Danja 2.0 Pictures

Me, Ginger, Jolene and Jacqui prepare to leave Maradi for Danja.

This is the incense they burn and swing around the ward for the smell.

Lots of bugs!

Meet Madje. Madje is a sock monkey made by my grandma.

Madje had many adventures in Danja.

The women loved her.

I told you that stone was big!

Jolene tames the donkey.

Hindou on the day of the dress ceremony.

Group shot.

The new hospital in progress.

Me standing inside the soon to be finished 40 bed ward.

(Check out that scaffolding!)

Two Weeks After Danja...

I have been home from Danja now for a little over two weeks. Internet was touch and go while I was there so I’ll try and touch on the exciting points I haven’t written about yet.

Early in the week of surgeries we came across a slight issue. A woman who had surgery was bleeding more than expected. Even though we quickly took her back to the OR and stopped the bleeding and she was doing ok, her blood level was still too low. She was going to need a blood transfusion. Two units of blood. When we found out her blood type we realized there were three people in our group with the same blood. Like blood transfusions on the ship, we were again, the walking blood bank. There were many differences between the lab on the ship and the lab at the hospital. They don’t do many blood transfusions in Danja and we quickly learned that. Someone had to go to Maradi first to get the blood bags. The lab then drew a unit of blood from two people in our group who matched the patient’s blood type. Then I drew blood from the patient so it could be tested against the donors blood for compatibility. The whole experience of obtaining the blood and checking it for compatibility all seemed a little backward to me. Drawing a whole unit of blood from the donor before even knowing if it was ok to be used. Here in the states if I give a blood transfusion there are so many checks and double checks to go through. Jolene and I were a little cautious, to say the least, about giving this transfusion. When I went to pick up the blood in the blood bank the people in the lab just pointed to the fridge. I walked over and opened it and there were two bags of blood sitting on the top shelf with A+ written on them. There was our blood. When I took it back to the ward, Jolene and I did our double checks… We checked the A+ on the blood bag against the A+ scribbled on a scratch of paper clipped on the clipboard on the patient’s bed. Jolene and I looked at each other, spiked the blood with tubing we weren’t quite sure of, but knowing it was all we had and knowing she needed this blood, looked at each other again and I’m sure she was saying a prayer along with me in her heart, we started the transfusion. The patient became a little itchy at the end of the first unit, but besides that there were not any problems! Phew! She went on to have a great recovery!

One of my favorite things about these trips to Danja is the tree. The women sleep in small cement type huts at night but during the day they all congregate under “the tree”. They sit there all day and talk, do each others hair, eat... Although on the previous trip we told the women who were coming back just for a check up to come a week later, many were already there. I think they come so early because they are so excited. Abou was a woman we did surgery on during the previous trip. She came early as well. The first few days there we were discussing how to teach the women about what they would be experiencing. It would be scary for anyone having these foreign people who can’t even speak their language want to cut them and touch them and put tubes in them. We decided the best way to teach would be to have a woman who has gone through this before tell them. Abou was our woman. She has this attitude about her. Not in a bad way, but just a confidence you don’t see too often in VVF women. I knew she would be great. I sat down with her and Houa and Hannatou to translate and when we asked her to tell us what she would tell the women I knew we had picked the right woman. We didn’t have to remind her about too many things. She talked about the sitz baths, the shower (and how to shower), not eating or drinking before surgery, about the IV and how they “give you water in your skin”, the surgery and how even though you can’t feel your legs, they will come back to you. She went on about the catheter, pain, bedrest… When she presented this to the women under the tree she did a fabulous job! She put on a gown. Put on a blood pressure cuff. Demonstrated a sitz bath. There is nothing better for teaching than having someone who has been there before teach. After her teaching she went on to sing. Abou was the one on the previous trip who sang the “Urine in the Oppressor” song. She sang that song but then continued on. She kept singing and then sang some song that had all our names in it. It was beautiful.

On Sunday night we joined the other missionaries from SIM for their time of worship. We were asked to do the speaking that night. We brought Abou and asked her questions and she spoke to the group. Again, she did a wonderful job. Dr Steve spoke then I was asked to share a bit. I shared about Aicha and the story I wrote about on the previous post then spoke about how the women care so much for each other. I think this is one thing I’m really going to take away from this trip. When a woman would leave the ward to go to the operating room, a woman who had gone through this before would come in, get her dirty, wet clothes and wash them. They would be clean and brought back before she was out of the OR. As I spoke, tears filled my eyes. These women show such love and compassion for one another. Only they can fully understand the extent of the pain and rejection each of them feels.

There was one event that happened that completely blew my mind. The day we examined the women from the previous trip there were also some other women there who we had not met before who needed to be seen. Dr Steve was examining a woman who had been leaking for 30 years. During the exam he looked at us and asked if we wanted to feel something. I put on a pair of gloves and felt it. It felt like a rock not too far inside. Dr Steve looked at us and he went to work to get it out. It was like birthing this rock. By the time he got it out I had to check my facial expression. I was cringing at this stone coming out. It ended up being an 8x5cm stone! It was huge. I know there have been larger ones in the history of VVF but this was gigantic in my eyes! We gave her antibiotics and a date to come back for her fistula surgery.

On Tuesday morning we had the dress ceremony. Eleven women danced. All left dry and I pray that continues.

Pray for Pee

The final two surgeries happened yesterday and today we started removing catheters. Eleven women had surgeries, one twice, and they are all doing well! The ward only has ten beds so on Thursday another one was brought in. It was something great to see because it means that in all these short trips, growth has begun. On the first trip out here only five surgeries were done and this is the forth trip and now eleven were done. It's great to see the growth even though the VVF hospital isn't complete yet.

On Monday we will do followup exams on the women who have had surgery at previous visits. It has been wonderful seeing them all again. They have all returned from the previous trip. Another thing that has been great to see is how the women help each other out. When a woman leaves the ward for surgery, another woman, usually one from a previous trip who is dry, will come in and wash the wet clothes of the one in surgery. When the women is on bed rest for twenty four hours after surgery, the other woman will bring her food and water and empty her bedpan if they have no family to do it for them. When it comes to these women they are never alone.

I was standing in the ward a few days ago and Aicha, a girl from the previous trip came running into the ward and yelled Sarahtou! Then she started looking all around for Linsay...sorry Lindsay. :) She is a girl who is 18 we helped on the previous trip. Later in the day I went to the tree to see her. She brought a girl up to me, probably about the same age and through hand motions and body language I realized she too had a fistula. Aicha had brought her. To me, Aicha isn't like the other VVF women. Maybe it's her age, but Aicha has this sort of attitude that an 18 year old in the states would have. I could just picture her passing this girl and smelling the urine from her then grabbing her and saying you have a fistula, come with me! I'm sure that's not how it happened, but I wouldn't be surprised. Aicha brought her fistual friend! One of the highlights of my week!

The small picture of me on this page on the upper right is from the previous trip. It's me with Hindou. Hindou was in the ward, showered and ready to go for surgery last August when we had to tell her we couldn't do her surgery this time. An emergency had come up on anther patient and we had to take her back so Hindou couldn't have surgery then. I remember sitting with her while she cried and cried, thinking we were going to leave her even though we had told her she would still have her surgery in November. She was the first to go this time. Her catheter came out today and she is dry! She has no problems voiding and is happy!

There are so many other exciting things I would love to share right now but we are headed to dinner. We have a little less than a week here. Now it's removing catheters and making sure the women can pee and empty their bladders before we leave. Please join me in prayer for this. You may think it funny to pray for someone to pee, but for some of these women their bodies don't know how. They haven't had to for so long. Their bodies are used to just leaking it out or their bladders don't empty completely which can lead to other problems too. Thanks!

Back in Danja!

We arrived here in Danja Saturday morning. The trip here was pretty uneventful. Spokane to Seattle. Seattle to Paris. Paris to Niemey. Then early Saturday morning on a small six seater Piper plane, Niemey to Maradi. It was exciting to run into Jolene, Ginger and Jacqui in Paris. I hadn’t met Jacqui before but Jolene and Ginger and I worked together in Togo on the Africa Mercy. It’s great to be here with some good friends.

Harmitan is here so there is a constant haze. This is when the winds blow in the dust from the Sahara. Because of this we didn’t have great visibility flying here from Niemey. I’m hoping for a dust storm but I’m told it won’t happen this time of year. Bummer. From the pictures I’ve seen they look incredible!

The women are here! They were sitting under the tree when we arrived! Many of the women from the previous trip are here for check ups and many more are here to be seen. The rest of the team arrives tomorrow and screening will happen tomorrow afternoon to see who are surgical candidates. Surgeries will then begin on Tuesday. The four of us have been working to set up the operating room and ward. It’s been great reconnecting with the group here who help us. They translate for us, cook for us, laugh with us and at us, help us out more than we could ask for, and care a lot for these women as well. It’s a good team to be a part of.

More to come soon!

And I'm off...

Yes, I haven't written on here in awhile. I got home from Togo and Danja mid August and here I am, again getting ready to go back to Niger in just a few days! I'm headed back to Danja for another two week trip with the Worldwide Fistula Fund. I can't wait! Not only will we be doing another ten surgeries, we will also be doing check up exams on the women who had surgeries last time! This means I will hopefully be able to see the women again who I met on the last trip! I'm really excited as well to see how the new hospital there is coming along.

My time here at home has been great. I spent time with my brother and his family first for a bit then came over to Idaho. I've been working and living here at camp for the last month and it has been great spending time with my sister and her family. When I'm gone I really miss my niece and nephews a lot so I really cherish the time I get to spend with them.

When I get back from Niger I will have about a month back stateside. Starting in January I will be moving to Sierra Leone for a year, working as the ward supervisor for the VVF clinic there that was started by Mercy Ships. I'm super excited for this experience and to see what this year brings. I'm also REALLY excited to be living on land! That in itself will be a whole new experience!

I'll be posting more on here now that I'm off on another adventure soon!

Pictures of Danja

The plane we flew in from Niamey to Maradi.

Alainie, Me, Lindsay and Ginger wearing our matching free bird head wraps.

The women waiting under the tree.

Camels are not as fun to ride as you would think!

Preparing for the dress ceremony.

Group hug!

Group picture.

The women in their taxi home.

The empty tree... until next time...

The new fistula center under construction!

Home

I arrived home yesterday after being gone for seven months. Thank you Esther for picking me up! It was wonderful to be picked up by someone I had met in Togo on the ship.

The last few days in Niger our internet connection wasn't the greatest so I couldn't keep you all updated but everything wrapped up really well there. Ten amazing women had surgery and almost all went home dry! The final day we had a dress ceremony and the women looked amazing! Their smiles were infectious and it was bittersweet to walk them out to the end of the road for their ride home. It was amazing to see their lives transformed in such a short time. Women who showed up scared and frightened left laughing and smiling. One of the girls I had tried to reach all week came up behind me as we were walking out and held my hand out to the road. It was a beautiful sight to see them all pile into the back of a truck and drive away. It is my prayer that as they return home, they will continue on this path of joy. That they will be welcomed and accepted back with open arms and that the joy I saw radiating out of them will continue.

Yo Yo Yo

In hausa the word for leaking, dripping is yo yo. I wondered why when I walked up to the group of women and just said yo, they all laughed. I found this fun fact out yesterday and today I was reminded of a camp song in which the chorus is "Yo, yo, yo..." over and over. I sung it to a patient today and she just laughed. It's an easy word to remember when I ask the patients if they are wet or leaking.

The final patients had surgery today. Ten women in four days. When I took one of the young girls to the OR I could tell she was petrified. Her mother was there but they speak Twarg, a language not many people here speak so we had difficulty communicating. We walked across the sandy ground and when we got to the door she stopped. She started crying. The fear that must go through these women and girls. To be in this state where they are outcasts and then brought to a hospital where white nurses are telling you how to prepare and how to wash and how to sleep in a bed off the ground and then being led to an operating room which is freezing to your standards and we will put you in stirrups and make you vulnerable and a male doctor is going to do your surgery after we stick something into your vein and another man is going to poke you in your back so you can't move your legs...I took care of her after the surgery and it took a bit to get her to smile, but she did. Her and her mother have been here for over a week waiting for this day. She is dry and has so much to smile about. Please keep praying for her and her recovery.

After the final surgery of the day we heard they were here. They are the camels. We had all been wanting to ride a camel on this trip and the time had come. They were waiting outside our house. When we drove down the road and I spotted them I got really excited! They were so tall and had seats on them and I couldn't wait... until we got out of the car. Camels are not the most graceful of animals. The way they stand up and get down to the ground scares me. One of them was yelling and was hating life. There were three camels and six of us. I knew that if I waited until the second round I would chicken out so I got on one. Here in Niger we need to wear skirts down to the ground. I showed more leg today than I have in months. There was no way around it. When the camel stood I screamed. I don't know how this seat didn't slide off. It felt so awkward. As long as the camel was walking I felt ok but if it was stopped I just wanted to get off. I will fully admit this was not one of my highlights for the week. After our short walk, when it was time to get off, the camel did his same awkward movements to lay down and again, not a good moment in my life as a volunteer. I was thankful only my friends could understand what came out of my mouth. Would I ride a camel again? No, but I am glad I did it today. The men who brought them got the biggest laugh from us all.

It is raining like crazy outside right now! It's actually a good thing for the tadpoles. The day we got here, the four of us girls walked by a puddle full of frog eggs. Every day we check on them and a day or so after we found it they had hatched into tadpoles! It rains almost every night so the puddle fills up. Once we had to fill up the puddle because it was almost dry and many of the tadpoles lay dead on the sand. We drug an old wheelbarrow full of old water and dumped it in. They were happy. Last night it didn't rain and we all got busy and the puddle dried up and the tadpoles died. We hung onto hope that they found refuge in the mud and with the rain now they will come back out. We can hope... This is our nightly entertainment.

................................................

I wrote this post last night but because of the storm the internet cut out. Here's an update on the tadpoles...they all died BUT the puddle filled back up to overflowing and it is full again of frog eggs! We will try to be more on the ball this time around.

The Urine Song

I finally found out the gist to the song the women sing:

I became wet.

My husband left me.

He took me to live with my parents.

No one wanted me.

I heard about this VVF hospital so I came.

There are nice nurses and doctors here.

Now I can be healed.

Only one day of surgeries left tomorrow. I had to fight back tears today more than once. Tears of happiness and tears of sorrow and tears of joy. Women and girls finding healing and others finding a longer road ahead. One needing to wait a little longer but in daya, biyu, uku (one, two, three) months she can come back for surgery.

How do these women and girls survive? I say girls because we have one here who is 14 who had her surgery the last time the clinic was running. 14! Wild. The youngest here now is 18 but looks younger. Only one more day then a week more of recovery and other things.

I can't post pictures on here because the connection is too slow. When I get home I'll post lots!

Urine is the Oppressor

The first two VVF surgeries were done today and the women are doing well and are dry! The day started of rough, which you will read about later, but it is impossible to not laugh and smile when you are with these ladies. Oh, how I love them!

I told you in my previous post about “the tree”, the place the women congregate. They lay their mats out and eat there and talk there and spend their days at this tree until it is time to be seen or have surgery. After the first woman left for surgery this morning I went over to that tree, my small book in hand which I am scribbling down the hausa I am trying to learn and attempted to talk with the ladies. My name in hausa is Sarahtou. I love hearing them say my name. Inakwana was all I said when I walked up and they started laughing and claping. I learned to say goodmorning, a change from yesterday when all I could say was sanu, hello. I have already learned more hausa in the few days I have been here than all the ewe I learned in my six months in Togo. Ina sunauki, what is your name. I am really bad at remembering names, but as they started telling me theirs I realized I would only have a few names to remember: Aicha, Howa, Mariama...if I say one of those three I will have a good chance of getting the name right.

Singing. I needed to hear them sing. After church last sunday, I needed more. The singing isn’t like what I have heard in Liberia or Togo. It’s not accompanied by the chicken dance or any other form of wild dancing. It’s slow and almost monotone. It’s really beautiful. I started moving my feet and clapping and they got the hint. I’m still trying to find someone to translate the words to the song they sang for me, but it was glorious. I could sit and listen to them sing forever. If they aren’t singing or telling me their names, we just smile and laugh at each other.

I feel like I have so much more to share but don’t know where to start.

For those of you who follow my blog, I wanted to let you know too that I received an e-mail today from Michael, Lovelace’s father. She went home to be with the Lord last week. I don’t know any details or how they are coping, but the last time Jane and I went to visit we had talked a bit about this time. He told us that he was never angry at God but that he trusted Him and knew that if Lovelace was going to be healed it would be and if she wasn’t going to be healed, then that would be. He trusted fully in the hand of the Lord and never spoke of anger or bitterness. She was loved so dearly here on this earth and I picture her now, asleep in the hands of God, no pain, no more dressing changes, she was a small girl who knew nothing but Love.

Under a Different Sky

I arrived in Danja yesterday and it feels like I have already been here for weeks. So much has happened and so many new experiences in such a short time. Niger is like no other African nation I have visited. The red dirt gives it a sort of pueblo feel. The red brick changes the color of the houses and the ground. I hear this July has almost set a record rainfall. I'm not surprised as it has poured the last two nights. Tonight I have only seen lightning but no rain yet. I'm sure it will come. The heavy rains are making the fields green which I hear is uncommon. Great for the crops though which this country is in need of.

We flew into Niamey, the capitol of Niger on thursday afternoon and stayed at an SIM guesthouse for the night. Yesterday morning we got up early and got on a small six seater plane. Dr Steve once asked what we were most afraid while planning for this trip. I said this plane ride. I was not looking forward to it but it turned out to be amazing. The takeoff was so smooth and to see Niger from the air was beautiful. Dry land, many small villages, small lakes, different types of irrigation for the fields, dirt roads and more dirt roads...

As we landed on the small airstrip in Maradi we passed many farmers tilling their land right next to the runway. When we stopped, people came to watch us. Going into this trip I knew modesty was a must, but almost immediately I felt like I needed to cover my head. I was wearing a long skirt to the ground but I needed to cover my head. I had made us all head coverings from fabric I saw at a VVF dress ceremony on the ship. It's of birds flying out of a cage, symbolic of the freedom these women receive with the new lives they get after they are dry. Long skirts and head wraps will be my clothing for the next two weeks. Within a few moment of landing, a man said he would have no problem finding us all husbands and yet a different man, as we were driving out, asked our driver were he was going with all these brides. We had to laugh.

Driving through Maradi and out to Danja took about fifteen minutes. On that drive we saw real cowboys. Small boys, maybe ten, shepherding their sheep and goats, but also sitting on large, very skinny cows, driving them. The real cowboys of Niger! We drove quickly around the hospital grounds and took a look at the VVF center being built. The walls are going up and it is amazing. I couldn't help but think of the women who will soon be using that center. It's a great gift to the country and such a need. During the flight into Maradi, seeing one, maybe two paved roads that whole time and seeing villages out in the middle of nowhere, it hit me again why VVF occurs and why we are here. The women in these villages, even if they wanted to go to a hospital for delivery, can't. There is no way to get to one. They would be walking for days, weeks. By then the baby would die and they would still end up with fistulas.

Today we got to work. We were told there were already some women here waiting for us by "the tree". They had been screened the last time Dr Steve had a team here and they are ready! My eyes teared up as we walked over to them. About fifteen women sitting on their mats waving as we walked up and smiling. I only know how to say hello in housa and that amused them as we shook their hands. I can not wait to get started! These women are sleeping on their mats under "the tree" just waiting. ..

Lindsay and I set up the ward with Mariama, one of the head nurses here working at the leper mission. We made their beds, cut black plastic garbage bags to use as pads on their beds and hung mosquito nets. Hanging the mosquito nets made me laugh. I never thought I would be here, hanging mosquito nets on beds to do VVF surgeries in Niger. At this moment, I would not want to be anywhere else though.

When we were done in the ward we helped Alainie and Ginger finish setting up the operating room. A few more things to do tomorrow and we will be set and ready for Dr Steve to arrive monday for exams and start surgeries on tuesday!

Here are a few more random stories of the last two days:

Today one of the guys working here took us to town to a "tea house". The tea house turned out to be a tea tent on the corner of a busy street. Maybe the best tea I have had. Spicy, had a good kick to it. The owner came and told us all the states he knew in the US and all the presidents he knew. A TIA moment at its finest (This Is Africa). Great place to sit and watch the city. Cows pulling carts, a man and a boy on a motorcycle carrying hands full of ginny hens? Women in their burkas. Men at prayer in a mosque. Trucks with too many people to count hanging on. Trucks loaded down and overflowing with goods. A gas station where you get gas poured into your gas tank from old glass or plastic bottles via a funnel. Sometime in the next two weeks I hope I make it back there.

After an afternoon out, it was dark as we drove back to the hospital. We were stuck behind a taxi coming up on a checkpoint. The taxi was full of women dressed in their finest. One woman was pretty glittery with all her sequins. We were stopped on the road talking about her sequins when a sheep slowly pops its head up in the back window from behind the back seat, looks around and slowly goes back down. We wondered if the people knew it was even there. It looked like a puppet. We all had a good laugh with that.

I'm trying to upload pictures on here but it's not working. Check back tomorrow and I will keep trying!

Danja

I thought I would take a moment to fill you in on my life after Togo. It's only the first two weeks after Togo, but that's a start. More to come later on my life after two weeks after Togo...

My time here on the ship is starting to wrap up and I can't believe how quickly the past six months have flown by! I leave two weeks from today and I feel like there is so much I haven't done or seen but those feelings are always swept over by the memories of the things I have seen and experienced and tasted and seen and touched.

In two weeks I head to Danja, a small town in Niger. I am flying there with three other amazing nurses I have met here on the ship. We will meet up with Dr Steve, the surgeon we had here on the ship for the season of VVF. He works with The Worldwide Fistula Fund and they are building a VVF clinic in Danja. When this clinic is complete they will have a 42 bed fistula ward! That is so exciting for Niger which is one of the worlds poorest countries and has so many women suffering with fistulas. Click here to see some pictures of the site and where it will be. Here is a picture I took from The Worldwide Fistula Fund website which shows the current SIM hospital and the outline on the left is where the fistula hospital will be.

Because the clinic is not yet complete, WFF partners with SIM, another NGO, which has a leper hospital on the same grounds where the VVF clinic is being built. They give WFF use of their operating theater a few times a year for two weeks at a time so Dr Steve can bring a team in to do surgeries. I will be working with Lindsay as a ward nurse while Ginger and Alainie will be working in the operating room.

Please keep us all in your prayers during this time. Pray for safety and health for us all. For protection from dehydration and the heat and anything man might throw in our paths. Please pray for the ten women who will be having surgery. For physical and emotional healing. That we all can meet the women where they are at.

Yovo Chicken

Last weekend I went back to Ghana with some friends. We went back to Wli Falls and this time climbed to the upper falls. It took about an hour and a half to get up. Scrambling up rocks and using roots to pull ourselves up. It was wonderful! A great weekend with wonderful friends.

After the waterfall we went and visited Lovelace and her family again. We decided to bring them some food so off to the market we went. It's nice to be out of the big city and in a smaller town market. People don't yell at you and you can just look around. You still get the occasional "Yovo!" but it doesn't seem to bother me as much. Fish, eggs, spices, rice, bread, fruit, roasted corn, palm oil... we were ready to surprise them with our purchases. We started down the road and came across a man selling live chickens... Yes! We walked away carrying a plump yovo chicken! There are many sad, scary looking chickens, but this was going to be a good meal, I could tell! We were all so full of excitement and laughter and we carried the yovo chicken to meet its new family.

When we arrived at their house, they were not there. Finding out from the neighbor boy that they were still at church, we waited for an hour and a half before they returned. We had been followed to their house by a small mob of children so we had plenty of kids to keep us occupied until their return.

They all pulled up in a taxi looking their finest from church, then my heart dropped. Lovelace looked lovely, but you could tell she's not doing well. She is now unable to walk because of the pains in her legs and hips. She is getting thinner as the tumors are growing. Michael, her father, has told us she is not eating much either. Esther, her mother, went and bought her a fan ice, ice cream in a sachet, and squeezed it into the corner of her mouth. She is so uncomfortable. We can offer ways to help her be more comfortable, but please pray her pain will go away.

Mighty Ships

On the sail here from Tenerife to Togo we were joined on board by a video team from the discovery channel in Canada. They were filming Mercy Ships for their show Mighty Ships. Tomorrow night, June 23, you can finally watch the show! For those of my friends not from Canada I am pretty sure you can watch it online. If any of you watch it, let me know how it is! We can't watch anything online from the ship. They were everywhere here...waxing the floors and setting up the wards, screening day and eating, we had video cameras filming us. I would love to see it but I will have to wait until I get home. Check it out!

http://www.discoverychannel.ca/Showpage.aspx?sid=13057

Knitting

I get asked what I do when I'm not working. Well, Tuesday evenings I go with a small group to the hospitality center to knit. The hospitality center is a place where patients go after their surgeries, if they are from far away, so they can come back to the ship daily or a few days a week for post-op appointments. It's a wonderful place for them. The wards don't have windows because they are below the water line. They get to go outside once a day to deck 7 for an hour. At the hospitality center they spend the majority of their time outside. They have room to run and play. It's a great place to go to hang out with the patients. I love going on Tuesday nights. I am never able to speak with the patients because there are very few translators there, but that's ok. Somehow you don't need verbal language to teach knitting.

Every week I think of Grandma Daphne, my grandmother who taught me how to knit. I know it would make her smile to know what I am doing with a skill she taught me. She was a wonderful knitter!

Faces of VVF

Before posting pictures, I want to share a couple stories of the VVF ladies.

First, Rosali. Rosali had her surgery and although she was dry, she was retaining urine. She wasn't able to fully empty her bladder after she went pee. She was taught how to catheterize herself as she was going to have to do this at home. The longer she was on the ship though, the more she was able to empty her bladder and the day she left she didn't have to catheterize herself anymore. Rosali went home dry and healed! The day she left I went to give her a hug and to celebrate with her. She gave me a hug then grabbed my hand and rubbed it on her bottom and exploded with a huge smile and loud laugh. She had wanted me to feel how dry she was and this brought her so much joy!

Then there is Adjovi. What to say about Adjovi... She occupies a corner bed and I can't help but smile and laugh when I look at her. She has had two surgeries already in the short time she has been here and although she is finally dry, she too is retaining urine like Rosali. Please pray this changes and she will be able to empty her bladder and not have to go home with catheters. She just makes me laugh though. Whenever I look over at her bed she is always sitting up talking. Talking to who? Maybe she's praying, but this woman likes to talk. She speaks Tchicossi, a dialect from the north of Togo that only one translator on the ship speaks. When I walk past her bed or she comes over to where I am, she will talk and I will nod my head and smile. She knows I can't understand her and I'll talk to her knowing she can't understand me. I love these moments of speaking but not having a clue what the other person is saying. It happens so often here with patients, with friends from other countries, with taxi drivers or people in the market. I think Adjovi just needs someone to talk to.

Here are some pictures of the ladies. Some are from the screening day and some are from the first dress ceremony on the ship when the women are dry and get a new dress and we celebrate!

Raven

My mom reads my blog to her fourth grade class and one of her students wrote this poem. I thought it was great so I wanted to share:

The Africa Mercy

Where lives are saved

Where saving the world

Is what you want

To do and making our

World the best it can

Be, To where you have

Joy to help others and

To see others as best

As can be

By Raven

Thanks Raven!

Aissa Update

After I just posted about Lovelace, I was reading up on friends blogs and came across this update on Aissa. Aissa and Lovelace were on the ward at the same time. Two small girls with two very different problems. Sarah is the PA who met Aissa in Cameroon and came with her to the ship.

http://sarahmcwa.blogspot.com/2010/06/please-pray.html

Here is a picture of Aissa the day she left the ship...

Lovely Lovelace

This past weekend Jane and I traveled a little over two hours to Ho, Ghana to visit Lovelace and her family. She lives in a small home with her father Michael, Esther her mother and younger brother Bright. Lovelace is five. She was a patient on the ship for six weeks or so. She has two tumors that cannot go unnoticed. One growing out of the right side of her mouth and the other out of the top of her head. It's impossible not to notice them. It's impossible not to notice how her bottom teeth are folding back on themselves, pushing her tongue to the left side of her mouth and how her top teeth are biting into the tumor. Impossible not to notice the large bandage on top of her head from where the tumor popped open, leaving a large gaping hole. Impossible not to notice her thin frame, arms and legs thin as sticks. How she walks, almost like an old woman who has had a lifetime to build her body up to the aches and pains in her hips.

I remember the day she was admitted to A-ward. Someone had mentioned there was a little girl coming in with a large tumor. I didn't imagine there was more than one tumor. The one in her mouth has been growing about three years now. The one on her head, only a year. Yes. I said only a year. This fast growing tumor is taking over. A scan was done and showed there is no bone where the tumor is growing. It has eaten it away.

Lovelace and her father came to the ship to have a biopsy done to see if there was anything any surgeons on the ship could do for her. The biopsy was taken after treating her for malaria, and although the lab had what they needed from the biopsy, the tissue had to be sent to another lab to be processed. This is not uncommon. Tissues are frequently sent overseas to labs in the states or Europe. They waited on the ship for the results. They waited and waited and waited. The results were taking weeks to get back to the ship so they decided the best option was to go home until the results came back. If they needed to, they could easily be back to the ship in a day. The results came back finally and the tumors are not something that can be treated here on the ship. She has been to numerous doctors to seek help. Lovelace and her father traveled to the states a year ago in December to seek treatment there, but she was too sick at the time. Her father showed us pictures of her standing in the snow in Baltimore. Quite the contrast of sitting in her home and thinking of her standing in the snow. If you ask her if she likes the snow, she answers with a quick NO!

We had wanted to take their whole family to Wli Falls, the tallest waterfall in West Africa on Sunday. We met them at the tro-tro station but only Michael, her father, was there. She wasn't feeling up to the two hour trip. The three of us went but I couldn't help but think of Lovelace the whole day, wondering how she was doing. After the trip to the falls we went back to their home and Esther made us banku and fish. Esther is a wonderful cook. She had made us fufu with a sauce with chicken the day before. Amazing dishes! To watch Lovelace eat is amazing. This girl has adapted to having over half her mouth filled with an invader. When she closes her mouth, her teeth don't touch. She shoves her food into the corner of her mouth and use her tongue to grind any meat. It takes awhile, but she manages.

I think of her daily and wonder how she is. To look at her now, since she has left the ship, two more growths have started on her face. Once above her right eye and another by her left ear. The life of this beautiful girl is in the hands of God. Please pray for her. Pray for her daily that she will be without pain and that God will do a miracle.

The Women Danced!

VVF is upon us! This is the time I have been waiting for. Since I cared for VVF women in Liberia three years ago, my heart has belonged to these women. What is VVF? VVF stand for vesico-vaginal fistula. Basically, it's a hole which is formed between the bladder and vagina which causes a women to constantly leak urine. The most common way this occurs is during prolonged childbirth.

Picture this: You are a woman in a remote village and you are pregnant. As you start going into labor, the other women around you come to help. If there is a problem, what do you do? What can you do? The nearest hospital is at least a days walk and since you have been laboring for at least a day already, it is too late to start that journey. You labor another day. And another. And possibly a third or a fourth before the baby passes, stillborn. You grieve for the loss of your child as you start to notice you are unable to control your urine. It runs down your legs without any control. Pads can't stop it. Medicine can't stop it. Because the baby was stuck for so long, and it pushed so hard on parts of the vagina that it killed the tissue there and caused this hole into the bladder or into the ureters or maybe even into the rectum so you are leaking stool as well. Nothing can stop this. You constantly smell. Flies swarm. You can no longer stay in the house because of this. Your family disowns you. Your husband leaves you. You have lost your baby. You are on your own. What hope do you have for a future?

Last monday was screening day for VVF. 66 women showed up. 60 were able to get surgical slots. That is an amazing number! Tuesday was the first day of surgery and today was the first dress ceremony. After a women has her surgery and she is dry, as we call it, she is given a new dress to go home in. Makeup is put on her face. Her nails done. A head wrap on her head to match her beautiful new dress, and we dance. Five women danced today. Five women who were wet but are now dry danced today. One was leaking for a year. Another for ten years. Another for thirteen years. They had all been left by their husbands. Ostracized by their communities. One of the women I saw smile for the first time today in a week. Hope is being restored. Lives are changed in ways I could never understand.

These women remind me of the passages in Luke 8:42-48:

As Jesus was on his way, the crowds almost crushed him. And a woman was there who had been subject to bleeding for twelve years, but no one could heal her. She came up behind him and touched the edge of his cloak, and immediately her bleeding stopped.

"Who touched me?" Jesus asked.

When they all denied it, Peter said, "Master, the people are crowding and pressing against you."

But Jesus said, "Someone touched me; I know that power has gone out from me."

Then the woman, seeing that she could not go unnoticed, came trembling and fell at his feet. In the presence of all the people, she told why she had touched him and how she had been instantly healed. Then he said to her, "Daughter, your faith has healed you. Go in peace."

These women ache to touch the edge of Jesus' cloak. To be healed. Not only did Jesus heal her physically, he healed her body and soul. We have a wonderful surgeon here right now to help heal their bodies. Pray for this healing, but also pray that these women can start to experience emotional healing as well. To not harbor bitterness or anger, but to forgive and be able to go on living their lives in joy.

Five women danced today. They danced. They danced. They danced!

Dzinye le Africa

Tonight I went on an airport run to pick up a load of new arrivals to the ship. This was my first time doing it here but I remember always loving to do it when I worked at camp. I love seeing and hearing first impressions. It reminds me of my first time landing in Africa. Ghana was my first African country three years ago and I remember the fear and excitement and just knowing my life would never be the same when that plane touched down. When I stepped off the plane onto the tarmac, I remember standing there, feeling the hot, humid air, and a man came up behind me and told me I looked scared. That was probably true. I had traveled overseas before but Africa seemed so big. So...far away and so different. True, it seemed like the differences outnumbered the similarities from where I come from, but it's just another way of living. Not right or wrong, just different.

Tonight, driving home with three people, first timers to Togo and to Africa, I had to laugh. "How many people can you fit on one of those motorcycles?" Ummm...five or six is the most I have seen, depending on the size of the kids in the family. No helmets. If babies don't fall off mama's back when she is walking, why would it fall off on a moto-taxi? Cheaper and faster way to travel anyway. "Not many streetlights, huh?" Nope. The lights from the zimi-johns light up the road, if the bike has one. "How many lanes on this road?" We still haven't figured that one out. However many cars can fit...

I wish I could be the first to take them all to the market to see their impressions of that too. The noises and smells and colors and touches and people yelling "yovo, yovo" over and over and over...

Dzinye le Africa.

My heart is in Africa.

Aicha

A few posts back I wrote about noma, the infection that invades your face and within days kills 90% of the people that it infects. Aicha, the seven year old girl that arrived on the ship from Camaroon with this, is doing amazing. The skin graft to the right side of her face is taking and she is healing more by the day. I had to laugh today because as I was working in A-ward, I realized every other patient in there knew her by name. Even the patients who were new to the ward. It's not because they know her history. How she was abandoned by her parents and taken in by her grandmother. How the last year of her life went from being moments from death to having the massive hole in the right side of her face being covered over by skin from her thigh. How her uncle has given up so much to be with here here and only having one other person besides Aicha that he can talk to in his own language. No, the reason everyone in A-ward knows Aicha is because of her bubbly, spunky, fighting spirit. This is definitely a girl familiar with the hospital setting. She no longer has her feeding tube in, but when it was in, she would give herself her own feeds. She would put on the syringe and draw back to see much of the previous feed was left in her stomach. She would push the medications down the tube. She would pour the food into the feeding bag and roll open the clamp to get the feeds to run. When it was finished she would let us know and she would flush the tube then go back to playing. I can't begin to say how funny this would be to watch. The day her tube came out was a big day on the ward. She had been wanting to eat for so long! Meals, even now, are an experience with Aicha. She can't eat rice because of her incision, so that doesn't sit well with her, but this girl likes to eat! If the meal trays are late, she will let you know. If she doesn't get enough, she will let you know. In the past year she has gone from perhaps a day away from death, to a bubbly, spunky little girl who knows what she wants and she will tell you. When you sit and think about it, it's amazing to see all the different people God has brought into her path, how far she has come and then to think about her future. She has one. What more is there to say?