since June. He is A Mercy Ships regular and I am a Dr. Steve fan. Last time he was here I was able to sit down with him and listen to the story of how he became involved with VVF repairs pre-Oprah/Bradgelina. It's a very interesting story that accompanies a very interesting man. But that's another blog entry.

For two weeks Dr. Steve is performing VVF repairs, most of which are "redo's"; patients who had surgery before but their surgeries failed. It's the last chance for these ladies; their final hope.

K.O. is only 21. Her chart tells her familiar sad story;
1 pregnancy
1 delivery
16 years old when fistula was formed
Child stillborn
Labor for 4 days
never married

Her injury was severe, scoring a 5 on a baseline assessment that Mercy Ships performs at screening days. A score of 0-3 gives a woman an 85% success rate while a score of greater than three offers only a 40% chance. The odds were against her.

Yesterday, K.O. was leaking and completely soaked her bed. After getting her to turn and move around the bed so I could change her sheets I noticed the corners of her eyes began to glisten. I stopped and sat next to her on her bed. Gently I stroked her head and held her hand and let her cry. The people of Liberia have all been through so much personal trauma that many have never had anyone to cry with; the feeling being that they have all been through hell and what makes your hell any worse than mine?

My heart sank as I watched K.O. cry. I wanted to cry for her (I almost did). She did not want to leak anymore. She didn't want to be embarrassed, ashamed, and ostracized. She wanted to have other children and be married. She was only 21 and the odds were against her.

After about 15 minutes and several tissues K.O. stopped crying and fell asleep. Today, she is lying on her stomach and not leaking as much. We are all praying that her body heals; that she beats the odds.

sunglasses

I went to the Fatima orphanage this morning and had a great time per usual. I happen to love big sunglasses, I brought two pairs to Africa with me. Seeing that rainy season is finally coming to an end (the Liberian people insist it ends exactly on October 15) I am finally needing to use my sunglasses.

Today the kids at the orphanage took turns trying them on. They were about as big as their faces. It was great.

I'm off to work.

bullets

A boy poses in front of mortar holes in the wall of the church.

The caretaker and his children stand in front of the shot up, broken church building.

The roads in Ganta were filled with shell casings. It was quite sad.
While walking in Ganta we passed a beautiful old church that was destroyed in the war. The walls were filled with bullet holes and entire roof was gone. Wanting to take a picture of the building our group stooped and walked towards the church. A Liberian man met us in front of the building. He was the church's caretaker.

Apparently it was a Catholic church and services were held throughout the war. It was destroyed in 2003 during "the third world war". A new church is currently being built at a different site.

emails

Here are a few emails I received this weekend... small small humorous :) The author's will remain anonymous..

from a dear friend...
"Hello my African queen,

How are you?

I am writing to get your permission to be you at the costume party this weekend. I’m still not sure if I’m going, but if I am, I want to be you.

I got this crazy idea on the prayer retreat, I can wear some kind of fun headband, red lipstick, a stethoscope, my camera and talk about all the good bargains I found this week….crazy huh?

Is that ok?"

From two 15 ish boys
I read this email at 11:30 pm after spending the weekend away (I was plenty plenty tired)

Hello Megan,
This is (name changed to protect the innocent), and
me and (name changed to protect the innocent) are doing an English project
for ms wagner. We are supposed to send and email to a
missionary in Africa so we decided to pick you. We are
supposed to ask you a couple different questions about
how this has changed your life. So here are a couple
questions for you: What do you think is one of the
biggest changes you had to make in order to adapt
there? At what age did you decide you wanted to go
into the missionary field? How much of a difference is
there from living here? Why did you decide for Africa
to be the place were you wanted to spread the Gospel?
What are some of the major medical conditions you've
seen there? We are going to start a prayer chain in
our class for you are there any important things that
you would like us to pray for you about? Thank you
for your time reading this email and could you please
respond as soon as you get the time because it is due
Monday.
God Bless,
name changed to protect the innocent''

This email made me laugh very hard. It was sent at 6:50 pm Saturday night. I could easily envision my own little brother sending it at the last minute and nervously waiting for a response.

the mountain

team Nimba

Esther's visit

Esther, a patient i took care of, comes to the ship weekly for physical therapy and wound care. Two weeks ago, during her first return, she sent my friend Melenie to retrieve me so I could say hello. Sadly, I was in the middle of taking our intubated patine to Cat Scan and could not leave the situation. Melanie told her I would try to see her next week.

Last week I worked night shift. Esther came around noon and asked the other nurses to find me. I was sleeping and the day nurses did not have the heart to wake me. Melanie said Esther was totally dejected that I could not come. She missed me.

Yesterday I was working in Faith ward (I was actually lip sinking to our feature film, "The Little Mermaid) when Kim Anna, who was Esther's adopt a patient, tapped me on the shoulder and asked if I was busy (I was busy lip singing). Apparently, Esther was in the next room having her physical therapy done.

I stopped singing and ran into the room.

Esther was standing in the middle of the room, wearing her purple dress, and smiling with all her gapped tooth goodness. Her hair was platted in a particularly crazy manner.

She threw her arms around me and we gave each other a bear hug. A long, lovely, bear hug.
It was so nice to see her.

Tonight, Esther, her sister, niece, and nephew ate dinner on the ship as Kim Anna's guest. We were all able to sit together. The cafeteria was a bit overwhelming for the normally loud and crazy Esther who sat there almost silently.

I'm so happy I was able to see her.

mirror

Today as I meandered throughout the ship shop I found they were selling full length mirrors. There are no full length mirrors on the ship. For the past four months I have only known what my shoulders up look like.

There is no Wal Mart in Liberia. The supplies we receive are shipped to us in large containers. Who knows the next time we will receive a shipment of full length mirrors. This was quite possibly my only chance to know if my clothes match after I get dressed, for the next eight months.

After searching for my bunk mate, Michelle, to get a consult, my impulsive nature kicked in and I bought the mirror. It's nice to be able to match my clothes again.

nimba 2

At 6 AM I finally surrendered to my insomnia and got up. It was quiet at the perfect chance to sneak out in the dimly lit dew with my pint sized new testament. I "washed" my face with an antibacterial wipe and set out towards the guest house porch. When I arrived at the front door I found it was locked and there was no key near by. Essentially I was locked in. We were all locked in (the man in charge had the key).

I instead opened one of the two windows in the small room by the door. The heavily screened window allowed just enough light for me to read the first few chapters of Hebrews. Since the generator was not on their was no opportunity to flip a light switch.

I am not a morning person but there is a stillness in the early morning that I quite appreciate when I am awake to appreciate it.

The calmness was soon interrupted by Carlos, one of our tip organizes, who ran through the hall singing a "Wake up, good morning", song. You won't find the lyrics of that song in the book "How to make friends and influence people."

By 800 our group of 20 was assembled on the front porch of the guest house, impressively only 30 minutes behind our original schedule. We passed around crackers and peanut butter and piled into our bus and a small taxi.

It took 1 1/2 hours until we reached the bridge, which was washed out, that would take us to the mountain. We climbed out of our vehicles, strapped on our backpacks, and waded over the river on a plank/log bridge. We then climbed a steep hill and made it to the bridges other side.

After some heated discussion on price, we arranged for four taxi's to take us to the top of the mountain, which was another 1 1/2 taxi ride.

We must have been stopped at least eight times. The UN/Liberian police seemed intent on making sure we did not reach the mountain. Our theme song, an adaptation from a Liberian radio classic, was "Nobody wants to see us on Nimba Mountain."

Our taxi's also had to pull over several times due to overheating or other mechanical malfunctions. (a side note, of the six people in my taxi, I was the only female. This occurrence is rarer than a simultaneous solar and lunar eclipse and I feel certain will never happen again during my Mercy Ship experience)

Finally, and I do mean finally, our taxi's could take us no further and we got out and hiked.

Mt. Nimba is Liberia's tallest peak and contains Iron Ore which was exported before the war. The mountain had lush, green steps carved into it's side and sat perched in front of a stunning green lake. The beauty was incredible. I felt like I was in an adventure magazine.

Most of the group planned on camping overnight, but I was on team turn around. We didn't want to camp so we turned around, took a taxi, and slept at the guest house in Ganta. There were many factors that influenced my decision to turn around and I am secure enough to say turning around was a beautiful experience.

Team turn around consisted of Dr. Russ, a retired eye surgeon, Vern, a Canadian plumber, Josh, a computer/IT guy, Becky, a fellow PICU nurse and kindred spirit, and myself. Quite the assortment of folk.

We drove the empty bus back to Ganta and enjoyed a lovely evening. I took a well appreciated bucket bath before heading for dinner at a local restaurant. Yea for rice and Coke in glass bottles.
That night we had a fire underneath a beautiful, starry African sky.

The next day we just hung out. We ate egg sandwiches, we crossed the Liberian border and went into Guinea, and we just enjoyed the general splendor of the African jungle. It was a lovely, relaxing day.

We waited to leave until our friends came safely back from the mountain. We left Ganta around 5 pm and made it to the ship by 11:30. We even sang a Kenny Rogers song during the taxi ride home.

The weekend was wonderful. It was so nice to get away from the ship and the constant pressure of living in a very structured environment. I was greasy, sleeping in mosquito netting, and taking bucket baths, but I felt more like myself then I had in a long time. You forget how little freedom you have when living on a ship. It felt great to be free.

The best part of the experience was simply being with other people. These kind of experience's force you to get to know those your traveling with. The fellowship and laughter was deeply appreciated.

It was totally worth going over 30 hours with no sleep.

pictures with commentary

here is a link to Nimba photos with dialogue. Be warned, I uploaded these at 3 am and there are some typos (by some I mean plenty plenty). Please don't judge my intelligence by my spelling and/or typing abilities :)

http://www.facebook.com/album.php?aid=14874&l=7d3d4&id=595499347

nimba part 1

This weekend I visited Liberia's tallest mountain, mount Nimba. It was a wonderful adventure.
About 20 Mercy Ships crew endured the extremely crowded seven + hour bus ride (with no AC) there. We fit 18 people and luggage in a van that comfortably fit about 6 Americans. And we sat there for over seven hours our arms, legs, torso's and books bags completely entangled. "Comfortable" had a very loose definition.

But the treachery of the travel showcased the caliber of people I was with. Not once did anyone complain, get angry or tense. We sang songs, we laughed, we stated the parts of our bodies that we could no longer feel, we talked about the differences between men and woman (why don't girls want to play soccer or video games?) and we had a great time.

We were stopped almost every hour at a government checkpoint which could be a bit frustrating. The check points are set up so guns cannot be mobilized throughout the country. We would flash our Mercy Ships badges and they generally let us pass. A few times we had to pile everyone out so our names could be written down and our ID's check. Piling out of the van was at least a 15 minute process and added plenty plenty to our total travel time.

When we finally arrived in Ganta, a city about 2 hours aways from the mountain, we happily found that our four friends who had taken a taxi (affectionately referred to as "team Ben") had arranged for us to stay at a hostile/guest house.

The house became dimly lit during the two hours the generator was running and we had large buckets of water next to each toilet that we used for flushing. There is no electricity in Liberia. It's like living in a constant blackout.

After drinking coke in a bottle and eating rice at a local restaurant, we went back to our cabins to sleep. I had worked night shift the night before and had at this point been up for over 30 hours. I was definitely tired and feeling slightly in human.

My friend Becky and I shared a room. We had a mattress that sat low to the ground and was drapes with a large mosquito net. Nothing fancy but it was a step up from a tent.

In the middle of the night (I thought) I woke up drenched in sweat. Becky was also up and I asked her what time it was, expecting her to tell me it was at least 4:30 am. When she told me it was only 11;30 I tried not to believe her. We had only been sleeping for an hour and I was already entirely sweaty and uncomfortable. I new it would be a long night.

I think I woke up at least four times. Around 2 am a school of roosters outside our window decided to crow every 30 minutes. I hate roosters.

top ten things I never thought I'd experiencine in this lifetime that I experienced this weekend on my trip to Nimba Mountain

10. I never thought I'd ride in a van with no AC and 18 people, that would comfortably hold six Americans, for almost eight hours strait, after working night shift.

9. Watching a Brazilian biomedical technician carry the equivalent of a yard sale (including a guitar and four filled plastic shopping bags) up Liberia's tallest mountain (which is quite ardours climbing at times)

8. Thinking, "Well, if the lighting strikes my friends on the Mountain, at 2 AM, I suppose the UN helicopter might reach them (maybe)."

7. Crossing the border of a country that is not in North America without a passport, only a friendly Liberian border patrol man.

6. Being the centerpiece of a hand woven Liberian bag advertisement.

5. Going through at least thirty UN check points in less than 72 hours.

4. Riding through Africa in a small van with great er half of my body protruding out the window, while videotaping and/or taking photos of the experience.

3. Coming to a place in my life where I only brought UNMIL t-shirts on my vacation.

2. I never thought turning around could be such a beautiful experience.

1. I never thought I would sit in the back of a Liberian taxi at night singing a Kenny Rogers song with a retired eye surgeon, a Canadian plumber, a computer guy, and a fellow PICU nurse (aka "team turn around")

Nimba Mountain

Nimba Mountain is the highest mountain in Liberia. In approximately 2 hours I will be climbing in a small Liberian but wit 16 other people to take a seven hour drive to Ganta, where we will stay overnight, and hopefully make it to Nimba the next day.

All on approximately zero sleep, seeing that I am just now finishing my last night shift.

It should be an adventure. This weekend is a ship holiday, everyone who works 9 to 5 has Friday and Monday off. So a group of us are going to the mountain.

The last ship holiday a few groups from Mercy Ships went to Nimba Mountain and their pictures were absolutely amazing.

Hopefully I will have a interesting update for Monday.

Have a great weekend.

Faith

marriage

Tonight I showed the patients some pictures I had from home. They enjoyed themselves. I like showing them pictures of my family and friends because I think it helps us connect on a very human level in that we can all relate to being a part of a family and having friends. It also helps the patients to realize that every member of this crew has made some sacrifices to be here and it gives me an opportunity to share with the patients why we all came in the first place.

After viewing the pictures Aaron was quite impressed.

"You look beautiful"

Aaron, who's age is somewhere between 17 and 23 (we are not really sure) in bed 38 later told me he wanted to teach me to beat rice. When I inquired why, he said he wanted to marry me. He then proceeded to ask me if I was able carry heavy basins of water on my head from the river.

I gave a hearty "no" to that question.

Marriage proposals are something every Mercy Ship girl receives the moment she walks through the gate off the port.

"White girl, I want to marry you," is the usual sweet serenade.

But I really don't think the Liberian men realize how high maintenance a western women would be.

For example, I cannot carry large basin's of water on my head. I would be unable to give birth, multiple times, by myself in the bush. I am not strong enough to make oil by repetitively crushing palm nut's with my arms. I don't know anything about farming or cooking over a fire. I would require, at the least, a small weekly allowance. I can't make my own clothes. I don't know how to beat rice. I would not feel comfortable breastfeeding a baby in the middle of a crowd. If a man hit me, I would attempt to hit back.

Aaron might want to think twice next time he throws around a marriage proposal.

Emmanuel

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Originally uploaded by megan_petock

This is Emmanuel.

He had a tumour removed from his face. He's nine and a little shy. He likes to be hugged.

Tonight when I started my shift I started I stopped by Emmanuel's bed to give him a hug and a hello.

"He has so many girlfriends,'' commented a nurse.

Emmanuel broke into a shy, happy, and slightly-embarrassed-but -not-really smile. Apparently I was not the first to give a specified hello to him.

''You (the other nurse and I) can both marry him,'' stated his mother from the far corner of the room.

Emmanuel tried to conceal his enlarging smile.

''I think I am a little old for Emmanuel, I would have to wait about thirty years.''

At this point, Emmanuel broke out into a fit of loud giggles.

Before he fell asleep, we sat and the end of his bed , read the 23 Psalm, and said a bedtime prayer. He melted his small nine year old frame into my side with one little arm wrapped around my waist.

Emmanuel has been rejected. He has been tough to look at. He has been teased by his peers. He eats up any attention he gets.

It's amazing to walk through the wards and realize they are filled with outcasts, many of whom are experiencing love and acceptance for the first time. You watch them come insecure and timid and gradually build up confidence and trust, until their personalities are spilling out.

We witness their physical and emotional transformation.

at 5 am

Nyamuh is a fifteen year old male who had a cleft palate/ cleft lip surgery performed. He is now the owner of several beautiful suture's which have reconnected his deformed face.

At the beginning of the shift I had his arm bound by a blood pressure cuff and his finger glowing with a small, red pulse ox light. After midnight, I no longer needed hourly vital signs so I dis attached both.

At 2 AM he woke up in a panic. He motioned me to come forward and I was concerned her was having some pain. While pointing to the monitor next to his bed, he asked if he needed to be connected to the monitor.

I said no.

He then asked if I needed to clean his suture line.

It was 2 AM. Definitely no.

His manner of speaking was extremely sweet. I could tell by his urgency that he just wanted to please and was afraid that he had done something wrong, something that might effect his surgery.

Gently, I assured him that everything was fine and quietly encouraged him to fall back asleep. I tucked him in and stroked his forehead until his eyes surrendered fully to the early morning.

I cannot imagine what his life has been like up until this point. The pain of being different. The difficulties eating. The mockery of his community and peers.

One mother told me this weekend that people don't consider babies with cleft deformities to be human beings. How sad.

I have been in Liberia for almost four months, which is very hard to believe. Living on a Mercy Ship does very little for a girls self esteem. The extreme lack of healthy foods, such as fruits and vegetables, despite my daily exercise routine, has made my jeans tighter and left me feeling constantly bloated. If I wear big earrings (which I wear pretty much every day at home), I am accused of being "dressed up". I don't even like to look too nice if I go out because it causes to much undesired attention. It's hard for a white American girl to blend in Liberia.

And I'm a little tired. I'm in the middle of a stretch of 9 out 10 days that I am working.

But getting the opportunity to rub Nyamuh's head as he fell asleep, tuck him into be, and see how sweet his spirit is, it's all worth it. The sacrifices made are small indeed.

justice

In a country that has spent almost 20 years in political turmoil, has had viscous men in authority in the recent past, and made rape illegal in December 2005, the concept of justice is in it's infancy. Poverty and corruption do not breed justice. But their are glimmers of hope throughout Monrovia.

baby Joanna

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Originally uploaded by megan_petock

This is baby Joanna who went home today. She had scared everyone a bit during her stay and we are all happy to see her safely go home.

a ride in the lift

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Originally uploaded by megan_petock

I am in the middle of a rather long stretch of shifts. I worked tues, wed, thurs, sat, sun, and now start my first of four night shifts. Plenty plenty busy.

Today was fun. Faith and Hope ward feel a bit like a pediatric hospital. I am enjoying myself. The African children are so beautiful.

I love how universal the nature of children is. Today I took eight pediatric patients upstairs to deck seven for some fresh air. We spent almost an hour and a half outside, it was lovely.

This is a picture of the boys on the lift. As demonstrated by their poses and karate eyes, boys are just boys, whether they are Africa or American.

I set up an obstacle course for the boys and they were sliding down plastic little tyke slides and weaving through chairs quite carelessly. They then spent a great amount of time kicking a yellow grapefruit sized ball into two small nets.

Before going back downstairs my friend Becky grabbed her guitar and we sang a few songs with the kids. They really seemed to enjoy it. We need to obtain the chords to some more children's songs (seeing that both our mom's have taught preschool, this should not be too difficult).

Many of these patients have had serious facial deformities that made them both difficult to look at and outcasts in their society. They really eat up physical affection.

Two of these crazy boys spent the greater part of the afternoon perched on my lap. Both had serious facial deformities. Both were staying in the ward without their moms. It was such a privilege to hold their hands and rub their backs, to give them some motherly love. It always seems to shock them at first. Touch crosses the concrete barrier society has divided them with.

I think of Jesus touching the Leper and eating with prostitutes. I'm sure He would hold their hands and rub their backs if He were on our ward. How lucky am I to do it in His stead?

Blessing

Blessing has received a burn contracture release surgery. She has been on the ward for almost a month. She has a sweet but sassy little attitude and is an absolute pleasure to be around. Today she repetitively asked me to take her picture. She would stand in funny poses waiting for the photo shoot to begin. Seeing that she has no access to TV or video I don't know who taught her to strike a pose. I guess kids are just universal.

goodnight

Before exiting the third deck after my evening shift, I walked through the ward to say goodnight to the patients. We have a plethora of beautiful children in our wards right now.

By 9:30 they were fast asleep in their beds.

There was little Cyrus, who had a massive neck growth removed, sound asleep next to his mama in his bed. Cyrus is the happiest nine-month old baby. He has the greatest smile, which her frequently flashes to the world, and loves to belly laugh.

There was Manja, who is recovering nicely form her burns. Her beautiful brown eyes are deep and wide set. Her lips elegantly carved. She looked like a sleeping porcelain doll.

There Margret who had a cleft palate/cleft lip repair. Margret is one and likes to dance. I would sing and dance she would mimic my actions, with much better rhythm of course.

Then there is James. James was here in July and I am sad to say he has made the transformation from baby to boy since his last visit. Four large teeth fill his gum line and he crawls around the ward with one casted foot with a seemingly endless source of energy.
He's got all us nurses wrapped around his finger. We are at his beck and call.

The children here are so beautiful. I heart them all.

extubated

Joanna, our little sick baby in the ICU, is officially extubated and doing well. Everyone is very excited. It's always nice to have a positive outcome.

For the past five days doctors and nurses have been checking in to see how Joanna was doing. Medical staff from England, America, Germany, Australia, Scotland, South Africa and Switzerland were all directly involved with her care. No one is in there home country or home environment. Most of the doctors had very limited pediatric experience.

It was a really amazing thing to see so many people, from all over the world, step out of their comfort zones, bypass cultural differences, and work together to care for a small baby- all while paying to work.

It has been equally nice to see how happy everyone truly is that Joanna is doing well.
This is a pretty great place to work.

After Joanna was extubated I got my first glimpse of her sweet little face. It's always so fun to pull off the ET Tube tape and realize a child was underneath the technology.

I'm happy for Joanna and her mother that she is doing well.

kids

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Originally uploaded by megan_petock

kids at the congo school opening. They were watching a dog get beat.

freedom

Yesterday when I walked by hope ward I saw Musu, a 21 year old patient, sitting on her bed looking very sad. Musu is normally clothed in a widespread smile. Her new thing is to comment to me that

"Meggee, your butt is big, it's fine. Your will marry my brother. Your will not carry your butt to America, you will stay in Liberia for my brother."

I find her quite amusing. I sat on her bed and inquired at what was wrong.

She didn't answer but just tried her best to hold back tears. I asked her if she was sad because her friends had left. She tearfully nodded yes.

The entire "Hope ward girls club", except for Musu has been discharged this past week. Musu was alone and missing her friends. I know how she feels.

Many of my friends have left in the past two weeks and it is really sad to say goodbye. You build fast, strong relationships here and ending them is hard.

I was feeling a bit sad, a bit like a lost child.

I find comfort in this

Hebrews 6:18-19

That by two immutable things, in which it was impossible for God to lie, we might have a strong consolation, who have fled for refuge to lay hold upon the hope set before us: Which hope we have as an anchor of the soul, both sure and steadfast..

At the end of the day that which is immovable will never be moved and that which can be shaken will be shaken. The security is in knowing where to place your hope and where to seek refuge. God is always faithful. Regardless of what may or may not happen, friends I gain and friends I may lose, health I enjoy or sickness I may endure, I am certain that my foundation cannot be shaken and know the desires of my soul will always be satisfied.

Such freedom to be enjoyed.

ICU

Our HIV education team is currently holding a conference out in Bong County, Liberia. The team was taking the two hour outdoorish train ride (which is very amazing, I hear) through Liberia and staying overnight. I had almost volunteered to help, but didn't want to over extend myself and decided to stay on the ship instead.

On Tuesday night I was sitting in the cafeteria at a going away party for a friend when the receptionist's voice came on over the ship PA system,

"Would the emergency medical team please come to hope ward. Would the emergency medical team please come to hope ward."

I joined the furry of medical professionals who dislodged themselves from their rooms and beds and assembled in Hope ward. A baby had stopped breathing.

I helped move the other patients out of the room where the baby was being worked on and helped some other nurses set up the ICU. The baby was intubated and I have taken care of her for the past two days.

Yesterday was my first time ever working in our ICU. I did not know where anything was and was unfamiliar with our ventilator. It has been over three months since I have cared for an intubated patient and we have no pediatrician's or respiratory therapists on board. I was a little nervous.

At home in the PICU we have lot's of people and resources. But I am currently only one of four pediatric ICU nurses on board.

When I came on, I had to make my own wrist restraints and figure out where everything was. i had stopped by and had the vent explained to me earlier in the day but it was still slightly nerve racking to use.

I was suppose to be off today, but I was asked to come in. The plan had been to extubate the baby but we ended up taking her to CT scan instead. Myself, another nurse and two anesthetists went on an ICU road trip, not something I had planned on doing in Africa.

It went rather smoothly. We had to wheel the stretcher through the OR to reach the scanner and once we were there your could only pass a body on one side of the machine. A reminder that we work on a hospital ship where there is limited space.

At the end of the day, it felt kind of nice to care for an ICU patient. By the end of my shift I felt very comfortable and confident. It was a good skill refresher.

Not quite what I had planned to do on my day off, and I definitely did not get paid overtime, but I was grateful for my PICU days seeing they enabled me to care for our patient.

I think it was good that I did not go to the HIV conference.

Becky and I

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Originally uploaded by megan_petock

My friend Becky, from Seattle, and I. We share the common bond of working in a PICU. Becky is great.

collapsed bridge

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Originally uploaded by megan_petock

the collapsed bridge as seen from the Ducor Hotel

traffic

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Originally uploaded by megan_petock

A boy sells newspapers to car stuck in traffic in Monrovia, Liberia. This is teh road that crosses the only working bridge that reaches downtonw Monrovia. There use two be two bridges, but the second collapsed.

Distiance is not the release for long travel times in Liberia. It's the roads. Most of the roads are dirt only. The few that are slightly paved have huge holes in them that bring traffic to a total standstill. It takes a friend of mine an hour to travel 6 kilometers in the morning (sorry I can't translate that into miles at the moment).

"You must take time" as they would say in Liberia, when traveling.
"Plenty plenty" time.