The rollacoaster tragedy and fun

How you can nearly overlook a person...so easily here. At the eye screening a lady turned up to the church along with the other 1000 or so patients. Seeing she had nothing wrong with her eyes she was not attended to....she was clutching her stomach and came with an older man. Somehow she got inside the compound to where the eye team were-Perseverance probably like the men who lowered a lame man in the bible in to Jesus presence. Her story is traumatising. She has a fistula- the smell was apparent. She didn’t want to sit as she would leak urine. How did she get it? Most women get a fistula through prolonged child birth causing a tear in the bladder. This young womens story gradually came out. She was recently to be married and to stop women enjoying the pleasures of sex and potentially straying they are often cut- Yes female genital mutilation. It seems this women was cut so badly that the valve on her bladder was destroyed. I can’t even begin to imagine to brutality and pain of the immediate cutting- no anesthetic too. Since then her husband rejected her and she was left. How God must look down in anger at what one human being or one set of beliefs can lead people to do to one another. God’s good design for sex and pleasure destroyed for these women. The difficulties of child birth and likelyhood of fistula’s increased due to all the scarring. Meanwhile the men stray at their leisure often bringing home the HIV infecting their wives. For this lady hopefully there will be some joy. An elderly church man brought her over a 100 miles to the screening. They arrived with barely enough money between them for the long taxi ride back. The eye team did a run around to scrounge together some money for food etc for them. The fistula surgeon is not here yet but this young women will God willing come to see him and I pray her bladder will be repairable so she can enjoy some normality of life and community instead of living as an outcast from her smell. Words probably can’t sum up your response or mine to this appropriately so I will say no more.

No need for seatbelts when your packed in like sardines- 12 0r 13 ppl in total

Every outreach before the OR’s are sterilised the hospital has a fun open night for all the non hospital crew to come and enjoy the hospital and get to feel a bit at home in it. Many of them serve us amazingly with food, cleaning, deck and trade skills to mention a few and they rarely get to see the hospital. Each dept designs activities for the crew and kids to do. Taking blood pressure, cannulating sort toys, suturing pieces of form, watching cataract surgery DVD’s and looking at the glass eyes. The lab hosted “A day in the life of a mad scientist”. The crew could pierce their fingers and test their own blood group. They looked at anti biotic plates, malaria, blood cells etc. I ventured into the OR and was smartly ushered into the stirrups- how graceful. Legs strung up a mile high and just as far apart -all to demonstrate what a fistula was and how the surgery was done. The kids then proceeded to throw a ball through my legs into a hole in a plastic sheet. The nurses had the pleasure of playing the troublesome patient whilst crew had to take temps, blood pressures and empty bed pans full or cordial and toilet paper. I am not sure all tactics used by the crew would pass normal standards- one crew member whilst bandaging a head held his patient down with a knee in her chest (he’s from the deck crew- perhaps that explains the man handling). All in all it was a fun night.


In stirups..... :S
Crew in the lab been mad scientists

What to do when the Togolese day volunteers are all on board for orientations and there is no room in the dining room for dinner- well a BBQ of course- on the dock. We had many local spectators probably wondering what those crazy Yovo’s (white people) were up too all piling off a perfectly air-conditioned, clean boat in their hundreds for dinner on the filthy port in the heat. Fun times.

Surgery started this week. The first 6 wks will be paediatric orthopaedics and maxillofacial surgery along with about 30 plus cataract surgeries a day. The wards were filling up with kiddies with bowed legs and club feet- now they are full of kids in casts that are going anywhere. The ship is also using a casting technique on small children to correct club feet which will mean only minimal surgery. They are teaching the local hospitals how to do it because plaster of paris and a small nick in the archilles tendon are about all that is required for the milder younger cases. The rush is on to get the casts on and off before the wet season in March/April- mushie muddie casts won’t be pleasant. The things we don’t even consider at home. The objects the kids put down their casts is interesting- nails, money the occasional grub crawls in.....mmm nice.

One of the first surgeries was a young boy with a large facial tumour. He had his maxiallar (top jaw bone) with teeth removed from his face and a muscle from his head moved across his face to hold his cheek up. These cases are not uncommon here and often a metal plate is screwed in place of the removed facial bones. I watched a DVD on this type of facial surgery where one of our surgeons operated- Dr Gary has been with the ship for nearly 30 years fulltime, brought a family up here and does some amazing work. When you see the face peeled back and the bones exposed and then removed you wonder how the patient will ever look human again- but with some clever manipulation of muscles and stitches hidden under the chin an almost normal looking face reappears- with swelling of course and excess skin that needs to shrink in time.
The Blood donor drive team- sucess with about 90 donors

Church is an adventure. I have attended two local churches in Togo. The first was in the North of Lome in a slightly rural area. We travelled along the road lined with homes built from women palm fronds and bamboo. Arriving at a large part finished church. As we arrive slightly late- which is normal and quite accepted here we are assured to the front stage facing the crowd in church. We take our seats as guests of honor. The sermon is mostly in French and translated also to a local dialect. The people though poor are all well dressed in their best. Some of the children where what look like grandpas slippers on their feet- many sizes too big. The church usher wanders around during the 3hr service with a switch which she uses to keep the kids in line and the dozing adults awake.

Last week I went to church in a fishing village. First we called to the tin shed where the men spend most of their days if they are working at the port and living here far from home. We stop and greet the dozing men- they look old and leathery but buff from their hard labor. This shed was where the church started- we stop briefly so the African pastor can have a chat and build relationship with the men. Driving a short way further into the village we come to an open sandy patch surrounded by cactis. In the middle is the church- a tin structure supported by small tree branches. Around the outskirts some foundations exist- the beginnings of what may one day be a brick church. In this very poor part of town it may be a lifetime until the bricks resume the shape of a church- particularly as the men of the village are fisherman and spend most of the year away from home. As such the church is full mostly of women and children and some older men. Some pictures of the two churches are below.
Church at the fishing village

Well I think I have come up with a good analogy for ship life to give you a fair picture. It is kind of like living life in a busy 8 storey Westfield shopping centre. Everywhere is public access and shared. Noise is constant and so is the flow of people all rushing around with one purpose or another. A few sit in the cafe and watch the bussle go by. A hive of activity..... Yesterday on my way to the laundry I past some children playing in the hall- I briefly enquired of their activitity, was invited to play ponies. It wasnt long before I was invited in by their parents- also people I hadn't met before. An enjoyable meal together followed and I had made some new friends and playmates I am sure. Maybe that bit isn't like the shopping centre- but it is unique and nice.

Lunch beckons and the computer battery is low so "so long"

Screening days- The joy and the pain

Where to start???

It has been some time since I last wrote and life has been insanely busy, interesting and at times overwhelming.

Last weekend the ship was blacked out so we went into town to the markets. The roads are as crazy as in Benin – potholes, zimee johns, rust bucket taxi’s and people people people- balancing all manner of things on their heads.The market is full of handy crafts and everyone is offering you a “Good Price, Good Price”. Which is code for they are trying to rip you off- but who’d blame them when you see their homes etc.

The military are everywhere with the upcoming election. They have a very public display of artilliery just in case you think of getting out of line. We have been caught in more than one election campaign. They are loud events where many trucks drive through the market with horns blahing, people yelling on megaphones and drums beating. The election has been postponed until the 4th of March- Please pray for a peaceful outcome- some people are suspecting otherwise (to the point that they are leaving the country)but so far so good.

Screening has commenced for the surgery list. I went on Tuesday. We were anticipating large crowds (which have been forbidden due to the upcoming election) however much to our surprise when we arrived less than 100 people were lined up. The line was orderly (thanks to our security). We were at a handball stadium right next to one of the major political buildings so we are unsure whether that scared people from coming- additionally it is hard to tell if the media is giving good advertisements as the election is taking precedence. We set up a maxilla facial table, an orthopaedics table and a data entry table for all patients with other ailments.

Initially I was on the line escorting people we were unable to help to either the prayer area if they chose or to the exit. It was a sad line to be on but at the time you have a job to do and do it compassionately. It is only afterwards that you take it all in and realise that for some you were their last hope, a life line. The people take no so graciously- even though they may have waited many years in hope that we could help them. Not everyone we had to turn away had a life threatening issue (well not yet). There were many thyroid goitres and hernias, which whilst back home were huge, here in West Africa they were relatively small. If they weren’t yet life threatening we had no choice but to send people away. With so few surgery slots only those who struggle to breath or have toxic thyroids will receive surgery. Maybe those with small goitres will be alive next time the ship comes- or maybe their goitres will have prevented them from breathing- a sad reality.

I was rotated from the turn away line to the pre screening line where those patients who the pre screen team thought we may be able to help came. Translators took brief medical histories and I tried my best French to greet and direct potential patients to one of our 3 nurses who then decided if the patient was suitable to see the doctor or whether there was nothing we could do. Some adults came through with leg deformaties/injuries- but there is only time to do paediatric orthopaedics so regrettably the adults will go home. Some twins came through- so cute and yovo phobic (scared of white man). The boy twin was bilateral club feet and is scheduled for surgery this week from memory. Another child with bowed legs hidden under baggy pants is also scheduled. We saw a child and adult with large keloid masses behind their ears who will be scheduled. The last patient of the day was a 16yo boy who had a large maxillary tumor on his face. He was so ashamed he dropped out of school. It will be great to see him in the hospital for the first surgery of the year.

A baby with an encehpocele (hole in the skull through which the brain protrudes) came. His mumma was so happy that he could be scheduled- even though the risk is high as the skull is opened and the brain brought back inside and the hole sealed. Without surgery though he could not live to adulthood.

A lady with a fistula tried her best French to explain her condition to me- thankfully someone had written the word “gynaecological”in English on a piece of paper she brought with her. Fistula surgeons are coming later in the year so she will come to another screening where a surgeon can examine whether she will be repairable by surgery.

Over the morning the line of people grew slowly. The military came by at one point and the fear in the crowd was obvious. How blessed we are to live in a country where police and law enforcers are not to be feared. Many of the patients were cataracts and dental so they were referred to our eye and dental teams. There are many more eye spots available as the cataract surgery can be done in 7 minutes here. It is crazy to think something so debilitating can be fixed in 7 mins (though with a lot of skill too).

There are many more patient stories I could tell but i'm sure they will come over the coming months....

General surgical screenings will go on 3 times a week for the next 10 wks. Eye and dental screenings go on with similar regularity until about June. Time is not a concept the Africans are familiar with so we can’t give the patients notice of their surgery more than about 4-6wks prior to surgery or they loose track of time and fail to turn up or turn up too early.

Unlike Benin where French, and 2 dialects were spoken I am told up to 23 dialects are spoken here so confusion is common. Will I ever be able to communicate- mmmm not looking likely.
Please be praying for surgery which starts on the 25th and for wisdom for the staff who continue to select patients we can help.

My cabin is filling quickly and I ebb and flow with bouts of missing home. It is a very unique environment to live in- 6 people in my bed room, 400 people in my house with any number of those in the lounge room, kitchen, dining room and laundry at a given time. Add that to a street address that reads something like the craziest busy port in hot humid West Africa with men who eye you all the time and a never ending bombardment of noise, smells and sights.......sensory overload big time. Prayer for my sanity at this stage would be great :)

There is so much more I could write about the events of the last two weeks- but you have more to do than read a long long blog –so until next time......
Au revoir

Thoughtless Thursday- Pictures from the Sail

With my room mate Keisha
Yens- our resident comedian (carpenter by trade)from Holland

Counting and Packing pills for the Pharmacy with Shaun providing the inspiration (Music) and the ship to provide enough movement that sometimes all your nicely counted pills slide off the table in one wave :)

Worship on the Bow

Cabin fever has set in bad- the newly formed powerwalking team- anything for amusement by this stage- sock golf was another sport introduced.

Maggies scavenger hunt birthday party team

Our Scavenger Hunt team (note for sensible reasons they only let us be responsible for one child in case we lead her astray or got lost on the ship... :))

Sunset from the Bow

Bienvenu to Togo

Bienvenu to Togo- Welcome to Togo.
We have arrived- Praise God for safe travels.
Just after 10am this morning we picked up our Pilot and pulled into the port of Lome, Togo. On route we passed numerous fishing boats reminding me of Benin- true to it they were bailing water out of the boats before having left the port.
We were up early anticipating the sight of land but the horizon was hazy. Around 9:30 we could just make out the beaches in the distance and a constant flow of exiting cargo ships indicated we were close to the port.
Pulling around the break wall we could hear a band. In front of us were several dirty big cargo ships. Spotting a crowd of people on the wharf we soon gathered which berth was to be our home for the next 6 months God willing. I say God willing because the Togo election campaign starts this weekend with the election scheduled for the 28th Feb. Whilst little unrest is hoped for the police presence is high and check points are common. The 2005 elections saw much unrest but 2008 was relatively peaceful. That is a prayer point for sure.
Many people colourfully dressed and waving excitedly gathered on the dock. The bands of brass instruments and drums beat out the turn “Our God is the most High God”. We could sing along with the people as we had become familiar with the song in Benin last year.
Due to the elections the gathering on a large crowd is strictly prohibited so only those approved by the Port officials and government would be there to welcome us.
Almost in slow motion we safely touched the dock and were tied- down came the gangway and the official welcomes began. In usually African style the official party of government was unable to make it due to the upcoming elections- I stood and listened as the welcome was translated to English- I am still unsure who made the welcome speech.
This is the fourth time that Mercy Ships has been to Togo- but this time is the first time with the new ship so the people are eagerly waiting.
Due to the elections we are unable to have a mass screening for patients so instead teams will into designated towns and clinics to do multiple smaller screens. Already a baby boy was scheduled to join our infant feeding program immediately- that is his mother was to meet us on the dock for his feed to start- however they are yet to turn up- maybe tonight or tomorrow- the concept of time is a mystery here.
As I sit looking out at the port a large cargo ship is been loaded with bags of grain. Rats and cockroaches are common residents here- as with any site associated with grain. Lorry’s are moving everywhere, large cranes move back and forth , shipping containers balance precariously on fork lifts and grain hoppers line the horizon. This is a busy working port....we will have no shortage of entertainment to watch over breakfast.

Today we all dressed up for the occasion and celebration as dignatories came on board. Behind me is the Togolese Navy - two ships in total.

Praise God for our safe arrival. I look forward to filling you in on the adventures in Togo.
Au revior.

Thoughtless Thursdays

I thought I would start a day of the week with only pictures or very few words (which as you know is hard for me :)) so "Thoughtless Thursday" it shall be.
Todays theme is my new home- The Africa Mercy

Adventures on the high seas

Well we've had some fun sailing- and I think the Psalmist best describes our journey so far:

"Others went out on the sea in ships; they were merchants on the mighty waters.
They saw the works of the LORD, his wonderful deeds in the deep.
For he spoke and stirred up a tempest that lifted high the waves.
They mounted up to the heavens and went down to the depths; in their peril their courage melted away.
They reeled and staggered like drunken men; they were at their wits' end.
Then they cried out to the LORD in their trouble, and he brought them out of their distress.
He stilled the storm to a whisper; the waves of the sea were hushed.
They were glad when it grew calm," Psalm 107 :23-30

Your guessed it- high seas, flying objects (indeed the ingredients for pancakes spread all over the galley floor (yep milk and flour....messy messy), stumbling lunatics.......

To say we were glad when it grew calm is an understatement- we were ecstatic :).

Now every movement feels like a peaceful rocking.

We have had a wonderful display of wild life. All of a sudden the amazing facial reconstructions we were learning about via DVD were abandoned when the bridge announced "Whales port side". 20 odd nurses evacuated the room for the sight. Finally resettled in our training session and "Dolphins port side" sent us diving for the upper deck again (our poor co-ordinators must have wondered whether they would ever get through the lesson).

Last night we enjoyed sunset from the bow of the ship with dolphins again gracing us with their company.

Bed is calling but just for my Sunday School kids here is what there take on the last few days might be (Thanks to Colin Buchanan). I am afraid you'll have to imagine the actions that go with the song- such fun:

Arr you.. Serving Cap –’n Jesus?
He’s the master of the wind and waves
There’s Yo ho ho
No other name by which you can be saved
Through Scurvy, shark and ship wreck
In ev ‘ry storm and strife
Sail on with Cap ‘n Jesus as the treasure of your life
Climb the rig-ging! Aye, aye Cap ‘n
Swab the deck! Aye, aye Cap ‘n
Row the long boat! Aye, aye Cap ‘n
And dance the horn pipe now...!
Heave a-way! Haul a-way!
Heave a-way! Haul a-way!
Land ho! Land ho! Land ho! (Hopefully after another 7days)

Until next time....

Onward Christian Soldiers

Yesterday we stood on the dock rearing to leave Tenerife. Some people gathered on the dock to see us off.
A local man and a real Spanish character stood playing hymns on the trumpet to see us off.
Great is thy faithfulness, Amazing grace and When the Saints go marching- it was so moving to hear him play, our language barriers no barrier to Christian fellowship and brotherly love. Some of the crew joined in song.

As we moved away for the dock the last audible song was very fitting Onward Christian Soldiers:

Onward, Christian soldiers, marching as to war,
with the cross of Jesus going on before.
Christ, the royal Master, leads against the foe;
forward into battle see his banners go!

Here stood roughly 400 Christians lining the decks headed for Lome, Togo; to confront poverty and it’s affects, to bring new hope through the gospel of Christ to a nation gripped by Islam and traditional witchcraft. A team united as Soldiers for Christ, from many nations and with many skills going to serve Christ by His Grace, in His strength, for His Glory, with Him as our leader in the mission -A scene that brought tears of joy and a feeling of been overwhelmed at how great our God is.
For now the foe these soldiers are facing is rough seas and seasickness and what a comfort it is to know that “The Lord on high is mighty than the seas, than the waves of the sea” Psalm 93:4 .
The smooth start to the sail............(Above)

We sailed into a stunning sunset last night and then the night sky was graced by a full moon and small meteor shower.

"From the highest of heights to the depths of the sea Creation's revealing Your majesty ......You are amazing God!! "(Chris Tomlin- Indescribable)

Pics of Tenerife and sailing

The Africa Mercy in port dwarfed by the stunning volcanic mountains on Tenerife. The Cruise Ships that keep us company in Port De Tenerife Santa Cruz

La Luguna North Tenerife.




Taking on fuel for the journey

Last day of freedom- at the beach Tenerife North