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"