Welcome to the Ward

Here are some pictures of the ward patients. The little boy is Adolpho. He had a mass removed from his ear. He is a very rambunctious child. He played with a truck constantly, supporting the theory "boys will be boys" even in Liberia. The little girl is Godgive (yes that is her real name). The rest are of the ward nurses getting "handover" and of various other patients. We are not allowed to take pics on the ward due to patient privacy, these are the communication departments' pics, hence the watermark.

Henry

Henry is a 21 year old guy that was brought to the ship from a dental clinic about 8 days ago after he pulled out his own infected tooth.When he was brought to the ship he was in bad shape. His heart rate was in the 150's, his blood pressure was low and he was really struggling to breath. The infection had taken over his mouth, jaw and right chest. He was brought to surgery emergently and they cleaned out the horrible smelling stuff that was killing him.

I received Henry from the recovery room and he had 14 penrose drains (drains that allow the exudate to leave the body to get rid of the infection) in his mouth and chest. Over the next couple of days I spent countless hours with Henry, changing his dressing, starting IVs, giving him meds, and just trying to keep him comfortable.

On Sunday and Monday they took Henry back to the OR to clean him out again. As of Sunday morning Henry was not looking good, I was starting to think maybe we would loose him too. All of this time Henry was quiet and very stoic. But on Tuesday I came in to take care of him, I almost started to cry. Henry was sitting up in a chair, the drains in his mouth were gone. I think I actually screamed in excitement and Henry started to laugh. Woohoo!! That to me was pure joy, to see a boy that was so miserable and incredibly sick, laugh. Henry still has a long way to go. His wounds are very open and really need to heal. Please pray that Henry will have no more infection and that he will recover quickly so he can go home!!!!

Pink Meatballs, Pasta in oil or butter

I have had the report back that some of the meatballs were pink in the center...alright, fair enough.  But let me give you a little bit of education and science behind some of the things and preparation we do.  (because it didn't bother some people)

The meatballs were first boiled for 20 to 30 minutes to quickly set the shape of the semi-ball form (we don't have the luxury or time of making them machine produced perfect orbs, I am sure you already know that so we will move along) and additionally to boil off and leave behind meat juice 'residue' and fats.

Then the meatballs are cooked at about 325F or 160C (roundabout proximation) for about an hour.  This tightens up the structure of the meatball as well as colors it with a better roasting brown (thats a color for you to request at the paint store, roasted brown meatball - it works well with a burnt caramel, or creme brulee on the molding and trim).  In addition to this it completely cooks the meatball.  Then I check the temperature for at minimum for 160F (71C).  Then it is held in the warmer/oven for an additional half four or more before being served on the line.  Sometimes meat can be fully cooked and still appear pink, this is true with smoked meats especially.

Another example is science that most people will not accept because their upbringing or knowledge will not allow them to...that is that meat can be cooked to a varied (depends on kind and cut of meat) temperature for a certain length of time and not be well done, BUT STILL has been cooked to the appropriate specs allowed by government regulations.  Which is the standard that most of the world goes by that has these health governing agencies in their country.  Some exceptions are of course fowl, more specifically (in our situation) turkey and chicken which internally should/has to be 165F or 74C.  Most of my specs are drawn from the food and drug administration.  Here is a link if you are interested in this: http://www.cfsan.fda.gov/~dms/fttmeat.html or here http://whatscookingamerica.net/Information/MeatTemperatureChart.htm 

But of course, you and I both know I couldn't have or didn't check every meatball. (laughing)  Just a few in different batches.

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Pasta!  Some of you may want to argue when I get done with this section but putting butter or oil in the pasta water doesn't really do what you think it does...I say its 50/50 (and food science backs me up with plenty of experimental statistics to prove it) and the experts say its 0% that oil or butter in the water actually helps the pasta not to stick together in the water.  Its one of those old traditions that was handed down and taught to everyone so long its hard to change the mindset.

From my experience and all the food science books I have ever read all you need is the proper amount of water per pound of pasta, a high enough temperature for cooking it, and salt in the water (for taste, not the silly change the degree in the water explanation, because even if it did what use is 1 or 2 degrees difference?).  Thats it. 

I have talked to Italians, Chinese (because supposedly they had the pasta before Italians but I won't be in that argument) and worked for a 'boat load'of chefs that all agree, water and salt.  Here on the ship I cook the pasta without watching it all the time.  A few stirs here and there, my pasta comes out beautifully time and time again...and when I teach it to others they have the same experience, no oils or butters.  No sticking.

So what does the oil do?  In the water it will attach itself to the pasta but not consistently because of the moving boiling water.  And then when it does it 'seals' the pasta so to speak.  What is the outcome of this?  Ever had that plate of pasta bolegnese or spaghetti and meatballs only to have watery sauce in the bottom of that plate?  Yep thats what it did, locked the sauce out of soaking into the pasta.

Now, all that being said...I add olive oil (when available, its extra virgin 'the good stuff' right now) after the pasta is in the pan, yes it still locks out some of the sauce from attaching itself to the pasta but this is the compromise:  When you are at home and want to add the pasta straight into the sauce or vise versa and eat it right away I would never use an oil or butter directly on the pasta, because the fresh cooked pasta will suck it up like a child and a milkshake...BUT when you are feeding 400 plus people that little drizzle of olive oil mixed with the remaining wetness of the noodle keeps the pasta from sticking together in big clumps while it sits on the line.  So a compromise is made for the best.

I will only add additional oils or butters (besides the drizzle) if I am applying some herbs or flavors to  the pasta...otherwise, NO I do not.  Although our cooking teams may decide to cook things differently this is my standard.

We should stand on that rock

Going to the market in Liberia is always an adventure, well leaving the ship at all is an adventure. Yesterday, Jen and I both were canceled from the ward, so we decided we would be brave and go to the market. We walked through the gates of the port and entered Africa (on the ship we are next to Africa but not in Africa). We stood by the road with our hand out, kind of waving in the direction that we would like to go, hoping that a taxi would stop and take us to the market. We stood there feeling very silly and watching taxi after taxi whizz right by us, with at least 7 passengers already in them. Then, a Mercy Ships Land Rover stopped and gave us a ride. It worked out perfectly. We then walked towards the "market" , I use this word in-quotes because it is by no means is anything like any market I have ever been to. It is a myriad of storefronts, Wheel Barrel stores ( a guy has a wheel barrel full of one kind of merchandise), and tarps of stuff on the side of the road. In some areas, it seems like a Liberian form of a mall. There are inside stores with lots of stuff and some of the stores are even upstairs (well up these uneven concrete things that kind of look like stairs). There are many things sold at the "market", we bought fabric, a serving dish (for my cookies that I often bake and share with friends, it actually looks like something from the summer collection from target), and Jen bought flip flops (slippers).

At one point we turned onto one of the side streets and there was a median-like structure in the middle of the road, but unlike our well-manicured western medians, it was actually a make-shift dump.

Once we accumulated all of our treasures and had enough hissing sounds and "white girl, white girl I love you!" yelled at us, we decided to venture back to the Ship. We needed to catch a taxi, which seems pretty much impossible. We tried a couple of different places, with our very best taxi catching wave with no success. So then we saw a large rock that we decided was a good idea to stand on so the taxis would see us better and then would definitely decide to stop. Many people just laughed hysterically and kept driving, but one taxi actually stopped and let us in.  We got almost to our destination when we figured out that this taxi was being chartered by a woman. When they got to the point in the road where they needed to turn and we needed to go straight we got out and the woman said we didn't have to pay.  What a blessing, we made it to the "market" and back to the Ship without even paying for a taxi.

Culinary Mystery

Here on the ship we have a smaller galley for individuals and families that want to cook their own food.  As an inheritance of small tools & devices from the 'cleaning out' of that area I have acquired a kitchen 'tool' that has been a mystery so far... (you can click on the pictures to see them bigger)

I asked (by email) a good friend Bob A Hunger Artist what did he make of the picture I sent him to which he sent out an email requesting the help of several of his food-centric friends.  In addition to this, he also posted this on his blog (which by the way gets way more traffic than my site does, by 'food' people at that!), and right away (or at last count) the first original post garnered 28 comments, mostly suggestions and humorous cracks.

Then Stephen The Foodist & Scotty Cooking In Theory & Practice also picked up the story...and later at Scotty's request, I produced another picture for him and Bob that suggests the proper 'right side up' look of the tool.

Stephen went so far as to inquire of the English (can't remember exact office) about the registered number posted on the tool...and we are currently awaiting an answer on that!  And for those of you who are curious, this is the only and exact writing on it:  REGD 911032 made in England.

So a final answer has not been forthcoming, and I am still enquiring from people here on board the ship since I have at least 30 nationalities represented on board at any one time...

Irritating as it may be (to us) it may be that this tool was really useless or does not work adequately, or maybe it's not even made anymore?  Which would explain why none of us know what it is, because we only remember the 'good stuff, the stuff that works.  And maybe sometimes the stuff that works so bad or was such a terrible idea that you can't forget it! (laughing)

A big 'thank you' to Bob at A Hunger Artist for kicking things off!  As well as The Foodist & Cooking In Theory & Practice for also helping out...BUT we are still looking for an answer out there!

Do you know what it is?

I hope Don can take a joke...

Mercy Ships founders and president, Don & Deyon Stephens were on board for some time which included the visits I blogged about earlier.  During this time there was a dinner for some distinguished guests that I was preparing for (outside of the regular 400 plus crew).  Don called the galley to speak with me about adding some guests.  Fine, no problem...having a restaurant & catering background we always plan for overage or surprises.

Thinking nothing more about the phone call we completed the meals and later that night I went back to my cabin after work. I noticed a message was left on my cabin phone (because Stephanie hasn't really gotten used to checking or retrieving messages) so I played the message for the both of us.  It was really quite simple it was basically a repeat of what Don asked me when he called the kitchen/galley only he probably called our cabin first.

After I played the message I just couldn't stop laughing and Stephanie wanted to know what was wrong with me so I explained...

Stephanie complained and voiced her disapproval of my several various attempts at being funny or informative in recording our message for the answering part of our telephone.  It was either too long, crazy, and/or she thought my various attempts were not so funny.  So finally I resorted back to a 'saying' that started on the Caribbean Mercy when we showed disapproval for something that we didn't like which is, 'Imakickyahead!' and translated to: I am going to kick your head.

So the phone answering message that Don got was:

Leave a message or Imakickyahead!!!

Don has a sense of humor, but I wonder what he thought about that!

(I am sure Stephanie was proud of me for that one too, NOT!)

Medical Screening Pictures

Caution: Medical Screening involves some graphic pictures and is exhaustive with over 800 low resolution pictures

That being said, I have completed the Screening Album and it is available on our picture page permanently or by clicking this link if you receive this by email subscription -

http://tyroneandstephanie.com/pictures/Screening

Stephanie probably appears in the album 6 to 8 times, and of course I was busy cooking on the ship so you won't see me there...screening day was actually the day before the Liberian President Ellen Johnson Sirleaf came to the ship.  And following that day was the pastors conference.  And following that day...

You can probably relate some of the pictures to earlier posts and maybe future ones, about patients that Stephanie will directly or indirectly be involved with...and for my part I have probably fed every Mercy Shipper you ever see in any of these pictures (whether they liked the food or not! [laughing]).

Benjamin

I was in the dining room last night with a plate of food, ready to sit down for dinner with my friends, when someone told me that Benjamin (the 14 year old boy that I wrote about in my last blog) had a Respiratory arrest (stopped breathing) when being transported to CT scan. He was intubated and evaluated, the CT scan showed extensive brain damage including a midline shift (meaning not good). The family was called in they said their goodbye and were going to return this morning to come get his body. The plan was to keep him alive on the Vent until the family could make it at 8:30 am to come get his body.

 This morning I woke up at 6:58am and was supposed to be at work at 7:00am, I through on some scrubs and ran down stairs. I had to take some deep breaths, I didn't know what I was going to find when I opened the doors of the ICU. The lights were dim and there were 4 Dr.s and one nurse and the captain praying for him before they took him off the Vent. The initial sight was so peaceful, so different from at home in the ER.

At 7:30am Benjamin was gone.  Ali and I washed his body and said our goodbyes. I can't express in words the connection that I had with this little boy. I only knew him for a couple days, but when you pour your all into keeping a child alive and comfortable the connections is there.  It is so hard to see a child die, to see his father grieve, and see his little body be carried down the corridor in a body bag.

Now as I am in my cabin and trying to process all of this I just thank God for letting me have the time I did with this sweet little boy.

ICUalicious

There are somethings I never get used to, no matter how long I have been a nurse. One thing that gets me every time is a kid in pain. Last night Megan and I worked in the ICU and we had 4 patients, 2 kids and 2 adults. We both had one child and one adult. I had Benjamin who is 14 years old. He was referred to the ship by a local hospital (this is quite frequent) with some swelling on his left eye, fever, and a myriad of other symptoms. When he was brought to the ship his frail little body was giving up. He was not very responsive and was rushed to the OR. When I received report (they call it "hand over" here), he had just gotten back from the Recovery room. His head was wrapped with gauze and he just looked so uncomfortable. My heart just aches for kids that are in pain or just uncomfortable. My first instinct is to try to calm them down with soft words and gentle touches (these are the times I wish I could sing better than an ear piercing sqwauk) but none of these measures help. Benjamin was still minimally responsive and gets very agitated at times (he flops around in bed) which is common with people that have brain injuries. Please pray that Ben wakes up and is able to be his regular 14 year old self. When I look at him I wonder what he is like. Does he play soccer? Is he chatty or quiet? I pray that one day I will know.

Each day that I am here I see God working in my life more and more. It shouldn't be a surprise but it is. For some reason (arrogantly I suppose), I  find myself thinking that I will give of myself but not receive as much in return. I am shocked each time when I see God work in my life, man I have so much to learn. I am currently reading Timothy and am learning how to take instruction. Paul writes to Timothy and tells him what to do and also encourages him in his ministry and personal life. Through this I am learning that instructions and encouragement is not bossiness. I have a tendency to become defensive when someone gives me instruction on something that I think I have under control. So, here I go. My goals for now will be... listen, learn, and let go.

Screening Day Pictures

Working Together

Mercy Ships Founders, Liberian President, and Executive Director of the Africa Mercy



Deyon, Don, President Ellen Johson Sirleaf, Solfrid

President Bush Getting His Groove On in Monrovia Liberia!

U.S. President Bush's visit to Monrovia, Liberia: (disregard the old website watermark)

He was gettin' his groove on!

The difference...

The difference between soup or sauce is usually the difference between lunch and supper. (or dinner if you want)

The round pot containers that we usually serve soup in for lunch are occasionally used for sauce at the evening supper/dinner.  There is hardly ever a time I will use the pots to serve a soup at supper/dinner...so rest assured it is a sauce of some sort.

A refresher - Please do not put pressure on our dining room staff to 'produce' a hot meal for you during lunch time.  Lunch time usually has hot foods (leftovers or re-creations) but the default when hot foods disappear during lunch is still the sandwich options and cold salads & fruits (and soup if it is still available).

If you feel you have a valid complaint send it to me thru the comment option/venue, if you would like a personal reply be sure to include your email.  Please respect our dining room staff & galley workers by directing your concerns to Peter or myself.

Once again, thanks to all the wonderful comments  to food service and continue to encourage our cooking groups and dining room staff!  It makes for a more enjoyable meal for all!

It makes...

The Difference!