TIA

TIA: This is Africa. We sometimes use the term when something doesn't go as planned. We use it more in a jokingly matter, when things could only happen in Africa and no where else in the world. TIA. 

So last Sunday was a TIA kind of day. Moise, our day worker, took us on an outing in Conakry. My friend, Melissa, and I waited an extra 15 minutes for Moise to show up the gate to take us to his church. TIA. When we thought he was not going to show, we decided to take a stroll down the street to find a church. As we walked by the round-about, Moise jumped out of a taxi, in his traditional dress, ready for the day. We ended up at a local church called "Amor de Dieu" meaning Love of God. We danced in the front and sang a few songs we knew in French. The sermon was preached in the loudest decibel possible. TIA. I take these moments (when I'm distracted) to pray for the Church. Pray for it be strengthened. The building we were in was just half full and knowing Guinea is majority Muslim, the need to pray for believers. Prayed for our patients who have come to know Christ, that they will have a place to worship without persecution. Prayed for each of the little ones that dared to come sit on my lap during the sermon, a welcomed distraction of course. TIA. 

Church ended about 1pm, it started at 9am. We were a hour late to begin with. TIA. We took a taxi for just a few miles down the street when Moise decided it was best for us to get out. The taxi driver would have charged us 25,000 Guinea francs instead of the 1,500 (what we paid) to go around the peninsula that Conakry sits on to get to the coast. So we not only cut through a neighborhood, but also a wedding reception to get to our destination. At the end of the street, there was a local djembe (drum) shop, so Moise and I took a few minutes to try these djembes out. 

Melissa asked Moise to take us to a local restaurant for lunch. So we ended up at Fougou-Fougou-Faga-Faga. We were seated under the shade of the palm trees and a great view of the coastline. The menu was read to us which included only drinks. Moise conversed with the "waiter" to ask for food, but the restaurant was not open on Sundays for lunch. So we gave our waiter some money to buy any food he could find on the street. He returned with a long baguette and six small bananas. TIA. Along with our Fantas, we enjoyed the breeze as we heard the drummers down the street practicing on the djembes.




Moise, Melissa, and I returned to the road that was the short-cut to the main road. Yeah, no road names. TIA. We walked through the neighborhood as kids played and women cooked outside on their porches. As we walked by one home, the lady of the household invited us to have lunch with her family. She had just made mango chutney- it was still on the fire when we took our seats. They made us feel so welcomed and thanked us for the work Mercy Ships was doing for the people of Guinea. TIA. It was a delicious add on to our bread & banana lunch and an end to another amazing experience in Africa.

This is Africa. This is a place I have fallen in love with over the four years and four countries I visited. These are the people I have been called to experience life with and love for this time.

Thankful

Today is a day to be thankful.

This morning, Andre came to us with a tumor on the top of his mouth. You probably could not tell from the outside that he had been suffering with this for years as it took over his mouth. However, by the look of the CT scan and the time and care it took for our anesthesia team to place a breathing tube- he was struggling to even breath. I assisted Dr. Gary in the surgery and the mass came right out after a little manipulation. It fit right inside the palm of my hand. Most likely it is not a malignant tumor, but it would have been fatal to Andre if he did not come for surgery on the ship. Today, be thankful for each breath.

Last night, I took the ship's youth down to the ward to sing songs and hang out with the patients. We made our way down the hospital corridor visiting patients and finished the night in the max-fax ward. I was able to check up on a few patients like Moussa and Nafi, both are recovering well. Madama, a 51 year-old cleft lip patient, had a mirror in her hand, as she admired her new lip. So one of the youth, Michelle, met Mariama in D ward. Both girls are about the same age, but one thing is different- Mariama cannot attend school because of her cleft lip. Michelle managed to teach her new friend a card game despite a language barrier and Mariama unable to understand the numbers on the cards. Mariama came with her father to the ship from the far north of Guinea and I met them at the bench today for her surgery. Melanie assisted Dr. Gary in repairing Mariama's lip, complete with a star-shaped nasal bolster and steristrip whiskers. Hopefully, one day Mariama will be able to attend school and be the star student. Today, be thankful that you are able to read.

Our last patient, Matwata, came all the way from Liberia for her surgery. I noticed Matwata shyly watching from her corner bed in the ward as we sang songs last night. The translator shared the words of "Trading My Sorrows" with the patients- "I'm trading my sorrow... sickness... shame... pain, for the joy of the Lord." Eventually, a small dance party formed with youth, nurses, and patients- including Matwata. Matwata had part of her lower jaw removed today by Dr. Gary and Maryke. Another common tumor we see here, called ameloblastoma, that aggressively takes over the jaw and mouth. Most patients are malnourished because the tumor makes it nearly impossible to eat. So today, when you sit down for your next meal, be thankful you are able to eat.

To some readers, I may sound a little to direct in this blog, but it is a reminder to me as well to be thankful. It was a long day so I was tired when the call team came and took over Matwata's surgery. I headed to my cabin to take some medicine to combat this cold I've held on to for awhile. Instead of complaining about the petri ship, I was thankful I had medicine near at hand to help me feel better. I proceeded to the dining room for dinner- I was more than thankful for the galley team that prepared Mexican food for dinner for the crew. And thats when it hit me, I was able to eat unlike Matwata. I have had the privilege to attend school and hope Mariama will be able to one day soon. Tonight as I sit here, I think of Andre recovering on the ward, that each breath he takes, he is thankful.

The Bench

If you ever been onboard the Africa Mercy, you know where "the bench" is on deck 3. It may look like an ordinary bench that you find in a park or a train station, but this one is special. At the bottom of the red stairs that lead to the hospital, you will find it strategically placed right in between the wards and the operating room. When we are ready for our patient, we call the ward and have them meet us at the bench. This is where the ward and OR nurses come together to give report. The patient is given into another pair of caring hands to look after them. I believe this is the place where God enters into the picture even more so when we collectively as a team bow our heads with our patient and pray for healing. We acknowledge we can not do this surgery without God leading the surgeon's hands and giving wisdom to the team to take care of the patient. The bench its made out of solid brown oak slats and has a metal plaque on it dedicating it to a beloved crew member we lost last year, Lady Jean. In past outreaches, she used to sit there patiently waiting for cataract patients coming from theatre. As I wait for my patient to arrive from the ward, I take that moment to be still. In the operating room, my mind and body are going a hundred miles per hour as I work, but this is the place to pause and remember why I am here. I am here for Jesus. And second, for my patients.

Sweet Binta recovering after surgery.

At the bench, there are moments with my patients that I will cherish for a lifetime. Just a month ago, I met sweet Binta at the bench. In report that morning, our team learned that Binta's first surgery had to be cut short because she lost several units of blood. Something her body could not handle again despite the abnormal boney tumor taking over her face. As I waited for Binta at the bench, I took a moment to pray silently we could help her more without complication. Binta using her arm crutches walked toward me with a smile overwhelming her face. Since she was holding on to her crutches, she leaned into me for a hug as I wrapped my arms around this precious one. She had no shame nor fear, she had been at this bench before. I completed my nursing duties including the operative checklist and as a team we lifted Binta in prayer. Dr. George was able to do her surgery and remove more of the bone from her forehead in just a few hours and only one unit of blood was needed this time.

This morning we gathered in OR 4 once again- Dr. Gary, Dr. Michael, Maryke, Melanie, and I- to go through the day's schedule of patients. Our first patient, was 5-month old Moussa, who had a cyst on his head to be removed. We called "D" ward to tell them we were ready and I volunteered to pick up the little one at the bench. I went over the chart with Dan, the ward nurse, and talked with Moussa's mother. Then I offered to say a prayer for Moussa as I placed one hand on Mama's shoulder and another on Moussa, who was in Dan's arm. During the prayer, I felt a very wet and slobbery hand on cheek and looked up to see giggly Moussa staring intently at me. I finished up the prayer asking God to be with us in the room as we took care of him. I cuddled this chubby baby as much as I could as we got him hooked up to monitors. We started looking for an IV and that took over a hour to find, but God gave us one at the right time. It was a busy couple hours and a few stressful moments for the team working to take care of Moussa. As we carried him from the operating room to recovery right where the red stairs end, I had to remember to thank God for listening to our prayers just a few hours before at the bench.
I love meeting my patients at the bench, seeing them smile as I try the local dialect with the help of a translator. I cuddled the babies there. I connect with my patients when I look them in the eye and say their name. I hear a small laugh when I introduce myself as "Alimatu." I see hope beginning to form when they realize this is where the healing starts. More than anything, I love that I am able to pray for my patients and God meets us there at the bench every time.

Shame

As I trotted down the blue stairs toward the operating room after my coffee break, I could hear music coming from the ward. The drums were beating and you could hear the patients sing "Higher, when the enemy tries to bring me down in shame, He (the Lord) lifts me higher." I love that the voices were so loud and clear, singing over the echoes of the drums, so all could hear even beyond the hospital on deck 3. 
I think back over the month I have been back onboard the ship and the patients I have taken care of in theatre. Each one of them has a story of shame, but also a story of healing. My first week we wrapped up fistula surgeries and continued with hernia surgeries. I have written a multitude about the fistula ladies in the past year. However, who writes about the man that suffers from a hernia and can't work to provide for their family? Or the patient that has to wear a hat to cover a lipoma (a fatty tumor) on his head? I stopped by A Ward later that week and saw all my patients from the "lump & bump" days and saw how happy they were. They did not feel that shame of looking or feeling different anymore. They felt human again. One papa I greeted and he gave me two thumbs up as I asked him "Como ca va? He then proceeded to point to the smiley face on the pain scale. Just with the removal of a bump on his head, the shame was gone, the weight on his shoulders lifted, and he was happy again. 
I need not to forget that even the smaller scale surgeries we do can make such a big difference in our patients lives. The second week I spent assisting in cataract surgery. Every twenty minutes, a life was changed, giving someone their sight back. It was hard to grasp this as we were moving quickly to keep the patients flowing from bed to bed. I believe our cataract patients are some of the bravest people. They arrive to the ship and a crew member takes their hand to lead them up our very steep gangway and down another set of stairs to the hospital. We collect them one by one as they sit on the bench outside the OR. We walk backwards and lead them into the theatre by holding both their hands until they reach the bed. We do this because majority of our patients our blind due to the dense cataracts. Their expressions are masked by fear of the unknown, but most of them lay still with only local anesthetic until we cover the eye with a patch. We walk them back to the bench the same way with their hands in ours, but this time they know something is different. The day worker translates my French "c'est fini" into a Guinean dialect and usually a toothless grin forms with a grateful "merci" to follow. The shame of being blind is no longer their story, they will hopefully be able to see again.  
Finally, the past two weeks I have been working in Maxio-facial surgery with the patients that are embarrassed because large tumors are taking over their jawbone or Noma that has eaten away their lips and nose. They feel the shame of looking different. Not one of them I would look down to, but people they know most likely have treated them like this. I look past the tumor or deformity and see a person that needs to know they are loved and will be cared for in surgery. As I check them in at the bench, I kneel next to them and hold their hand and look into their eyes as I introduced myself as "Alimatu" their nurse. A hint of a smile can be seen despite the tumor or cleft lip, because they know I see them for the first time and not their shame. 

Chapter

This post is long overdue. I might as well use the "African timing" excuse to keep me in good standards with all my blog readers. Most of you, I imagine, will extend the grace needed, as it has been hard to find the right words to type. The words to end the Sierra Leone chapter of my life. The tears are inevitable (on my side) as I think upon God's faithfulness over the two years I have been in Sweet Salone. I look as far back to the end of 2011 when I was stateside recovering from gallbladder surgery, a car accident leaving me with a broken arm, and my dad in the hospital- still with Sierra Leone and her people always on my heart. Would I even be able to go back to Africa? Would I ever work again on the ship? Could I still work at AWC with this delay? I usually stay on the positive side of life, but I really did struggle to see the good amidst the troubles. After two months and one to many plane ticket cancelations, I learned lessons that will stay with me all my life. God did bring me back. I had to learn my identity is not Africa or being a missionary, but being His- no matter where I am in life. So fast forward a year (full of blogs about my fistula ladies) and I am finished with my year contract with Aberdeen Women's Centre and I traveled home to Texas for Christmas.  Thankfully, with a round-trip ticket I returned for two weeks in January to say goodbye (again) to my patients, coworkers, and friends. As I look over pictures from these two weeks and remember the encounters I had with people, I see God doing His final work in me in Sierra Leone.


My last weeks of 2012 at AWC were quiet on the clinical side of things due to presidential elections. So I spent more time with Millicent on teaching her computer skills. By mid-December we had completed the Operating Room Policies and Guidelines! Milo and I had battled throughout the year with cultural and nursing differences, but this month we worked side by side as a team. We understood each other for the first time as I let her take ownership of this project. If I had done the book myself, it would have sat on the shelf and collected dust like the others before me. This time I was able to teach Milo so she could teach her nurses what I wanted to do all along. While we worked on the computer she always had trouble finding her reading glasses, so when I returned in January I brought back a glasses case. She was so thrilled for the small gift and she gave me something in return. Milo introduced me to a new nurse, Agnes, as she sat in the recovery room reading the guideline book learning the nursing standards I had come to teach at AWC.

Kumba in November waiting to greet me outside my office. 

The same day, I spent the afternoon with the fistula ladies and Teacher Hagar. I had brought pack beads for jewelry making and the most cherish craft supply- crayons. These ladies could spend hours each day (I could too) coloring anything put in front of them from hygiene lessons to Bible story pictures. So that day I sat with the ladies in the courtyard to do some crafting as they quizzed me on my Temne and Mende words. A lady came and sat down next to me and said "Thank you Allis"- and I realized it was Kumba. Kumba was a precious lady that came to us in September, using forearm crutches, which is not easy to get around in Africa while leaking urine after a traumatic childbirth. Despite seeing many of her friends on the ward come and go, she persevered through physical therapy. Everyday she would exercise by walking from her bed to the bench outside my office.  It was heartbreaking that we had to send Kumba home over election time since she was still not strong enough for surgery. I was worried she might not make the long journey back to Aberdeen for surgery in January, but she did and she celebrated her gladi gladi that next week. Kumba reminds me of other ladies we had to turn away or delay surgery for various reasons. However, for these women, I pray that they don't give up hope like Kumba and find the healing they need at AWC.

Gbassay, Murray, & I (aka Aunty Allis). 

I thank God for these moments of joy as I hug and dance with my ladies one last time. I spent the day with a precious one (for her protection, I will call her"K") at her house, being served cassava leaves, and being shown sewing projects. I have promised to help K in her schooling and her training as a seamstress. My little sister as I like to call her, is growing stronger and taller since the last time we saw each other in November. Another reunion was a total surprise, when Gbassy (pronounced "Bashe") showed up for her follow-up appointment seven months late. We both squealed in excitement seeing each other again and embraced in a hug with her baby Murray in between us. Gbassy had brought coconuts for me as a thank you gift for her surgery in March. I had joyous tears as she told me she was still dry. I tell Papa God tenki for these sweet moments with my ladies and forever cherish them in my heart.

I came to teach the nurses and care for patients and in return I was taught lessons not only as a nurse, but in serving and in love. I hope one day I will return to Sweet Salone. I spent time contemplating the future with friends on Salone's beautiful beaches and dreamed of what would come. For now, I trust that God knows the plans He has for me. "Plans to prosper, not to harm, but to give me a hope and a future" (Jeremiah 29:11) as I find myself over a week in Conakry, Guinea onboard the M/V Africa Mercy for yet another chapter in my life.