By my side, By my side

Tyrone and I have both blogged about the VVF ladies but this week I have worked with them on A ward. When you first walk into the ward the smell of urine is very obvious. The women that are on the ward right now all are on their second or 3rd surgery due to unsuccessful surgeries in the past. Some of the women are hopeful that their surgery will work this time, some are joyful that their surgery was successful, and some are terribly depressed because their surgery did not work. The problem is that some of the ladies are so damaged that there is just no tissue to fix the fistula (a whole that is caused by prolonged child labor).

When the surgery is over and they wake up from their pain meds, we ask them "Are you dry?". As a nurse, this is such a hard question to ask, because so often the answer is not what we ant to hear. When they shake their head and say " I am wet", my mind starts to think about how they will have to go home once again to their village and potentially be shunned because of their problem. But, when the answer is "Yes I am dry", we all rejoice. Actually, the Liberians tend to jump up and praise the Lord with a song, when they have been blessed by Him. Yesterday when the answer to that fateful question was "dry, dry, dry", she jumped out of her bed and sang " I have a big, big God-O and He's always by my side. By my side, by my side."

On Tuesday I went to the Dress Ceremony, which is a time of celebration and commitment for the ladies that have had successful surgery. They each get a new dress that represents their new life. They each talk about their journey and each lead (by lead I mean sing at the top of their lungs and dance around) us in a song that is relevant to them. One of the things that stuck out the most is one of the ladies was talking about how she stopped going to church because she would leak all over the bench and would start to smell. She then looked at Dr. Steve and said "Thank you Dr. Steve for giving me the gift of being Dry. Now I can go back to Church. Your God will be my God." 

Baby

Her name is Baby, yes that is her real name. She is a shy, small, 15-year-old young lady. She came into our hospital early this week for surgery on her jaw. Most of the left side of her face has disappeared over the last 2 years due to a disease called Noma. 

'Noma is a type of gangrene that destroys mucous membranes of the mouth and other tissues. It occurs in malnourished children in areas of poor cleanliness. The exact cause is unknown but may be due to bacteria called fusospirochetal organisms. This disorder most often occurs in young, severely malnourished children between the ages of 2 and 5. Often they have had an illness such as measles, scarlet fever, tuberculosis, cancer, or immunodeficiency. Risk factors include Kwashiorkorand other forms of severe protein malnutrition, poor sanitation and poor cleanliness, disorders such as measles or leukemia, and living in an underdeveloped country. Noma causes sudden, rapidly worsening tissue destruction. The gums and lining of the cheeks become inflamed and develop ulcers. The ulcers develop foul-smelling drainage, causing breath odor and an odor to the skin.'

When Baby entered into D ward she held her head down, her shoulders were slumped, and did not make eye contact. My first interaction did not make us fast friends. I had to start an IV and she later told me we were not friends because friends don't stab each other. SO I spent the rest of the evening trying to win her friendship. I brought her crayons and we colored together, but she lost interest. So I brought her a slinky and she played with it for about 5 minutes then she again lost interest. So as my last-ditch effort I brought her an etch a sketch. As I showed her how it works she smiled and said "Thanks my friend".

Baby went to surgery and they made her a new left side of her face. It is quite remarkable actually. She came in with no confidence and left with her shoulders straight, her head held high, and a beautiful symmetrical face, and I... gained a friend. 

Lasagna

Well, I thought I might give you a little insight into the Lasagna just in case you might have a few questions rumbling around in the back of your head.

We don't currently have any ricotta or cottage cheese to use in our lasagna so I use a bechamel sauce with parmesan cheese added. Also, we use the standard Mozzarella cheese.

Sometimes the 'white' layer tends to disappear altogether when cooking the lasagna except for maybe seeing some stretchy white stuff here and there. You would probably be interested to know the classic lasagna has ricotta and bechamel sauce for the 'white' part and later people used what they liked best like cottage cheese. I prefer ricotta, but alas there is none of either.

Hope you enjoy it anyway...and zucchini was in the veggie one that was offered.

NO FOOD? NOT TRUE!!!

[to all the faithfull people that eat what we serve, the ones that compliment & encourage the food service crew even when they hated the menu, the ones that carry on with life even if the food wasn't what they wanted that day or the next...keep it up!  and disregard this post]

I have tried to be political correct, humble, organization conscience, and a little removed when maintaining this blog...it really is my own personal blog that is linked to the AFM intranet for those of you who enjoy being able to actually look at a dinner(supper) menu for the week.

But today multiple complaints were aired about food running out at 12:30 for lunch today...to which I say is UNTRUE!  Really I don't want to beat this dead topic into the ground but it is way past the limit of times it should have ever happened.

Hot food is never guaranteed for lunch, and I covered this quite well in an earlier post.  And because there is food you may not personally want to eat, does not by any means translate to being out of food.  If we have a lot of leftovers, then you have a lot of hot food for lunch.

AT 1pm, after the food was down in the dining room for 1 1/2 hours I received rice, snow peas, and soup back from the dining room.  Cold cuts and cheese were out for lunch along with options from salads, and the minimum of peanut butter and bread is always out!  And that my friend is what I have been conveying to crew since Mercy Ships has set this standard (it has been the same practice on the CBM, ANA, & here on the AFM).  The only place that it may be different is at the IOC.

I have also noticed that the dining room staff are the recipients of most of the complaints & criticism.  This is unfair to them and it is not right.

Please adjust the condition of your heart to the reason you came to serve and move forward from there...so somebody else can get to the peanut butter!

Ciatta went home....

Let's be honest, not many patients that come back from the OR on a ventilator, on the ship, have happy endings to their story. Ciatta came into the ship very sick, but yesterday she went home with her family and she looks wonderful. I had the privilege to get to know her and her 4 children and husband over the past week, and they really are lovely people. Today she came back to the ship to have her dressing changed and her wound looked at (which is fine-o) and she brought me an African dress, skirt, shirt, and head wrap. When she told me she wanted to buy me a suit I cried and she wiped my tears and told me she loved me. When she introduces me to people she says I am her white daughter. When she took my "measurements" she told me to stand up and turn around and told her husband to buy a dress and my size is "plenty, plenty". Which apparently is very large. Pretty much it just made me laugh.

Put your hands on your hips....

Today I was on D ward and it was a great day. The ward is filling up with the cutest kids in the world. Oh my they are just precious and they love to be loved on. After the shift we took them up to deck 7 and 2 of the girls were trying to teach me how to dance African style. They said "Put your hands on hips and shake your hips". It was so fun to see Fatu (12 that had cleft palate surgery) and Baby (15 jaw reconstruction due to Noma) dance, laugh, blow bubbles, and really enjoy life. The VVF women were learning how to crochet and the young boys Abraham and Emmett blew bubbles, pretty much it was great.

Multi-purpose tubs

I stole a few pictures from Michelle Zeller (her blog is mzellerafrica.blogspot.com she does palliative care).  Just because the pictures were so cute.  (yes, this is still Tyrone talking).

   

We have several of these tubs that we use in the galley, colored just like the one you see here...we use them for defrosting meats, marinating meats, making salads in bulk (coleslaw, macaroni, tuna... those kinds of salads), and a myriad of other things.  Here in Liberia, well as you can plainly see it works as a good bathtub for babies!

I am sure this is what I would have looked like as a child if I was west African and grew up in Liberia~ (pssst, I still eat like that)

This is baby George eating his rice.  How cute is that?

The Liberian Handshake

An example of the Liberian handshake. This is used whenever greeting or meeting people. Mostly a simple handshake and the snapping of fingers is what I use.

1 - grasp the hand of your counterpart:
2 - slide into a thumb-to-thumb grip:

 

 

 

 

3 - pull back to clutch the finger tips of your counterpart:
4 - release with a loud snap of the middle fingers:
Note that the handshake can be abbreviated by jumping straight from the quick hand shake to the snap.

 

Reminds me of a couple of handshakes in my old neighborhood...

Pictures of Henry

Henry is still here on the ward. His wounds (from a severe dental infection that almost took his life) are healing and he looks so much better than the first day I received him in the ICU almost 3 weeks ago.

Henry spends most of the day just sitting around waiting for the day to pass, but during the week he goes up to deck seven and plays football (soccer) as his Occupational Therapy. I went up the other day and we were teammates and pretty much won by a lot.

A Walk To Beautiful...

Stephanie and I both saw a movie here on board that will soon be playing on PBS in the states, which I will soon give you information about.  http://www.walktobeautiful.com/   -  http://www.fistulafoundation.org/movies/screening.html  We were able to view and see the movie because of Dr. Steve Arrowsmith (who is currently here on board).  Bio available here at this link: http://www.globalhealth.org/pop_ups/events/steven_arrowsmith.html

We would both strongly recommend you see this movie, it is not Mercy Ships affiliated except for Dr. Steven being Vice President for International Program Development for the Worldwide Fistula Fund, and we do these same surgeries here on board the ship for the women of West Africa and in a clinic in Sierra Leone.  This movie will definitely help open your eyes to life changing operations that we have eradicated altogether in richer parts of the world.  Fistula what?  What is that?

I (me Tyrone, being the guy that I am) was even moved by the emotion and power that this one surgery or hope that these woman have can mean so much...so its not just for the women to watch or understand!  And even how sometimes it takes more than one surgery!

Broadcast Premiere

• NOVA on PBS
      May 13, 2008 -  Check your local listings or go to pbs.org for details

 

Cooking Teams (#2)

If you missed the first installment of Cooking Teams you can catch up here.

My role as Chief Cook/Lead Chef (the title really does seem to change on a whim) sounds good on paper.  The reason I say that is because on paper my hours are from 8 to 5 Monday thru Friday (Riiiiiiiight).  I guess it could be in certain circumstances or if I really didn't care and wanted to get on with life outside the kitchen, but I am one of those people who love it.  I usually stay hanging around the kitchen thru to 6 or 630pm just to see things thru or just do some recipe research or the small 'pushing paper' part of my job by creating menu's or questions to bother my boss about, he loves it. (I am being sarcastic)

In the past we had some special events, functions, and dinners which usually involved me working on the weekends, and if you are actually on the ship when are you really ever off from emergencies and unknowns?  Believe me, a lot of unknowns or surprise things need to be done that involve guess what?  That's it, the galley!

If you remember me talking about the earlier schedules of the cooking teams in my last post you will see that my schedule has me working with both teams thru out the week (remember team Fried Chicken and team Watermelon?).  Oh and by the way, I named the teams not to be cliche (ok maybe partly because I thought it would be funny) but because I actually like both of those foods allot...although I try to keep my fried chicken intake down for all the obvious reasons.  Being able to consistently to work with both teams on and off thru the week really helps me to keep a good handle on things and to see both strengths and weaknesses in each team.  And that in turn helps me to know how to menu plan, clean, cook, and get organized in the kitchen/galley depending on the character and quirks of the team working.

Now that most of the special events or food functions have passed away I may actually have weekends off...BUT the joy in that is now I can start 'hanging out' or signing up for other projects and events.  This weekend I have signed up to go out Saturday to help work on construction projects for a local orphanage, Stephanie has also signed up for a totally different project than mine and she will get to visit with handicapped kids (& maybe some adults) at a home.

Hope in the Hall

I was walking in the hall from the kitchen to D ward when I stopped abruptly and was overcome with emotion. There were about 10 Liberian women, patients on A ward, walking toward me singing "I have hope, I have hope, I have hope in Jesus." These are the women that are having VVF surgery.

VVF stands for vesico-vaginal fistula. During prolonged labor pressure from the head of a fetus can cause internal tissue to become necrotic (dead). A fistula develops between the bladder and vagina and causes a constant leak of urine. More severe fistulae may include the rectum and feces will leak as well.

Western medicine has eliminated this condition in the developed world. But in Africa, at least 2 million women are leaking.

They leak because girls are forced to marry before they have fully developed pelvic bones. They leak because their bodies are malnourished. They leak because maternal care is not accessible. Often, a woman will endure five to six days of unattended labor. Her efforts produce a dead baby and a solemn memorial. It is insane to me that 1 out of 16 children die instead of live during the birthing process in west Africa.

Last night as these women, with their catheter bags in their hands, walked down the Hall of the Africa Mercy Hospital singing with a smile on their faces "I have hope, I have hope, I have hope in Jesus", I was reminded that I have a lot to learn.

Ciatta

Tuesday evening I was assigned to D ward and I had one of the Academy students (the school for the kids on board) as a job shadow. KimAna's family served on the Caribbean Mercy when we were there and now are on the Africa Mercy. She is 15 and is interested in being a nurse, she will be following Megan and I for 7 shifts. We received report, started our assessments, charting, vital signs, and of course held the babies.

Around 5pm we heard that we were getting an ICU patient with a Dental infection (big surprise). She came in and was having a hard time breathing. All the Doctors came in and we got her ready for emergent surgery.

We went to dinner and when we got back the patient was on her way back. Her name is Ciatta, she has 4 children and a husband for 13 years, that loves her so much that when he saw her after surgery he threw himself on the floor out of despair. Ciatta came back from the OR still intubated ( breathing tube in her nose and on a ventalator). We got her settled by putting her on sedation meds ans morphine for pain control. We placed all the tubes that are normal for a intubated patient. KimAna got to see a lot.

 The next day we both came back bright and early for morning shift. Ciatta looked much better. By late morning we started taking out all the tubes we placed the night before, including the breathing tube. Ciatta made a wonderful recovery. She sat up in a chair and was even transferred out of  the ICU.

At the end of the day I was blessed by Ciatta. I got to see the whole process including the recovery, what a blessing.