no, no, yes...

It has been a wild ride for me this past year. I came to the ship arrogant, to be totally honest. I simply thought I had something to offer to the community of the ship and also the people of Liberia. Yes, I have skills, gifts, and talents that the Lord has blessed me with but I thought, Stephanie Ruth Barton could make a difference.

It all changed on February 18th. It was screening day and definitely the worst day of my life as a nurse. That one day of seeing the true needs of Africa (not just what is shown on Western television) showed me that my abilities, or even the most talented, helpful person in whole wide world is just a small, small piece of this incredibly large need.

On screening day we spent the majority of the day saying "no" to people with medical problems that we do not specialize in, in order to have room for the patients that we can truly help. Screening day was just the beginning of this process. (In Liberia there are no specialty surgeons other than the occasional NGO surgeon that sets up shop in the local hospital, but there is still a problem, there are not really any skilled anesthesiologists either. So even then the surgeries performed are only simple, for the most part.) People come to the gates of the port begging to be seen by a Dr. desperately hoping that they can board the most technologically advanced hospital in all of West Africa (aka their only option for their medical problem).

Kwelywan is 7, his father has brought him to the ship 3 times now in hopes that his son would get a "yes". The first 2 times they did tests and conferenced with Doctors around the world and the answer was no. Kwelywan has an encephalocele. An encephalocele is a birth defect where a piece of the skull doesn't close completely, therefore brain matter seeps out and forms a bulge usually in front of the face, between the eyes. The surgery is very complex, requires a lot of care, can have severe complications including death. These are surgeries that are rarely done in the States, so doing it here seems unreal. Dr. Gary has done 2 already this outreach and has had good results both times.

The third time that Kwelywan and his dad entered the ship they received the long awaited "yes". In my heart of hearts I feel conflicted. I am so excited that he may have the chance to live a life of acceptance in his village. However, I am worried that we may have bitten off more than we can chew. (can I say that?) This is the Kwelwan that I remember.

He is playful and silly. Now he is laying in bed with a bandage covering 2/3 of his whole head, so miserably uncomfortable that he can't help himself but to just thrash around in bed (not the best thing for a kid who just had brain surgery). This is where the arrogance comes in. I as a nurse want to come on to a shift, get report on my patients, then fix what is broken, but I can't. I can do my best. I can use the skills, abilities, and gifts the Lord has blessed me with and I can trust in the Lord to do the rest. That is my part of this big picture.

the list goes on...

It is so easy to get wrapped up in my own little world. It is easy to complain about spending most of the weekend in the bathroom feeling like death is just around the corner. It is easy to complain about my 4 night shifts in a row, 2 of them being 12 hour shifts. The list goes on. Then a reality check came crashing in. His name is Melvin. He had a tumor on the side of his that pushed his eye over to the left. If you just looked at him, you would think "ah not that bad, considering some of the massive tumors that are seen on this ship." But his CT scan showed something different. Melvin's tumor was so large it pushed the septum (the bone of your nose) and his eye over. So here I am back at work after thinking I was going to die from vomiting and Melvin who just had his face rearranged is relaxing in his bed. As I changed his dressing hourly due to his continual blood loss and checked his blood count every four hours he would ask me how I was feeling and encouraged me to sit and rest. Oh man, a nice dose of perspective.

Glad

As a nurse it is inevitable I will receive report from a worn out nurse that has expended all of her available energy and resources trying to calm down a confused, irrational, scared, or combative patient, I just never thought it would be here on a ship in West Africa. I arrived to D ward bright and early this morning and the night nurses looked shattered.

I can not even imagine how scary it must be for our patients to come aboard our ship alone. They don't know us, they may live so far into the interior they may be unfamiliar with white people altogether. They don't speak English, and some of them may not even be capable to understand what to expect even if has been explained in their own language.

The lady in D1 ( I will leave her nameless due to the nature of the events) had surgery yesterday and returned back to the ward. She speaks Kpelle so the communication was difficult but there were not any real problems. Apparently shortly after the evening shift nurses left she started acting very paranoid and eventually disappeared. The nurses frantically looked for her in the ward, no sign of her. They then searched the hospital, still MIA. They called security to come help. As the nurses were searching high and low they noticed a random foot peaking out from under the linen cart behind a box. Ah ha!! The foot belonged to the missing patient. The sequence of events that followed this include a very frightened/ confused  patient doing irrational things. The patient was finally calmed down and the other patients were able to go back to sleep.

After I received report I mentally chose to be glad, not to be irritated that I had to care for the patient that was obviously going to take a huge amount of time and effort. The morning was filled with drama, irrational behavior, and tasks. At one point the patient was trying to steal the other patients tea and bread. We as a team of caregivers chose to still be glad and not irritated.

I have been learning lately the true meaning of "You have made me glad". Before it was just lyrics but now I choose that to be the anthem of my heart. He has made me glad. If I were to honestly sing that song before, it would be more like "He has made me sad, He has made me anxious, or He has made me irritated". There will always be things that are sad, irritating, worrisome, upsetting, but to think that everything has to be perfect in order to be glad is missing out on so much of life. So, as I chased around my patient, juggled all my other tasks and patients I was glad... finally!!

I will bless the Lord forever
I will trust Him at all times
He has delivered me from all fear
He has set my feet upon a rock
I will not be moved
And I'll say of the Lord

You are my shield, my strength
My portion, deliverer
My shelter, strong tower.
My very present help in time of need

Whom have I in heaven but You
There's none I desire beside You
You have made me glad
And I'll say of the Lord

You are my shield, my strength
My portion, deliverer
My shelter, strong tower
My very present help in time of need

deeper

There is something about working in the wee hours of the night that makes me look a little deeper or more carefully perhaps. When all the lights are off (except for the one covered with African fabric) and the curtains are pulled as a make-shift  wall between those awake and those asleep and my  work is complete, I start to notice the humans beings that are occupying the beds of D ward. It is easy to just see the bandages that need to be changed, or tubes that need to be filled, or drains that need to be emptied. On the flip side it is also easy to see only the personalities of our patients and forget they are here because they need medical care that their country can not provide them.

I worked the past three nights and it was actually wonderful. Yes, I hate night shift, we all do but I had the most beautiful patient and they made it worth it.

Kelvin is in his 30's and is completely blind. His brother slept on a mattress under his bed and did his best to care for him. However, Kelvin's brother has very little sight himself. At one point I saw him trying to help the patient next to Kelvin tie her gown closed. His face was about 4 inches from her gown and after a while the task was done and the ladies backside was covered.

Kelvin has a sweet and gentle nature and anytime he needed my help I would hear him say "Sister Miatta." I learned quickly that when I approached him to say "Kelvin, it is Miatta. I am here. What do you need." When it was time for me to leave this morning he called me over and said " SIster Miatta, Thank you for your kindness and help. I will not forget you. I will pray that God will reward you for helping me"