Goodbye Africa.

The time is here.

This part of the journey has come to an end.

Today we may be leaving Africa, but not without leaving a piece of our hearts behind.

We will be spending a few weeks traveling on the way home, so we'll be silent for a little while. We will be home come the end of May.

Thank you for walking this journey with us!! We are forever grateful.

nursing on the AFM

Before I leave, I thought I'd finally write down (0r rather list) some of the quirky things that make nursing on the Africa Mercy unique, interesting, challenging, and incredibly rewarding. I came up with thirty, but I'm sure there are more. :)

You know you're a nurse on the AFM when...

1. Your coworkers are also your roommates.

2. You can roll out of bed 20 minutes before your shift starts, walk up to breakfast, eat, and still make it on time.

3. The commute to work is a less than five minute walk down the hall or down a flight of stairs.

4. It doesn't phase you that men, women, and children all share one big hospital room.

5. You ask your patient a question and the patient in the next bed answers it.

6. You find yourself using the strangest gestures to communicate with your patient.

7. Your patient's mother sleeps under the bed and it's perfectly normal.

8. You give ensure for the NG feed. And if it the tube is obstructed, you just pour down some coca-cola to remove the obstruction.

9. You give Lactulose like there's no tomorrow to keep "the bowels open."

10. Your coworker tells you she's "going for tea" (her lunch break, of course).

11. You have to share two to three vital sign machines between 20 patients cuz there just aren't enough to go around.

12. You work with nurses from all over the world.

13. The stethoscope feels heavy around the neck because you haven't used it in ages.

14. You check your patient's bags before discharge and they don't think anything of it.

15. Sometimes you use three-way translation to communicate with your patient. Like the patient two wards down who can speak to the patient's mother in the next bed who then can speak to the translator who speaks to the patient. Still following? :)

16. You instruct your patient how to make clean water for their wound care at home.

17. You give injectable Fentanyl by mouth as a premed. And Tylenol sounds funny because you've been calling it "Paracetamol" for so long.

18. You have to remind your patients multiple times not to sit on each other's bed.

19. You have to show your patient how to use the toilet and shower.

20. Singing and dancing are a daily occurrence.

21. You muster your patients every week for a fire drill.

22. You work days, evenings, and nights. And sometimes all three in the same week.

23. Sometimes you eat the patient food if there is leftovers because you like the African food.

24. Supplies change depending on what's donated.

25. You hand write everything because there is no such thing as computer-charting.

26. What's a pyxis?

27. Your patient has never been on a ship before, let alone seen the ocean.

28. Your oriented patient sleeps through the night.

30. You use betadine for everything, and a curtain with magnets for privacy.

Most importantly, Jesus is the center. He is the focus of what we do and why we are here. We share a common thread and we are here because we WANT to be. And prayer is ESSENTIAL. We begin and end each shift in prayer together. We pray with our patients and for each other. Because that's just what we do. And because we are wise enough to know we can't do what we do on our own strength.

Some of us nurses at my goodbye party

Sandra and Namina

I first met Sandra while on Advance here in Sierra Leone. We instantly connected and she has become a dear friend of mine over the last six months. Her friendship has been a blessing and her heart for missions and 'Salone' is an inspiration. I will miss her.

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Chapter One: Dr. Sandra Lako helps a child in need

Born in The Netherlands, Sandra Lako’s childhood years took an adventurous voyage across the African seas. Her family took a leap of faith and committed to long-term mission work onboard the Mercy Ships hospital ship, the Anastasis.

They served mainly in the impoverished countries of West Africa. So, from the tender age of two, Sandra was immersed in a lifestyle of serving the needs of the most deprived communities in the poorest nations. This was the life she understood and embraced. She recalls life on the ship as being contented and sheltered in some ways. Attending the ship’s academy enabled her to develop confidence and to find fulfilment in educational achievement.

Sandra’s unique upbringing offered opportunities that ignited her passion for medical work. At fifteen, she helped with some medical teams onshore. There had been a measles outbreak which left a trail of devastation in the health of the local population. Her duties were to help feed the malnourished sick children. On her first day, she witnessed children dying. That moment forever changed her life. She says, “There was so little to do to help. I felt helpless. It triggered thoughts that, medically, to have skills would actively help.”

That thought led eighteen-year-old Sandra to leave the ship, return to The Netherlands, and complete her education to qualify as a doctor. First, she achieved the International Baccalaureate qualifications needed for medical school before attending Nijmegen Medical School. During her studies, she visited The Gambia for her internship (elective), and then she went to Tanzania in her final year at medical school. Both experiences confirmed her passion to use her medical skills to help the poor. Finally, she completed a diploma program at the Liverpool School of Tropical Diseases. Now, she was primed and ready to practice as a doctor in Africa.

Shortly afterwards, in March 2005, she was presented with an incredible opportunity. Mercy Ships was planning to open a land-based facility in Freetown, Sierra Leone. They required a doctor to set up a clinic, but the scope of the services to be offered was undecided. Dr. Sandra valiantly took on the responsibility and immediately set about researching the priority health services needed.

To identify the optimal use for the new facility, she explored the local health system by shadowing doctors in local hospitals. Despite urgent medical needs for all the local population, Dr. Sandra discovered some alarming statistics regarding the high mortality rate of children – 1 in 5 children do not reach the age of five years old. She convinced the local community leaders that there was an over-riding need to provide a clinic for children. In May 2005, the clinic opened.

Early in 2009 a very sick child arrived at her clinic suffering from a condition commonly known as noma. This malicious and aggressive bacteria destroys the flesh. For most sufferers, it results in death. In fact, there is a 90% mortality rate.

This case was unusual. The little five-year-old girl, Namina Yillah had survived the condition for two months. Although her fighting spirit had avoided death, the severity of her symptoms was evident. Her face tragically displayed a gaping hole lined with decomposing tissue. To make matters even worse, her significant malnutrition was an imposing threat to her recovery.

Although the case looked impossible to treat, Dr. Sandra repeatedly asked herself, “How can we help?” This positive approach demonstrates the optimistic outlook and the resilience in the face of adversity that is so intrinsically in the heart of Dr. Sandra. She carefully evaluated every option for success.

There were no immediate solutions. Fundamentally, Namina had survived against all odds. Dr. Sandra decided to treat the wound and change the dressing every day. This intensive treatment was accompanied with improving Namina’s general health by providing multi-vitamins and cartons of milk.

After six months of daily treatment, the infection cleared and the wound stabilized. Namina was finally ready to receive surgery to rebuild her face. However, the local medical teams had little expertise and no facilities to perform this type of surgery. Only Mercy Ships could provide the treatment Namina so desperately needed. So the daily treatment continued for the next 18 months while waiting for the Africa Mercy to come to Sierra Leone.

During that time, Namina’s health remained in a delicate state. She was vulnerable to contagious bacteria and suffered from several illnesses, including malaria and chest infections. Dr. Sandra recalls, “She was a very sad little girl. We had to wait until the end of the day to do her dressing changes due to the pain. She was so brave.”

Finally, they received the news they had anxiously awaited! The Africa Mercy had docked in Freetown. The hospital ship . . . and hope . . . had arrived!

To be continued . . .

Story by Claire Ross
Edited by Nancy Predaina
Photos by Debra Bell

salone snacks

I've been meaning to write about what we'd refer to as the "walking Wal-Mart" on Advance (more for my documentation and memory). When sitting in traffic, people walk up and down the streets selling any and everything. You can purchase items (food, clothing, games, furniture) from your window without even stepping foot out of the car... you name it and they can find it for you :)

I love me some "sweet" popcorn in a bag.

And plaintain chips.

My favorite is coconut water. And its so good for you too. :)

....mmmmm. yum. The flesh is like the dessert after your meal. Love it!

noble things.

A wife of noble character who can find?

She is worth far more than rubies.

She selects wool and flax and

works with eager hands.

She is like the merchant ships,

bringing her food from afar.

She gets up while it is still dark;

She provides food for her family and

portions for her servant girls.

She considers a field and buys it;

out of her earnings she plants a vineyard.

She sets about her work vigorously;

her arms are strong for her tasks.

She sees that her trading is profitable,

and her lamp does not go out at night.

In her hand she holds the distaff and

grasps spindle with her fingers.

She opens her arms to the poor and

extends her hands to the needy.

She has no fear for her household;

for all of them are clothed in scarlet.

She is clothed with strength and dignity;

she can laugh at the days to come.

She speaks with wisdom,
and faithful instruction is on her tongue.

She watches over the affairs of her household.

Her children arise and call her blessed.

He makes all things new.

Life after the rain. Fresh start. New beginnings.

These words encompass the last few weeks of my silence, as well as my current state of heart, and what i believe is still yet to come.

Life after the rain. For all those of you who responded to my 'plea

for prayer' and did just that, thank you. The second screening was completely night and day from the first. The crowd was organized, calm, quiet, and things went very smoothly. We rejoice in the 300+ people who received surgery dates over the next ten months!! PTL!

Fresh start. We are finishing our fourth week of surgery! Does anyone else besides me think that's just crazy? :) Its been busy, busy, busy all over the ship as we have become "operational" again. Days have been full of getting the hospital up and running again, orienting new staff, starting surgeries, preparing for and hosting the medical reception, and then dealing with some challenges over some of the processes in place with our host country. Tim spent the last few weeks finishing up advance work, affectionately referred to as the "Container Expediter," a title he is glad to hand over. :) I have enjoyed being back on the wards, where my heart is. Although advance was a privileged experience, it reinforced my love of patient care over administration. Every day I see lives change before my eyes. Like Isatu, who wasn't allowed to go to school because of her cleft lip. She now smiles and is so excited to be able to go to school! Or Margaret, who said "those kids won't provoke me anymore" when she saw her face after surgery. Oh how I will miss this.

New beginnings. In just a couple short months we will be on American soil. Going home. A new chapter. Our minds are switching gears as we are talking about home now more than ever. And trying to get a handle on what that means and might possibly look like for us amidst the non-stop demands of our schedules. Truth is, we don't know. And quite honestly, for the first time in my life, I am okay with that. This way when God does reveal His plans, we are open to whatever, wherever, whenever. Over the last two plus years we have seen many, many people come and go. Countless goodbyes. Its surreal that it will soon be our turn. I don't think it will really hit home for me until months later, when the dust has settled, and there is some quiet to begin processing.

As for fun, last weekend we spent an adventurous day out with friends on Banana Island. After a two-hour car ride to the beach, we then took a sketchy boat ride across the ocean to the island. :) We spent a lovely afternoon on a secluded beach that included napping in a hammock and eating a delicious meal of fresh tuna, lobster, couscous, and hummus.