Reflections

I love the boats here!  They are each so unique and colorful.

I have just come to the realization that my time here is beginning to come to a close.  Only a month and a half left.  It has gone by so quickly.  The last few weeks I have been reflecting on the uniqueness of being a nurse on the ship.  Most are memories that make me smile, laugh and really enjoy my time here.  

Here are a few of those memories:

The jam/worship sessions that occur on the wards:
This usually occurs in two ways.  In the mornings with the patient life team or in the evenings with a crew member who may to come down to the wards to play music.  The patient life team is a group of day volunteers who were specially selected to support the patients while they are here.  They act a bit like a social worker would back home.  Every morning they go to each ward and lead a time of prayer and singing.    Some of the songs include "Tel Papa God Tenki" and "You are the Most High".   Each time a crew members come to play songs in the ward it is a little different.  Every once in a while it gets a little crazy and before you know it someone is freestyle rapping with the music and people are up dancing.  It is quite fun, although I have noticed some increase in requests for pain medicine after this.  

Playing with all the little pikin (children):  
Working with kids at all for that matter!  They have called the ward I work on "A ward, play ward" and it is very true.  We have a large amount of children on the ward at the moment, which can be fun as well as noisy!  Not all the kids have had surgery, some are here because their parents had surgery and they are too young to stay at home.  When there is down time on the ward we get to play games.  Whether it is playing Jenga, memory, balloon football (soccer), or reading a book, I know that I would never get to do this while working back home.  

Visiting patients at home outside of work:
I had the opportunity to go to church with one of my patients (Mariama, the patient I was teaching to use  email). It was a great time.  Her caregiver, who is now a day volunteer with us, met me on the ship.  We then walked about 20 min to the podapoda stop.  Then took a podapoda (along with 16-18 other people) to the other side of town.  We met with the rest of her family and walked across the street to her church.  The service lasted about 3 1/2 hours, 2 of which were singing and dancing.  Thankfully most of the sermon was in English, so I was able to understand it.  After the service we went back to their house and had a yummy meal of groundnut (peanut) stew over rice with fish.  It was quite tasty, a bit spicy, but good. 

Some random photos unrelated to the blog post, but I thought they were cool!

Dogs making use of any shade they can find.

Charlotte Falls with some friends

Joseph's arm before surgery,  I think he
had boiling water poured on his arm.

Joseph after his surgery.  He was so proud of how straight
his arm could go.

Women carrying their baskets across the beach.

Fisherman getting ready to go out for a night of fishing.

From Start to Finish

Meet Tamba!   He was one of the first plastics patients to come to us in May.  His hand had been burned as a small child and when it healed his hand had contracted into a ball.  Tamba wasn't as outgoing as some of the other kids, but he would sit on his bed and observe all that was going on.  The longer he was here the more he came out of his shell.  There were many games of balloon football (aka soccer), Jenga bowling, as well as coloring and drawing.

Pre-op photo

Pre-op Photo

The goal of the plastic surgeon was to release the contractures in Tamba’s fingers in hopes that he will regain function of his hand.  The first few days after surgery consist of keeping the him as pain free as possible and protecting the skin graft.    After 5 days the dressing changes begin.  This can be a very scary process, especially for the children.  It usually involves a lot of tears and screaming.  This only gets worse when we begin to exercise his fingers, which he hasn't moved in years.  It was common for Tamba and his friends to hide under the bed when we mentioned that it was time for exercises.  It is hard to see them cry but in the long run we know that if they don’t do these exercises, their hands will go back to the way they were.  After weeks to months of this we finally get  to see results. 

Tamba with Junior.  This is a good example of how we wrap
their hands so that they will not contract again.

Learning to grip!

Finally being able to grip.  Look at that concentration!

  

Tamba’s hand doesn’t look like a normal hand but it is functional again.  Which means he is able to write, color, play with blocks and hold a spoon or fork.  Tamba is still at the hope center waiting for his donor site (the area we took the skin graft from) to heal.  During one of his many trips to the outpatient department he happened to run into the the plastic surgeon,  who had just returned for a second round of surgeries.  Tamba promptly ran up to surgeon and showed him all he could do with his hand.  He was so proud and excited to show the doctor how his hand was working.  


There are so many other success stories like his and it has been amazing to witness them.    

The Hospital and the Patients



One of my favorites, who has since gone home.

 Getting to know some of the patients has been great.  It is both sad and exciting to see them leave.  I've included some pictures of them as well as a few pictures of the ward and co-workers.

Everyday we take the patients from Deck 3; where the hospital is located, all the way to deck 7.  It is on deck 7 where there is an outdoor area for the patients.  This is the one time the patients are able to go outside while on the ship.  As the patients say "It's like going from Europe to Africa".  It is always a fun time to play with the children as well as relax with the adults.  Since there are no windows in the hospital it's nice for the patients to get outside to see the sun and feel the breeze. 



Being Monkeys!




Fun times with coworkers on the ward



 

The ward
This shows about 1/2 of a ward.  We have 4 total wards.





Some of the mom's have started to make
beaded purses, which they are now
selling on the ship.







Internet Lessons!!!

Mariama listening to some music.

As some of you know I have been working on the plastics ward for the past couple of months.  The only patients left are the ones that have been having some problems with healing.  One of those patients, Mariama, had boiling water accidentally poured on her hand when she was a baby.  She is now thirteen years old and has been unable to use that hand since.  We have done a surgery to release her fingers so that she will regain some function with that hand.  One day she comes up to me and asks how to send someone an email. 

The following conversation ensued:
"Well, you need to set up an email account"
"How much does it cost"
"It's free"
"Can you help me set one up"
"Well, do your friends here in Sierra Leone have emails"
"No"
"Then what do you need one for"
"Well some of my friends from the ship that visit me want me to email them"
"Ah... that makes sense"
"Do you have access to a computer and the internet once you leave the ship"
"Yes, I can use the one at school"
"Well then I guess I can help if I have some free time"

She said she had some experience with computers at school, so I'm thinking maybe 1/2 hour and we should have it all set up,.   All I need to do is show her how to set up the email account.  I did not realize I had overestimated her level of computer experience, until after the whole account was set up.  I asked if she had any questions.  The first question was "How do I get to my email?" and the second was "How do I send an email".  At first I am thinking maybe it is the language barrier, even though she speaks fairly good English.   So I have her sit in front of the computer so she can practice.  Sometimes you just need to practice something before it really gets into your head..

"Alright... first go to the internet", this statement is followed by a blank stare.  I then point at the icon and say "Ok... click on the internet icon".  Again, another blank stare.  I then show her the mouse "So, if you move this mouse, you can see how it moves the little arrow on the screen.  Move the arrow so it lands on top of the internet icon, now you need to push down on the mouse 2 times fast and it will open up."  At last! A look of understanding.  YAY!  It takes 3 tries at "double clicking" but we finally get to the internet.

I then proceeded to continue this method of explanation until we went over sending emails and how to log out of the account.  As you can imagine it took us much longer than the original 1/2 hour I thought it would take. I think we will need to have a few more practice sessions before she really gets it down, but is was exciting to see her learn and begin to understand how the computer works.   Afterward she was so excited to be able to write her friend she had met on the ship.

Bunce Island

View on the way to the island

We made it up the hill!

A couple of weekends ago I went with some people to Bunce Island.  Slave traders used to keep the slaves here, before they were transported to America or other countries.  Most of the buildings are in ruins now, but they have started a conservation project to preserve the area and promote tourism there.  We were able to go in a Mercy Ships vehicle which saved the hassle of bargaining with the podapoda drivers.

We took the scenic route there over bumpy poorly maintained dirt roads.  It was really quite fun not only the ride but the scenery was beautiful.  It was as if we were transported from the busy city to remote villages in a matter of 1/2 hour.  It was very green and lush with areas of farmland and villages.  We then reached a small fishing village, which would be our launch point.  Some of the local fisherman took us to the island in their boats.  None of the boats had motors so they used wooden oars to row us across the water.  A lot of work for those men, but they were very efficient.

The village where we launched from to get to the island

Once we got to the Island we were free to roam the Island and look at all the ruins, it was like arriving at a lost city as vines and plants were growing over the buildings.  There was an archaeologist there that was helping with some of the restoration, and he let us know some of the history of the Island.  He mentioned that the main house or living quarters were joined with the slave area, so the slave owners could look out their second story window and view the slaves in the yard.  I was really nice to get away from the business and noise of the ship and city of Freetown. 

The old ammunition storage area

Inside of the slave masters house

Outside of the house

An old well, with some nice murky water at the bottom

The slave holding area

2 Months

 It is crazy to think that I have been here 2 months already.  Time seams to be flying by, while at the same time moving so slowly.   Things are becoming more routine, going to work, eating at the scheduled times, going to meetings, and getting off the ship.  I am even beginning to get used to the constant chaos and noise of the ward.  Half of the patients on our ward are children which means that they each have a caregiver with them.  Some of these caregivers have breastfeeding children with them as well.  All the extra people lead to more noise and less space.  At the same time it is quite fun to play with all the kids.  There is never a dull moment!  This will be changing in a couple of weeks though as the plastics surgeon has left and we will be transitioning to general surgery for the summer.

Views of the John Obey beach.  I enjoyed the overcast skies
because it was not so hot.  The afternoon rain was
refreshing.

Many of the people I arrived with are beginning to leave, because the minimum length of stay for ward nurses is 2 months.  It is sad to see them go because I was just getting to know them.  It is also hard because they are heading back to family and friends and I am reminded of my family and friends.  At the same time I'm excited to see what will happen here.  There are so many more relationships to develop and things to learn.

The huts we relaxed and ate under,
especially when it began to rain

Even though life here is becoming more normal I still get the periodic reality check of "Whoa, I'm in Africa!"  This happened while at the beach a couple of weekends ago.  We were relaxing beneath the shade of a hut on a sparsely populated beach and thinking how amazing it is to enjoy such pristine beautiful beaches and being some of the only people there.  I thought back to being in San Diego, where there are always people on the beach.  There were many days when I wished to go for walk along a secluded beach.  Little did I know I just needed to go to Africa!  At many of the beaches around Freetown you can see the remnants of a once thriving tourist destination.  Before the war Sierra Leone was a popular destination with european tourists.  Many people are trying to bring the popularity back, but it is hard to get past the image of it being a war torn country.

Our dinner of barracuda, and rice with sauce.
May not look all that appetizing, but it really was quite tasty.

The Hope Center and the Ship

I have taken care of all three of these kids.
The girl on the left had a lipoma removed from the right side of her face
The girl in the middle had a severe burn contracture
and her arm was stuck to her side.  Her arms now move freely.
The boy on the right had severely bowed legs,
which are now straight.  One of the first things he said after
standing for the first time was "look how tall I am"

There are many patients that travel from all over Sierra Leone and sometimes from neighboring countries.  It would be very hard for them to make it to their post-op appointments if we sent them home after being discharged from the hospital.  So Mercy Ships has converted a building close to the ship to house these patients.  It is called the Hope Center.  I think it helps us nurses as well. We get sad when we go work and notice that the patient we had built a relationship with is gone.  I brought a camera with me the last time I went.  Shortly after arrival my camera was in the hands of the kids so most of the pictures were taken by them.  As soon as the camera comes out all you hear is "Snap me, snap me" or "I want to snap".  It definitely made for some interesting pictures.  It's really fun to visit.  The kids run and give you a hug.  The people of Sierra Leone are such a warm people.  It's amazing how far a smile and a hand shake can go, especially when you don't speak the language.

Kids having fun with the camera!

He originally came in with club feet.

I think I am attempting to explain arthritis.  As I was talking
about the space between the joints and the part that breaks
down, the girl on my lap says "cartilage".  

A few pictures of my floating home

The small space where I live.  I am on the top bunk.
There are 2 other bunks like this in our room.
All 6 of us share one bathroom

The other view of my sleeping area.

The front of the ship



The back of the ship.  The ship is
registered in Valletta, Malta



The Mercy Ship logo on top of the ship