Sunday August 9

It's August already and therefore means that I am fast approaching my leaving date. The official notification of my leaving was posted on my door - the disemabarkation form which has to be signed by various departments. There is always red tape to be completed no matter who or where you are.

However in the meantime I have managed one more trip to Casa del Papa and also visited Ghana. Well in the overall scheme of things it's more or less next door in comparison to flying in from the UK! Having family there makes it so easy to visit and the coach trips either way were all part of the experience. Two of the translators who work in recovery were exceedingly helpful. One purchased my ticket to Ghana and then came in to work early so that she could provide cover for another translator to take me to the coach station on the back of his bike. Needless to say he went at a reasonable speed and came with me to the office while I checked in to ensure they knew I was there. Father has an amazing way of providing people for us as we travel if we just look out. A gentleman came and sat next to me on the bench and having started off in the usual french then realised that I was not a native french speaker. He was a pastor from Nigeria and therefore spoke English. We stayed together while we waited for the coach to depart at 12 noon . Departure in reality was 1.30pm. One learns to be philosophical about such things. I couldn't go anywhere until the caoch ws ready to leave so just sit and talk. There was a cover over the waiting area and in fact it was a cool day, by Benin standards, so no real problem. As I showed my ticket boarding the coach I was told to sit on the front seat. The manager was also travelling on the coach and sat by me. He spoke good English too and in fact at one point having crossed the Togo border we passed an accident right outside a cemetery. I made a joke about being close by and he saw the funny point. The crossing into Togo had to be made on foot. So everyone headed out of the coach and walked. I went with them since they all seemed to know what they were doing. A policeman came and found me and walked me back to the immigration desk which was laid back from the side of the road and not well marked. There was no problem but just made me smile. As the only white passenger on the coach I was easy to spot! Entry in to Ghana an hour later (Togo isn't very wide) was completely different. we all stayed on the coach and passports were collected up. The coach moved and then one of the officials returned to the coach to collect......me! I had to go and fill in immigration forms. No surprise but I was intrigued how the official found the correct coach and had my passport in his hand. I'm so pleased that I had gone to the effort of obtaining my visas before travelling. the coach may have left without otherwise as these things can take a while. It may seem a lot of effort but really the travelling is all part of the fun and the smile I received from my new niece made all the effort worthwhile. I think her parents were happy to see me too! My return was not dissimilar and again Father provided me with help. Another pastor working in Ghana who made sure I crossed the borders without difficulty especially when the Benin immigration wanted to see my passport which the courier from the coach had collected. It was all duly stamped when he handed it back to me on the coach.

So this week we have been a little quieter at work. On Friday was able to go and garden for the day at the agricultural project in Hevie. Mercyships has community development programs which are geared towards local needs. At Hevie local men are being taught how to grow crops efficiently and in accordance with the way God intended. There is indeed a science to it all and includes, not burning the land to clear it, not ploughing the land but allowing the soil and the animals and naturally occuring bugs to sort out the soil. Growing complementary crops as, for example, beans and corn in rows or tomato plants and soya beans. The men who are being taught will shortly be trained on a "train the trainer" course once the building of the new training centre is complete. The construction project is for this centre and is about one mile away from the area being used to grow the crops. It will have lecture rooms and dormitories for up to 12 people at a time. The idea is for this work to be ongoing when Mercyships leaves Benin.


Busy pulling out weeds!

This Sunday saw my last service at Four Square church and I was delighted that a new family onboard and one other person came with Christian and I. Even more delighted that the man to whom we witnessed several weeks ago is still coming.

Of course I am reflecting upon my time here and I have learned so many new skills and made many friends - thank goodness for facebook. Friday will be a day of sadness in many ways as I leave friends behind who have become like family and yet of course I look forward to seeing my own family too. If there is one thing I would have to remember its the little baby whose life we battled to save and yet still lost. I know I have a sovereign God who has all things in His hands and this baby is gurgling happily safe in His arms. But I have also seen great joy in women who are no longer wet and many people who can now see. There is a book in the Old Testament written by a prophet called Micah. he was around about 750 years before Christ was born. He had had a vison about Samarai and Jerusalem. He had a deep suspiscion of the phony religion of the leaders of Judah. He warned the common folk not to be deceived by this religious pretence of the nobilty. The peole asked him what they should do to please Go. Did they need to make great sacrifices in order for God to listen to them and save them and he tells them "He has shown you O man what is good and what does the Lord require of you? To act justly, to love mercy and to walk humbly with your God". Micah 6:8
As I finish I reflect on meeting the challenges of this verse. I hope that I have acted justly, or fairly, to all with whom I have contact, That I have shown mercy and been compassionate to all that have crossed my path. Most of all I trust that I have learned to have a humble heart that enables me to carry on my walk with Father day by day.

Sunday July 19

The last two weeks have been just as hectic especially this last week as I have been the only anaesthetic nurse in the department.

Enough of the excuses and on with the news.

First I need to make a correction to my last entry (July 4). The story about the newborn baby with a problem with her eyes was incorrect. The cause was not as I stated but was in fact an infection that occurred in the womb and caused her conjunctiva to swell. Sorry about that mistake.

A couple of weeks ago I went to the ward service and to simply be apart of a service that was being simultaneously translated into 3 other languages certainly adds time but is also interesting to hear. English to French and then French to Fon and another dialect which is spoken by only a few but means that all can take part in the service. probably part of the service that most remember is the worship time. Seeing ladies up and dancing while holding onto their catheters is indeed a memory to treasure. The rhythm is something else. The whole translation thing can be time consuming as sometimes to interview patients can take 5 translations then of course we don't always know how accurate the translations are and coping with languages that have no future tense...

All the VVF surgeons have left now and for the last 2 weeks we have had just general surgery and eyes so we have been able to run 2 rooms for the general surgery too. This has proved remarkably effective as a patient can be anaesthetised in the one room while the other room is completing the surgery of their patient. This means that there is less time lost for the surgeon who moves between rooms.

Last weekend we had to close down the water,power and evac systems while the cooling system was cleaned out. Just about the entire crew left the ship for the day. I was no exception and had a very enjoyable day at a place called Casa del Papa. Basically a beach resort with swimming pools and a very pleasant restaurant. Even more importantly the coffee is good too!

Last Sunday I went to the morning service at church as Christian was back and then during lunch was invited to walk to one of the local hotels for a swim. We actually had a lift as one of the drivers for the hospitality centre was just about to go there and dropped us off on the way. Having swum, drunk coffee and chatted we decided to walk back. On our way,we called into the hospitality centre as the doctor I was with had not yet visited. I walked her through the centre and we saw some of the patients there who were busy playing cards. One lady was outside preparing the evening meal for them. On our way out we thought that by turning left we should be able to walk back to the road we needed without doubling back on ourselves. We soon realised that we were unsure of where to go next so did the female thing and asked for help. A young lad - young to me - shewed us the way through and we would undoubtedly have got very lost without him. The narrow streets and alleyways were reminiscent of a Charles Dickens novel except that it was much warmer. We later discovered that we had walked through the fishing village. In fact it reminded me very much of areas of Uganda that I have visited in the past. we had a few children calling us "Yovo" but this is simply a term meaning "white person". But far more importantly these single roomed dwellings, some with a a thatched roof others with tin, are where many of our patients live. These are the poor communities we have come to serve.

As I have mentioned there are always staff leaving and in the last two weeks more friends have left and the community of the ship continues to evolve. Sometimes its hard work having to constantly introduce oneself without it sounding either trite or too well rehearsed.

On Friday the program reporting was about the new dormitory that is being built to house "Train the Trainer" courses at the new Agricultural Centre that has been developed by Mercyships. These are programs designed to teach the locals "how to fish". The programs are going well and there were the usual collection of photos, some quite amusing - like the lorry with a delivery of stand not being able to quite reach its destination because the back wheels were in a ditch. The rainy season has been the heaviest for 10 years. Waters levels are up everywhere and in fact a state of emergency had been declared by the government. Probably the safest place to be in heavy rain is on a ship, at least it floats!

Just occasionally we have emergencies to add into the list. This lady who really is smaller than me had VVF surgery 3 weeks ago but was having problems passing urine adequately. The surgeon on board agreed to attempt to place a special kind of catheter and the result is...one very happy patient, relieved of the stress and pain. I had looked after her while the small procedure was carried out under local anaesthetic. along with a brilliant translator called Bridget. We sat either side of her, comforted her and held her hand. This picture says it all and is what "makes my day"


This next week sees the return of Esther the lead anaesthetic nurse and I am hoping that over my last few weeks here I can go and visit some of the projects that the organisation is involved with. We also have a max-fax surgeon joining us so that will create more diversity for us again. At the end of the week the main eye surgeon is going on vacation for a few weeks to attend conferences etc so the following week will see more changes.

This weekend the ship was supposed to have been to the filling station for fuel but was postponed Friday lunchtime. So hurried plans were made for day trips out and I was invited to return to Casa del Papa. Such a hard decision, it took me all of half a second to say "yes please". We had a delightful day and the sun shone for us, unlike the previous weekend where it put in only a brief appearance. Today I went to the family service. This is a new initiative for this outreach. Each family takes it turn to organise the service which is aimed very much at the children. Some weeks there are craft activities, this week we had a game of bible trumps with each family. I was simply "fostered" by one of the families. It was great fun watching the children become involved, happy to put actions to the songs and generally enjoy themselves. Afterwards I was invited to join them for snacks in the dining room and then spent a happy hour just chatting to the other mums. Children don't change that much from one generation to the next in some of the things they do or say.....

Saturday July 4

Independence Day if you're American. The ship is strangely quiet as we have a "ship's holiday", in effect a 3 day weekend. So yesterday was an extra day off and felt like Saturday too. I remained on the ship after my morning run as I was on call and am so today. Not unfair as I swopped calls with others.

So having left everyone in the lurch wondering what was happening now seems a good time to catch up. There have been moment s of joy, sadness, long nights and early mornings so situation normal really.

The workload has not been arduous but simply long days with VVF surgery running late several times simply because the nature of the surgery is complicated. The surgeons often struggle to find anything that looks like normal anatomy. But the work is rewarding. One lady who had such surgery did become quite ill one night and required a special intravenous line called a central venous line to be inserted. (CVP) Although called at 10.20pm on the Saturday evening to help with this procedure the decision was then made not to go ahead. However she deteriorated later that night and so I was called at 2.30am to help insert this line. I stayed up the rest of the night as by the time we had succeeded, having had to give the patient a general anaesthetic, and cleared up there really wasn't much point in going to bed. I did sleep well that night and had snoozed during the day.

We are very fortunate to have some excellent consultants who give of their time and one such came from Canada for a month. He specialized in paediatric anaesthesia and having several sick kids was put to the test. This included putting a CVP line in when no easy access could be found for a regular cannula. A week later I was helping him in the intensive care unit (ICU) to place another CVP. The baby was 14 months old but weighed just 5kg. She had a particular bowel problem that in the US or the UK we would deal with at birth. That she had survived this long was a miracle. Heinz and I worked with others for over 2 hours before we succeeded. Sadly later that night she died. It took both of us quite sometime to recover emotionally from that experience. It's difficult when one is holding a child and as she did, see them looking straight through as if to say" I've had enough" and not be affected.

The following day we were talking to each other and supporting each other as we tried to put our own thoughts in to some sort of order. One fights so hard to give these children the best opportunity of life but God decides in the end we accept that for her, it was the time for her to be with Father. She's probably gurgling now very contentedly!

The photo below is a much happier one. One contented 3 hour baby who was brought in from one of the local hospitals as an emergency. Normally we do not accept emergencies but this an exceptional situation. The baby had been born with her eyes the wrong way round. I deliberately haven't included the "before" photo but the "after" one is kind of cute and what we strive to achieve. Again we saw God's timing here as we had the appropriate surgeon onboard to carry out what is actually a simple procedure - if you know what your doing!



There have been yet more departures of longer term staff and a couple of these have been from the OR. Pam and Margreet left during the same weekend, leaving a huge hole in the department. With facebook, keeping in contact is so much easier these days. We knew almost immediately that they had arrived home safely and are now busy re-adjusting to life at home. Others will come and fill the space but they had been a part of the orthopaedic team and then had taken up roles within the VVF and paediatric general surgery rooms which were new areas for both of them. It can be difficult having spent 4 or 5 months working with a team that all sings from the same song sheet to suddenly be thrust back into a world where minor details seem so important to others. Keeping the mouth shut can be very hard!

In the last 3 weeks it seems that we are hot news, at least in Gloucestershire. I have had a story put up on the local BBC news website about my blood donation. Paul and Rebekah have spoken on the local BBC Gloucestershire radio Sunday morning religious program about their visit and article also appeared in the international version of Christian Today about their trip. I have also been invited by the Association for Perioperative Practitioners to speak at a conference in Harrogate during October.

This last week has seen the visit of the President of the American Association of Perioperative Nurses (AORN). Mercyships has partnered with AORN and this visit was in connection with this process. We had a great time together sharing information and learning how the association could help us to improve what we are doing. Along with him there was a group that came from Instruments of Mercy and Integrated Medical Systems. They refurbish old instruments so we are hoping that they will be able to help us prolong the life of the instruments we use. thankfully they also repair endoscopes so our 2 endoscopes that we use for difficult airway intubation can also receive some TLC! Having the opportunity to chat with this group made me feel very much like home, talking about repairs and loan instruments..

As part of the eye team although not a constant member depending on the needs of the department, I am able to attend a small group that we have, led by the main surgeon, Dr Glenn Strauss. This group meets weekly for bible study for an hour and then an eye team meeting when we can discuss any problems that are arising. having the chance to share in a small group like this is all part of community living but adds to the team spirit and the sense very much of working together as a team. Opportunities occasionally arise for us to visit other parts of the team and its always good to see what is happening. It would be easy to become blinkered in our view.

The other group that has established itself to a routine now is the 6.00am running team. As people come and go the team members change but this morning has to be the most memorable. Only 2 of us met as the others were away - it being the long weekend - and being Saturday it was the long run day. Having not run for about 15 months I have been gradually building up my running again and this morning we went about 14.5k (just over 9 miles) in the wettest conditions ever. The two us were soaked before we reached the end of the dock, 500 metres from the gangway. The rain is warm so not a problem other than running with wet feet, with the best will in the world it's impossible to remain dry. The great advantage is the rain although warm keeps us cool so the long distance is easier. For the pair of us it was the longest run we have done. Sadly for me this mornings partner returns to South Africa on Thursday so next week the pace will be a little faster so I'll have to work harder. We do take small water bottles with us, the idea of which probably ought to be patented. They are empty 250ml bottles which held saline to which are then attached pieces of velcro. One piece of velcro is then wrapped around the hand so that they are easy to carry. We were dripping as we came up the gangway and stayed in the dining room just long enough to collect water and cups of tea but not long enough to create puddles of water. We really were that wet! Since then the sun has shone and dried up the puddles. Now the last Lions match to look forward to this afternoon. On call has its advantages - it gives a valid excuse for staying onboard and having to pass the time by watching such games on the screen!

Amazing to realise that I have only 6 weeks left onboard.

Tuesday June 9

I'm not sure I have the audacity to apologise for the long wait but "manners maketh man" so apologies.

One or two slight distractions - like having to share my computer with husband and daughter. They have come and both gone now. It was great to have them here. While Paul was here we shared a couples cabin on deck 4 which had air con, so for the first time in four months I actually used a duvet at night! He brought with him some belated birthday cards and even small gifts which people had very kindly sent out.

Paul spent 2 weeks working as a mechanics teacher, showing the lads how to take out a landrover 110 engine and then rebuilding it. The sweetest moment? When it started first time as the key was turned. Not sure who was most pleased, him or the lads he was working with.

I had managed to fill his spare time with a mix of social activities which included eating out - always a good activity, seeing the local countryside and environs and learning something of the history of the country. This was acheived by eating with friends at various locations, visiting Abomey, 3 hours drive away and taking him swimming at the local hotels.

I visited Abomey a few weeks ago but this time went in a Mercyships 110 so we a reliable vehicle. The journey home was a little bumpy as we took a track rather than the main road which is subject to long delays because of roadworks - no different to home really. Abomey is the home of one of the main Kings of Benin. 3 brothers came from further away and decided to split one remaining in Abomey. Testament to their lineage was the kings ruled on average for 40 years and handed over to the eldest son. It is a fascinating history and there are still a few artefacts that have survived the years.

Perhaps one of the most unusual things we did was to take part in some evangelism with the church that I have been attending regularly since being in Benin. We
went to the church to meet up with everyone for a short service - only an hour - and then went out in 12 groups. There were about 8 in our group and even then we split into 2 small groups so that we didn't overwhelm anyone. We spoke to two groups of men who were just sat at the roadside. We gave out new testaments to a couple of the men who were more interested in what we were saying. The following week one of the men turned up at church which was great to see. We actually gave him a life home and found out that he was a shoemaker and that his wife was pregnant. The man was quite badly paralysed from the waist down but managed very well. The teams were well managed as there were always a couple of others who remained with any vehicles that went and prayed for the groups.

Becky had the chance of diving with the team on the ship and even though the visibility was poor still had a great time. "Very safe but knew how to have fun" was the description from the dive master. we went to the stilt village together on Saturday, just before she went home. The ride up the lagoon to the village is probably the best part and certainly we saw plenty of fishing going on. The traps for the shrimps reminded me of the traps for the salmon on the Severn, basket like structures.

The work has continued on the ship in the meantime. VVF surgery is being undertaken again with new surgeons and as always the eye rooms continue to keep us busy. One of the eye surgeons who had been with us for 3 months has now left to go and work in Gabon and will be using the skills and techniques she has learned on the ship. we also lost another long term crewmember from the eye team as she returned to the States with a view to returning to study another nursing qualification. A pool party was help for these 2 on deck 8 one Sunday afternoon. A very pleasant way to spend a couple of hours. Shaded from the burning sun and with a pool to cool off when necessary. As with all these social gatherings everyone brings something to the party so we had smoothies, ice cream and raspberries, cakes and savoury snacks plus a lot of laughter.

My work has been very mixed with some anaesthetics, scrubbing , teaching and looking at procedures/policies and how we measure up against recommended practice. Just a little variety in the day never quite knowing what I will do in any one day.

I know that others read my blog as permssion as been requested to use photos that I have put on the site or if I would share stories that I have told. Quite amazing, that you just never know who will read it.

The nature of the ship is that the population constantly changes and recently there seem to have been a lot of goodbyes especially to folk that have been here several months. this includes my cabin mate of 3 months who returned home a week ago. The cabin is strangely empty without her and there are no more long late night talks about life and the universe. It does however mean more sleep!!

I will endeavour to be more diligent in writing my blog - but please don't hold me to it!!

Saturday May 16

Apologies to all of you following my blog with avid interest. But the was good reason why I couldn't write last week. All the computer system was down for pretty well the whole weekend of civilised hours!

So much to catch up with. Two weeks ago I was invited by Anne, one of our translators to her daughters 10th birthday party. Anne lives in Cotonou during the week but her home is Abomey, a 3 hour drive from the ship. Inviting several of us we st off at 10.30am collecting people along the way. A 14 seater taxi had been organised and there was plenty of room for the 10 of us who went. The group included 3 of our day volunteers, one bringing her 2 children aged 6 and 3. Apart from the usual stops for petrol, which was poured into the fuel tank through an old T-shirt to filter it, from a very large glass flagon and food we made the trip in a little over 4 hours. Roadworks cause as much mayhem in Benin as they do at home. Anne was a superb hostess and looked stunning in her outfit. Esther her daughter was also a very good hostess as we were given cold drinks and plied with some amazing tasting food. After we had eaten we all went to visit the old palace in Abomey. It was an interesting visit and we glad to have the translators with us as the guide spoke in French. In Abomey the local dialect is Fon but is a more pure form than that spoken in Cotonou (according to our Beninoir friends).

Several of the group had decided to stay in Abomey overnight and with the experience of others on the ship had booked into a pleasant guest house for the night. having opted to return the same day with one other crew member the remainder of us set off home. About half an hour from Abomey the driver pulled over with braking problems. So we had to find alternative ways home. Stopping a taxi to drive us all to Cotonou proved a challenge, not least of which because the taxi driver of our 14 seater felt he had been insufficiently paid by us. Agreeing a price for the complete return trip before leaving Cotonou the translator who had organised the taxi paid only what she though was right. the vehicle she had booked was supposed to be in much better condition and she had been annoyed when she saw the vehicle in the first place. we did manage to hail a taxi but there was space for only one person so we gave that to the lady with 2 young children. About ten minutes later another vehicle stopped that would take the remaining 4 of us. Nina agreed a price with the driver and we all got in the car. Our first taxi driver still feeling sore about the amount we had paid him and seeing us about to leave decides that he wants yet more money and leans inside the vehicle, removes the ignition key and tries to move away quickly. He's soon stopped as by now quite a crowd has gathered. After much discussion and a little more money he finally allows us to go but part of his decision was the fact that 2 of the passengers (Linda and I) were with Mercyships. We did make it back to the ship quite safely but it was certainly an interesting time!

So on with the weeks work. The ship has an unconventional blood bank. There are no facilities to store blood. For patients to receive blood the crew members are called upon to donate at the time it is required. This means the patients receive whole blood. All crew members who give blood are volunteers, there is no coercion although a small campaign was run recently to encourage more donors. Filling in a form, checking basic levels of health and having a blood sample taken are the only requirements before being placed on a list. When I was asked to give blood I was working but as donation is seen as a priority there is never any question about being able having the time off. A ship has limited space and so often an area becomes multi-functional. For blood donation the ICU is used.

The photo shows me relaxing, with my coffee cup in hand since I was halfway through my once daily Starbucks americano and I was not going to waste it! The process is not so different to home as the blood is weighed and 500 grams of my blood was soon in a bag. What was very different however was seeing it being checked and given to a patient who was lying in a bed in one of the isolation ICU beds within 3 minutes of being donated. No need for a blood warmer. The woman to whom it was transfused would later have a below knee amputation but was actually too ill to have surgery that day. She came to the OR the following day.

Saturday May 2

Not sure that I've had a birthday this week, more a celebration of life. I've had the song sung to me so many times, had so many treats and specila events happen that I certainly won't forget this one in a hurry. It started Sunday evening the 26th with a phone call link to my home church at Gorsley near Ross on Wye at the beginning of their evening service..

Monday evening I attend Toastmasters and their too they remembered it was my birthday. tuesday at work as we met at the board for our meeting oin the OR corridor I was sung too again - I had made cake for them too. wednesday evening is the eye team small group and we shared we brownies and ice cream in honour of my birthday. Friday 33 of us went out for a meal to the local Lebanese again everyone sung to me. I've had quite a few cards and some lovely presents. I've been very spoilt and will look with fondness recalling this particular birthday.

Meanwhile there has been work to do and I have continued in my role as anaesthetic nurse for another week. I really enjoy the change and working with different people. I have spent most of my time in the orthopaedic room as that's where most of the children are and have worked again with the same anaesthetist. this always makeslife easier as we begin to work very much together as a team. The surgeons have great fun and taken the english banter well. It's amazing how certain always come back and find myself just slipping in roles that I have had before.

On Wednesday we had a little lad who was about 3 who was to have his club feet corrected. As I carried him up the corridor I was aware that his breathing was not all it should be - his chest was rattling beneath my arms! Alerting the anaesthetist to this she listened and decided that he really needed a chest xray and antibiotics for 24 hours before we should operate. At home we would give a full course of antibiotics and have the child back 3 weeks later. This option wasn't available for this little boy as the paediatric surgeon was leaving at the end of the week. By giving him 24 hours we were able at least to start the process and give a better chance. he had his surgery on Thursday to correct his club feet. as the plastering was finished the surgeon put the lads 2 feet together and stated the lad had "happy feet" meaning they were pointing in the direction they should be normally not all bent round as they were. Perhaps the most important thing though which took place each time I was in the orthopaedic room this week was the way each member of the team took it in terms to pray before we started surgery. Our prayer for this little boy was that he would grow up strong and loving tha Lord. One day hopefully he will be told about his operating on a big ship and about the people who cared for him and why.

Our community meeting on Thursday evening is always an important time on the ship and this week I had been asked to be MC for the meeting. The international lounge seats around 300 and was pretty full. The service is also shown by video link to cabins. Having had due notice I was prepared for the meeting and spoken with the main speaker, who had had some devastating news about himself just 24 hours earlier. he still wanted to speak and so I was left wondering how I should set the tone for the meeting. In fact I decided to go with the way I fely Father had led me including the short reading which was not a bible reading but one about a chinese woman who had a cracked pot that she filled each day from the river and used to water the seeds she planted. The cracked pot felt ashamed because it couldn't carry its full quota of water like the second complete pot. She reassured the pot that she had known about its flaw and explained how she had used its "flaw" to water the seeds that flourished into beautiful flowers which she used to grace her home with beauty. we all have flaws but God is able to use our flaws too to help other people. The speaker used the verses from Jeremaih ch18 v1 - 6 to illustrate his points.

....and so life continues

Saturday April 25

How much more different can the weeks be? This is one of the things I love about being here. So this week has seen me transform into an anaesthetic nurse for the week and a thoroughly enjoyable change it has been.

I have spent most of the week working with an American anaesthetist who specializes in paediatrics. As one who has not seen children under the age of three years as patients for a VERY long time this is quite a shock to the system. But God has been very good in giving me someone who loves to teach and who likes to drink black coffee. What better combination could there be? We have managed to work together exceedingly well considering the circumstances here and without all the cases being straighforward. I have twice done a "Starbucks run" which has met with great approval.

It was probably a good time for me to remind myself of the skills I need to practice once in a while to maintain my own professional practice.

One of the ladies with whom I travelled to Parakou and Natitingou right at the beginning of our time in Benin has left this week to return to the UK so off we went to the local Lebanese restaurant for a meal, all 11 of us. it's a great little place right on the beach with a view of the ship. The food was OK but the company better. Just as well as it's the place I've chosen to go for a meal next Friday to celebrate my birthday.

The general fitness levels are keeping up OK. I've been out running about 5 times this week - just as well with these meals out. The heat and humidity do take some getting used to though.

The other real fun thing I've done this week is to celebrate St Georges Day. Having a conversation about 3 weeks ago with other English folk onboard I suggested we ought to really try and mark the day so tea and scones - all 9 dozen home baked - were produced on Thursday evening after the community meeting along with strawberry jam and cream. we decorated the midships lounge with flags and balloons and even had a Lord of the Realm with us for the occasion. Hopefully the image is on here of all the people who turned up. One or two weren't actually English but have lived in England for quite sometime so we let them in! we heard the story about St George and then sang the National Anthem. It at least raised an awareness of the day (which is also Shakespeares birthday).

So yet another busy week, next weeks promises to be even busier.....

Sunday April 19

The view has changed from where I am sitting typing into the computer. We have moved the ship all of 400 metres or thereabouts as we needed to fill up the tanks with fuel. Rather like going to the petrol station but a rather slower process since we have to take on about 700 tonnes of fuel. For those who hadn't been on the sail from Tenerife it was all rather exciting. It was a good opportunity to hang over the rail and chat. Some of the crew had decided to leave the ship overnight and were off by 8.15am. Others of us decided that we would move our usual Sunday morning run to Saturday morning so I was out running out 7.00am.

However I'm rushing ahead. The week was again different as Monday was a ship's holiday it being Easter Monday. It was also a holiday in Benin. A trip to Casa del Papa in the back of a 4x4 with new crew was great fun. It's a good way to meet new staff, bumping along the beach road. The weather was typically English - raining. However our spirits were not dampened as we found the sheltered part of the resort and spent time chatting over coffee. Since one of my reasons for going was to be able to swim in the pool there, I duly changed and swam, after all I would be wet anyway and actually swimming in the rain was not an unpleasant experience.

Crew are always coming and going and this week saw a crew member leave who had become a christian whilst serving on the ship. This is not as uncommon as one might think and is always a source of great joy to the other crew members.

I spent Friday morning at the eye clinic at the hospitality centre. This is a converted warehouse about 15 minutes walk from the ship. Patients are housed there overnight and this has relieved the pressure on beds in the hospital. We have the same problems of bed occupancy as the NHS! But we also see the eye patients there post operatively and so Friday saw the first patients coming for YAG laser treatment to their eyes following their cataract surgery. This treatment helps to prevent the formation of a secondary cataract. Thankfully there is an air conditioned tent up in the warehouse so the room for the laser treatment is cooler. The tent would normally sit on the dockside but this is not possible here as the dock is narrower than Monrovia and lorries rumble up and down the dock passing very close to the ship. It would simply be too dangerous hence the reason for having a tent in the hospitality centre.

And then it's Saturday again with its chores of washing and ironing. I also made with 9 dozen scones in the afternoon with some help from one of the English ladies on the ship. We are celebrating St Georges Day with tea and scones, complete with strawberry jam and cream. I have some flags and balloons to decorate the area where we shall simply have a fun time together on Thursday evening.Watch this space and if I remember to have my camera out I shall post a picture next week.

Sunday April 12

I thought you might like to share in my easter Sunday thus far. Having set my alarm for 5.40am and I know that for some of you that does simply does not exist...I went to help finish setting up the dining room for the easter brunch which was served at 9.30am. The ward staff who would not be able to get to the brunch had the usual breakfast made available to them since the brunch was served much later than the normal weekend time of 7.30am.

We had a sunrise service which commenced at 6.30am and this is the view I had of the sunrise this morning from deck 8 of Africa Mercy overlooking the sea at Cotonou on a ship which has noticeable movement.

I left for church with Christian at 9.00am and there was a visiting speaker from Nigeria. He was the pastor who started the Four Square church in Benin. But the best part for Christian was that the Nigerian pastor preached in English! So he only had to translate a small part of the service for me. In addition the worship group started by singing a hymn in french but to a tune I knew. The words were not a translated version but I was able to sing and probably knew the tune as we ll as anyone else at the service! The Nigerian pastor also broke into a couple of english choruses which I also knew. He is Lord and one other. On the way home from the service we stopped to have a coconut each. For the princely sum of 30pence we each had a coconut. the girl cut off the top, we drank the Juice inside and then she split the coconut open, fashioned a spoon out of the "lid" and we ate the soft part inside - very refreshing!!

Saturday April 11

I am well aware that for those of you following my blog it has been way too long since I last wrote. But at least i have a couple of interesting stories to share this week. So why have I been unable to write - mostly just too busy!

The work has continued at a pace. We now have both of our translators learning to scrub for our eye cases and we planning on teaching a third member of the team too. Keeping an eye on them plus having new staff who have not previously worked in the eye rooms or even seen such operations along with eye surgeons coming in to learn the new techniques presents several challenges in the day. Add to that the need to also be the anaesthetic nurse for general anaesthetic cases and there you have my roles sorted. Teacher, mentor, theatre sister and most importantly showing the love of God in all I do in some way , shape or form.

Last week was fairly quiet for us and the rooms ran much as always. By last weekend I was ready for a break and spent Saturday at Bab's Dock with several other "Mercyshippers". This included a game of volleyball of about an hours duration. I was the oldest player by at least 12 years. No points were counted although we played approximately by the rules but its hard to judge what's in or out when the court is in water! Thankfully only knee deep but it did mean that falling over was less painful - just wet and even that was great since it helped with the whole cooling off process. In the evening the "eye team" which includes the surgeons, staff who run the clinics as well as theatres and the npost op staff all went for dinner at a local Indian restaurant. I found it easier to simply read the menu than the french translations provided. I know what Rogan Josh is and yes, it tasted very good. Sunday I was on call so attended the ward service and caught up on one or two bits.

Monday mornings we always begin with our own prayer time in the eye rooms led by Glenn Strauss. It's a time to meet new staff and surgeons, find out which surgeons should be visiting and just ask for Fathers blessing on the week. Tuesday afternoon we had an emergency case that took up the whole afternoon. A five year old girl had fallen over a couple of days earlier and a stick had penetrated her eye. Not an unusual problem here but because she had been taken to the clinic early one of our visiting surgeons was able to operate on her eye. She had ruptured the globe of her eye so it took sometime to stitch everything back in place and the decision was made to remove her lens since it was broken in several places. We have a phaecoemulsification machine which we don't use too often since it will not cope with hard lenses but in this young girl the lens was soft. So out it came and we irrigated and aspirated until the lens was out. It may be possible at a later date to put a new lens in to the girls eye. This may seem like radical surgery but it is more usual here to see an eye that has died because the injury is left unattended for too long and that then requires the whole eye to be removed. So that took us till 5.00pm to complete so for us a late finish.

Thursday saw another unusual day. We don't operate on Fridays because we do not have clinics for 1 day post op patients. Good Friday brings this a day earlier as it's a ship's holiday so we would not normally work on Thursday but we had 4 general anaesthetic cases, all children. What made this even more different was that 3 of the children were from the same family. Aged 1,3 and 7 all 3 were either completely blind or had very little sight, being able to distinguish light but no more. We could only imagine the anguish of the mother as she had all 3 children operated on in one day. The little 3 year old stole my heart. She was given a pre-med to make her sleepy but in fact all it did was to make her act as if she were drunk. She soon stopped crying as I picked her up and gently rocked her, talked and sang quietly to her. Tickling then worked well and giggles ensued, so much so the anaesthetist wondered what I had done to her! Patches come off the next day with our patients and I went to the ward yesterday morning to see her patches come off and watch her reaction. Mum was ther and happy for me to pick her up and although upset initially, as soon as I started talking to her and rocking her gently she obviously remembered me and stopped crying. I was greatly privileged to be able to remove her patches and see her trying to work out what was different. I had a small red brick in my hand and by the time I left her she had picked up from my outstretched hand several times. Her eyes had been checked while I was cuddling her as I crouched down with the eye surgeon behind me using a mobile slit lamp. The event put a whole different slant on Good Friday for me as for her this was indeed Good Friday as she will be able to see. I hope to be able to follow her progress through with her 2 and 6 week visits to the clinic.


....as for the little girl with the dreadful eye injury...she will need to wait at least a month before we know if anymore can be done for her but at least she will have a normal looking eye which is so important if she is to marry. These things matter here in West Africa.

I shall be at the sunrise service on deck 8 of the ship tomorrow morning and then helping to prepare the brunch which is being served. Tomorrow night after an early service there is "open house" or rather more aptly "open cabins" for which I have baked - so no surprises there. Monday is also a holiday for the ship and I am joining others in going out for the day - to a pool wher I can swim to my heart's content. "God is good - all the time and all the time God is good" I pray that you will have blessed Easter time.

Saturday March 28

I was asked the other day what I missed most about my normal routine in the morning. It caused me to really stop and think what it was started the day “right” for me. It’s so easy in the rush of day to day life to pass by and not consider how our actions and decisions affect ourselves and others. Having paused for thought, whilst eating my porridge, the way I arrived early for work so that I didn’t have to rush into the day, had time to stop and talk for a couple of minutes with both day and night staff on the ward was important to me as I felt I was more in touch with what was happening on the ward which could ultimately affect my day. Being able to chat with Alan about life and the universe in the department over a coffee as he ordered stores for the operating theatres are the parts of the routine that I miss most.

So how does it vary here? It’s simply a much bigger hospital and the layout of the ship means that I don’t walk through the ward area to reach the OR department. I only have one or two patients per day that are even staying on the ward since most of the eye patients walk on and off.

So my day may start at 5.45 am if I decide to visit the gym or go for an early morning run. Breakfast is served until 7.30am but 3 days a week there are “devos” which commence at 7.30am so breakfast can sometimes be a little rushed but then there’s no washing up for me!

Down to the department for 8am for a “board meeting” to discuss what is happening in the day, changes to the lists, pray for the day, and then off to our rooms. Being in the eye rooms we prepare for about 30 patients most days and the majority of those will be for cataract surgery. Our 2 rooms have patients in them by 8.10am and so our day commences. We work steadily through our list of patients to about 11.30am. This will include teaching new staff in the OR department and also some of the Beninoir surgeons who are coming to learn the technique which Dr Glenn Strauss has developed.

If there are patients who require a general anaesthetic these will often be done last on the morning list in the room in which I most frequently work as I am then able to help the anaesthetist.

Lunchtime and then the afternoon continues until we finish the list. Clear up and stock up ready for the next day. If I’m on-call I will check the other rooms to see if they will require help to finish their list. By 6.00pm most days we are finished. There are always exceptions to the rule and we work on a principle of expecting the unexpected.

Evening activities can include Toastmasters, in service training, small groups (rather like housegroups) or simply catching up with emails, laundry and friends. An occasional meal out always makes a welcome break too and I have begun to investigate the local restaurants. Research on these continues…….

Saturday March 21

It's the first day of spring at home in the UK. As I sit a look over the port of Cotonou with 8 large ships including the Africa Mercy in a temperature of 28 degrees already and a high humidity, it's hard to imagine being cool at the present time.

My on call last Sunday was very quiet and gave me chance to catch up on a few things that needed to be done. One of the dental team nurses from the UK team went home last Sunday night and kindly agreed to post a letter to a good friend for me so that was my priority. For someone who has no access to the internet, letters are a great way of keeping in contact. For the sender the computer of course allows photos to be included and this is indeed what I have done.

But I was also able to spend some time with another British couple sharing an "after service" cup of Yorkshire tea with them. The ward service is held at 10.30am in A ward in the hospital and is a time when all the normal protocols of a hospital ward are broken to some extent. Patients and crew mix together sharing beds so we know a bed will seat at least 4 people. The singing is for the most part "a capello" (unaccompanied) unless there is a drummer for the African drums but it is joyful. Patients who are able will often dance to the music as we all lift our hearts to God. One of the translators spoke last week. We have many translators on the ship and some are pastors in their own churches.

As far as work is concerned the week has been just has busy as the previous weeks. In the eye rooms we average 30 cases a day which often include general anaesthetics. These tend to slow down the list slightly simply because of the set up required for these cases. At least I am able to hone my skills with small children. Singing lullabies seems to work well, I just wonder what wold happen if I tried it in the UK - maybe a new practice!

The week has also seen the start of a new small group which I am leading. We are using a DVD by Andy Stanley called Breakaway and certainly the first part provoked discussion and gave us a chance to learn more about each other. Looking at how our beliefs affect the decisions we make and the outcomes of those decisions and how knowing Father affected our beliefs and subsequent decisions. We meet every Wednesday at 8.00pm.

Also on Wednesdays at 6.00pm we are often offered the opportunity to be given a lecture/presentation by one of the medical team. This last week Dr Steve Arrowsmith talked about VVF surgery covering some of the technical stuff but also with stories about some of the women who have endured often years of being an outcast before someone finally took them for surgery.

Bryan Burton has continued his series on Being and Doing the Mission of GOd and he concludes on Sunday evening. Today I am looking forward to going out for the day with friends having already finished the domestic chores for the day. So no real exercise today but I have continued for the the most part in my effort to keep fit while here.

Saturday March 14

There are special moments in the life of Africa Mercy OR which will always remain with me. This particular moment took place on Wednesday morning when I was preparing to help anaesthetize a 4 year old boy who was to have his congenital cataracts removed. Picture if you can a Greek doctor who now lives and works in Germany. He has four children of his own. He also happens to speak French and English. He's tall and slim with a beard.

Very gently he carries the blind, frightened child into the OR, talking to him all the time and sits down with the boy on his lap. His long arms are wrapped around the child to make the child feel secure. In one of his hands he has a face mask and places it carefully over the nose and mouth of the child and then begins to rock the child while singing a barely audible lullaby in French into the boys ear. There you see compassion in action as the child goes to sleep without struggling or crying. A special moment indeed.

We a new ophthalmologist with us now. Dr Hofman will remain with us for 3 months to complete her fellowship and when she leaves us will be moving to Gabon to a village 10 hours drive from the nearest city of Libresville. There she will be working as an eye surgeon for 2 years sponsored by Samaritans Purse. If you help with the shoeboxes at Christmas there's a high likelihood that its the Operation Christmas Child run by the same organisation. She has now been joind by her husband who is not a doctor and he is going to help out on the eye team an a more administrative capacity so we are delighted to have them with us.

I am now more confident about giving peribulbar blocks and have "flown solo" with them. All seems to be going well thus far.

We have also been privileged to welcome onboard Dr Bryan Burton from Seattle who is giving a series of lectures/sermons on Mission why and how we do it, looking at God's calling etc. I've enjoyed the first 2 sessions and look forward to the others. Boring he is not and he has a very easy accent on the ear.

Today being my only day that I can leave the ship this weekend as I'm on call tomorrow, I was offered the chance to travel to a resort about 50k away where there was a very clean pool with the option of beach or pool as they were next to each other. A long swim and a pleasant lunch, a few minutes of quiet rest and it was time to return. This was definitley the better option to running the Cotonou half marathon which also took place today. I was tempted to join in but thankfully common sense prevailed as I've not been running for sometime.

I have however undertaken some form of exercise for the last 5 days be it in the gym, running on the dock in the early morning or swimming. So having said that I needed to increase my regieme of exercise to keep fit I have commenced. long may it continue!!

Tuesday March 10

So what happens in the week that keeps from writing quite as regularly as you would all like? Life. Since I wrote last week I have had a steep learning curve, met new staff, said goodbye to others and decided that I need to keep myself fitter than I am currently.

I remain in the eye rooms and this week have learned how to give a peribulbar block. In laymans terms that meansputting an injection in to someone's face just below the lower eyelid to numb the eye before we operate on the eye. just like the dentist numbing your mouth before a filling. Learning this technique will enable me to speed the process in the eye rooms as I'm not waiting for a surgeon to give the block. With 2 surgeons operating this will enable us to complete more cataract operations.

Meanwhile in the rest of the department the VVF surgery continues. 20 more patients came down from the north of the country late last week and are now having their surgery. On Friday the first "Gladdie Gladdie" ceremony took place where the ladies who have had surgery arre given a new dress. It's a sign of their freedom from being permanently wet with urine.

Dr Gary Parker along with another surgeon is continuing with the maxillary facial surgery. These patients have tumours which are often disfiguring beyond anything we would probably see in our own countries simply because the people here don't have easy access to doctors. These are things of which I can't put pictures out because along with all patients I care for they have the right of total confidentiality.

Orthopaedics continue and we have new surgeons for this speciality this week. This always presents new challenges for the staff who have to learn what the new surgeon wants and likes. But somehow we always manage to work together in good humour.

On Thursday I was part of the worship team for our community service and it felt like a great honour to be able to help lead others in worship.

Over the weekend I went out to see the stilt village of Ganvie. It was originally built so that the people there could not be taken as slaves but is now home to quite a large population. The boat trip is about 14 kilometres and is interesting as I had a chance to see something akin to the salmon traps used on the River Severn although here they were for catching prawns (shrimps) and also other fishing devices. The lagoon in which the stilt village sits is not incedibly deep but it is the dry season here. Not sure how deep it gets later in the year. The photo is of the village as we approached it.
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Sunday I spent going to church in the morning where we were thoughtfully moved by the stewards so that we were under the fans and then managed to be dropped off at the pool. The local hotels are becoming used to seeing "Mercyshippers" frequent the place at weekends. Hopefully it will increase profits for them.

Yesterday evening I spent some time playing my guitar with a few others and helping to teach some the basic chords while also learning from those more proficient than myself. Along with discussions with my cabin mate late into the night my time is filled more than adequately.

I am hoping to start a new "small group" rather like a housegroup on the ship and the plan is to meet alternate Wednesdays. I am fortunate that a family has offered the use of their lounge so that we can meet in peace. Public areas on the ship can be noisy at times and that can making having peace and quiet to discuss, share and pray more difficult.

So life continues.

Hello all!

This is the IT "expert?" Just checking to see how this all works, so mum can add photos from now on! And as you can guess, I managed to figure it out! So from now on, expect photos!!! :D

x

Wednesday March 4

I can't believe that a week has gone by without adding to the blog. It's probably a sign of just how busy I have been.

So now into our second week we are operating in all six rooms. I am in the eye rooms where we are beginning to have about 30 patients a day through our doors. 2 rooms with a connecting door aid our communications with each other and enables the surgeons to walk between each easily. Today we performed about 30 cataract operations and a couple of other more minor procedures.

On Monday we operated on a 3 year old girl who has never seen as she was born with cataracts. When her patches were taken off on Tuesday she took a minute or so to realise that she could actually see then picked up a book and started turning the pages. That is what makes the days so worthwhile. Her life will be changed irrevocably by this operation. She will now at least have the chance of going to school as any other child and being able to learn to read and write. I beginning to use all my skills again as we have begun to operate on children in the eye rooms. They require general anaesthetics and this is an area in which I work. There are challenges as the lack of space means confined working areas but we are able to work safely.

We have had several VVF ladies through now and there was a party for the first ones to celebrate their return to normal life for them. They are given a new dress and matching headscarf to as part of the celebration. If you can read Catherine Hamlin's book "Hospital by the River" you will gain insight to the lives of these women and the difference this surgery makes to their lives. They are able to find work again and where they have previously been cast out by families, are welcomed back as they are no longer debilitated by this condition which arises from prolonged childbirth.

Over the weekend I spent Saturday on call then on Sunday went to church in the morning to the FourSquare Gospel church. This is a worldwide church that preaches the gospel as it is. I went with four others and we had a good time there. Christian , who took us, used to attend the church when he lived in Cotonou. Afterwards we took a drive out to Ouidah which was the centre a slave trading for Benin. There are 2 gates there. When called the "Gate of no Return" marked the place where the slaves were boarded onto ships never to return. In 2001 another gate was built 300 metres along the beach and this is the "Gate of Return". Built to commemorate the first Christian brothers who landed there in 1861, it is a beautiful monument, very simple in its design with the country of Benin outlined so that one can look straight through it to the sea. We didn't have enough time to visit the museum in town but we had great fun for the afternoon and the cool breeze off the sea was a welcome relief.

I have begun to run in the mornings. Not sure quite how long the dock is but I suspect it's about three quarters of a mile from one end to the other and return. Even at 6am it's very warm. There is also a local pool and tonight I have been able to go for a swim after work. This has to be timed to perfection as we leave at 5.00pm inorder to be at the pool in time to be able to swim for about half an hour, shower briefly and then return to the ship by 6.30pm before the dinner line closes. It's a great way to unwind after a day though.

And so life continues. Thank you to all who contact me when you read my blog. Sorry if some of you have problems adding comments - I don't why it happens. I'll try to add in a couple of photos when I've consulted with my IT expert!

Wednesday 23 February

We started surgery yesterday. All six operating rooms had lists and although not working to full capacity on our first day we their was an excited air of expectancy as we met together. There is a large whiteboard in the operating department corridor where we hold our "board meetings" each day with all staff including the sterilising room, doctors translators and nurses. We have this meeting before any of us move into our respective rooms. Any problems and plans for the day can be discussed such as changes to lists/staff or on-call rotas. Then as a department we pray together - just one person leads the group in prayer and then it's off to work.

I shall be working in the eye rooms for most of my time here and shall be helping to teach staff the way we work on the ship and also having the privilege of training the translators how to scrub for our eye cases. We are always busy but we pace ourselves as the surgeons are also training some of the local doctors in the techniques they have developed which work well in Africa. So not only are giving fish, we are teaching people to fish.

The max fax rooms will always be busy as there are so many poor who have large tumours who wold never be able to afford the surgery and in eyes, being able to give the gift of sight will change a persons life as they are then more easily able to work and support themselves. With VVF surgery, orthopaedics and general surgery being carried out too we have a wide variety to challenge us. Where possible we will use staff with the specialist knowledge in those areas but learnig a new area is fun too - ask me about it, I only seem to be in eye ORs in the ship!

We have had one very sad incident with a previous patient had had a cleft lip and palate repaired some 17 years ago. She had returned to the ship because she was having problems with her heart. On Monday she collapsed as she was at the bus station buying her ticket to return to her home in the Cote D'Ivorie. Brought to the hospital we managed to stabilize her for a while but later on Father called her home. In the days she had spent with us she had been able to see old friends and had gone to church Sunday morning and joined in the community service onboard in the evening.

As medical staff with a heart of compassion there is always a question of whether we could have done more and we have to remind our selves that we do not make those ultimate decisions. We can only follow the advice of Micah the old testament prophet who said, " What does the Lord require of you, to act justly, love mercy and to walk humbly with your God".

Saturday Februay 21

They came in their thousands - over 2000 people attended the main screening in Cotonou on Thursday and Friday. The atmosphere in the Halle des Arts was electric at 7.00am Thursday morning as so many staff involved with screening made their way to their respective areas of work in the stadium.

Security staff had arrived at 3.30am and already there were lines of people waiting. As the vehicle I was in drove towards the stadium it took me a moment to realise that the line of people I could see were for the screening.

Nursing staff took on a variety of roles offering water, comfort, escorting patients to the various areas and generally helping out. Staff in a variety of other roles on the ship joined with us to help guide patients, to pray with them, to keep the children occupied. Seeing dining room staff running around a hot hall with a small truck filled with children, laughing and giggling. Balloons going asunder, kicking balls around and dancing to the beat of the drum.

Histories were taken, patients seen by nurses and doctors as appropriate and then for some the all important green card - not the work permit for the US but the card which said "we can help you with surgery". Some patients were referred to further screening clinics to be seen by specialists such as eye, orthopaedic and VVF. Some had to gently told that what was wrong with them could not be helped by surgery and we saw mixed reactions. relief that someone had simply listened and had been able to put a name to their problem, others totally despondent that they or their child could not be helped. They were all offered an opportunity for someone to pray with them. Where we can not help Father can give comfort , relief and healing.

I suppose that I was fortunate in some ways as I was at the point of completing and giving out the all important green cards. My colleague and I were at the end of, what for some was, a long line and yet still they had smiles on their faces. One more elderly man in particular I remember who was just so grateful for what had happened that he took his card as if it were his most prized possession, of more worth than anything else he had ever owned.

Earlier in the week I had been showing doctors and nurses the operating department. There were several of us and we all had a room or two to show our visitors who came from the local area around Cotonou. They had all been invited to a reception when presentations were made about what the ship can offer in the way of surgery. The walk around the OR department was just a small part of the evening but it gave me chance to practice my French again.

On Tuesday I was able to visit a local hospital with Dr Glenn Strauss the eye surgeon. He was visiting a local surgeon aho is coming on board to undertake further training with Glenn. My role? I have been asked to help train 2 nurses to scrub for eye surgery. I went to see the kind of conditions the nurses are currently working with so that I can help train them appropriately.

Much as it may seem all hard work it has been a real joy and privilege to be here for this and I wouldn't have missed it for the world. There have been lighter moments too as I've found a swimming pool and friends who are as keen as me to keep fit. I've even had an offer for free swimming lessons in return for guitar lessons, a fair swop to me. So, a busy week and the reason for slackness in adding to this blog. Next Tuesday we commence surgery and we have a busy week. Til next time TTFN as Tigger would say.

Monday February 16

Back safe. We arrived back at the ship at 3.40pm Sunday afternoon after an 8 hour journey from Natitingou. Well, what an experience. The expression "This Is Africa" or TIA for short really did apply.

Originally we were supposed to leave the ship on Tuesday and everyone busted a gut to have us ready - this included completing shore leave passes etc. At 7pm the ministry finally contact us to say that they would pick us up at 10.30 Wednesday morning. We left at 2.30pm for a 6 hour drive. Arrived at the Parakou University hospital and met the medical director who informed us that he was expecting us the previous day.....my tongue had zig zags in it from the effort of keeping it still. But they did at least have consulting rooms ready for us and hotel rooms for us to stay in.

The following day (Thursday) we saw about 100 patients of which 57 were scheduled for surgery and 18 for further screening by specialists. We had asked for coffee and sandwiches......the coffee finally arrived at 1.00pm after we had asked again but lunch did not appear. The translators who should have been there never did appear, but Father knows our need and boy, did he answer prayer.

A youngish man - maybe late twenties, early thirties called Paul, had brought 15 or so patients, could speak french but no english stayed all day and translated into the local languages for me as I was trying to tell patients about coming to the ship for surgery and tablets that they need to take. I haven't spoken much french since I left school 32 years ago other than a bit when I've been to Paris. Father gently put the words into my mouth and reminded me of words and phrases that I had learned and so we were able to communicate quite successfully.

Another young man, Yousebi, just appeared. He was a social worker in the hospital who spoke both french and english and he just stayed helping one of the other staff who spoke no french. Father provided for us. The doctor who came with us speaks Spanish 1st French 2nd and English 3rd. He was outstanding. If I didn't know how to explain something he would write down a phrase for me, if someone was rattling off in french he would come to my rescue. In fairness the lack of lunch was made up as the Ministry did organize a good dinner for us, the restaurant was set for us when we arrived and the menu already sorted. During the day we had seen a variety of patients with max fax, orthopaedic, general surgical needs and also some VVF patients. VVF stands for vesico vaginal fistula and happens when a woman has a protracted labour, typically of several days because of the breech position of the baby. Lack of health care facilities means that she cannot reach a hospital for help. The babies are born dead and if the woman develops a fistula she will constantly leak urine. If you want to read a fascinating book about a doctor who has made a real difference in this field can I suggest you read The Hospital by the River by Catherine Hamlin.

On Friday morning we set of for Katitingou via the coffee shack opposite the hospital for breakfast where Yousebi came to meet us and say goodbye not that we had told him we were calling in there - how do the Africans manage that, and arrived at 11.30am to be told we had arrived a day early. In the original schedule we were supposed to have started screening at 8am that day, never mind arrive at 11.30am. It was quickly apparent that they were not at all prepared. There was no hotel booked, no advertising of the screening had been done and they had nothing organised. They finally took us to a hotel where we had to wait while the rooms were made ready, then took us for lunch . We went back to the hospital at about 3.00pm met the medical director were shown around the small hospital - I was itching to see inside the Operating Theatre but didn't ask - maybe I should have, and we made arrangements for setting up the next day. He organised translators again only French to local dialects but of course with so little advertising - they put out a message on the local radio and had a man going around with a tannoy on a bike Friday evening, we had few patients. However they may be the starfish that are rescued! - I have told you that story haven't I?

We then got taken on a short "sightseeing tour" including the local museum which was actually very interesting. At least our drivers were good fun. The driver of my vehicle only spoke French and about ten words of english. We had a couple of meals with them and they joined us for drinks etc so we had some fun then they dropped us at a decent restaurant last night where we had a relaxing meal just the 7 of us that went.

We left at 7am Sunday morning, returned to where we had breakfast the day before but it was closed but we found somewhere else for breakfast further on the road. Unfortunately there was an accident on the road at one point and the poor girl was dead but we had to just drive on passed it. We could not have done anything even if we had stopped. It was pretty upsetting but a reminder of the fragility of life. There was a sombre mood for some time in the vehicle. Anyway I'm back safe now and raring to go. main screening is later this week on Thursday and Friday and they will be busy hot days....

Tuesday February 10

I'm in here in Benin. This is just a quick entry today as I shall be away for 5 days traveling up country to Parakou and Natitingou as part of the screening team.

One story just to relate before I go. Yesterday there was a technical problem with one of the engines. It prevented us from being able to enter the port. The anchor was dropped. But the most amazing thing that happened, and what I love about the ship, is the way the small groups began to pray immediately. The was a real sense of us wrestling with God in prayer about the situation.

As we are now in port with the engine sorted I leave it to you the reader to decide how it happened. Certainly the engineers working on the problem were aware of God helping them....

Saturday February 7

Goodness, where has the week gone? Sorry to those of you who are following my blog. We are still sailing but are now passing the border of Cote d'Ivorie and Ghana. I've had to put my clock forward one hour as we've gone 7 degrees 30minutes over from 0 degrees longitude. Consequently it's not dark until 7.30pm which makes a nice change. it gives chance to enjoy a post dinner coffee while watching the glorious sunsets. A couple of evenings ago not only was the sunset beautiful but in the background one of the surgeons was practising his classical guitar playing up on the deck. It was truly wonderful.

We have continued with the orientation program for new staff in the department and I even undertook a little teaching on Friday as Esther, Paul and I covered some of the anaesthetic side of the work. All 3 of us spent considerable amounts of time preparing for the session and it was well worth it.

As the days have passed I have seen dolphins, flying fish and today the piece de resistance was to see killer whales. They were incredibly graceful. The sighting of such animals is helped by the bridge officers who let us know by tannoy if they sight anything. There then follows a rush to the appropriate side of the ship. On a couple of accasions the dolphins have been "riding the bow" which is such fun to watch as they dive underneath the bow and follow the ship.

In accordance with maritime requirements we have had several drills while at sea. Todays exercise was for a "man overboard". It certainly added interest to the day. Tomorrow should be the last full day of sailing as the plan is to arrive in Benin on Monday. With the sea as calm as it is that should be acheived. There will be a special ceremony at the dockside to welcome us. It's the fourth time that the ship will have been to Benin so we are known there. I shall be returning to deck 2 on Monday but will only be in my cabin for one night as I am then going up country to help with screening.

This is a small team that is traveling north to 2 different towns, Parakou and Natitingou. We shall be away for 5 nights 3 days traveling and 3 days screening. I am very excited about the trip although a little nrevous as I shall be helping to schedule patients for surgey. It's a wonderful opportunity to see the country so soon after we arrive. I suspect that my guiding experience will be widely used again including beating Heath Robinson at putting up a mosquito net. Sadly there will undoubtable be patients that we will not be able to help and I hope the sense of helplessness will not overwhelm me. To see patients come with so much hope and to see those hopes devastated will be hard. There is no easy way to tell a person that you can not help them. But there will be many that we can help.

I'm reminded of the story that Don Stephens relates in his book about the history of Mercyships. A small girl on the ward of the Anastasis was telling a nurse how she loved to put starfish back in the sea when they were on the beach When the futility of the activity was pointed out since there were so many starfish on the beach, the little girl commented that to the starfish she threw back in the sea it made a difference. I believe that this is how we must view our work. Looking at the difference we can make. More importantly for me is the difference I can make because God has put me here to complete the work.

Tuesday February 3

Life continues at pace - albeit quite slow at present in terms of speed. Apparently we passed Dakar at about 2 am this morning. Sorry I didn't see it but I was tucked up in bed asleep. So far the sail has been remarkably smooth for which I am very grateful. I really didn't want to see just how good my sea legs were and I'd be quite happy to not have to see how tough they are.

After the weekend it was back to work having spent time sunning myself and catching up on chores, including moving home temporarily. The bow on deck 5 has been opened up for us to use as a rest area. This is normally closed when we are in port but has a great vantage point. I have seen dolphins "riding the bow".

As we have staff new to the OR department sailing with us the opportunity of time has been used to give them a very thorough orientation. They will have to help the new staff who arrive once we are in Benin so will need to know about the paperwork and where things are. The staff development team have made sure that all staff have orientation to Benin too, so each morning this week there is an aspect of life in Benin that is being covered. Looking at cultures, security and various other matters.

Thankfully Starbucks is open as usual and as the price of an americano is not prohibitive I have one each day - just to keep up the caffeine levels! I am kept busy trying to help write new manuals with our German lead nurse for anaesthetics. This is paperwork and as such means that I have to have a drink in hand. Starbucks fits the bill nicely.

Tonight I joined with about 100 others in our international lounge to watch a film made by an american former member of the peace corps who returned to Benin and at least some more of the country. Voodoo has quite a strong influence among some of the population and we saw a little of that in the film. Earlier as an OR team we watched a DVD made about 5 years ago now onboard the Anastasis (the ship used before Africa Mercy) made by BBC3 and featuring a BBC presenter who went to the ship for 2 weeks while it was in Sierra Leone. It showed the screening days, a little of the surgery and balanced out the joys and sorrows of the work.

So tomorrow is another day and we continue to sail south....

Saturday January 31

I'm at sea - no really at sea. Writing a blog as the ship rolls from side to side is an interesting experience....We left Tenerife at 13.00 with banners waving and a trumpeter playing his heart out. It was quite an emotional time but also very exciting. My longest voyage before today was from Harwich to Denmark overnight. Already have been up in the bow (the front bit) with some others and watched a magnificent sunset which has it dropped below some clouds radiated beams both above and below the cloud. Who else but God could paint the sky in such a glorious way.

The sun was shining and many of us spent the afternoon in companiable times, reading, chatting and drinking tea. Gosh, it's a hard life but someone has to do it! But then it is Saturday and a day off anyway. Be that as it may I did manage to go for a short run this morning before the 8am shore leave deadline. Just to cap off a wonderful day the Starbucks cafe was opened at 7pm. Tomorrow is definitely another day and I shall be catching up with a few things - like re-stringing my guitar. Then I'll be able to make good use of the super little (or not so little) present I had from friends at church - a songbook. Thanks guys, really appreciated your generosity and I'll be using it during devos.

Friday January 30

Life has been busy for the last 3 days. Items of note include purchasing new equipment for the department and my cabin tying down equipment in the department so that during the voyage, should it be rough, all the kit stays in one piece. This is no easy task for us as we have expensive operating microscopes to care for amongst all the other equipment. Anaesthetic machines and carts, stools, trollies, operating tables all required tying down. Scrub sinks are full of rubbish bins and other odds and ends. it's quite a sight really. I have taken a few photos to show the scene.

Then Esther, the anaesthetic team leader and I have been working on writing a new manual for anaesthetic nurses that come onboard as well as needing to write a manual for how to change the bellows over on the anaesthetic machines (we don't have the latest model machines) and also how to change from the compressed oxygen supply that comes via the usual pipeline to using an H sized cylinder with 4-6- hours of oxygen supply. We have had to do this in the past when the compressed supply has failed and it's a fiddle.

However there has been a little social life too. I went out for dinner on Wednesday night with 3 colleagues from OR and we were directed to a restaurant which served an excellent chicken curry. Yesterday evening I walked into town with a few friends to see the gardens in Santa Cruz. There were delightful double orange camiliae and burgonvillia making a wonderful canopy over a large roof. The sculptures were interesting - one was rather like Mr Universe but with oversized hands.

But now the ship is being made ready to sail. The captain hopes that we shall be leaving tomorrow morning or by afternoon at the latest. I have moved cabins as I am not allowed to sleep on deck 2 during the sail. I am sharing a rather nice guest cabin which also means I have a porthole to view the horizon. It has also meant that I have had to pack up firmly anything that I don't want broken on the voyage. Those years of moving around as a student nurse came to the fore as I packed crockery and other breakables. The ship has actually been moving quite noticeably today and we are stilled moored. The weather forecast is not brilliant for the next 24 hours but should improve by Sunday afternoon. The ship has had various inspections all of which it passed, in fact one inspector commented on how professional the crew were and then found out that we all volunteers. He was stunned.

Tonight I'm on call as the "crew nurse". Basically the first point of contact for anyone who is unwell or injured. So far all has been quiet and I'd love it to stay that way for the night.

Tuesday January27

So I didn't get to the shops on Monday.I was too busy helping to tie down equipment for the sail at the end of the week and having discussions with the OR supervisor about the forthcoming outreach. As always , in operating department there is a balance between surgeons patients and staff which we try we to achieve.

It's no different for us on the ship. We are also hoping to create new teaching materials for staff so that when they come onboard there is an easy "how to" guide for various different aspects. One eventuality that we have to cover is how to change over from the compressed air to the big cylinders that are located in each operating room. In an land based western hospital we would not even need to think about what we would do but hre on the ship any issues like that have to be dealt with differently. We have enough to do to keep us busy on the voyage and beyond.

When we reach Benin we have 10 days to set up the ship ready for surgery and also to help out with the screening days. These 2 days are when we begin to see the patients who will have travelled many miles because they have heard about the mercyship and that they may be helped by the teams of doctors and nurses there. Long queues form and people generally wait patiently to be seen. Once the patient is seen and a decision made that surgery is appropriate, the surgery is scheduled and the patient given an appointment card to return to the ship.
These days are long and tiring but essential for the work to carried out as efficiently as possible.

A small group of us went into town to buy up supplies both for ourselves but also more importantly for the department. Sometimes it's easier to hand in a receipt although ever mindful that the money we spend is given by others to enable the work to continue.

I shall be moving cabins at the end of the week as I normally sleep on deck 2 but maritime safety laws dictate that no-one can sleep down there on a voyage. Now I'm grateful that I didn't bring too much out with me. A 20kg allowance focuses the mind somewhat!

As people begin to return to the ship so life returns to normal community life. It has been very quiet, almost eerily so but the morning meetings are beginning to fill up. This mornings devotions affectionately known as "devos" was about 2/3rds of normal attendance. School has started on the ship although not all the children have returned. There are a couple of new teachers too. Tonight I am going to the airport to meet up with one of the returning OR staff and hope that she's not too tired to realsie that it's me!!

Sunday January 25

it's about 10.30pm and I've rfinished unpacking. Thanks to my daughter everything arrived well packed and intact. Flight was on time and I was met with no problem. The ride to the ship took about 45minutes and it was lovely to see the ship again and to meet up with friends from previous trips. This time the access is on the starboard side of the ship and the steps up to the entrance are a little steeper - but actually much easier to climb. In Liberia they were very shallow and really needed to be taken 2 at a time.
I have a cabin on deck 2 and am sharing with Lorinda. She very kindly left me to unpack so that I would have a little m,ore spaceto move round. Everything has disappeared and I've found a home for everything. Tomorrow my plan is to walk into the town of Santa Cruz just to look round, well maybe have a coffee too!

Thursday January 22

Just three more days and I'll be winging my way to Tenerife with Monarch Airlines. At least it's warmer there than here.

The spare is in there somewhere.....just a pile of things to be packed. Last minute coffee's with friends and that's about me all done...roll on Sunday

Thursday January 22

Only 3 sleeps left!!No I haven't packed yet but the spare bed is disappearing fast with all the things I would like to take.

What's more worrying is the "techie" stuff that I'm taking this time. I'm not a "technophobe" just not as quick to have all the latest gadgets.

Howevr I have got to the point where I now just want to go although there are still people to see and one or two minor things to sort. thankfully all the "big" stuff is done.

January 16

Just nine days to go and so much still to do...I have everything important sorted it's just the stuff at work to finish off and hand over and one or two guiding bits.

Still once I'm on the plane it won't matter....

3 weeks to go!

3 weeks til I go!