sailing

After spending almost seven months in Liberia, the Africa Mercy is officially en route to the Canary Islands.

This week was more exhausting than I could have imagined. It was filled with cleaning, moving boxes, and securing any item that could potentially fall or be hazardous while sailing. Us ward nurses were responsible for cleaning, packing, and securing the entire hospital, which I assure you was no small task, but we had fun doing it.

For example, we had the ward Olympiad, in which we performed various jumps into large piles of green mattresses. There were several spontaneous cleaning dance parties. Also, there was the CT scan disco dance party during the power blackout that occurred when the generator's were being worked on. It was a very creative event. Carols, one of our biomedical technicians, provided the dance music with his cell phone. David, from central supply, grabbed two scanners and used the laser to provide a strobe light effect. My blingy watch even sufficed as a makeshift disco ball when we hung it from the ceiling with a magnet. It was a good time.

Today we played the ultimate game of man hunt, a.k.a. stowaway search. It's important that there are no stowaways on board before leaving for obvious reasons, so two ship wide searches occurred to prevent such a problem from occurring, one right before sailing and one right after. During the first search four crew members, as well as 26 hard hats, were hid throughout the ship. We were divided into teams and given designated area's to assess and search for stowaways. I was a little disappointed that I didn't find either a hat or a crew member. I guess I lost that game.

The Africa Mercy was originally built to move ferry's over a small stretch of sea and not for long sails on open water. So the bottom of the ship is very flat and provides an intense rolling effect when sailing. About every nine seconds the ship rolls to it's side and back. It leaves you feeling quite strange and tired. Many of our crew members are already sick. I'm hoping I will not morph into of those members.

fire

"Beep, Beep, Beep, Beep, Beeeeeep,"

"Attention, Attention, there is a fire on the ship."

I looked over the clock and saw the time, 6:00 Am. Oh how I love mornings.

I rolled out of bed, grabbed my "muster bag" (a bag pack with food, water, and warm clothed in case I were to be stranded on a lifeboat in the ocean) and waited for the second round of alarms.
The alarms sounded along with the command to avoid any red painted steps because they were filled with smoke from the fire.

Of course, at 6 AM my brain is not functioning so I naturally walked towards a flight of red steps only to be greeted by clouds of smoke. I turned back around quickly.

After stumbling my way to deck seven, where the crew was mustering (gathering in specified groups), I was handed a bright orange life jacket and headed towards group D. All while the captain continued to give updates on the worsening ship fire.

Around 6:30 we were given the final command,

"Abandon Ship."

Which was followed with,

"Please walk to your lifeboat with your muster station and then hand in your life jacket. The drill is over."

something lovely

this is a poem from The Chrisitan Book of Mystical Verse composed by A.W. Tozer.
I am a fool for beautiful language and iambic pentameter.

In Heavenly Love Abiding

In heavenly love abiding,
No change my heart shall fear;
And safe is such confiding,
For nothing changes here:
The storm may roar without me,
My heart may low be laid;
But God is round about me.
And can I be dismayed?

Wherever He may guide me,
No want shall turn me back;
My Shepherd is beside me,
And nothing can I lack.
His wisdom ever waketh,
His sight is never dim:
He knows the way He taketh,
And I will walk with Him.

Green pastures are before me,
Which I have not yet seen;
Bright skies will soon be o'er me,
Where the dark clouds have been.
My hope I cannot measure;
My path is life is free:
My saviour has my treasure,
And He will walk with me.

Anna Laettia Waring

Bong Mines Photo Tour

aren't they cute?
friends atop the Land Rover
the lake we swam at
the collison of sun clouds and rain clouds

leaving the train station
the outskirts of Monrovia
dusk
town in Bong County
we were moving fast

the mountains and lakes

our pimped out ride
remnants of the old mine
people in town
atop the Land Rover. We are actually even cooler than we look.

Bong Mines

On Saturday I went with a group of Mercy Ships crew to the Bong Mines, which are abandoned mines in Bong County, Liberia. We travel there by strapping our Land rovers to the flatbed of the local train, which happens to be the only working train in Liberia. We then climb atop the Land rovers and enjoy the two hour train ride through Liberia's lush, green bush.

The train ride was amazing. It's like being on a Disney ride except that it's real.

The route is filled with excited children and adults who furiously wave at the strange caravan of foreign NGO workers. Some of the kids were so excited and waved so hard that I'm not sure it was entirely healthy.

When the tracks ended we drove the Land rovers off the flat bed and up the mountain to the abandon mines. Huge empty steel frames were eerily scattered throughout the mountainside, serving as a sad reminder of Liberia's turmoils past. During the war the buildings were stripped and are now completely dysfunctional. The potential profit, revenue, and jobs simply lie broken and untouched. Wasted potential, a true tragedy.

We parked our vehicles in front of a giant lake which was perched at the base of two steep cliff sides and formed by previous mining. I hadn't planned on swimming but I couldn't stop myself from jumping in. The water was totally clear, I could look down and see all my toes while my head was out of the water. Kind of like being in the Atlantic Ocean at the Jersey Shore (that's obvious sarcasm if you've ever been to the Jersey Shore) The water was deep and unless your were standing on the shoreline you could not touch the bottom.

A few of us climbed about 20 feet up on the surrounding cliff and jumper off. Something I had always wanted to try. It was quite amazing.

It was a great way to spend my last Saturday in Liberia.

ward nurses

On Friday the Africa Mercy ward officially closed. One by one, the remaining patients trickled out, being either discharged or transferred to a local facility.

Us nurses have been very busy during the outreach. We have had a grand total of zero vacation days since June, we have worked various amounts of overtime (when we are short staffed or have an increased acuity there are no other floors to pull nurses from), and are all pretty tired and ready for a break.

But it was very sad to see the patients leave and later walk through the empty wards. We been taking care of the most adorable collection of African children.

In the after noon, we celebrated with an ice cream party which was followed by a ward nurse dinner. Nursing is one of the most unglamorous professions I think of. I won't go into details as to why, but there have been many times in my short nursing career that I have thought, "I don't get paid enough to this"(Now I think, "Paying volunteers should never have to do this").

After seeing your co-workers live in scrubs and pony tails, it's always fun and surprising to see each other dresses nicely. There were about thirty lovely Mercy Ships nurses, not in scrubs, looking lovely at the Royal hotel on Friday night.

A ship full of young, female nurses and very few young men. No wonder the boys here are always smiling.

superhero's

I have spent the past two days working in the warehouse and hold, hauling, moving, and packing boxes of medical supplies. I assembled an intergalactic space costume from random things I found in the warehouse, taking on the new identity of "Intergalactic warehouse wonder woman". David Cox was my trusty sidekick, "The Slayer". We got very dirty but we had a lot of fun. And the world is now a safer place.

thankful

Happy Thanksgiving.

Today I didn't sleep in or go for a walk in the crisp air. I didn't dress up or see my family. I didn't watch a single parade or football game. Tomorrow I won't be getting up early to go shopping. I had an omelet and tomato's for dinner. I spent the day working in a dirty warehouse.

This is an international ship and the day only had meaning to the Americans. Other countries don't celebrate American Thanksgiving.

This Thanksgiving has not been typical. But typical is so overrated.

Being in West Africa there are a slew of physical things I have a deepened appreciation for. Like clean water, electricity, trash cans, paved roads, parents, food, houses with roofs and floors, cars to drive, the Internet, computers, phones, clothes, sturdy shoes, and health care.

There are the deeper issues that touch that deeply affect are humanity that I am grateful for. Like being born in a country that values and respects women never having to worry about leaking urine because I had not obstetric care. I've never lived in a place where rape was legal. I received and education and can read and write. I have a job. I've never seen a Friend or family member shot in front of me or had to run into the bush fleeing for my life.

Tonight, the Americans gathered together for some pumpkin and apple pie. It was very yummy. We went around and said something we were thankful for. Being here the list is so long. But the deepest truth, the thing I am most thankful for, is God's faithfulness. That He saved me. That He has given me so many beautiful and precious promises in His word. Truly His Words are strength for the weary, water for the thirsty soul, hope for the hopeless, love for the broken, and a rock of refuge in times of trouble. I am thankful for the security and steadfastness's that is always found in Christ.

And He is simply calling me to follow Him. Not to serve Him, not to save the world, not to be faithful, not to accomplish much, not to be strong, not to be beautiful, not to be wise; He'd rather that I was just His small child. I am free to fall, free to be weak, free to be unimpressive so that the glory would not be mine but be Christs. So that He might be my strength, He might be my steady feet, He might be the beauty and song of my life. I can just be the earthen vessel. Entirely ordinary.

Grace is demanding while it demands nothing. There nothing we could ever do to deserve any love or forgiveness, all the righteousness bestowed upon our lives is entirely God's grace. And yet, if truly live surrendered to grace we find ourselves standing at the very thrown of our king, our hearts broken and filled with love. We then are free to no longer live our lives before men but instead before our king. The very nature of His holiness will demand more than any dream or debt and leave our faces buried in loving reverence towards the ground. And grace will again pick us up and fill our lips with heavenly praises. Songs of adoration and love.

I'm most thankful for grace.

Deuteronomy 4:9 Only take heed to thyself and keep thy soul diligently, lest thou forget the things which thine eyes have seen, and lest they depart from thy heart all the days of thy life;”

orphans

My friend Lyndsay asked me to come to the orphanage she visits and take some pictures for her. My plan was to be as covert but that ended up being impossible. As soon as the kids saw my camera I was immediately flocked too and followed. I guess that's what celebrities feel like.

After the initial camera shock, and some helpful advice form myself to the kids, things settled down a little. Kids are so universal. It doesn't matter what country they are from, how much or little they have, they are all starving for affection, love, security, and safety. They like to play with toys and sing songs. They like to be mischievous.

A couple from Mercy Ships is building a new, larger orphanage for these children and will live their starting in February. Right now, the kids live in a tiny building with a girls bunk room, a boys bunk room, and one small open all purpose room. The area outside the house is fenced in and very small. There is very little room for the kids to play. At the new house, they have planned to have some open space.

Here are some photos of the kids.

whales

A new favorite pastime of mine is watching the world news. It's nice to find out what's going on in the world and living in an international community has sparked my interest in the global community.

We have a satellite that gives us two to four channels. Sometimes they show CCN at night. Sometimes it's the BBC (which I prefer).

Last night it was CNN. They were airing a ten minute story about the whales that are being hunted and killed off the coasts of Japan. Apparently it's an outrage.

I have no bad feeling towards whales, but I had to turn it off. Ten minutes of airtime dedicated to whales when I sit in a country with no water, sanitation, or electricity. A country that has thousands of malnourished children and as many as 70% of the women have been raped. A country with only 120 doctors.

I'll be more outraged about the whales when malnourished children stop existing.

A day with Michelle

My roommate Michelle is a part of the Mercy Ship palliative care program. She is writing an article for a magazine and asked if I would come with her for the day to take some pictures. Yesterday I spent a day in the life of Michelle.

Working on the ward you sometimes forget that you are in a war-torn, unstable, poverty stricken country. The ship is a western box. The hospital is a hospital. A little smaller, a little more crowded than at home, but it's a hospital.

Yesterday I was reminded that I am in Liberia.

Our day started by visiting Levi, a ten year old boy I had cared for on the ward, who has a large tumor and will be starting chemotherapy treatments at St. Josephs Hospital, a local private medical facility. Mercy Ships has an agreement that allows us to send patients that need chemotherapy to receive treatments.

We were going to Levi's house to drop off supplies he would need for his chemotherapy treatment, like IV's, tubing, and bags of fluid, as well as give instructions to where and when he should go to the hospital. The discussion in the car was about Survivor, another patient who needed to receive chemotherapy, that had been admitted to the hospital on Thursday. Hospitals in Liberia are not like hospitals in the US. You pay for treatment as you go.

For example, in order to receive a blood transfusion several steps needed to occur. First, the family would have to pay for a test to cross match the blood. Then, they would pay 400 LD (about 6 dollars) for a bag to store blood in. They would then have various family members come to the hospital to be cross matched to see if they were donor's. If no family member was a match, they could pay 20 US dollars (a unaffordable price) and have the hospital locate a donor.

When we arrived at Levi's house, we found him covered in green flecks. He had the chicken pox and this green stuff was suppose to reduce the itch. He looked very uncomfortable.

We took his mother to St. Joseph's hospital to give her a walk through of taking Levi for his treatments. We also visited Survivor, who after being in the hospital for five days, had not gotten his needed blood transfusion. He didn't even have an IV.

Jean, the head of the palliative care program, had the same blood type as Survivor, so she donated her own blood in the hospital's lab to give to Survivor. Things are done a bit differently in Africa.

Lucy

This is a VVF patient with Lucy, one of the ship kids. Isn't she simply beautiful!

goodbye

Yesterday morning I took care of a three year old boy. He had showed up at our eye tent last week with his mother and baby sister. The mother gave an admission history that made it sound like the boy had a severe infection in his eye, which was plausible to his clinical symptoms.

However, when they preformed surgery on the eye they found long extensions of a brain tumor that had thick extensions down the optic nerve. His brain was most likely filled with tumor. They eye trouble was just the surface level problem.

Yesterday, when I came on to assess him his heart rate was dangerously low and he was taking long, intentional breaths, probable side effects of his tumor filled brain.

I have been at the bedside of dying children before and it was obvious that this little boy was near the end of his life.

At home, working in the Intensive Care Unit and the #1 Children's hospital in America, there were still times when I took a patient down for an MRI, only to return with the tragic news that there was nothing we could do. The child was going to die and all our skills and resources could not stop it.

It's always heartbreaking.

There was nothing we could do for this boy, so we sent him home.

Before he left, we had a thorough discussion with the mother to make sure she understood what was happening to her little boy. She understood.

She is a single mother with limited family and very few friends. She has few resources and little money. Her shock was apparent. I'd don't know how she will cope with her child's death. But it doesn't matter if your rich or poor, black or white, American or Liberian, a mother's heart is always a mother's heart. Sending a child ahead is cripplingly painful.

Before he left for home, I was able to hold the boy in my arms for about fifteen minutes. His face was thin and his body slightly emancipated. He was in a state of peaceful slumber but every so often would open is eyes and give a gentle yawn, then he'd go back to sleep. I held his head close to my neck and he buried his head into my chest, surrendering his little strength to my arms.

He didn't seem to be in any pain. His body looked calm and peaceful.

When I took his IV out, I was somewhat happy for him. We weren't going to intubate, or place a central line in his neck, or give him medication to increase his blood pressure. We were going to let him go. Naturally. Peacefully. Quietly. Calmly. Beautifully.

Being with a dying child is a bittersweet experience. A part of you breaks thinking of the sorrow their death will cause friends and family. You break thinking of the injustice that a child be cheated of their life. But a part of you feels an amazing sense of privilege that you are in the moment. You are one of the last people to stroke their forehead and gently hold their arm. You get to cry with the broken mother. It's very powerful.

When I see children suffer and die, it always comforts me to think of the host of angles that must be sent from heaven to earth to ease their transition into heave. I think of Jesus, who gently said, "Suffer the little children to come unto Me." He who has a special place in His heart for the weary and weak surely must give special care to the little ones He takes home.

I was privileged to be the hands that held him here. Amazing.

breathing

It's funny how we spend so much time in life waiting to arrive at some place that we can't quite put our finger on. I don't think it's a place that can be found this side of eternity.

Surgery on the ship officially ended today. The ship will be sailing in a few short weeks. In less then four weeks I am coming home for a three week Africa break in Philadelphia. I'm excited about coming home and seeing old friends and drinking fresh warm coffee.

I spent my day cleaning our now empty Peace ward in preparation for the upcoming sail. My music was playing loud, I was able to sing along, and the bleach water didn't sting my hands, so I must admit I rather had fun. There's something quite fulfilling about physical labour.

A mass exodus of crew members is occurring over the next few weeks and it is sad indeed. I have been a bit distracted by the constant effort to "those last few things with those last few people you love before those last few days they leave". It's always a bit unsettling to say goodbye to Friends that you very well may never see again (other than on facebook of course).

As I think of going home, my pure excitement is overcast with a small cloud of dread. I have been surrounded by poverty for almost 6 months. I have met people from all over the world. I have been on adventures. I have seen the remnants and product of the worst in men. I have seen the hope and generosity of saints. It's alot to experience but it's even more to process.

I am afraid the culture shock may cut painfully deep as it probably should.

Coming to Africa I thought I might have some deep revelation or spiritual insight into what my ultimate calling in life was. There was a small effort to hold my breath in hopes that the entrapped air in my lungs night be released in a infinite and complete manner.

But I still feel like I am holding my breath.

The short breaths keep my grasping for air, grasping for direction, grasping for purpose, grasping for security, grasping for faith, grasping for reality, grasping for God. There is a daily dependence that must be learned. A moment by moment realization of the frailness and inability of ourselves.

We are suppose to be meanders. We are suppose to be hoping for something eternal. We are suppose to be storing our treasure in heaven. However, when the moment of faith arrives, when the refining fires burn and the heat reaches my skin, I look to what is next, I complain about what I don't have, I long for the greener grass. While this is the place where I ought to arrive. This is where I am called to live. Uncomfortable teaches us to be content. Contentment frees us to succumb to faith and love.

I'd like to learn to live there.

Broad Street

My friend Melenie, who has been here since June, is leaving next week :( Today we went to the market to buy some last minute Liberian paraphernalia. We stopped midway at the Palm Hotel for refreshing chilled soda's. An Irish man approached me who thought I might be a tourist. The friend he was traveling with was writing a chapter of a tourism book on Liberia, but they have yet to meet an actual tourist. I have been here six months and have yet to meet a tourist. 15, 000 UN soldier's constantly patrolling the streets with large guns is sort of a downer on attracting tourists. My guess is it will be a short chapter.

Candi

My bunk mate, Michelle, is on our palliative care team. The palliative care team visits and assists patients and families who are terminally ill by supplying food, offering rides, performing wound care, and bringing patients to the ship for visits.

Often, they work with pediatric patients. Because she is out in the community, Michelle has really seen the profound effects of living in a country with no health care system in ways I don't appreciate on the ward. Many times her terminally ill patients are dying from illnesses that would be cured in the western world. Her stories can be heartbreaking, per usual in Liberia.

You can check out her stories on her blog at http://mzellerafrica.blogspot.com/

Today, Michelle needed someone to ride with her to pick up Candi, an 11 year old girl who is dying of Burkett's Lymphoma, so she could come visit the ship and have the bulky dressing on her affected left eye changed.

Candi was wearing sparkly multicolored slippers (flip flops) and a cute little sundress. She smiled and laughed as if she didn't notice the bandage that swallowed her head, whispering her nose and obstructing her left ear. We brought her to the ships treatment room and I read her a story while Michelle collected dressing supplies and we waited for her pain medication to take effect. (We read a pop up version of Peter Pan and I performed all the voices and spoke in an English accent)

As Michelle redressed the bulky, necrotic, and stench filled tumor that took over the upper left quarter of her face, I held her hand and rubbed her back. It's so sad that this is Candi's life. A disfiguring mas is claiming her face and nothing can be done to stop it.

Candi is from the Ivory Coast. Michelle told me she does not want to go home because she is afraid she will die. She's 11 and she knows she is dying.

eye surgery

Yesterday I was able to go into the OR and observe a few eye surgery's. I was able to watch Dr. Russ in action! It was amazing to watch the skill and precision involved in surgery. The eye is so small and delicate.

Sometimes, being on the ward, I can forget how many people it takes to make Mercy Ships work. I forget that there are so many different types of people, with different complex skills and abilities, that are always functioning together.

It really makes me appreciate the work that is done here and the people that do it.
And I'm pretty lucky that I get to physically love on the patients (particularly the ridiculously beautiful children :)

paitence

It's funny, before coming to Africa I had only taken care of pediatric patients. I went into nursing because I wanted to work with children. I knew the entire time I was in nursing school that I wanted to take care of children. Adults were never even an option.

But being on a hospital ship has forced me to be flexible and to succumb things I never would of stood for at home. Like working 50 to 60 hour work weeks. Or working 11 out of 12 days in a row. Or coming in on my only days off to take care of sicker patients that my experiences in the PICU qualified me to take care of. Or working 6 months strait without any sort of break. Or taking care of adults.

I don't think people always understand how challenging and tiring it can be to work in a constantly changing hospital environment when you are often working far outside of you comfort zone. I think us nurses deserve a break :)

Last week, I took care of only adult patients. By the end of the week I became a little cranky.
Yesterday, as I snuggled with beautiful little 10 month old Patience, I realized the source of my discomfort, I missed being around children. It was almost a subconscious realization.

Patience is a beautiful, snugly little girl. I spent most of my shift stealing her from the arms of her mother. She has a complete right side cleft lip and would spend her life being shunned and made fun of if she did not come to Mercy Ships.

It's extra amazing to hold and love these children because the world has out casted them. I watched Patience mother nervously watch as myself and other nurses loved her little girl.

Today Patience received her corrective surgery. It's a beautiful transformation to be a part of.