Monday, 30 March 2009

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, 21 March 2009

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, 14 March 2009

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, 10 March 2009

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.

Monday, 9 March 2009


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, 4 March 2009

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, 25 February 2009

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, 21 February 2009

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, 16 February 2009

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, 10 February 2009

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....