Michele on the Africa Mercy

The Finale

2008-04-27T13:41:00.000-07:00

As many of you know by know, I have returned home to the States indefinitely in order to take care of my mom. She spent three weeks in the hospital and a skilled nursing facility and finally went home on Friday. We moved her into a new place as she is not able to live independently in her condo.

Having left so quickly, I didn't get to say goodbye to everyone including most of my patients. Two have died since I returned home. I did get to see Michael off to Ghana as he left the Monday before I left. He has not started his chemo treatment yet (I don't know why they are delaying) but hopefully it will start in early May.

I did get a job the day I returned home...see, all that planning and polling about my future apparently didn't help - God had other plans. I'll be self-employed (yea, a real income) working from home as a software designer for the next 6 months (that's what I did before becoming a nurse). After that, who knows. I'll have to see how my mom is doing - I hope to return to Africa at some point.

I don't plan on blogging anymore since this was about my experiences in Africa. Good-bye!

Weekly update

2008-04-05T04:37:00.000-07:00

My wonderful patient, Monica, died this week. She was in her 30s and had breast cancer. We only met her about three weeks ago and when I saw her last Friday, she was doing seemingly well. No complaints, just a small cough. We had a fun visit, just sitting outside by the river she lives next to and talking. In another place and time, she is someone that I could have been good friends with.

When I showed up for a visit on Friday, I knew something was wrong as I was walking to the house. There were lots of people just sitting around on benches outside and inside the house - that's always an indication of a death. As soon as I walked up, Monica's sister Rose came up to me, grabbed me in a hug and started to cry. 'She fini-o, she fini-o' Rose kept repeating, meaning 'she died.' Rose told me that Monica started having trouble breathing on Sunday but decided not to go to the hospital for any help and she died Tuesday morning.

The family will be meeting on Saturday to decide on funeral arrangements and what to do with Monica's four children. The children will most likely be given to Rose to raise (that's what Rose thinks anyways). Their biological father is dead and the stepfather will probably not take any responsibility for them.

We also got three new patients this week, all children. Nelly (5), Princess (10) and Alexander (5). All three will be getting chemo for Burkitts lymphoma (cancer) starting Friday. On Friday, five of our patients will be at St. Joseph's hospital receiving chemo at the same time. Makes for easy visits when they are located in the same place!

Here are some random photos from the week:
The U.S. Navy was in Liberia for PR/humanitarian reasons. Many Mercy Shippers were able to tour their High Speed Vessel (HSV) and their big ship anchored outside the port. Here is a group heading out to the Navy ship. Notice the sunken ship behind them.

Father and daughter.

Surrounded by kids.

My friend, Liz and my translator/friend, Jerry next to our LandRover.
Random pig walking around in front of my friend Rose's church.

Only God Make Me Big Boy #2 (there is a #1 taxi as well, I've seen it:)

Photos

2008-03-30T10:57:00.000-07:00

More photos to share! This is Nemle (aka Old Man Wallace although I can't bring myself to call him that). He's in his 70s which is really, really old for this country. You can see his cancerous tumor on his neck. He's a retired teacher.

Here's Nemle's aunt. She looks like she's close to 100 years old.

This is Alfred, one of my newest patients. He's a mechanic but has had to quit working because of the cancer in his right arm. He moved to his fiancee's house so that he has someone to care for him. On our first visit, his soon-to-be mother-in-law gave us a whole sack full of avocados as a thank you...it's so humbling to receive such a gift from people who have almost nothing - but they don't think twice about offering you what they have.

Just some cute kids at Alfred's house.

This is Armstrong, one of my patients from last outreach, and our translator Jerry. He is mentally and physically handicapped but doesn't have a terminal illness. I hadn't seen him since November - he has grown in inches but his body seems to be shrinking and he's now very stiff.

Armstrong's mother just had a baby two weeks ago named Favor. Here I am holding the new baby!

Ship life continues

2008-03-18T14:39:00.000-07:00

A lot of people back home ask me how I like ship life and I can't say really that I dislike it or like it. It's just different...so I was trying to think up a way to explain it. So I want you to think about all of these people and picture them in your head:

You
Your boss
Your boss's boss
Your boss's boss's boss
Every single one of your coworkers
Your doctor
Your doctor's nurse
Your hair stylist
Your librarian
Your local grocery clerk
Your local Starbuck's clerk
Your car mechanic
The person who washes your car
Your teachers
Your principal
Your pastor
Your church worship teams
All the people in your church
Your dentist
Your dental hygienist
All of your neighbors within a one block radius
The person who fixes your computer or helps you with your internet access
The person from whom you rent DVDs
Your local post office clerk
Your local bank teller
200 random people you crossed paths with today that you don't know but look vaguely familiar

And now imagine that you see these people all the time because you all live together. You see them at breakfast, lunch and dinner; you see them in the library and while doing your laundry; you see them at meetings and at church; you see them when you go out to a restaurant and when you are looking for a quiet, private place to read; you see them when you are working out or when you go to the movies; you see them when you hang out at Starbucks or when you go grocery shopping or when you are on your break at work or you go to the bank; you see them in their work clothes, in their casual clothes and in their workout clothes; you see them with their spouses and children and with their friends.

You basically see every person who has a connection to either your home life, work life or church life everywhere you go. Even in the middle of the night when doing laundry - one of these people is bound to be there!

Some days I miss my nice, quiet condo back home but, for the most part, I'm acclimated to ship life and it is just normal now. I'm not sure what I'll do when I get home and I actually have to make an effort to see any of these people!

An odd day

2008-03-17T13:48:00.000-07:00

Today started off normally with a quick visit to Levi to make sure he was doing ok after his chemo treatment last week (which he was) and also to give him a soccer ball we promised. Here he is with his new soccer ball.

So after this visit and a couple of other stops, we headed back to the ship for lunch. As I was pulling into the port, my translator saw a little girl who was just sitting at the entrance. She looked familiar so we stopped and found out it was one of our patients from last year named Grace. She's 13 but looks maybe 10. She got in the car and we asked what was she doing here. She told us she had walked from her house (a two hour walk, I'm guessing and through heavily congested streets) because she wanted to come on the ship. She'd been to the ship before a couple times last year to watch movies and have lunch. She didn't tell anyone at her house she was leaving.

We turned the car around and drove her home. Her granny and step-mom were furious. She had left early that morning to go buy some peanuts and just never came home. I can't imagine how worried they were - it's not like there is a process here to find missing children as far as I know. She was obviously in big trouble. I'm just thankful we went to the ship for lunch and saw her - we don't always do that. She would have had to walk back home.

Then we headed back to the ship for lunch (again) and while I was there, I got a message from my boss saying we were getting another patient. It was a little 1 1/2 year old girl with retinoblastoma (cancer of the eye) that was referred to us by another organization working here called The Next Right Thing. This organization connects sick kids in developing countries with medical care in countries like the U.S. The patient hadn't actually been seen on the ship but this organization was trying to find someone who would help care for her because there was nothing they could do since the cancer was too far advanced. So we called the phone number we had and talked to Habib. He said he would meet us and take us to the patient. He told us the location which happened to be right near where we have another little patient who is a 1 1/2 year old boy named Archie with retinoblastoma.

So we drove an hour to meet this man Habib. We picked him up at the junction and started to ask questions about this little girl and, after a few minutes of discussion, we discovered it wasn't a little girl at all but it was our little patient Archie. For whatever reason, the family had not told this other organization that Archie was under our care so they referred us a patient who was already a patient. This is a city of 1.5 million people and we only have 7 patients so I find the odds incredibly small that this would happen. Anyways, I'm glad there isn't another little patient out there!

We went to Archie's house and just made our visit a day earlier than planned. He is not doing well. He has a large tumor where his left eye would normally be. A week and a half ago, he could see out of his right eye and was out playing with other kids. He cried at our white skin and wouldn't let me hold him. Sometime last week, he lost his vision in his good eye and is no longer up playing. He let me get close to him and touch him because now he can't see my white skin. He is restless so we upped his pain meds and will revisit tomorrow to see how well that worked. His family is really sad so they could definitely use your prayers while they go through this horrible time.

One final update: we had planned on sending our patient Michael to Ghana this week to start his chemo treatments. But it may actually work out that he can receive the treatment here in Monrovia and about 1/10 the cost of sending him to Ghana. He would get to stay in his home and hopefully continue his college studies while in treatment. Please pray this would all work out for him!

Updates

2008-03-15T07:20:00.000-07:00

The days here sometimes seem like the longest days of my life but the weeks seem like they are flying by. Almost every day is really hard. There are so many people with medical needs that aren't being met in this country due to lack of accessible healthcare, lack of money and lack of education (I recently talked to someone who lives in Monrovia who didn't know there is a free pediatric hospital here - seems like something you should know when you have 12 children). Every day I have to tell at least 5 people that we can't help them. It makes for really long days (not to mention it is scorching hot here - much worse than last year).

We're on track to send my patient Michael (22 years old with Hodgkins lymphoma) to Ghana for chemo, hopefully this week. His brother will go with him to take care of him while he is in the hospital and if he's home sick from the chemo. Neither had a birth certificate so it took awhile for them to be able to get passports. Michael is currently attending college thanks to sponsors in the U.S. but he will have to give up his studies for at least six months while he is away. He is the hope of his extremely large family. Here's a picture of Michael with his father Rudolph.

My patient Levi (10 years old with Burkitts lymphoma) is still receiving chemo and is almost done with his treatments. So far no one has survived this cancer even with chemo so I continue to pray that Levi will be healed completely. Even though the chemo kills the cancer pretty quickly and the tumors can go away in as little as two days, their little bodies are almost always undernourished and immunocompromised so the chemo is hard on them. Here's a picture of Levi (with my sunglasses) and his little brother Ivan.

We have been visiting the family of Survivor quite a bit since he passed away on March 1. They are devastated - I can't think of much worse than losing a 5 year old to cancer, especially when he finished his chemo and everything seemed to be going well for him. His family left this week to go upcountry for what they call the feast. It is what they do when someone in the family dies - everyone comes from all over the country to pay their respects and have a big meal. They already had this feast planned because James, Survivor's father passed away in October. So they decided to combine the feast for both James and Survivor.

For cultural reasons, Rebecca (Survivor's mother) is no longer part of her husband's family even though they were together for 12 years and have 6 children. Her children remain part of the family. One of the things that will go on while they are at the feast is decisions about Rebecca and her children. They will take up a collection of money that will be used to support her and her children. Her children, however, will probably not remain with her - they will probably be given to the oldest brother of James (named Steven) and his wife Doris to raise. On my last visit, Rebecca said to me 'Oh sis Michele, you need to just forget about me.' As far as she's concerned, she's out of the family. It made me cry...I told her I would never, ever forget about her.

Here is a photo of their large extended family. Rebecca is third from the left in the back row and Doris is first from the left in the back row.

My patient Mark (26 years with squamous cell carcinoma) is really having a hard time. While we were in the Canary Islands, he went to the local hospital and they debulked his facial tumor. However, the skin grafts didn't take and now he has a large hole in his face that is infected. And, since they couldn't get all the cancer, it has returned and is growing very quickly. He's having a hard time coping with the pain and the daily sterile dressing changes. We are working to get his pain under control but it's not an easy task here since we don't necessarily have access to the meds that we would use back home. Here's a photo of Mark with his 2 year old daughter Angelina.

Here's Angelina 'driving' our car! She's a beautiful little girl with a big smile.

My patient Sarah is a wonderful, vivacious 75 year old with lots of energy even with the cancer. She loves for us to visit and likes to tell us about her family and her growing up years. She wants her whole family to meet us ('her people' as she calls us) so next Tuesday I'm expecting a big group of people at her house. She is well cared for by her family. Here's a photo of Sarah.

We made a visit to the family of Rose who passed away last summer to see how her four children were doing. Here they are with the neighborhood kids goofing off.

Baby George eating his rice.

My partner June and I had a large box of metal and plastic bowls that we donated to an orphanage called SOS Village. My translator Jerry's sister Dorothy is a house mother there who lives with and cares for 8 children. She called my translator and told us she wanted us to come by so she could thank us. So when we stopped by on Friday, she had a whole African meal cooked for us.

I have been here over 8 months and so far have avoided, on purpose, eating at an African's house. But there was no way I was going to avoid this. It was such a humbling gesture considering these bowls weren't anything special but to her, they were a big gift. She said this was her way of inviting us into the family - her own mother, she said, was really hospitable and they always had strangers over to their house for a meal.

So we had rice, chicken with pumpkin, fried plantains, french fries and hot dogs (I didn't eat one - that seemed like a sure way to food poisoning). It was all really, really good and it was a fun lunch. She told us about her family and told tales on her brother (our translator). She talked about living during the war and about the kids she cares for. We met all eight of her kids at the house (plus she has four of her own children who live at another house).

This house she and the kids live in was the biggest, most furnished home I have seen here. It has at least 8 rooms - two kids per bedroom. It had a living room, a dining room, kitchen and even a TV (haven't seen a TV here before since it takes electricity). All the rooms were furnished and each child had their own bed. The floors were concrete instead of dirt. I think these orphaned children were living well above the normal standard of living.

Here's June and Jerry before the meal.

Here's a picture of Dorothy and her 8 children (plus a neighbor boy).

A little one getting a bath!

My friends Marilyn and Lesley and I went out for dinner tonight at a Lebanese restaurant called Sajj. The tables are under huts out on a patio. As usual, no matter what restaurant you go to, there were other Mercy Shippers there! Now that I can drive, it's a lot easier to get out and there are plenty of restaurants that cater to the western/NGO crowd. The difficulty is getting home at night since there are no street lights and so many people walking the streets. They are dark-skinned people usually wearing dark clothing and they dash across the street in front of you. I'm not sure they understand that you can't see people at night when there are no street lights and it's a scary experience to drive here at night. Here we are at the restaurant.

Updates

2008-03-02T07:42:00.000-08:00

I have some sad news about my little 5 year old patient Survivor. He passed away on Saturday morning in a local hospital here. I did get to spend about an hour and a half with him at the hospital on Friday afternoon so I'm very grateful that I got to see him.

Survivor had Burkitts lymphoma and had been receiving chemotherapy. He had his final chemo treatment a week ago Friday. When we saw him last Tuesday, he was up and about but not feeling very well. Then on Friday morning, his family called and said he still didn't feel well and so I told them to take him to the local children's hospital (run by Doctors Without Borders and it's free). When I arrived Friday afternoon to check on him, he was awake but very weak and jaundiced. They were giving him IV fluids as well as blood. We prayed over him for quite awhile and just talked and sang to him.

His family will bury him today (Sunday) and we will visit them Monday afternoon. He was a beautiful, shy little boy. He'd sit on my lap but I could never get him to talk. His mom says he talked all the time but he wouldn't ever talk around us. Survivor's father just passed away in October so his mother, siblings and extended family are really hurting so please pray for them.

Here are a couple of photos of Survivor.
Survivor (r) and his older brother Promise (l)
Having fun on the ship.

I also have some photos from our screening courtesy of our communications team. I never heard a final count as to how many people came to the stadium but there were easily over a thousand people.

The line of people waiting and hopeful that we could help them.
Nurses (in blue) taking health histories and vital signs.
The United Nations and the local Liberian police were on hand to keep order. Thankfully, it was very orderly chaos at the stadium.

Entertaining the kids. Some of these children waited with their families for up to 15 hours.

More kids entertainment (jumproping). We had singing, face painting, coloring and balloons.

A little one getting her vital signs taken.
Since we do orthopedic surgeries, there were many kids with bowlegs.
Getting a physical examination by nurse anesthestist John (a fellow Iowan from Carroll)

Making friends and showing the love of Christ.

Father and daughter.
Results of inadequate healthcare. Her foot is fused to her leg due to burns she suffered.

The prayer team (I'm in the far background in blue). I was on the team who prayed for those we weren't able to help medically.

The golden ticket. He is holding a green surgery card.

Last week

2008-02-24T11:37:00.000-08:00

In the last week, we've screened over a thousand patients, hosted the president of Liberia on the ship and I talked with five new palliative care patients. Plus President Bush was in Monrovia for a few hours.

Screening
Screening day was last Monday at the soccer stadium. We left the ship at 6 am and by the time we got there, there were already hundreds of people lined up. I left the stadium around 9 pm when the last patients were seen. I was in the prayer room where people came for prayer if we weren't able to help them medically. We also had a few people who came for prayers of praise and thankfulness when they did get a surgery date. I'll post some photos when our communication team has released them.

My roommate Megan described the whole day in her blog so I'm just linking to hers instead of repeating everything she said! http://megisinafrica.blogspot.com/2008/02/screenig-day.html

Presidents
On Tuesday, Madame President Ellen Johnson-Sirleaf came to the ship. She's an amazing lady and I have great respect for her and the job she has to do here in Liberia. She gave a brief speech in our large meeting room which I got to hear. Some of our leaders also gave presentations about what our plans are this outreach in Liberia.

On Thursday, President Bush visited Monrovia. Monrovia has three main streets (for a city of 1.5 million) and they closed one of them for most of the day. I had to cancel all of my visits because traffic would have been gridlocked on the other two roads plus I couldn't get to the patients who live off the closed road.

My new patients
I received four new patients from screening and one additional one later in the week. Each one of them has cancer for which there is no treatment. Each one received the news from the doctor and then from June and me that they were going to die from it. Two of them probably don't have much time left here on earth.

There's 75 year old Sarah with a large tumor on the right side of her face. We visited her in her home on Friday and she is the cutest lady. She's pleasantly confused and because of her confusion, she doesn't know the whole prognosis.

We were supposed to visit on Thursday but couldn't come because the roads were closed. She doesn't have a phone so we couldn't call her to tell her we would come on Friday. So when we showed up, she just kept saying, 'Oh my people, my people have come!' It was so cute. She said she waited the whole day by the road on Thursday telling everyone that 'her people' were coming to visit. I don't know if she really did that or she was confused but she was so excited when we showed up on Friday.

Next is 70 year Nemle Wallace (or Old Man Wallace as he told us to call him:) He's a smiley guy who just took his diagnosis in stride - he never stopped smiling. When we visited him on Friday near his home, he was just so happy to see us. We only got to talk for a few minutes because it took us an hour to find him (they don't have street addresses like we do back home). He told us what junction to go to and then told us to just start asking people where Old Man Wallace lives. Well, we did that but no one knew Old Man Wallace! Mainly because we were about a half mile farther than where we were supposed to be.

Next we saw 22 year old Michael. He came to screening because of a tumor growing on the side of his neck. Unfortunately, it's Hodgkins lymphoma. Back home, this is generally an easily treatable and curable cancer. Here in Liberia, it's a death sentence for a 22 year old young man. He goes to school and runs a small business. He's good-looking, strong and healthy. I had no idea how to tell someone that age that he is going to die from this cancer.

He stayed on my heart as well as on the heart of Dr. Shrime who examined him and gave him the diagnosis. So Dr. Shrime, his wife (another Dr. Shrime), June and I are working to find treatment for Michael outside of Liberia. There is treatment in Ghana and Ethiopia but there are many obstacles to overcome for him to go.

When we visited Michael and his family (he's the oldest of 9 kids) on Friday, they were pretty devastated and worried about his diagnosis. We told them we were working to find Michael treatment. Please pray that God will make a way for all of this to happen.

Next there is Deddeh, a 26 year old with advanced cancer. She has a very large tumor protruding from her face and she is skin and bones. She doesn't have much longer to live. She has two small children. When we went to visit on Friday, we found out her family had sent her upcountry to an herbalist (a medicine man) for treatment. We had already told them there was no medicine for her sickness but they said if they didn't send her, the village would think they didn't love her. It's sad because it will cost them a lot of money they don't have but I understand - I'm sure I would do the same if I lived here and believed as they do. So we won't be able to visit her since she'll stay upcountry.

Finally, our last patient Sandi was received on Thursday. He was at screening for some large tumors on his left forearm. We knew it was cancer then but brought him to the ship on Thursday for an x-ray. If the cancer had not metastasized (spread), then we could amputate his arm to stop the spread of the cancer. Unfortunately, it has already spread to his lungs.

It was a sad visit. He's 37 and has 8 children ages 1 - 15. He lives an hour and a half from Monrovia so I won't be able to visit him. I sent him home with 3 months of pain medication and told him to come back after 3 months if he needed more. I don't expect him to live that long.

The hospital
We started surgeries on Thursday and so the hospital is starting to get busy. We currently only have one of four wards open but that will change over the next few weeks as we get more surgeons, more OR nurses and more patients. The dental clinic and eye clinic both open tomorrow (Monday). Those clinics are actually not on the ship - the dental clinic is at a local hospital and the eye clinics are at various locations throughout the city.

Restarting Palliative Care visits

2008-02-16T08:07:00.000-08:00

I've enjoyed all the comments and emails I've received about my poll. Currently it looks like I could be adopting a Liberian child and moving to Alaska! Now that would be a culture shock for the child since Liberia is near the equator and it is hot, hot, hot 12 months a year! I still have to see how God weighs in on all these ideas. If anyone hears from Him about this, let me know:)

Last Wednesday, my partner, June, and I restarted our palliative care visits. It was great to be out in Monrovia again despite the terrible heat. Even though it has only been two and one half months since we were here, I am feeling a little more hopeful about Liberia and it's future. Last outreach, especially towards the end, I was really feeling disheartened - that the problems here were just too big to overcome. It seemed like most of the Liberians I came into contact with were downhearted. Maybe it was just my attitude. Maybe it was just because I was surrounded by death all the time and that I needed a break. Or maybe it was true. I'm not sure but I feel like there has been a change here.

The government has been working on the roads and there is quite an improvement in some areas - Jamaica Road, Somalia Drive and Tubman Blvd. There are still plenty of potholes but at least there is hope that maybe some day there will be decent roads. And there are now city buses! I'm told they are cheaper than taking a taxi and they have provided additional jobs (including the wife of my translator).

There are people (mostly women it seems) cleaning up the streets that are littered with trash. There are hundreds of women out and about with brooms sweeping the streets. I'm told they are being paid and I hope they are earning a living wage - I'll have to ask. New houses are being built at least in the couple of neighborhoods I visited. The stick frames are going up and there were lots of clay bricks to be seen which are used for walls.

On the other hand, crime has slowly been increasing month by month and the UN is decreasing troop size. It continues to feel like there is an uneasy peace. I believe there is still a lot of corruption although I haven't experienced it first hand as some on the ship have.

We had five patients remaining from the last outreach and we decided to visit them before we started getting new patients next week. First we started with Sah, the 54 year old man with throat cancer. He had a tracheotomy and was unable to speak but I loved our visits with him. When we arrived, Sah's brother in law, Joseph was there. When I asked about Sah, he said 'please come sit here.' He went into the house and brought out Kumba, Sah's wife and then told us that Sah had passed away on Feb. 3, the day before we returned to Liberia.

Kumba told us that Sah's last three weeks were not good - he was unable to eat or drink and was in pain since he was no longer able to take the pain medication we had provided. I'm thankful his suffering is over and that his wife was able to care for him in his last days. We looked at photos and reminisced about our visits. He leaves behind 3 little girls (ages 13, 6 and 4) plus several older children.

We also went to visit Martha. She was a 50ish women with some type of cancer that was eating away her face. When we arrived, we were told by her brother in law Prince that she had passed away on Jan. 9. She had gone upcountry to her parents village to seek treatment from a medicine man but she died while there. As we sat inside the house talking to Prince, I could still smell her sickness - it's like it had permeated the walls of the house. It's not a smell I will soon forget.

We also visited Levi, Survivor and Mark, all of whom are still surviving. Each has a story that will take some time to tell so I will leave that for my next blog.

We have our big medical screening on Monday at the large football (soccer) stadium. We have advertised throughout the country and hope that only the people with the type of sicknesses we can treat will come. We don't know what to expect, possibly between 1000-2000 people but that is really a guess. I will be working at the prayer station - this is where people come after they are told that we cannot help them. And out of these people, I expect some will have terminal illnesses which is where I will get my palliative care patients. So I'm praying for none but will probably get a few.

Tomorrow I'll talk more about how screening will go. We have been warned that we will possibly see thousands of people lined up, all of whom have a great need and we could potentially be turning away a lot of those. When we advertised, we indicated the types of sickness we could help with but people with other types of sicknesses will come just to see if we can help. While we will be saying yes to many, many people, we will be saying no to a lot as well. It will be an emotionally draining day - one I am looking forward to because of the number of people I will get to pray for and tell of God's love for them and one I wish I never had to experience in my life. How can my heart not be forever broken by the magnitude of the suffering I am going to see all in one place?

Today, I believe that God's grace is sufficient. I'm not sure if I will believe the same thing after Monday.

Peace,
Michele

My journey

2008-02-09T15:39:00.000-08:00

I have only 4 1/2 months left here with Mercy Ships and have reached a time where I need to start thinking about my next steps. I had purposely not thought about what I would do after Mercy Ships because I wanted to enjoy where I am without thinking about the future. But now, it's time to start some planning.

As a single person with few things to constrain me I have thousands of choices available to me about what I want to do with my life after Mercy Ships. It would be easier if I could get it down to two choices but when I have a thousand choices, I'm afraid I won't be able to decide.

So for fun, I set up this little quiz to get your input on the next journey of my life. I've listed some of the things I've thought about that are interesting to me and I would possibly like to do. So now you can vote on what you would like me to do. Just a disclaimer, this is just for fun and I'm not necessarily going to do what random strangers vote for - we'll see how it goes. Of if you have other ideas I haven't listed, you can post them in the comments.

The quiz is on the right hand side. Good luck, my entire future balances on the outcome of this! (not:)

Back to Liberia

2008-02-06T05:14:00.000-08:00

We made it safely back to Liberia after a six day smooth sail. There was an hour and a half ceremony on the dock welcoming us back. We had to stay on the ship to watch since we weren't cleared by immigration yet but our two Executive Directors plus our media team particated dockside.

Not much has changed. It's very hot and humid, just like when we left. It's also been pretty hazy as you can tell from the pictures.

Here are a couple of photos from our arrival:

People awaiting our arrival

One of the two singing groups that performed for us.

This ship will be our neighbor for awhile. Notice all the UN soldiers aboard. It was seized by the government because of the large amount of cocaine found on board.

Sailing

2008-02-02T04:40:00.000-08:00

We left Santa Cruz de Tenerife on Wednesday and are now heading to Liberia. We are three days into a six day sail and I'm not sure where we are other than off the coast of West Africa somewhere. The sail seems to be much smoother than the last and I have only been sick off and on. Last sail I spent almost the entire time in bed.

The pace on a sail is much slower than usual (except for those who are actually making the ship sail - officers, engineers, etc.). We've had some briefings on Liberia (not much has changed since we left but crime continues to increase), watched a few movies, eaten some great food thanks to our new chef Tyrone and his kitchen crew, and we've had fire/piracy drills.

Here are some miscellaneous photos of Tenerife and of us leaving.

Back on the ship

2008-01-21T14:35:00.001-08:00

Canary Islands
I made it back to ship safe and sound and with only two different 7 hour layovers, one in Chicago and one in Madrid. We are currently in port in Tenerife de Santa Cruz, Canary Islands. We are scheduled to leave here to return to Liberia on Wednesday, January 30th.

There isn't much to report right now. I've been working on developing a workshop to teach churches how to take care of the terminally ill. I've also been working some in crew services, helping clean the ship, working in the library, helping unload containers and supplies and I watched a welder for a couple of hours to make sure he didn't catch himself or the ship on fire (called Fire Watch).

Liberia
On a completely separate note, I've been thinking a lot about our return to Liberia and trying to prepare for it. If you follow global news at all, you have seen articles recently on Liberia. The trial of former president Charles Taylor is ongoing in The Hague and the Truth and Reconciliation Commission of Liberia (http://www.trcofliberia.org/) has been holding hearings and some horrible atrocities are coming to the global light.

When we return, I don't know if the people will be different now that these hearings are going on...do they care? Does it just reopen old wounds? Will it trigger more violence? Will it bring reconciliation? These are just some questions I'm thinking about and areas to pray about.

The following is a link to a recent Yahoo article on one of the hearings...parts of it are very graphic and so unbelievable the suffering humans inflict upon other humans.
http://news.yahoo.com/s/ap/20080121/ap_on_re_af/liberia_general_returns;_ylt=AmuAkGfoKXfR4vCO.RvurEpI2ocA
I also finally watched Blood Diamond last night. I wouldn't recommend this movie for general entertainment but more as an education about what the people of Sierra Leone and, similarly, Liberia, have inflicted upon themselves as well as what innocent people have endured.

Baby Joanna update
So many of you emailed me about and prayed for baby Joanna last year. She was a six month old baby for whom we performed a cleft lip surgery - she then went into cardiac arrest and was put on a ventilator for 3 days. She survived and was sent home and we visited her a few times at the end of the year. I received an email last week forwarded from my translator that baby Joanna passed away in December. I don't know any details other than that. We knew she had brain stem abnormalities and too low of a heart rate so I'm not completely surprised, just sad.

Peace,
Michele

Coming home

2007-12-12T14:59:00.000-08:00

I'm leaving Thursday morning for vacation. I arrive in Des Moines Friday night and will return to the Canary Islands on Jan. 17th. During my vacation, I won't be posting so check back after January 17th.

Merry Christmas!
Michele

Dry dock

2007-12-11T12:13:00.000-08:00

Today our ship (along with the crew) went into dry dock. That means we moved from our nice dock across the street from the mall and all the action over to an ugly shipyard where lots of construction is taking place. The ship was lifted up out of the water (with us on board) so that maintenance can be done on the underneath of the ship. It was a very fascinating experience and I have the photos to show what happens.

This opening is where we are starting out. The ship goes in backwards so these photos are all from the back side of the ship.
Once we got lined up these two little tugboats came over and our line handlers tossed out two of the lines. The tugboats attached these lines to their boats and they pulled us in.
I'm not sure how these little boats can pull our huge ship but they did.
Once they got us closer to the little canal, the tugboats took our lines and attached them to the side on some kind of machine and then the boats got out of our way. Then these machines pulled us all the way in.

After we were in properly, some divers hooked up things to the bottom of the ship and then the floor was raised up so we were out of the water. Then these bulldozer machines pulled us into our berth. Sorry for the non-technical description...I have no idea what they did to make all this happen.

These are the three ships we are next to so you can see what it looks like when they are out of the water.
This is the view from the front side of the ship...this is where we came from.

Here are the stairs we use to get off the ship.

We will be in dry dock around one week. During this time, we fortunately have running water (toilets and showers) but minimal power. No a/c so it's really hot in our cabins and no laundry facilities but we have our computers and lights. We are about a 2 mile walk to town which I made tonight for a pizza dinner.

I'll be home in three days!

Peace,

Michele

Las Palmas

2007-12-08T10:10:00.000-08:00

We arrived in Las Palmas (the city name) on the island of Gran Canaria on Thursday afternoon. After some problems getting a berth, we ended up at a dock that is directly across from the start of town and a mall. Between work and being on call, I've only been able to get out twice so far.

It feels good to be back in a country that isn't chaotic. Streets are paved and driveable, there isn't any honking, people are walking on sidewalks and cross at the crosswalks, there aren't any animals being shepherded down the street, no one is yelling at us or asking us for money, there are malls and grocery stores and restaurants, and I can go out by myself. In other words, it feels normal again.

The weather is cool here compared to West Africa, seems like it's in the low 70s. It's been mostly overcast but the cooler temps are so great.

Here are some photos of Gran Canaria:

Here's where we are docked until Monday.

This is our dock.

Here's the mall that is directly across the street.

Sailing

2007-12-05T00:59:00.000-08:00

We've been sailing now for five days. I spent the first four days in bed sick, as I expected. Today is much better! We should arrive in Gran Canaria tomorrow at 10:00 am (Friday). Here are some photos from the sail:

End of the outreach

2007-11-25T08:06:00.000-08:00

I survived my first outreach here in Monrovia. The hospital is shut down and all the patients have returned home. We've said good-bye to all of our palliative care patients and their families. The dock is looking more and more bare as all of the containers are being loaded onto the ship. The dockside medical tents have been packed up and loaded. The entire ship's crew is in the process of cleaning and securing equipment so that it doesn't end up on the floor damaged during the sail.

We will leave sometime this week but I can't give the official date because we have to be careful of stowaways. If people know the date we leave, they will try to board the ship for a free ride to the Canary Islands so we're not allowed to give the date. I guess all of the crew will go through a pretty extensive search of the ship looking for stowaways.

We've already had our first abandon ship drill and we'll have at least two more before we leave, I think. I'm responsible for handing out lifejackets so at least I'll be one of the first to get one!! But I'll be one of the last to actually get on a lifeboat if we really had to abandon ship. Obviously I don't expect to have any problems but you never know, considering that ship in Antarctica just sank and all the passengers had to abandon ship. Anyways, the leadership on the ship takes this very seriously and we will be prepared in case of emergency.

The sail to Las Palmas, Canary Islands will take about 6 days and I'm not sure if I'll have internet access or not so I may be out of touch during the sail. Once we're in Las Palmas, we'll be in dry dock for approximately four days. That means the ship will actually be lifted out of the water so that it can be inspected and any repairs made. During this time, we're told it will be like camping. We won't have running water so no toilets or showers. There will be portable toilets/showers available somewhere (out on the dock possibly). Once any repairs to the lower half of the ship are made, the ship will go back into the water and other inspections/repairs will occur. We then will sail to Tenerife, Canary Islands around December 23 where we will stay until the end of January. We'll then sail to Sierra Leone and stay for just a few days, then back to Monrovia.

On another high note, I'm cabinsitting for someone who is on vacation for two months so I am in a three-berth cabin with my own space and a porthole! I actually got to wake up this morning to natural light. In my usual cabin, there are no windows so every morning when I wake up, it's pitch black and feels like three in the morning. I've discovered I really don't need much space but it's nice to have your own little area that is only yours (even if it is only about a 7x8 space).

I looked up the weather in the Canary Islands and it is in the 70s year round. I can hardly wait for the cooler temps. Plus I'm looking forward to the snow when I get home for Christmas!

Peace,
Michele

Goodbyes

2007-11-22T09:33:00.000-08:00

We've been saying goodbye all week to our patients so it's been a long week - just one more day to go. Here are the people I've said goodbye to over the last two weeks:

Sah: he's 54 with cancer. We brought a local pastor with us on our final visit in the hopes that he will continue to visit with Sah. Sah said this week he is tired of suffering and wants to die. There were lots of tears. I expect by the time we return in February that he will have passed away.

Martha: she's 50ish with cancer. We also brought a local pastor with us on our final visit so that someone will visit while we are gone. It may have been a mistake but nothing we can do now. The pastor (a woman) and a couple friends prayed for Martha fervently at the very top of their lungs. I hate to be skeptical of someone else's faith but I don't think God is deaf and I don't think He listens more when you are literally screaming. Again, there were lots of tears.

Mark: 26 years with cancer. He's a sweet guy and my heart really hurts for him. In our final visit as we talked about preparing for death (including the need for forgiveness), he told us how his mother and siblings rejected him because of his skin color (he is albino). His mother knows he is sick but she won't see him even though they live close. Some of his siblings don't even know he has a terminal illness. Heartbreaking. I don't have any photos of Mark but here is his adorable little girl Angelina.

Candy: 11 years old with cancer. This is the worst goodbye. We see her everyday to do her wound care and all week she has just sobbed. Today was really hard for us and for her. She and her dad will return to Cote D'Ivoire next week for the first time in almost two years. She said she is happy that she will get to see her mom. We've taught her dad how to clean her wound and we've found a medication that works for the pain during the wound care.

Survivor: 5 years old with cancer. His dad died just two weeks ago. His mom is having a hard time as you would expect - she's left with six kids and no income. She just started to learn how to basket weave so I bought her first two baskets for $20.00 which should provide food for them for several months. Survivor is getting chemo and has one more treatment. In the photo, Survivor is in the gray/yellow tshirt in between his mom and dad.

Levi: 10 years old with cancer. He was supposed to start his second chemo treatment on Tuesday but it got delayed because he has chicken pox. We don't have an official diagnosis yet so the chemo may not work.

Winifred: 40ish with breast cancer. She's very weak and has had a respiratory infection that won't heal. This could be very dangerous for her. I don't have any photos of her.

Armstrong: 2 year old mentally and physically disabled. There were lots of tears since we were his mom's only support system. I am worried for their future. Here's Dr. Tom and Armstrong's mom adjusting his wheelchair.

Joanna: 7 months old with cardiac/brain abnormalities. Baby Joanna is doing well and her mom is happy. Joanna is sitting up which is a positive sign since we don't know how well her motor skills will work. She can't roll over yet.

Grace: 13 years with TB. Her growths continue to shrink and I expect her to fully recover. There were lots of tears but I think mainly because they can't come to the ship anymore to eat lunch and watch movies.

Nelson: 29 years old with a benign fibroma. He will have surgery to remove the remaining tumor when we return in February. His father passed away two weeks ago.

We also said goodbye to lots of families of patients who have already died:
Family of Nush (8 years old)
Family of Josephs (12 years old)
Family of Korto (3 years old)
Family of Liaa (20-something)
Family of Rose (26 years old)
Family of Yatta (50s)

It's been a very emotional two weeks and I'm looking forward to our break. The crew is in the process of cleaning the hospital wards, the OR and also starting to load things onto the ship. I think they will start loading cars this weekend. Next week, I'll be working on paperwork - we have to write an end of outreach report and then we'll sail sometime next week or so.

Peace,
Michele

More random photos

2007-11-19T13:18:00.000-08:00

Just some random photos for your viewing pleasure...mainly because I'm too tired to express any real thoughts.

Little Prince asleep in our car after a fun day on the ship (we watched Finding Nemo)

Baby George by our car. A prime example of one way disease is spread here. Their children crawl on the ground where the chickens and other animals have been...the children touch and eat things that cause disease and then they get sick and many times die.

Baby Joanna...remember her? She is the baby where we fixed her cleft lip and then she ended up in cardiac arrest and on a ventilator. She is doing fine. She wouldn't stop crying so the photo isn't the best but you can see her 'normal' face.

Emmanual, Mawi and Handful in their new school uniforms. Their mom passed away a couple months ago and they are now being raised by their Aunt Grace (along with Baby George).

Beautiful Mawi...I adore her. She has this little pipsqueak voice and talks 100 miles an hour and I never understand a word she says.

Sharing the road with sheep, as usual. BTW, they are sheep, not goats. You can tell because their tails are down. If they looked just like this but their tails are up, then they are goats.
Movies in Liberia. They are little huts with a tv and a satellite dish. These boys are watching the movie without paying.

The little girl on the right is practicing for mother hood. She is carrying her stuffed raccoon on her back the same way mothers carry their babies.

Peace,

Michele

Mark

2007-11-14T12:58:00.000-08:00

We visited our 26 year old patient named Mark today and I was nervous to go because it seems like there is always something wrong going on in his life. Mark has either basal cell or squamous cell carcinoma (a skin cancer) and, because he is albino, we can see that his entire body is covered in the cancer plus he has a large, protruding tumor covering half his face.

Mark is married with two little girls who are 4 (Olivia) and 2 (Angelina). Whenever we visit, he is home with Angelina while his wife works doing domestic work for a wealthy couple. His wife is gone from 6 am to 8 pm working 6 days a week and she is paid $20.00 a month. Of that $20.00, she pays $16.00 in taxis just to get to and from her job which leaves a net income of $4.00 per month. That is what this family is currently trying to live on.

Before Mark got sick, he was a mechanic working on big trucks and made a good living. I can tell because of the things he has acquired in his house. His family lives in one room of a house that is maybe about 12 x 12 but he has electricity, a bed, a tv, vcr, dvd player and a stereo. I have not seen any other family with these kinds of things. Most live in one room and only have a couple of plastic chairs and some mats to sleep on.

We planned on visiting Mark at the end of the day because we didn't want to have to rush to another patient in case he needed some support. Last week, when we visited, he told us his wife was leaving him that evening because she was afraid she would catch his sickness and she didn't want to deal with it anymore. If she left, he had absolutely nobody else to help him. He only has distant family left and they live far away. He had a few friends but they only visit every once in awhile.

So Mark was really distressed about this (as were we). He can't work because he is very weak and the large wound on his face bleeds a lot if he exerts any physical effort so he has no means of supporting himself. He also cannot do the wound care for his face because he only has one eye remaining and, because of his albinism, that eye sees very poorly. Not to mention he wouldn't get to see his little girl every day (the 2 year old lives with him, the 4 year old lives elsewhere with her mother).

When we left last week, we were very sad for him and his situation. So we started to pray...that God would change his wife's heart and that she would stay and want to take care of him. We tried (unsuccessfully) to find clinics where he could go to get his wound care done. We brainstormed with others to see how we could help him but we weren't coming up with any answers since we are leaving very soon.

So when we pulled up to his house today, we saw him sitting outside but little Angelina wasn't around as she always is. My heart just fell. We went into his small room and started to talk. He was really depressed and teary-eyed. I could see his dressing change on his wound had been done today and it was well done so I know he didn't do it. He told us his wife had had a change of heart and was very concerned for him and decided not to leave. Little Angelina was at a neighbor's house playing with her children.

He told us they had finally run out of money yesterday and he and Angelina hadn't eaten yet today (it was 3 in the afternoon). He didn't have the 30 cents it would take to buy a meal for the two of them. Of course, we gave him money for food but that was only a very short term solution. We couldn't buy food for them everyday and they only earned $4.00 a month which wasn't enough to pay their $10.00 a month rent let alone buy food.

So we started to brainstorm with him about how they would survive. He was very concerned about how they would live after he was gone. He told us his wife was very unhappy in her job (obviously) and she had told him earlier today that she really wanted to quit because it just wasn't worth $4.00. She had run a successful business in the past selling various products in the local markets and she wanted to do that again. So the more questions we asked, the more we could see that he understood how to run a business. And this type of job would allow them to work together as a couple just a few blocks from where they live. And Angelina would get to see her mom all the time.

Jean just looked at me and said "Are you thinking what I'm thinking?" and I said "Absolutely!" So we (meaning Mercy Ships) gave him the money to get his business off the ground right there on the spot. We didn't even have to pray about it as we usually do. Mark was just so grateful and relieved and excited. He would tell his wife when she got home that she didn't have to go to her job ever again and they were going to the wholesale market tomorrow to get started.

It's such a great experience to see God answering a prayer so clearly. We were praying that his wife would have a change of heart and Mark was praying that God would make a way to earn more money.

Just getting to be a part of helping Mark and his family makes every hard part of this job worth it. I experienced true joy and peace in my heart today. I don't feel that often but when I do, it reenergizes me and makes me want to do this work forever.

I'm signing off with a picture of Angelina.

Peace,

Michele

Liberia in 2008

2007-11-13T12:17:00.001-08:00

We received official word yesterday that the Africa Mercy will be returning to Liberia for 10 months in 2008 instead of going to Sierra Leone as planned. So we will be leaving here sometime towards the end of this month, sail to the Canary Islands and stay until end of January then come back to Liberia.

There have been many reactions to this announcement - some people are upset, some don't really care one way or the other and some people are happy. Personally, I'm glad to be coming back because I still have patients who are alive and need continued care. Now, when we leave, we can leave our patients a couple months worth of pain meds and then we can start revisiting them when we come back (assuming they are still alive). Plus I know Monrovia well and can easily find my way around.

In other news, I've been driving for a week now and really like it. It makes me feel like I'm living in a more normal situation than I actually am. Currently I can only drive for business purposes but next year when we return I'll be able to check out a car for personal reasons (like going out to eat or going to the beach) so it will give me a little more freedom.

I'll be home in 31 days! I'm planning on spending 4-5 days in St. Louis after Christmas but other than that, I'll be in Des Moines the rest of the time.

Peace,
Michele

Armstrong

2007-11-11T14:16:00.000-08:00

I know a lot of my blogs are somewhat depressing because of the nature of my job...and this one probably will be the same by the time I'm done. I really don't want you to get the impression that nothing good ever happens here because we have so many success stories from the patients on the wards. It's just that now that I'm not working on the ward, I'm not experiencing these successes first hand. But I assure you, everyday Mercy Ship volunteers are restoring sight to blind people, removing huge facial tumors and showing the love of Jesus by accepting people who are considered outcasts.

But today, I want to tell you about my 2 year old patient Armstrong. He's a cute little boy that is physically disabled and, as far as I can tell, mentally disabled. Here he is with his mom Filemina. We don't know what happened to cause his disabilities but I personally think the injuries occurred during a prolonged and difficult birth. His mother says he was treated for tetanus two days after his birth. You can never really get the whole story from people here - I'm not sure if it's a communication problem or if they really just don't know. Back home, we'd have all kinds of lawsuits filed but here, people just chalk it up to a curse or the African sign (that's what they call any sickness they can't explain which is almost all sicknesses) and move on.

I'm not exactly sure how Armstrong came to be a palliative care patient because he doesn't have any type of illness and hopefully will live a relatively long life. But we have become friends with Filemina and stop frequently just to visit.

I cannot imagine the difficulties of raising a completely disabled child, let alone raising one in a country like Liberia where there isn't a single social service program to assist you. Armstrong requires round-the-clock care and his mother will be the sole person providing this for the remainder of his life.

We have seen Filemina's struggles firsthand and have nothing to offer except our compassion.
Filemina is dependent upon a boyfriend for food and shelter. If he doesn't provide this (which he threatens to do at times), she has no means of supporting herself and Armstrong. She can't leave him in someone else's care so she can work (even if there were any jobs here). Her family will not help her even though they live only a few minutes away and there are zero government programs to assist in this situation. It's not like back home where people can get social security or food stamps or go to a homeless shelter or a food pantry or a church. There are literally no resources for her.

She is incredibly sad because we are leaving. I think we are the only people who talk to her about her struggles. We will only get to see her one more time this week - it will be really hard to say good-bye.

On a completely different subject, we celebrated Thanksgiving last week. It was a very different experience than Thanksgiving at home. I did no planning, shopping for food, cooking, watching football, taking a nap, hanging out with family. The planners of our Thanksgiving did make it special, though.

For dinner, we had turkey, ham, stuffing, mashed potatoes, sweet potatoes, glazed carrots, corn, cranberries and different salads, apple, pumpkin and blackberry pie with ice cream. The food was amazing and I didn't have to do any dishes afterwards. Then we had a celebration church service with a message and worship music. At one point, a crew member from every country (36 countries) got up and said a quick prayer in their own language. It was really moving. Overall, it was a really nice day and the great food really boosted the morale of the crew.

On a food note, I never realized how much food impacts morale. For the first two and 1/2 months here, I ate almost exclusively peanut butter sandwiches twice a day. But ever since we got a chef volunteering the food has been wonderful. After a long, hot and depressing day, it is so nice to come back to the ship and look forward to dinner. Everyone talks about how great the food is and how it has really impacted their attitude. I now only eat peanut butter sandwiches when we have lamb:)

Peace,

Michele

Saying goodbye and driving

2007-11-05T13:21:00.000-08:00

We've started the process of saying goodbye to our patients and families because we will be leaving Liberia soon. Today we said goodbye to our first family because it will be unlikely that we will be able to visit them again.

In this family, I never got to meet the patient, Liaa, because she passed away before I started working in palliative care. Liaa left behind three small children and now her mother Theresa is caring for them (the husband left her when she got sick). Mercy Ships helped Theresa to start a small market business since she now had three more children to feed. She makes 'small small' profit but it isn't really worth all the effort. We've offered her ideas on how to improve her business but she has resisted them. For example, she will buy 10 of something for 100LD and then she will sell the 10 items for 100LD. Obviously that doesn't make sense to spend your time on a market business like that.

Anyways, she is doing what she can and the oldest child at least is in school this semester. Here's a photo of the baby, who will never know her mother. Her name is Chinese Girl (yes, that's her real name) and she cries everytime she sees me. She has TB and she also just spent a week and a half in the hospital for respiratory distress. She is absolutely adorable!
Here's a photo of the entire family. Jerry (our translator), Josephine, Dorcas, Theresa, Chinese Girl, Rebecca and Jean (my partner).

It was a really good visit and it was nice to kind of bless them and then release them back to their normal life. I think as long as we visit them, we keep them from their post-mourning life. It would be different if we were friends. We like to think of our families as friends but I don't know that they see us that way. We're in this awkward position of having things they need and want and they are in the position of always asking us for things. It makes for an unbalanced friendship.

The other exciting thing that happened today is that I took the driving test and passed so I am now officially a Liberian driver. I didn't actually have to get a license here or pass a Liberian test. My drivers license from home is valid here and I had to pass the test by taking out the Mercy Ships head of transportation so that he could evaluate if he wanted to entrust a valuable Land Rover to me:)

So I hopped in the Land Rover and he said we were going to the police station. I'm thinking 'uh oh' that's downtown and there's a really steep hill where I have to stop for traffic (the car is a stick shift). But it went fine...I didn't kill any pedestrians or hit any taxis or stall the car. So I will officially be driving starting Tuesday. (BTW, the reason we were going to the police station is a long story but let me just say it wasn't pleasant and I kept thinking about the guns they were carrying and that we were making them mad!)

You may be thinking that driving isn't a big deal but you've never been here to see how bad the streets are and how crazy the pedestrians are and the fact that you share the streets with taxis, people, cows, goats, wheelbarrows, street vendors, humongous overloaded trucks and tons of broken down vehicles. You don't go fast enough to hurt anyone if you hit a taxi but people (kids and adults) run out into the street all the time without looking.

The other scary part is that we are frequently on roads that are so bad that we have to be in four-wheel drive. Just today, the road to get to Theresa's house was bad and I'm really surprised we didn't get stuck. Here are some photos of the road so you can see what I mean.

So I hope I survive the next couple of weeks driving.

Levi

2007-10-30T14:25:00.001-07:00

We got a new patient today, a 10 year old boy named Levi. Levi came to the ship to have a tumor removed from his face. They got him into surgery and found that the tumor was very invasive and probably cancer. He had part of the tumor removed here. He's been preliminarily diagnosed with Burkitts lymphoma and will get chemo. We took him and his mother to the hospital this morning to start his chemo treatment.

Please pray that this cancer is Burkitts (any other and there is no chemo treatment for it) and also for him to be completely healed. Also please pray for his mother Grace who is fully aware of the seriousness of what is going on. Her faith is very strong but she is understandably very upset.

Here's a photo of Levi taken by my roommate Megan.

Peace,
Michele

Random photos

2007-10-30T13:44:00.000-07:00

Here are some miscellaneous photos of places I've been, things I've seen and people I've met:
Pigs just walking down the street next to our car
Our patient Sah's daughter T-girl and a neighbor kid
A bathroom in the middle of a swamp

A little girl following us at Mary's house

Boys watching us at Sah's house

Sah with two of his daughters (VeeVee and T-girl)

A view of the ship from the roof of Fatmata's house

Grace with the many children she is raising

Gracie's house (at least 5 kids and 3 adults live here - I'm not sure how)

Wearing my sunglasses at Gracie's house

Baby George learning to walk

Rose getting her hair platted (braided). I love the baby - he wants to know what's going on!

Peace,

Michele

Another Monday

2007-10-29T14:33:00.000-07:00

It seems that Mondays have become the day on which we have to attend a funeral. As I expected and discussed in my prior post, our 19 year old patient Gbah died Sunday evening. We called at 5:45 Sunday evening to find out how he was and was told he had died at 5:30, just 15 minutes before.

So our morning started off by attending a funeral. When we got to the house where Gbah was, there were probably 60 people sitting outside on the porch and in the yard. We sat next to Morris, the father, and talked for a while. He told us what had transpired since we left him at the pediatric hospital on Friday. The doctors at the hospital spent the weekend trying to stabilize him but were unsuccessful. A doctor called Morris into his office on Sunday and told him that they had done everything they could but Gbah was going to die. They suggested that Gbah go home (the cost of dying in a hospital here is high - it would cost about 2000 LD which is $33.00 USD to transport a body...people here don't have the kind of money). So Morris brought Gbah home and he died later that day with his family around him. If Gbah had remained at the first hospital, he would have still died but he would have died alone.

For the burial service, they couldn't get a hold of their pastor so they asked us to pray. I read two Scriptures and Jean prayed. Then six men carried Gbah to the gravesite which was just a 1 minute walk and we followed. The burials here are so fast...you take the body to the grave, fill in the dirt and then you leave. It took less than 10 minutes. It just seems like there should be more - I'm not sure what there should be more of but it seems too fast. They will have a memorial service in their church later this month. They do this because many relatives will come from up-country and must have time to travel.

Even though I've only known this family for six days, they treat us like we are someone important (this happens a lot, now that I think about it - all of our families treat us this way). It's humbling and uncomfortable. I'm not sure if they are being hospitable or if they really actually think we are important people. I wish they knew how much we are just ordinary, normal people. And in the case of our patients who are dying, we have almost nothing to offer them from a tangible perspective. But the great thing about this job is that we get to tell them that God loves them and that we love them.

We're getting another new patient in the morning, a 10 year old little boy named Levi with Burkitts lymphoma. We'll take him to the hospital for chemo and pray that we have a different outcome from our two patients with this disease who have died in the last two weeks.

I'm finding that every single day here is really, really difficult and I almost dread people asking me how my day was. But I wouldn't want to be doing anything different at this moment in time. I feel like I'm here for a reason and that God is really using me - I'm not really sure how He is using me but I'm greatly confident that He is.

Peace,
Michele

What the lack of healthcare looks like

2007-10-26T14:18:00.000-07:00

Before I came to Liberia, I liked to complain about our healthcare system, our insurance companies and our hospitals. I complained every year when I had to choose a healthcare plan - that it didn't fit my needs, it was too expensive, it didn't cover my meds and on and on and on. And I know I'm not the only one with these complaints.

We are an unbelievably spoiled and privileged society - and we don't know it. This is what it looks like in one of the poorest countries in the entire world where there is no healthcare. We have a 19 year old patient named Gbah (pronounced jeeba) - we just met him for the first time on Wednesday morning. He has Burkitts lymphoma and was so weak on Wednesday that a family member had to carry him on his back to our car. Gbah is skin and bones and couldn't hold his head up. It didn't take a medical degree to tell he is critically ill.

We took Gbah and his parents to a local hospital here so that he could get chemotherapy and maybe have a chance to live. We always take our patients because you have to know what you are doing or they will not admit you to the hospital and no one will help you. So it took awhile but they finally took him up to the ward where we left him with his parents.

Late Wednesday night, Jean got a phone call from the father saying no one had seen Gbah that day and no one had started any treatment. We have no authority over the hospital so there was nothing Jean could do. Thursday morning we went to the hospital to admit another patient so I went up to the ward to talk to the nurse before talking to the father. She told me that Gbah was going to get a blood transfusion before starting chemo. I went to the father and Gbah and tried to reassure them that the doctor had reviewed his chart and that he would be getting a blood transfusion that day and that he needed to be stronger before starting the chemo. I noticed that Gbah did not have an IV started. This young man had critically low sodium levels (a level lower than any I have ever seen before) - he should have had IV fluids started the minute he was put on the ward. 24 hours later he'd not had any kind of treatment. I know his lab values were critical because we did the blood tests on the ship so that the hospital wouldn't have to do them.

Early Friday afternoon, we received a phone call from the father. He had taken his son out of the hospital and was now trying to find another hospital to give his son a blood transfusion. The phone service here is horrible and we couldn't get the whole story but we couldn't meet the father until 4:00 pm. So we finally got to the father and found out the whole story.

The lab that takes care of the blood said that the father needed to pay 1025 LD (about $17.00) up front for the blood. He only had the $5.00 we had given him for food (food here only costs about $.75 for a meal). But if a family member donated the blood, they would only have to pay for the bag the blood goes in. They tested the mother and an aunt and they didn't match. They wouldn't let the father give blood because they said he was too old (he's 50). When he realized the family couldn't give blood, he went back to the lab and then they told him they had no blood for him to buy. So he told the doctor he was taking him from the hospital since they couldn't give him a blood transfusion. The doctor told him to bring Gbah back on Monday if he could find another hospital to give him a blood transfusion. Yes, the doctor let a critically ill person leave without doing a single thing to stabilize him.

So now the father was in our car at 5pm on a Friday asking us for help and we had no way to help. None of the hospitals have labs that are open after 4 pm. None of them are open on the weekends (even though they technically have emergency rooms). None of them will transfuse blood over the weekend. Jean actually has the type of blood Gbah needs but there isn't a hospital for us to take him to. The father also told us that Gbah has had constant diarrhea for two days which means that the critically low sodium levels from Wednesday have to now be extremely critical. The father was actually giving Gbah ORS (a sodium replacement drink) himself in the hospital.

We told the father we couldn't come up with any options. So I told him that he must tell us what he wanted to do. The father said he wanted to take him to the pediatric hospital to see if they will help. His son is 19 but he was going to say he is 15. The pediatric hospital here is run by MSF (also known as Doctors Without Borders), it's free and they actually have a real emergency room.

A family member carried Gbah to our car and all I could think of is that he is going to die in the car. He was obviously in critical condition. We drove as fast as we could to the pediatric hospital and stopped out front. You can't actually park by the hospital - there are gates and you can only walk to the hospital. So the family got Gbah out of the car and carried him to the ER. Jean followed to find out if they will admit him. She met the ER doc who said they will only tranfuse blood over the weekend if he is in critical need of it and the family must donate blood to replace the blood that is used.

We left the family there to deal with the nightmare. I fully expect to receive a phone call this weekend from the father to tell us Gbah has died. I'm not hopeful at all. If they can stabilize Gbah, he will have to be returned to the original hospital because it is the only one who can give the chemotherapy he needs.

As a nurse, there are so many things that occurred with Gbah that I can't even comprehend: a hospital that doesn't rehydrate a critically dehydrated patient while in their care for two days, a hospital that doesn't have blood because people here don't donate blood, a doctor who allows a critically ill patient to leave (in a taxi, no less), hospitals with ERs that can't treat emergencies after 4 pm or on weekends, nurses who won't tell a worried father a single thing that is going on, a hospital that doesn't give a single pain medication to a patient in serious pain.

This is what it looks like in a country without a healthcare system. This is what it looks like when the people of a nation live in extreme poverty. The only reason Gbah even has a chance is because Mercy Ships has made chemo available to people with Burkitts and that Gbah came to Mercy Ships to even know that there was chemo available. Everyone else in this country with cancer just dies a painful death at home.

This whole situation is not an isolated incident. We have a little patient, Survivor, who is also receiving chemotherapy. His father is critically ill with cardiomyopathy. His family took him to 2 different hospitals for help and was turned away because he didn't have the money to pay up front. The second hospital sent him home after he sat outside the hospital all day waiting to see if someone would help. They gave him some meds without even evaluating him or doing labs (3 of the 4 drugs have nothing to do with helping cardiomyopathy and the one that could actually help is such a low dose every other day, it will have no affect). We haven't gotten a phone call but I expect we will get one saying he has died.

We live in a privileged and wealthy country with our own problems. But the amount of injustice here is horrendous. Some days I feel like there is no hope and this is one of those days. But the more injustice I see, the more I want to be part of the solution that brings hope. I think the more injustices I see, the greater my desire is to continue to serve here.

I'm ending with my favorite Bible verse and my philosophy of life, Micah 6:8 - 'He has told you, O man, what is good; and what does the LORD require of you but to do justice, to love kindness, and to walk humbly with your God? (NASB).

Peace,
Michele

New patients

2007-10-23T14:20:00.000-07:00

We're winding down with the outreach in Liberia but you'd never know it because we are still getting new patients every week! Last week, we received a new patient named George who was 15 years old. When he came to the ship seeking treatment, he was already so weak he couldn't even walk - his uncle carried him onto the ship. He had Burkitts lymphoma (a fast-growing cancer) and it had only started growing 3 weeks prior. We took him to St. Joseph's hospital on Wednesday to start chemo and on Sunday he passed away at the hospital. On Monday morning, we phoned his mother to see how he was doing (we were on the way to the hospital to visit him) and she told us he passed away. So instead we went to visit her to support her. It seems like we've done this a lot lately.

Tomorrow, we are getting another patient with Burkitts lymphoma who is 19 years old. His name is Gbah. He is also too weak to walk and has much pain in his abdomen (exactly the same as George) so I'm not very hopeful about his prognosis. We will be taking him to the hospital in the morning to start chemo.

I know I've said in the past that there is no cancer treatment here in Liberia and that is 99% true. However, a Mercy Ships doctor procured some chemo drugs last year but they are chemo drugs that work only for Burkitts lymphoma. So any person who comes to the ship and gets a diagnosis of Burkitts gets free chemo treatment at a local hospital who we have arranged to administer the drugs. But it's not a guarantee - almost all of our patients who are getting this chemo have died.

We also got a new patient today named Fatmata. She is 67 years old with some kind of cancer (the exact type is unknown but it's not Burkitts). We visited her today along with her daughter and son-in-law and went through the whole explanation about her diagnosis and prognosis (she is going to die from it). When they asked whether there was any medicine anywhere for this disease, we had to give them an answer that is difficult for anyone to hear. We have to tell them that, yes, there is medicine for this disease but only in places like America, and England, and Australia but not anywhere in West Africa.

Fatmata and her family are Muslims and they welcomed us, as Christians, with open arms (and hopefully we did the same). They were so grateful that we cared enough to come and visit them even with bad news. Fatmata cried and cried but she also just kept saying thank you, thank you for coming. At the end, we did tell them we are Christians (I'm sure they knew this because it's very evident to anyone who comes to the ship which she had) and asked if they would allow us to pray for them. Surprisingly they did!

I'm only pointing this out because this is the first time I have personally sat face to face with a Muslim family where God was any part of the discussion. And, at least in the U.S., we are so inundated with negative news stories about Muslims that it was a really good experience for me to meet this family and see how they are normal, everyday people just trying to make their way in the world. It was good to be able to hug Fatmata and to put our arms around her while she cried and to just love her for who she is, a person created in the image of God.

I'm going to end with a few photos so that I end this post with something upbeat - I know my posts can be depressing and sad sometimes so I'm trying to balance it with something to make you smile!

This says 'to be a man is not easy.' Sorry men but it is way, way harder to be a woman in Liberia than a man.

I'm not sure why but this made me really laugh! So does this mean the dog is good during the day?? And how are they supposed to see this at night when there are no lights because they have no electricity? And I'm glad they have the arrow or someone might miss the words below it!

Peace,

Michele

Noma

2007-10-20T13:33:00.000-07:00

What's noma you ask? I'm guessing most of you have never heard of it - I'd never heard of it until I got to Liberia so this will be an educational post. Noma is a disease that exists in the poorest countries of Africa, a disease that has been eradicated from developed nations for over 100 years (except it was very common in the Nazi concentration camps). It is a disease of malnutrition and poverty and usually affects children. It is a disease we face here on the ship.

Noma comes from the Greek word that means 'to devour.' This disease affects the face of a child and basically eats away at the tissue. A simple round of antibiotics could stop it but you have to have access to healthcare in order to know this. The usual course of getting noma is like this: a child is who already malnourished and immuno-compromised gets a systemic illness (usually measles - of course, we don't see measles much in the U.S. since we are all immunized against it). If they survive this illness (most don't), they are susceptible to infections in the mouth. This infection turns into noma which eats away at the face (mouth, nose, cheeks). The mortality rate from noma is about 90% - if the child survives, they are left with a very disfigured face.

There are an estimated 400,000 children affected by noma in Africa. However, there is only one hospital in all of Africa (in Nigeria) that can perform surgery to restore their faces. And there is Mercy Ships.

We currently have at least one child on our ward who survived noma. Her name is Mathlyn and she has been with us for quite awhile as the reconstruction of her face will take place over many operations. Here is a photo of my roommate Amber and Mathlyn after her first surgery. Mathlyn had noma when she was 2 years old - she is now 11 years old and weighs only 61 pounds. When you are missing your lips, palate and part of your nose, it is difficult to get an adequate amount of nutrition. Currently her mouth is sutured shut so she is being fed through a tube in her nose and she has a trach so she can breathe.

Dr. Gary Parker, our long-time maxillo-facial surgeon, gave a presentation to the medical staff about noma and how they reconstruct the face in surgery. It was absolutely amazing. If you are the queasy type, you may want to skip over this part! I'm not sure I can explain this very well but I'm going to try to give a very oversimplified explanation.

The surgeon basically has to use other parts of the face to replace the parts that are missing. For example, if you are missing your upper lip, they use part of the bottom lip. They can't just cut out part of the bottom lip and reattach it to the upper lip because the tissue would die if you cutoff the blood supply. So they cut part of the bottom lip but leave part attached and flip it upside down to attach it to the upper lip. So at this point, it is attached to both the bottom lip and the upper lip. This remains this way for 21 days. This is the stage Mathlyn is in which is why her lips look so odd. After 21 days, another surgery is performed where the tissue is cut from the bottom lip. This tissue now becomes the upper lip (the bottom lip is now smaller).

If more of the face is missing (like the nose), then the surgeon uses a flap of skin and muscle from the temple region (it's called a scalping flap - I think the name says it all as to how they remove the skin) and reattaches it to the the area that is missing in the same way as the lip (they don't actually completely detach it from it's original place for 21 days).

Sorry if that makes you queasy but I personally am amazed by the techniques used in reconstructive surgery! The goal for these surgeries is to help that person become part of society again. Their faces will never look exactly 'right' but hopefully they are repaired enough so that the person can eat, drink and talk normally and can go out in public again.

So there's your African disease lesson for the day. Another reason to be thankful for living in the richest countries of the world.

Peace,
Michele

Day in the Life

2007-10-16T13:07:00.000-07:00

I haven't said lately how much I love my job so I'm saying it now: I really love my job. I'm feeling renewed coming off of 3 1/2 days off and am ready to face the world again. Today was a typical day, full of ups and downs. Here is how my day unfolded:

First visit is Winifred. She's a thirty-something grumpy and sarcastic women with breast cancer. I like her - I'm pretty sarcastic myself sometimes. We go through the comedy routine of trying to figure out if the pain medicine is working and how often she takes it. She says we are acting like journalists with all the questions. She asks about her swollen right arm and we say 'we don't know' for the first of many times today. We can speculate a thousand reasons but we have no diagnostic equipment. She doesn't like our answer. We pray for her before we leave. As we are leaving, we are approached by neighbor George Brown (they always introduce themselves using their full names including middle initials). His right arm is numb and he has trouble breathing and wants us to help him. We explain in great detail why we can't help him because we don't have the diagnostic equipment or the right kinds of doctors and then I pray for him.

Second visit is Jenna's family (Jenna passed away). We meet with Jenna's daughter Massa and find out the whole family is sick with malaria and this has kept her from finishing her college computer classes. Massa is determined to finish and get a good job - this is the first time I've heard this from any Liberian female. We pray for her before we leave. As we are leaving, we are approached by neighbor Solomon who is being led by his niece. Solomon went blind 10 years ago and is asking us to help him. We explain that the sickness that caused his blindness is not something we can fix and then I pray for him.

Third visit is Yatta's family (Yatta passed away). No one is home. As we are getting in the car, Yatta's daugher Miatta appears so we ask how she is doing (fine), talk a few minutes and head out.

Fourth visit is Nush's family (the little boy who passed away last week). We spent 30 minutes crying with Aretha, his mother and praying for her. Junior, Nush's father shows up and we also pray for him. Junior asks if we can take their daughter Jessica home with us. Huh? We say no, of course. Then Junior asks us if we can help pay for the headstone for Nush's grave (we think this is what he was asking - our translator had already headed to the car). Aretha is mad that he asked. We said we'd pray about it.

We head to the ship for lunch. It's the usual peanut butter sandwich.

Fifth visit is Gracie's house. We stopped by to make sure she is taking her TB medicine as directed. Her growths are getting smaller and everyone is happy. She asks if she can come to the ship. We brought Gracie and Candy to the ship last Thursday and watched Beauty and the Beast. She'd never seen a movie before. We'll probably do it again next week but we'll have to take her out of school for a day. Instead of us praying, Granny prays for us in Kpelle (a local dialect). I didn't understand a word but it was a very energetic prayer and I'm sure God understands Kpelle:)

Sixth visit is to Martha's house, one of our new patients. We start the comedy routine again trying to find out if the pain medicine is working and how often she takes it. It takes us 30 minutes to figure it out. Someone sits a baby on my lap and he promptly pees all over me. Good thing I'm laid back - it doesn't phase me, we just continue the conversation. Martha asks if we can , in addition to giving her the pain meds and wound care supplies, start providing her with food. Again, sorry we can't do that. Before we leave, we pray for Martha. As we are leaving, we are approached by Mary (Martha's sister) and she explains she has pain in her side and can't have babies because her tube is blocked. Once again we explain we don't do that kind of work on the ship and we're not sure what is causing her problem. We've said this a lot today.

We take the long way home so we can drop off our translator and we run across this funny sign. I'm not sure they had to be so graphic!

We spend the car ride home talking about the day - what was good, what was hard. And then we pray the remainder of the car ride home. By the time we get home, dinnertime is almost passed but we're in time...and they are having really good baked chicken tonight (bonus). I sit down at a table with Judith to eat dinner and find out I'm getting a new patient in the morning, a 14 year old boy with Burkitts lymphoma. He doesn't know he has cancer -we get to tell him in the morning - I can hardly wait (that's my sarcasm coming out). Jean and I now need to rework our whole day's plan for tomorrow.

After dinner, I walked for an hour with 2 friends and had a great conversation about what God has done for us in the past and what we think the future looks like. After my two minute shower (a ship rule), I'm blogging and going to bed. It's only 9:00 pm here but I only got 2 hours of sleep last night and I'm tired. My six year bout with insomnia had ended last January but it returned in July.

Tomorrow, I start again. I really love my job!

Peace,
Michele

About Mercy Ships

2007-10-13T17:01:00.000-07:00

I've gotten some emails asking for more information about Mercy Ships so I thought I would give some more information about this organization. It is definitely an organization I am proud to be a part of and would highly recommend it to anyone looking to get involved in mission work.

Mercy Ships is a non-profit organization whose purpose is to bring hope and healing to the forgotten poor using Jesus as its example: the blind see, the lame walk, the mute speak and the Good News is proclaimed and demonstrated. For those of you who read my blog regularly, you know about the hospital - where surgeries are performed everyday to restore sight, repair orthopedic problems, restore dignity to women leaking urine, remove facial tumors and restore function to burn victims. This is a large part of what Mercy Ships does but it's not all.

One of the problems with many NGOs (non-governmental organizations) is that they come into countries like Liberia that are in desperate need of support (and I'm sure with good intentions) but cause long-term stability problems. If an NGO comes in and gives handouts but doesn't create programs that are viable once the NGO leaves, then they have not really helped all that much. For example, if an NGO comes to Liberia and distributes rice for free, it is definitely welcomed during the emergency phase when people are starving. However, if they continue to distribute rice for free for years on end without establishing any programs to help people find ways to provide food for themselves, then what happens when that NGO leaves? People again are starving and have no means to feed themselves.

Mercy Ships is different than these other types of NGOs. The hospital part of Mercy Ships is definitely a unique program that really only impacts the individual who is having surgery. It doesn't necessarily have an impact on the nation as a whole. But the hospital is only one ministry that Mercy Ships offers.

Mercy Ships partners with local organizations (usually churches) in the country where we are working that already have visions and goals. We don't come in to start programs on our own - we only help local organizations that are already working to make a difference. So when Mercy Ships leaves the country, the program doesn't just fall apart.

For example, a Mercy Ships team helped build a new medical clinic. This clinic was the vision of a local church. The church had saved enough money to purchase some land and was planning on building a house for their pastor. However, the church/pastor decided that the community needed a medical clinic more than the pastor needed a house. So they decided to use the land for the clinic instead. They were in the process of making the cement blocks for the new clinic when Mercy Ships came alongside them and helped to build the clinic. It is staffed by local doctors/nurses and just opened in September. It is the only clinic available to serve this community of 50,000 people. This clinic is not dependent upon Mercy Ships for funds or volunteers. It is self-sufficient and when we leave in November it will not be affected.

Here are other programs that Mercy Ships has going on in addition to surgeries while we are here:
Womens empowerment - teaches women how to create and operate two businesses: how to raise rabbits (to sell) and how to raise bees (to sell the honey).
Agriculture - teaches farming techniques (including to prisoners so they will have a skill when they get out).
Community Health Education- works with a village to reduce health problems caused by lack of hygiene, latrines, clean water, etc.
HIV/AIDS - challenges pastors to form groups and lead the campaign to address this issue.
Mental health - developing programs at the request of the Liberian govt to address the mental health issues caused by the trauma of war.
Church empowerment - assists to bring churches together to make a difference in their community. Is sponsoring an upcoming pastor's conference that over 450 pastors will attend.
Schools - a new school in Congo Town was built. The community had already laid the foundation of the school when Mercy Ships came alongside them to help finish the project.
Dental Clinic - operates daily out of Redemption Hospital to provide free dental work. In addition, they travel to the prison to also perform free dental work.
Mercy Ministries - provides opportunities for the crew to volunteer at Sisters of Charity (the organization created by Mother Teresa), two orphanages, a home for the disabled, the mens and womens prisons and the pediatric hospital.

Mercy Ships also has a land based operation in Sierra Leone where they have a permanent clinic that performs free VVF surgeries (the leaking urine problem) as well as the New Steps rehab clinic providing rehabilitation services to physically disabled people (1 out of 10 people are disabled in Sierra Leone because of the civil war).

Mercy Ships also has a land based operation in Honduras called Global Missions Health Institute. It's an educational and empowerment program that assists medical professionals and community health workers to design programs for sustainable health care improvements in the communities in which they live.

As you can see, Mercy Ships is more than just a hospital ship and we are always looking for volunteers. Any skill that you possess can be utilized by Mercy Ships. The medical staff is a small part of this organization. In addition, we have accountants and hairdressers here; chefs and kitchen staff; housekeepers and hospitality crew; engineers, electricians, plumbers, deckhands, security and maritime officers (and many other ship-type positions that I've never heard of like bosuns)...it takes a lot of people to run this big ship! You can come for as little as two weeks or for as long as the rest of your life (if you come forever, you get a better cabin:).

So there's my plug for this great organization. You can check out their website at http://www.mercyships.org/.

Peace,
Michele

Palliative Care

2007-10-10T13:21:00.000-07:00

Ok, so it's a two post night. This post is in response to Tyronebcookin who asked that I give more specifics about the palliative care program on Mercy Ships so here it is. Thanks for asking, Tyrone!

The PC program became an official program this outreach. In years past, Mercy Ships has done PC but never had a budget or anything. The PC team is made up of two nurses (Jean and me), one translator, and then we have 4 crew members who go out with us when their schedules permit.

From a nursing perspective, PC is like home health care rather than hospice care back home (at least in the States). We have patients that are referred to us that need some sort of ongoing support because they have a condition that we can't help with on the ship. Most of the time they have a terminal condition but not always. We go to their homes and do wound care, provide pain medications, do lots of teaching. We also provide emotional and spiritual support - this includes praying, reading Scripture, doing Bible studies. We've tried support groups but Liberians don't talk about death or feelings or anything that makes a support group work. After a patient dies, we continue to visit the family to give them support.

Most of our patients have cancer and most of them are children, although we received 3 new patients this week who are all adults. We work M-F from about 7:30 - 5:00. We don't have a car on the weekends so we can't do any weekend visits.

We get our patients, usually through screenings done by the ship (dental, maxillo-facial, eye). People come to the ship for help and when we see it is something that is malignant or something we don't have the expertise for, they get referred to PC. We've gotten a couple of patients just walking in the market. We don't have a big enough budget or enough PC staff to seek out patients in the community.

It's a great job but emotionally and spiritually demanding. I'll be taking over the PC program in Sierra Leone since my partner Jean is leaving in January. We, hopefully, will be getting another nurse to replace Jean but it really needs to be someone who will be staying the majority of the outreach in Sierra Leone (until Nov).

Tyrone, if you or your wife have more questions, please feel free to email me at mzeller27@yahoo.com.

Peace,
Michele

Nush and Joanna

2007-10-10T11:45:00.000-07:00

My beautiful little patient Nush died Monday night unexpectedly. I've talked a little bit about him in the past. He was the one we gave money to last week so that he could go to school for the first time ever and he was soooo excited about it. Nush turned 8 on Sunday.

Monday afternoon, we had planned to visit him to give him his birthday presents. I got him a football and Jean got him some Matchbox cars and some school supplies. Because we have to be back on the ship by 5 pm to turn in our car, we ran out of time and couldn't see him. So our plan was to visit him first on Tuesday morning to give him the presents. On our way out of the ship, Nush's uncle Jeremiah called and told us Nush had died last night. He just started vomiting so they took him to the clinic and he died. Just like that...no warning or decline in health.

It was a devastating call. Even though Nush had cancer, he was getting chemo and seemed to be so healthy. I never expected him to die so it's been a shock - and especially so to his family. Right after the call, we went to Nush's house. There were so many people, crying. I've described their mourning process in a previous post (see post from Sept. 21) so I won't go into again but it was the same as the last time.

We took Nush's body to the gravesite in our Land Rover. If we hadn't been there, they would have had to take him in a taxi. The men in the family had been digging his grave all morning. It was an area out in the woods - it was a beautiful area but it's very strange to my Western thinking about cemetaries. The father said a few words and then they asked us to say a few words. Jean read Psalm 23 and then talked about Nush and his life. Thankfully, this has happened to Jean before where she was expected to be the preacher at a funeral so she was prepared and said some really meaningful things, in my opinion.

Nush had the biggest smile and really cute dimples. Plus he was really outgoing. When we drove him to the hospital, he was a backseat driver and always pretended he was driving and also kept giving Jean directions on what to do. He liked to dance and I'm really sorry I didn't take a video of him dancing. Last time I saw him, he was doing this hilarious dance but I thought that I would have him do it again the next time so I could video him. You never know that there isn't going to be a next time.

We brought him to the ship about a week and a half ago for some fun times. Here are some photos I took. Here he is showing off his play-doh jewelry and getting his feet painted. We put paint on their hands and feet and then pressed them on to paper.

Here he is with his adorable younger sister Jessica.

Please pray for Nush's mother, Aretha. She wasn't doing too well yesterday.
We stopped by their house today to see how she was and drop off some rice but she was at her parent's house.

Everyday something happens here that makes me think about God's sovereignty vs. human suffering. Everyday we are approached multiple times asking for help for some health problem - yesterday it was a little 5 year old girl whose head was tilted sideways and stuck in this position; the day before it was a little 4 year old boy whose legs were both bent to the left; sometimes it's people missing limbs; one time it was someone who had travelled three days to get to Mercy Ships for an orthopedic problem but came across us before they got to the ship. And everyday, several times a day, I have to say I'm sorry, we can't help you. Most of these problems are not things we can fix on the ship and even if they were, our surgery schedule is full for the remainder of the outreach in Liberia. It's absolutely heartbreaking to say 'we can't help you' when Mercy Ships is their final hope for healing through human means.

I have no answers to the questions about why a sovereign God 'allows' suffering. I just know that, even without answers, my faith is growing stronger everyday. There is no way I could do this job if I didn't believe in an eternal hope. I heard several times at the funeral yesterday that Nush's death was God's will. I absolutely do not believe the death of an innocent little boy was God's will. Death was never God's will (read Genesis if you don't believe it). And then read about the crucifixion and resurrection of Jesus Christ to see how God overcame death. If death was God's will, why would He send Jesus?

I'm going to end on a high note. Baby Joanna (posts from Sept 28 and Oct 7) went home Monday and we stopped by to see how they were doing. Joanna and her mother Rebecca weren't home but were at church down the street. Let me tell you, this is a huge deal. Until this week, Rebecca had NEVER been able to take Joanna out in public because of their belief she is cursed. Joanna's uncle and grandpa were just beaming and saying they were so happy about Joanna's new face and thanking us profusely...another humbling moment since we were so close to losing her.

Peace,

Michele

Ups and Downs

2007-10-08T13:31:00.000-07:00

I've found that every day in palliative care is different and it's never all a good day or all a bad day. It's always both. We may do one visit where everyone is happy and then the next family we visit is grieving. Emotionally it's up and down, up and down. Today was like that.

We had two new patients referred to us last week so we visited them both today. The first visit is never good and I don't look forward to them. Our first visit of the morning was to Mary. She is a 24 year old with retinoblastoma (a cancer in the eye). She is from another county on the border of Cote D'Ivoire far from Monrovia and had come with her uncle and mother seeking treatment. She has been here five months and away from her two children who are 9 and 6.

Driving out to where she is staying was a new experience for me as it was out in the countryside. Liberia is actually a very beautiful country once you get out of the congestion and poverty of the city. There are mountains, lots of green trees (they call it the bush - we call it woods) - coming over the top of a hill and looking out over miles of green and mountains was amazing to witness. So far I had only experienced the congestion of a city of 1.5 million people.

We arrived at the village where Mary was staying and it was lots of mud and stick houses, big shade trees and, of course, lots of kids. We spent about an hour with her and her family and it was really hard. We are always the ones who have to tell them that there is no treatment for what they have and that the disease will worsen until their body gives up. There were a lot of tears from Mary and her mother.

They will be leaving on Friday to return home so we will visit again on Wednesday to bring more pain medicine and dressings for her wound. We also took a family photo so they will have a remembrance of Mary. I don't think she has long to live - she is stick thin and has pain throughout her body so it's probably metastized to other areas from the eye. Here is a photo of Mary with her mother and her two uncles.

I've posted before about this culture and their grieving process. Today I noticed something else. Whenever anyone cries, the men always tell them in harsh words to stop crying. I don't know why they do this. God made our tears for a purpose. Fortunately, no one listened to them.

We left the family and made our way to the next person who is also new. Her name is Martha and her husband met us to show us the way to the house. It was also a new area of Monrovia that I hadn't seen. We had to park a little ways from the house and then hike over a small, rocky path. Here is the view from the path.

This last photo shows the ocean in the background as well as a large burned out building that used to be the Defense Ministry building. It's a sad reminder of the war. You can also see in the forefront of this picture the framing of a new house being built. Unfortunately, all of the people who live in this area are squatters (they don't own the land - they just put up a house on someone elses land). Our translator told us the government eventually would kick all of these people out of their houses and tear down the buildings.

We made it to Martha's house and it was a deja vu from our visit to Mary. We had the same words to say - there is no treatment and your body will eventually give up. Martha was there with her husband and three of her sisters. Again, there were lots of tears from the women. And again harsh words from the men to stop crying. At times, it was a surreal experience. While these women were wailing, one of the sisters pulled a live chicken out of a sack she had been holding (because it kept squawking) and just held it by it's legs while she cried. I'm glad she did since the chicken moving excitedly around inside the sack was really distracting.

Martha has two children who are 19 and 13. They sent the 13 year old boy away to a mission school because he would cry when he saw his mom's wound on her face. When we were ready to leave, Martha asked us if we would take her children and care for them when she was gone. It was heartbreaking to say no (Jean said it, I didn't).

We didn't offer to take a family photo - Martha has a big, open gaping wound and a pretty distorted face from the tumor growing. I'm not sure if we will offer in the future when there isn't so much crying.

Our last two visits of the day were the good parts. We spent our usual time with Candy who continues to feel fine although she has lost quite a bit of weight. We have finally figured out a pain medication protocol that works so her wound care isn't very painful. She was smiling today.

We ended with a quick stop at Gracie's house. I haven't talked about her before, I don't think. She is 13 years old and has lots of growths around her neck and face. She was referred to palliative care many months ago because the doctors believed what she had was malignant. We finally had a biopsy done on her last week and, great news, it's not cancer...it's TB. I only thought TB manifested itself in the lungs but it can actually attack any area of the body. In her case, it looks like small tumors. And the even better news is that TB can actually be treated here in Liberia!

So we will be taking her to the TB clinic tomorrow to get her started on the medication - she will have to take it everyday at the same time for at least six months. I'm hoping the growths start to reduce right away so she doesn't have to wear her scarf around her head and neck everyday. Here's a photo of Gracie - she is beautiful!

The day ended with another going away party. Last night we had a going away party for my roommate Joy who left today. Tonight we had a going away party for my friend Gea who is leaving Wednesday. Thursday we will have a going away party for my roommate Amber who leaves Friday. There are an unbelievable number of good-byes in both my job and on the ship.

Peace,
Michele

Emergencies on board

2007-10-07T02:24:00.000-07:00

We have emergency crews on board for many different possible situations. We have a fire crew to take care of fires (we've had one since I've been here) and we also have fire drills about every two weeks to make sure we all know what to do. Fires onboard aren't good especially if you are out to sea. The fire we had last week was a small electrical one and no one had to leave the ship. But it's a scary thing when the PA system calls for the fire team.

We also have an emergency medical team that consists of doctors, nurses, stretcher bearers, chaplains and the captain. This alarm, unfortunately, has gone off more times in the last 3 1/2 months than it ever went off in the previous few years I'm told. The first time I heard this alarm was on July 29 when one of our crew drowned far from the ship. Our team went to see how we could help. Sadly, it was far too late when the team arrived. Ever since that day, the sound of the emergency medical team alarm makes me sick.

Since then, it has alarmed at least 8 times, usually because of patients on the ward and several times in the middle of the night - it is a horrible sound. Twice it has gone off due to the fact that someone has brought a very sick person to the dock - we aren't an ER but apparently people think we can help better than the local hospital. Both times we have been able to stabilize the patient and send them home.

The last alarm was at 10:40 on Tuesday evening. The alarm came on saying 'Emergency medical team report to Hope ward' and then it repeated three more times. Since I don't work on the ward anymore, I don't know the patients so usually I wouldn't be worried that it is one of my patients. However, this time was different - baby Joanna was on Hope ward (see post from Sept. 28 if you don't know who I'm talking about).

My roommate Amber (an ICU nurse) and I hopped out of bed, got dressed and rushed down to Hope ward. On the way, we stopped in ICU as they were preparing a bed and I asked what was going on. Someone said a one year old had stopped breathing. I was slightly relieved from the fact that Joanna was 6 months old so it couldn't be her. So I asked 'what bed?' and they said 21. My heart stopped - that was Joanna's bed.

I continued on down to Hope ward to find about 15 doctors and nurses around Joanna's bed. All the patients from that side of Hope ward, including Rebecca her mother, had been moved out to the other side. I stood outside in the hallway and watched the action and finally one of the nurses came out and I asked what happened. She said Joanna was in cardiac arrest (her heart stopped) and respiratory arrest (not breathing). She had a flat line on the heart monitor which means that you can't defibrillate (shock the heart) to restart it because there has to be some electrical activity to begin with. So they did CPR and gave drugs.

After a thousand prayers and what seemed like an hour (which was only a few minutes), I heard Joanna crying - crying hard, an angry cry. An unbelievable relief. They continued to work on Joanna to stabilize her for quite a long time. All the while, nurses would go to Rebecca to give her updates on what was happening. By this time, I was with Rebecca, along with Jean, one of our counselors and several other nurses who had come to know Rebecca.

Finally, Joanna was stabilized, intubated and on a ventilator in ICU. None of the doctors or nurses knew what had happened. It was two days after her surgery and up until the point her heart stopped, Joanna was doing well. For the next 3 days, Joanna remained in the ICU, on a ventilator and heavily sedated. We had a 24 hour pray watch for her by the crew. Clementine, our amazing discipler from Togo, spent countless hours (even sleeping in the ICU) supporting and praying for Rebecca and Joanna.

A CT scan showed some abnormalities in the brain but we will never know why she arrested. She has periodic episodes of sleep apnea (she stops breathing) and, at times, an abnormally low heart rate for a baby. Last night, they moved her to Peace ward and so now I can go and visit her.

She is doing well, is eating, breathing fine and her heart rate is usually fine. Hopefully, she will go home in the next few days. It is very likely that if she had been at home on Tuesday night, she would have died. So, while we are happy that Joanna is doing well now, we don't know what her future holds.

If this happened back home, we would spend tens of thousands of dollars on diagnostic tests so that the family could know for sure what happened and what future problems she would have. We don't have such diagnostics here so we won't know for sure what happened and we don't know for sure what Joanna's future will look like. We know her heart rate is far too low but she has lived six months with this problem. We know she has abnormalities in the ventricles of the brain as well as the cerebellum but we don't know how this will affect her (although we have some ideas).

So now I struggle with an ethical dilemma. If I was back home, we absolutely would give the patient and family all the information we have so that the family can prepare for the future. I don't know how to handle it here. Most of what we would tell her would be speculation. We are dealing with West African culture where there is no future planning even with information. Not to mention their lack of understanding of the human body (most people believe any medical issues are curses and the person with the problem should be shunned from the family so that the family will not be cursed also). So what's the purpose of telling Rebecca that Joanna may not be able to walk or perform any kind of motor skills due to her abnormal cerebellum or that Joanna's heart could stop at anytime (will Rebecca ever sleep again?). They have no apnea monitors to alarm if she stops breathing. They would have to have someone watching Joanna 24 hours a day and, even if they did, they wouldn't know how to resuscitate her.

So Jean and I will continue to support Rebecca and Joanna in the future but we really will have no answers for her. Joanna could live one more day or 50 more years (the same as any of us). My fear is that one day Rebecca will wake up and find that Joanna died in the night.

And by the way, her cleft lip is fixed. This may seem like a small thing compared to all her other medical problems but here it is very important. Because people think it is a curse, Rebecca has not been able to go out in public with Joanna. At least with her lip fixed, they can go out in public and not be seen as outcasts.

Anyways, I'm tired of emergencies and I hope to never hear that stupid emergency medical team alarm again for the rest of my life.

Peace,
Michele

Signs and photos

2007-10-02T12:51:00.000-07:00

We took our little 6 year old patient, Survivor, to St. Joseph's hospital today for his chemo treatment and this is the sign over the door as you walk into the hospital. Liberian English doesn't always make sense...even our translator who usually understands the point couldn't figure it out!

We were stopped by the side of the road waiting for our translator to get directions and these children walked by. I gave them candy and then asked 'where are you going' and they all said in unison 'yes.' Then I asked 'why are you carrying chairs on your heads' and they all said in unison 'yes.' I gave up. I speak English and they speak English but it's not the same English! They continued down the road and I took this photo. It's scary, though, because this is actually a 65 mile an hour highway they are next to.

We ended today at Nush's house just to drop off supplies. He wants to go to school so we gave his mother the $40.00 needed to enroll Nush and his sister for the semester. $40.00 is what kept them out of school. Ridiculous. Nush was ecstatic when he found out he was going to get to go to school. He's 7 years old and hasn't been to school yet. He will miss a few days every three weeks for his chemo treatments. His birthday is Sunday so we got him a football for his birthday. Here we are with Nush. I told him when we visit next week, I want a photo of him in his school uniform!

I also took a short video (51 seconds) of one of our visits to Nush's house. We are sitting on the outside part of their house where they cook and do laundry. It would equate to a front porch (except there is no porch - it's a dirt floor.

Photos and Liberian culture

2007-10-01T14:22:00.000-07:00

People here love to have their photos taken, especially children. They don't actually want or even know that you can make a copy of the photo - they just like to look at themselves on the camera screen. But many times, it's not the children who ask to have their photos taken. Last week, I was taking some photos of kids and a lady walking by asked if I would take her photo. Here she is. She laughed when she saw herself on the camera screen.

Sometimes they are really funny about having their picture taken. Today, I was walking through an area to go to one of our patient's homes and a man came up to me and asked if I would take his picture. He had seen me the week prior taking some pictures. So I said yes but then he said he wanted to go put on his suit jacket. He was in really grimy, torn shorts and tshirt so I said on my way back from where I was going, I would take his photo.

So anyways, we were sitting in Thomas' house talking and this man comes in (no one has doors or anything so no one thinks this is strange) and he didn't just put on his suit jacket, he was in clothes they would normally wear to a wedding or some very important event AND he had this laminated certificate from some ministry of Liberia stating he had passed an exam and is now certified as an inspector and sand cutter. So he showed me the certificate and I dutifully exclaimed how great it was he was able to get this (I assumed he was looking for praise...I'm not really sure).

So I took him outside and took his photo with his certificate. Then on my next trip, I will give him a copy. Here he is. This is only one of the many, many differences between Liberian and American culture. The funny thing is that this is the second time this has happened. Another lady a few weeks ago asked if we would take her picture but she wanted to change. About 10 minutes later, she came out in wedding-type clothes. Too funny!

I learned about another cultural thing today that my logical mind can't comprehend. We visited with Thomas today (he had the 12 year old son Joseph who passed away two weeks ago) and all of his relatives are still here from the memorial service from a week and a half ago. So we questioned why they were still here (there were 7 of them from a village that is a 2-3 days drive from here) and Thomas said he didn't have the money for their transportation home. So we were puzzled but gave him some money to help.

So we asked Jerry our translator what that was all about. He said it is a very common belief that if you live in Monrovia (the city vs a village or the bush) then you have lots of money. So whenever anyone dies, many extended family members travel to the funeral and then require that the deceased person's family pay their transportation home, not to mention feed them the entire time they are visiting (this is why we provide a 100 lb bag of rice to the families of patients who die). This would be like my 4 siblings and me flying one way to California and then expecting my brother there to pay our way home. It's crazy. The people in Monrovia that we are working with are dirt poor including Thomas. He is having to use money he would otherwise use to send his children to school.

But what is even more illogical to me is that people will pay for the transportation home because, if they don't, the family members will say bad things about them to the community to which they are returning! So in this case, Thomas will probably spend money that would be used for school to send his relatives home (whom he didn't invite to come) just so they won't say bad things about him.

Culturally, West Africa and the U.S. are night and day. Whatever we seem to find the norm, the opposite is probably true here. I know I'm generalizing but it is frequently true. I'll start posting more about the differences so you can see why assisting countries like Liberia to get back on their feet is so complicated. There is a huge potential for misunderstandings not to mention our western belief that everything we do is the 'right' way. Western countries coming to Liberia to assist have in many ways actually hurt the progress here. More on that on another day.

One last photo that has nothing to do with the culture, just having fun with kids. This is me with Mawi (I posted a picture of her in an earlier post) and the new baby, Genevieve, that was born into one of my patient's families recently. Actually this new baby was almost born on the ship. The mother was on the ship from Sunday - Tuesday, we took her home on Tuesday afternoon and she had the baby Wednesday morning (one month early). The nurses on the ship would have freaked out but it would have been really exciting compared to all the bad emergencies we have had on the ship in the last three months.

P.S. Baby Joanna had her surgery today and Mama is big-time happy. It's too early to tell how her new lip looks because of the bandage over it but I'll post a photo as a soon as the bandage comes off (see post from Sept. 28 if you don't know what I mean).

Peace,

Michele

Driving through Redlight District

2007-09-28T14:21:00.000-07:00

I finally learned how to show videos on my blog. This is a video of what it is like to drive through town. People, animals and cars share the streets here. We are driving through an area called Redlight District (no similarities to the infamous Redlight District in Amsterdam:). The video is a little over five minutes long. This is what I experience for about 3-4 hours everyday since that is how much time we spend driving from place to place.

My internet connection is too slow here so I couldn't actually check to make sure this video works. Someone let me know if it doesn't work!

Stories - Baby Joanna

2007-09-28T11:35:00.000-07:00

I want to tell you up front that this one has a happy ending! We received baby Joanna (6 months) as one of our patients about three weeks ago. Joanna was born with a clept lip and palate which means that her lip and the top of the roof of her mouth didn't develop properly and so there is a hole where there should be a lip and palate. These aren't that unusual in the U.S. but we fix them. Here is a photo of baby Joanna.

In Africa, many times the mother and the community will reject the baby because they believe there is a curse. In this case, Joanna's mother Rebecca did reject her (but didn't abandon her). She brought her to the ship a few months ago for help but the baby was too underweight to have surgery. So Joanna was put on a feeding program and the nurses also helped Rebecca to bond with Joanna.

So all was well for a while. Joanna gained weight and Rebecca took on her role as mother. So a month or so ago, Rebecca brought Joanna to the ship to see if she was ready for surgery. Upon her full physical evaluation, it appeared she had a heart murmur and the anesthetists were concerned she had either an ASD or VSD (which are basically holes in the walls of the heart). They were concerned that she would not survive the surgery and so we gave Rebecca the bad news - we wouldn't be doing surgery on baby Joanna.

Obviously, Rebecca was devastated and cried and cried. I can only imagine how much she hurt knowing that her baby was going to grow up in a society that shuns people with deformities. Rebecca was so upset that she was referred to us so that we could provide ongoing emotional support.

So we visited Rebecca and Joanna (and big sister Madeleine) 3 weeks ago. Rebecca told us that she thought God was angry with her and that was why Joanna had this problem. So we told her how much God loved them and he didn't cause this and all the other explanations we come up with that really don't provide answers.

Now for the good part. For the last two weeks we have had a pediatric oncologist, Tom Walwyn, from the UK going out on visits with us so we asked if he would evaluate Joanna so we could get a better idea of what her problem was. At this point, we had no idea what her heart problem was and whether she would live a long or short life. Dr. Tom evaluated her last week and detected NO heart murmur - in fact she was perfectly healthy. So he arranged for Joanna to come to the ship on Wednesday for an ultrasound of her heart.

Fast forward to Wednesday. Baby Joanna and Rebecca come to the ship for the ultrasound. Dr. Wolfgang, our new crew doctor and heart specialist, and Dr. Tom perform the ultrasound and they see only a strong, healthy heart. So we are all now very excited. Dr. Tom gets a hold of the person in charge of the surgery schedule and she says we can fit Joanna in the next day for her surgery. So now Rebecca is crying and I'm crying. And we all have huge smiles.

It turns out, though, that Joanna had a respiratory infection so to be safe, we are postponing her surgery a few days after a few days on antibiotics. Joanna's surgery will be next Monday, Oct 1, so Rebecca and Joanna will come to the ship on Sunday to be admitted.

Tom says sometimes VSDs/ASDs repair themselves on their own. I'm skeptical because it has only been a month or so since we heard the murmur but it's possible. I prefer to believe God healed her. We have been praying so much that God would make a way for Joanna and I believe He has. If Dr. Tom hadn't come and if Dr. Wolfgang hadn't come or if they had come earlier or later than they did, baby Joanna wouldn't be having surgery. And we won't be back to Liberia until 2010 at the earliest. Joanna would have grown up with her deformity and her mother would have lived all these years believing Joanna had a heart problem.

Here's a photo of Rebecca, Joanna and Madeleine. I can hardly wait to post an after-surgery photo!!

Peace,

Michele

Photos

2007-09-24T14:05:00.000-07:00

We visited Joseph's family again today to give them some photos and I took some pictures of our adventure of getting to the house. Fortunately, it hasn't rained much in the last two days so it was mostly just muddy - previously it was flooded and we had to walk through the water.

These are the houses we walked through over paths to get to Joseph's house. They are baking these clay log things which they sell - that's why there is so much smoke.

Here are some of the clay logs. People actually eat clay - they consider it a food item!

A little girl in her home as we walked by.

This is Joseph's house in the forefront. Today it was just really muddy getting to the house - last week we walked through water.

We are walking away from the house now. In front of me is Joseph's oma (grandma) who raised him. You can see more of the clay logs.

These houses make me think about how little we actually need to live (of course, they don't have winter). Not that they should live like this but they do and they survive. It puts my own possessions into perspective.
This is the view from our car as we are backing up to leave. As I've said before, we are like monkeys in the zoo and whereever we go, people gather around us and stare. You can see the small crowd that gathered to look at us. Rather than just let them stare at us, I usually get out of the car and walk through the crowd and shake their hands (they do that here with everyone, even tiny children) and ask their names and take photos. It's my 15 minutes of fame!

This last photo is just for fun - some schoolboys who wanted me to take their picture. Liberian children are some of the cutest kids ever!

Peace,

Michele

TGIF

2007-09-21T12:23:00.000-07:00

I'm thankful this week is over. It's been a good week but stressful as we've had to support two families who have lost loved ones recently. Families are starting to gather from all over the country and the grieving is occurring en masse.

Today started off great...it was a beautiful, sunny day which is unusual since it is the rainy season. We started off by visting the family of Rose, who passed away a couple of weeks ago (I wrote about her on Sept. 11). We were just making a short visit to drop off a 100 lb bag of rice because we knew Rose's funeral was on Saturday. When we first got there, we found out Rose (a different one than the one who passed away) had had her baby the day before. So we got to see the new baby and take photos. The baby won't have a name for at least another week.

While we were waiting for the family patriarch, George, to get there, I played with lots of kids -the best part of the job. They kept trying to take my bag because I always have candy in there for them. Here's Jean holding baby George (that's not the new baby) and Rose who just had the baby.

So finally George showed up and we gave him the rice and prayed for them. Then he said that they would be bringing home the body of Rose later that day and asked if we would come back and take family photos. Yikes...not something I was looking forward to but, of course, we agreed that we would come back later that day.

So next, we went to Korto's granny (her name is Mama). I wrote about Korto earlier, the 3 year old girl who passed away about a month ago. Hanging out on Mama's porch is really fun. There are lots of kids and Mama's English is good so she is easy to understand and we can actually have full conversations.

Jean and I had already decided we wanted to help Mama restart her selling business. She used to sell dried fish and other meat products but when Korto got sick, she had to quit selling to take care of the little one. That was seven months ago and she has no money left.

Before we told Mama we wanted to help, we asked her to tell us about her previous business. For someone who has never been to school, she is one smart businesswomen so we are very encouraged that she will be able to make a good living if we provided the startup costs.

So it was the most amazing experience when Jean told her Mercy Ships was going to give her $100.00 to restart her business. That's about 5 months of income here. She just kept raising her hands and thanking us and shaking our hands and praising Jesus (she's the one who just became a Christian about a month ago, the week Korto died). She was so overjoyed. It is really an amazing feeling to impact someone's life so directly and then to see their reaction. Just watching her face as she counted out the money Jean handed her was priceless. Wow, I wish I could explain it better in words so I can remember the feeling.

As we were leaving I took a photo with all the kids there and had them hold my Eddie doll (the Principal Financial Group mascot). My friends from Principal sent him to me so I could take photos of him in Liberia. Principal has a contest to see all the places Eddie goes so they will submit a photo and maybe we'll win (what do we win, Jamie?).

We did two more visits and then it was time to return to Grace's home to take the photos. When we got there, George and the casket had not yet arrived so once again, we hung out and played with kids. Here's a few of the photos.

This is 4 year old Mawi (holding Eddie). She looks like this because instead of saying 'smile' when taking their photo, we say 'show your teeth.' So she showed her teeth! Mawi talks non-stop and likes to beat up on her older brother Emmanual. Mawi and Emmanual are two of the children of the Rose who died. She also has a sister named Handful. I told Mawi she got the wrong name - she should have been named Handful. She didn't understand a word I said:)

This is a little neighbor girl. You find many times, girls this age are expected to look after younger siblings.

Another group photo. You will see that Mawi is missing because she was very mad that I wouldn't let her keep my Eddie doll. She refused to be in the picture. Handful is the little girl in the middle with the blue dress and the patch under her eye. She just had surgery this week on the ship to remove a benign tumor.

This last photo is the neighbor doing laundry. Their babies go whereever they go and they often sleep through situations like this.

So finally the van appeared at the house and the men carried the casket into the house. The next 15 or so minutes after this was one of the most distressing experiences in my life. The mourning began almost as if on cue. The women started screaming and wailing and falling on the ground inside the house.

We were waiting outside with most of the kids, not really sure what we were supposed to do. Finally, someone led us into the house so we could take photos of the family around the casket. It was extremely stressful and people were inconsolable.

The worst part is that the children were completely ignored. While people were trying to console the adults, Mawi and Handful were just standing against the wall staring at the casket. I picked up Mawi and put my arm around Handful and just held them and prayed over them. Adults just kept walking past us (including their father) and no one even looked at the kids. Eventually I took Mawi out of the house but a lady outside took her from me and took her back in. So I went back into the house and Mawi again was standing against the wall alone. Handful was sitting next to her aunt, patting her back. Handful is only 8 years old. Someone should have been patting her back.

While we chalk up many experiences we can't explain to cultural differences, this is one I will never understand. I can't imagine the trauma these children have gone through today (and I'm told this kind of wailing/screaming will go on all today and tomorrow). And I guess one day, they will mourn like this in front of their children.

So I probably sound pretty judgmental in this post. But just because a culture has always acted in a certain manner doesn't make it right. Today is one of those days where you realize you can't change the world but hopefully I made a small difference for Mawi and Handful.

Stories - Joseph

2007-09-18T11:59:00.000-07:00

I could only hear one side of the phone conversation this morning but I knew it wasn't good. Jean was speaking to Thomas, the father of our 12-year old patient Joseph. She hung up the phone and just left the office. I knew Joseph had died...and I hadn't even got to meet him yet.

Joseph died yesterday (Monday) and was buried the same day. I find this very difficult to comprehend. In the U.S., when someone dies, we usually have a funeral where everyone can view the body and can say their good-byes. That is actually a luxury that requires money. I never thought of it as a luxury before.

In Liberia, people who have money only have money for real essentials, like food. They don't have money to keep a loved one who has passed away in a mortuary while funeral preparations are being made. People must be buried here very quickly (for obvious reasons). And so Joseph was buried the same day he died, before any of his family members could travel to Monrovia to say their good-byes.

Another luxury we have back home is a casket. Here the cost of a casket is far beyond what any ordinary person could ever expect to pay. They do have cemetaries here - the difference is that the body is buried in the hole in the ground without a casket and without a headstone. Sometimes they will place flowers. I felt sad wondering if anyone would visit Joseph's grave and how would they know where to find him.

We went to visit the family after Thomas called. It's been raining buckets here so we had to park the car a ways from the house and navigate our way through mud and water to get there. Because there is always so much flooding, many people have already put out concrete blocks, tires, etc. to make pathways to walk on and fortunately, this awkward path existed. We worked our way through a housing area that I can only describe as looking like the homeless camps we see back home. These houses were made of four tall sticks and then some raggedy tarps thrown over the tops. Everyone lives in poverty here but this seemed especially harsh.

But we finally reached Thomas' house and were welcomed in, as we always are. And as always, all the neighbors came to see what we were doing. There's really very little you can say during this kind of heartbreak except I'm sorry...and that's what we did. As my friend Gary told me, we usually say things to make ourselves feel better or less uncomfortable. I wished I could take away their heartache but I knew there were no words that could do this. We prayed for them and they were so grateful for our interest in them and their son...as if we were someone special. I was so humbled.

And then we left with a promise to return. We also left them with a 60 pound bag of rice. In this country, when someone dies, family and friends come to visit from all over the country. The family is then expected to feed all these people who come which is a very difficult burden. So Mercy Ships provides the rice. There will be some sort of a memorial for Joseph once all the family has a chance to travel to Monrovia.

Here is a photo of Joseph and Thomas about one month ago. I can see that Thomas was already sad. He did say today that he is happy that Joseph is no longer suffering. And that's what we hold on to.

He will wipe every tear from their eyes, and there will be no more death or sorrow or crying or pain. All these things are gone forever. Rev. 21:4

Ceilidh

2007-09-16T14:48:00.000-07:00

If you're thinking 'huh' about my title, that's what I thought when I first saw the word. It's pronounced kaylee and it is the Scottish Gaelic word for visit. A ceilidh is a social event with music and dancing and we had one here Friday evening. It was the most fun I've had in a long time.

All we knew was that this event was for all ages, we would be dancing and you didn't need to have any dancing abilities (thankfully, since I have none). We all met outside on the dock at 7pm and then spent the next 2 1/2 hours dancing. There were at least 100 people there.

We learned maybe 10 or so dances with names like Stripping the Willow and the Gay Gardens. Our event leader would teach us the dance first and then once the music started, she would call out the steps over the PA system.

We were dripping sweat and laughing so hard for those 2 1/2 hours. My roommate, Megan, took photos when she wasn't dancing. These are some of the ones she took.

We're actually doing The Wave here (that's not Scottish:)

Signs

2007-09-14T03:55:00.000-07:00

There are lots of funny signs and slogans to see when we're out in town so we always have our cameras ready to take a picture. Here are a few that we've seen.

Stories from the week

2007-09-11T13:53:00.000-07:00

It's only Tuesday and I have so many things I want to talk about! But I'll try to condense...my roommate, Jo, went home to Wales on Monday. I will really miss her:( Here she is at her going away party (in the middle, Hannah - L, Prisca - R).

Monday started off badly (starting with Jo leaving) but ended on a happy note. Monday morning, we went to see our patient Yatta who has cervical cancer. She was in some serious pain and generally not doing well. Her family was taking her to her home village later that afternoon so her sister could start caring for her. Unfortunately, she will be leaving her 7 children behind in Monrovia. Four of her sons and one of her daughters were there and you can tell they really love their mom. So it was sad to see that she was going to leave them. However, she was going to her home village where her father lives. Her father disowned her when she became a Christian so we're praying for reconciliation between them. So this was the last time we would see Yatta.

After saying good-bye to Yatta, we went to visit our next patient Rose. When we got to her sister's house, everyone was looking really sad. Then they told us Rose had died last Thursday. It took us by surprise and it was a really sad situation. She left behind four children under the age of 7 - one is a baby. Here is a picture of Rose and her children. I am posting the photo so you can see that the people dying in Africa are real - not just statistics we read about in the newspapers in the U.S. about X number of people dying in Africa. Every person has a story and a family they are leaving behind. If Rose had been born in the U.S., she would not have died from this disease.

One of the gifts Jean gives to families is that she always tries to take family photos and then gives them multiple laminated copies so that the family has a remembrance. People here don't have cameras or photos - so in Rose's case, without a photo, her small children would never remember what she looks like. I think it is a precious gift.

After that sad visit, we picked up Candy and Kaka who I've already written about. Candy was actually smiling and laughing when we picked her up and she was smiling and laughing when we dropped her off. That was a good ending to the day - just seeing her laugh like a regular little girl was good for our hearts.

One of the fun parts of the job is interacting with all the children we come across. They are everywhere and I get to hand out a lot of suckers! The funny part is that many of them have never seen white people before and they are usually either curious or scared. Today, we were walking to a house and I saw this little boy about 3 years old walking down the street, happy and smiling. He then turned and saw us and he literally turned around and ran screaming down the street with both of his hands in the air. It was just hysterical! I think that's going to be one of the best memories of this whole experience.

Earlier, we were making a visit and we were sitting on the front porch with the family and all these kids would stick their heads around the corner or up over the porch to look at us. But if I went over to talk to them they would run. The woman we were visiting said they had never seen white people before. They were laughing but shy. The kids always warm up to you once you pull out your camera - they love to see themselves in the small camera window. Here are two sisters who were very fascinated by us. And next is a group picture of some of the neighborhood kids plus Jerry, our translator. He likes to be in the photos as much as the kids.

More kids - this is Lucky Girl on the left (yes, that's really her name) and Jessica on the right. Lucky Girl just laughed and laughed when she saw herself on the little camera screen.

Speaking of Lucky Girl's name, another funny name we ran across is Chinese Girl (the daughter of one of our patients). It feels really strange to call a little kid 'Chinese Girl.'

That's all for now. I hope the photos are giving you a feel for Liberia and the work God is doing here.

Peace,
Michele

Stories - Candy

2007-09-09T09:11:00.000-07:00

Candy is an 11 year old girl who I got to see four times my first week on the job. She is very shy, especially around her dad and other adults. Candy has retinoblastoma (the same cancer I described in the previous post) and it requires that we clean the wound three times a week.

Candy and her father, Kaka, are from Cote D'Ivoire (that's Ivory Coast for us Americans) which is the country directly east of Liberia. They came to Monrovia in March of 2006 seeking treatment for her cancer. Her mom and siblings remain back in the Code D'Ivoire and Candy hasn't seen them since. Here's a picture of Kaka and Candy.

Unfortunately there is no treatment but Candy won't go home and Kaka is respecting her wishes. Candy believes if she goes home, she will die. Even though she isn't getting any treatment here, she doesn't understand and it's heartbreaking. It's heartbreaking to know she is away from her mom and family during her final months here. It's heartbreaking to know there is no treatment in Liberia for this cancer while almost no one dies from it in the U.S.

This is the hard part of the job. Kaka understands what is going on but he's trying to balance the hope Candy has with the harsh reality of the cancer. We could spend more time getting Candy to understand there is no treatment but what's the point - who's to say that we should take away every last bit of hope she has. If she lived in Monrovia, it would be easier but she doesn't. It's like she has to make a choice between the hope she has and spending her last months with her family. Ugh, it's horrible to think about.

She and Kaka are living in a rented room and we go to pick them up every Monday, Wednesday and Friday afternoon. We take them to a local medical clinic where we can do her wound care. We play games (like Uno) or with play-doh while we wait for her pain medicine to kick in. Here's a picture of Candy with some play-doh jewelry I made for her. And you can see in this other photo that whereever we are (white people) there are children watching us!

We try to really make her feel special and love her and encourage her. On her last birthday, Jean had a birthday party for her on the ship with cake and presents and decorations. About 8 little girls from the crew came to celebrate with her.

Last Thursday, we brought her to the ship along with another 11 year old girl patient of ours, Grace, and Grace's twin sister Gloria plus the two dads, Kaka and William. Just so they could have some fun. We painted our nails and colored, ate peanut M&Ms and drank pop. Then we had lunch in the crew dining room. When the three girls were together, they talked and played and laughed. It was so great to see them smiling because they don't do a lot of that. Here are some photos from the day.

From left to right: Gloria, me, Candy, Jean, Grace.

Grace, Candy and Gloria up on Deck 7.

William (Grace/Gloria's dad), Jerry (our translator) and Kaka (Candy's dad). The men sat around and talked while we played elsewhere with the girls. Parents are generally pretty harsh with their children here (in my opinion) which is why we decided to separate the groups - the girls could play and talk without having to worry about getting in trouble. There is a huge difference between how they act around just Jean and me than when their dad's are around.

Stories - Korto

2007-09-07T14:04:00.000-07:00

I've finished my first week in palliative care and I'm really tired. This job is far more tiring than working in the ward, physically, emotionally and spiritually. And it's awesome! There are so many things I could talk about, it's hard to know where to begin.

One of the best parts of the job is being out with people in their own environments, in their homes and neighborhoods. When we visit a patient/family, we go to their house and we usually sit out on their front porch or lawn or whatever they have in front of their house and we talk. There are always so many people around especially children. We visited a family today and there were 17 children sitting with us on the porch and almost all of them lived in the house. Here is a picture of them with our translator Jerry.

We currently have ten patients and four families of patients who have passed away that we visit, usually at least once a week. Some we visit multiple times a week if they need nursing care or if a patient is in the final stages of dying. Fortunately, none of the patients I have seen are in that final stage.

I am going to write about my patients but will leave out many details because I want to make sure I tell their stories without compromising their dignity. But my prayer is that as I write you get a sense of who they are and what their life is like and that you would pray for them and their families as you read.

Today, we started with a visit to the family of Korto. Korto was a three year old little girl who passed away just last week so I never got to meet her. She had retinoblastoma which is a childhood cancer of the eye(s). In the U.S., there are about 350 new cases of this cancer each year and the death rate is 5%. No one knows how many cases there are in Liberia but 4 of our original 22 patients have this. The death rate in Liberia for this cancer is 100%. There is no cancer treatment in Liberia.

Here is a picture of Korto's house. We hung out on this front porch with a million kids and lots of chickens.

We didn't get to talk to Korto's mother today as she was at the market selling her goods. There's no time off from work here to mourn the death of your child. Korto's grandma was home with all those children in the first picture as well as a few of her daughters and sons and sisters (there are so many people you can't keep track). Granny is an amazing woman. She was the primary caretaker for Korto as well as most of these children.

Here's a picture of some of the family. Left to right: Pastor, Korto's mom, Korto on her lap, Oumaru and Granny.

When asked how the family was doing, they say 'we are trying.' I interpret that to mean 'we are sad but moving forward.' I hope that's what it means - they won't talk about death or grief so that is all they will say - 'we are trying.' Nothing more. So we talk about other things.

Last week, during the final stages of Korto's death, Granny became a Christian. Her entire family is Christian (her brother is even a pastor which is why the one little boy is named Pastor) but she was a Muslim until last week. Today, she was joy-filled over this. She was excited to tell us about her new church and how they welcomed her. She was adamant that we know how much her heart has changed in the last week, even in the wake of grief. She said she has so much peace and love in her heart. And she was forgiven - over and over she kept saying this. Her family, obviously, is ecstatic.

Granny is unable to read or write but starting this week, she has been accepted into a literacy program so she is going to learn. I'm guessing she is in her 50s and she is thrilled with this opportunity. Fortunately, she understands the importance of education and all of the children in her household are going to school. Mercy Ships has helped by paying the registration fee for all of Korto's siblings. School in Liberia isn't free - that's why most of the children are not in school.

Since Jean and Granny were doing most of the talking, I was free to sit and watch and pray. I wish I could put into words what it felt like to be on that porch but I'm not sure I can. It felt like pure peace and true relationships. I was envisioning Jesus interacting with all of us and I could see his love for this family. I am absolutely confident that Korto is living in the embrace of Jesus right now.

Tomorrow, I will tell you about Candy, an 11year old girl from Cote D'Ivoire, also with retinoblastoma.

Peace,
Michele

New job

2007-09-05T14:39:00.000-07:00

I started my new job in palliative care on Monday and it has been awesome, everything I hoped it would be so far! I can't say much right now as I'm so tired - I'm switching back to a day work schedule from a night schedule (I went to bed at 6 pm last night). But I wanted to post some photos I took as we were driving out in the city and countryside to travel to our patients homes. We've really been using the four-wheel drive option on the Land Rover!

Traffic jam on Jamaica Road thanks to the cows.

You don't see this much in West Des Moines!

Trying to decide if we can make it through this. The photo doesn't do the treacherous nature justice. We backed up and went another way. Jerry, our translator, is on the right and a local man on the left.

The walking bridge over a flooded road. The flood didn't stop the cyclist but he tipped over in the water about 3 feet later.

Two new friends. One is the daughter (L) and the other is the sister of one of our patients, Leah, who died last month. We went to visit the family to see how they were doing.

Clearing amongst a group of homes we walked through to get to Leah's house.

Jean with some friendly neighbors. You can see the tire in front of the girl on the right - that is the rim to their well and they were getting water.

City of Monrovia

2007-09-02T15:48:00.000-07:00

The ship I live on, the Africa Mercy, is currently in port in Monrovia, Liberia until November 30. Monrovia is the capital city of Liberia and has a population of about 1.5 million. Monrovia is actually named after James Monroe, the fifth president of the U.S. Prior to that it was named Christopolis named after Jesus Christ. What were they thinking??? Notice the Liberian flag next to the map - it is very similar to the U.S. since Liberia was founded by freed U.S. slaves.

The country spent 14 years in three different civil wars from 1989 - 2003. A democratically elected president, Madame Ellen Johnson-Sirleaf, was elected in November 2005 and since then Liberia has experienced a fragile peace due to 15,000 UN peacekeeping troops. The troops are very visible, especially to Mercy Ships as we have to enter their checkpoint to get to the ship and their barracks are right next door to us. In fact, we (meaning Mercy Shippers minus me:) play the UN teams in frisbee and volleyball. The troops that live next to us are from Bangladesh.

President Johnson-Sirleaf was educated in the U.S. at the University of Colorado and Harvard. She was imprisoned for a time during the war and spent time in the Monrovia prison. We have a ministry that goes to the prison every week to minister to inmates and two weeks ago, the President happened to be there at the same time. I wasn't there but many of our Mercy Shippers got the chance to meet her and saw the cell where she was imprisoned.

The judicial system here is slowly being rebuilt. However, in the meantime, many of the prisoners have been in the prison for months or years and have never been charged or had a trial. Many of them are in prison for debts - if a family member would come and pay their debt, they would be freed. Every week our team returns home with a list of phone numbers of relatives to call to see if they can come and free their relatives. My roommate Dorothy has made some of those calls and finds that the relatives didn't know they were in prison. Unfortunately, most of them do not have money to pay to get them out of prison.

The city of Monrovia used to be a tourist place prior to the war. When you ask Liberians about their country prior to the war, you will hear that it was a beautiful city. They have many beaches since it is located on the Atlantic Ocean and they even had a five-star hotel called the Ducor Palace. Monrovia had paved streets, electricity, sewers/plumbing, hospitals, banks, a university - it was a thriving metropolis that was the place to see in West Africa.

Today, there isn't a single stoplight in Monrovia, there is very little electricity, the roads are horrible, there is no sewage system or trash pickup, the hospitals have almost nothing to offer, unemployment is 85%; it is a burned out, bullet-ridden city trying to make its way back.

My roommate Megan visited the Ducor Palace which sits burned-out on the top of a hill overlooking all of Monrovia and took some wonderful photos of Monrovia which I am posting here.

A few updates

2007-08-27T17:31:00.000-07:00

Peace Ward

I spent four nights this last week working in Peace Ward. Peace Ward is really not very peaceful! Since I got here, I have been only working in Faith Ward or Hope Ward where we have the ladies who have had VVF surgeries and the occasional eye patient.

But for some reason, they put me in Peace Ward - I'm ready to go back to Faith/Hope. Peace Ward holds patients who have had orthopedic surgeries (club feet repairs, bone fracture repairs, burn releases) and they are all in casts. It is also a mixture of kids and adults and that is why it's not peaceful.

Kids and pain and our white faces make for a lot of screaming and crying. Kids also means there are a lot of extra people around since they all have a caregiver (mom, dad, aunt, etc.) that stay with them at all times. (A funny side note: the caregivers sleep on mattresses under the beds of their kids...not something you see much of in the States). And then you mix those kids with adults who have also had surgery all in one big room and you have chaos. Not to mention, Pippolo, the clown comes down every evening to entertain the kids by making balloon animals.

Fortunately my patients were all adults except for Esther, a 16 year old. I've been caring for Ella who is 84 years old - that is a miracle in this country. She is well-off and has traveled all over the world. Her children and grandchildren live in the U.S. She had her hip repaired and has been here about 12 days and she has had enough. Her bed is right next to Roosevelt - the 7 year old who is in a cast from his waist to his knees and apparently she doesn't like his manners.

One night, she was complaining to me about him and just kept saying 'That boy is too frisky.' I had a good internal laugh about her terminology. But an hour later, she was offering him a piece of her apple.

Then there is 16 year old Esther. When she was three, the rebels put her arm in a fire. She came here because her arm had contracted and needed to have the scar tissue released (it's called a burn contracture release). She has her arm in a cast and wires sticking out from the tips of her fingers. I can barely stand to look at it. She endures painful dressing changes every three days. Unbelievably, she is always smiling...and she's pretty pampered by the nurses...the word 'princess' comes to mind (notice the tiara:).

Here's a picture of Esther (on the right) with my roommate Megan. She taught Megan how to carry things on top of her head like a real African woman. It took several nights of practice but Megan's pretty good at it now.

And speaking of a princess, the names of the kids on the ward make me smile. Here are the names of some of the kids currently in the hospital: Princess, Remember, Roosevelt, Baby, Angel, Mustapha (isn't that from The Lion King?) The adults' names seem to be names we are used to or African names but there seems to be some odd naming trend going on with the younger generation.

Waterside Market

On a totally unrelated topic, I went with three friends to Waterside market yesterday. We went in a cab with 7 people in it that was built for five - and amazingly, the cabbie didn't rip us off when we paid the fare. Waterside market is several long streets filled with hundreds and hundreds of people walking around, seemingly doing nothing. There are street vendors selling anything you can imagine, some with their product in wheelbarrows (like chicken) and some on their heads. Others just sit on the sidewalk with their stuff all laid out neatly on blankets. For some reason, there are lots of vendors selling dishes.

Then there are vendors that have a little booth and some even have actual stores you go into (these all seem to be owned by Lebanese people rather than Africans - at least the ones we went in). We spent an hour or so 'shopping' which isn't really the same kind we do in the States.

When we walk down the streets, we stand out and everyone is always watching us. And not only do they watch us, they constantly yell things at us (more specifically, only men do this). This is what we hear as we are walking: hey, whi woma marra me (meaning hey, white woman marry me); musy ship (meaning mercy ships); be ma fren (be my friend); or just plain hey, hey! And they make lots of sucking noises at us which is horribly offensive. Anyways, it's why I don't go shopping often!

I wish I had a picture to show you but it's a little dangerous to take out a camera in a crowd. The amount I paid for my camera is a year's wages for a Liberian and so we try not to do anything else that draws attention to us.

We caught a taxi back home and met a wonderful cabbie named Musu. He was married with three children and a granddaughter. Wow, he was passionate about Liberia and America (as they call the U.S.) and the younger Liberian generation and how they wanted handouts and didn't want to work and what the last three wars have been like. Prior to the war, he had a good job in a bank. Now he drives a taxi seven days a week but he owns the taxi and all he makes is his. We got a flat tire on the way back which will cost him $21.00 US to fix which is a few days wages for him.

I find that getting out and experiencing the Liberian culture in a mass of people is tiring and bizarre. But when I meet individual Liberians (like Musu) and have a chance to talk to them and learn more about their lives, it is an amazing experience and it makes me glad I am here. After a few hours out in Monrovia, it also makes me thankful for the air conditioning and my little cubbie home on the ship.

Tribute to Collin

It has been just under a month since our crew member, Collin, died here. It still makes me sad as I pass the door to his cabin which was right next to mine. On the Mercy Ships website, http://www.mercyships.org/, there is a video tribute to Collin on the first page. It was played during his memorial service here on the ship. It is his family's wish that Collin's work here not be forgotten and I ask that you view the video and let his message penetrate your heart. Continue to pray for his parents, sisters and other family as we continue to do here.

Peace,
Michele

Community life

2007-08-27T15:34:00.000-07:00

I've been living on the ship now for two months and have pretty much adapted to living in community. I never lived in the dorms in college so this is a unique experience for me. One thing I've learned is that you have to be flexible and give people a lot of grace - it helps to be laid back like I am. This is not a place for people who need to be in control and have everything their way because it is the opposite here - you have almost no control over anything and you can't insist on your way since you have between 5-9 other people living in your cabin (yes, we have ten-berth cabins).

I've been so lucky to have the roommates I have. Our ages are 24, 26, 32, 33, 42 and 57 and we come from 5 different countries (5 nurses and 1 doctor). The opportunity for conflict and misunderstandings is huge but we all actually get along really well and everyone is considerate. I know many other cabins where people just can't seem to make it work...so much for the Christianly attitude of grace.

The hardest part about living in community is that you are never alone, not even when you are in your bed sleeping because you have a bunkmate sleeping as well. You eat meals together, you do laundry together, you watch tv or movies together, you check your email together, you worship together, you work together. You can't go anywhere off the ship without at least one other person and preferably in a group. You are sick together (we've had lots of this lately - it just gets passed from person to person).

And it doesn't matter what time of the day because this is a hospital and a ship that operates 24 hours a day. I did laundry at 3:30 a.m. the other night and there was someone else in there doing laundry at the same time! I tried to go into the International Lounge (where we have all our community meetings and church) at 1:00 a.m. a few days ago to pray and there was a group of musicians in there practicing.

For the most part, I like the community living but as I've been thinking about whether I can do this long-term (two years or longer), I'm not so sure. Long-termers have better cabins - some have single-berth cabins but many are in four-berth cabins. I've heard the family cabins are great, just like apartments with multiple rooms and a kitchen...maybe I can get a family to adopt me while I'm on the ship:)

Some great things about community living: always someone to talk to or play games with or pray with or eat with...someone else prepares all your meals and cleans up after you...there is always a birthday to celebrate (meaning chocolate cake)...I have many, many friends from all over the world...no one cares about what you do for a living or how big your house is or how much stuff you have because you don't have anything here - just your small little cubbie. Most people are just here to serve God.

We have youth pastors who work in the kitchen, retired couples who work in housekeeping, doctors who are on call 24 hours a day and don't care if you call them in the middle of the night, nurses who spend their off-hours down on the ward just hanging out with the patients even though they just spent the day working on the ward, mothers who bring their young children down to the ward to play with the kids who have had surgery, teenagers who live on the ship that hang out with teenage patients after school, nursing supervisors who stop by the ward at midnight just to make sure we're doing ok.

I'm not saying everyone is perfect and we're living in paradise! We're living in a country that is so poor that it doesn't even rank on the list that ranks how poor countries are. And we take care of people everyday who have tragic stories to tell and many, many people who come looking for help and we can't help them. And we're living in community with 400+ other people and we are working a lot of hours and shifts and people get cranky.

So, for now, I'm fine with community living...it's just a different way to live. We'll see what my attitude is 10 months from now!

One last note: I'm coming home for Christmas, thanks to frequent flyer miles! I'll be in Des Moines from Dec. 14 - Jan. 5th. See you then.

I'm going to leave you with some photos of community living:

Ans and Melanie just hanging out.

Music night. Every two weeks or so, we have some kind of musical event in one of the lounge areas. Last week, we had a gospel singer, Tina Greene, visiting the ship so she sang for us. One week there was a talent (or lack-of talent) show. This photo is a night where some of our crew put on a concert. At times, someone will just sit down at the piano to play and others will come up and start singing and, the next thing you know, there is an impromptu worship service going on.

Jo and Jo out on the town. Jo (on the left) went home to England today. Jo (on the right) is my roommate and my friend - she will be going home to Wales in two weeks.

Celebrating a birthday in the dining hall.

Out on the town - Melissa, Rachel, Jo and Megan. Melissa and Rachel are nurses here for two years. Megan is a nurse here for one year.

Dessert after the Thursday night worship service. Every Thursday evening, groups of crew members make a special dessert for the rest of the crew and we basically hang out and socialize after church.

Peace,

Michele

My new job

2007-08-23T09:38:00.000-07:00

September 3rd, I will be starting a new position as a palliative care (hospice) nurse. I met today with Jean Brown, currently our one and only hospice nurse, to get more details about the job. I'm in for a challenging few months.

There are two parts to the job. First, is caring for patients who are terminally ill. I will be traveling to the patients' homes with Jean to provide nursing care along with spiritual and emotional care. Most of her patients are kids with cancer - I wasn't prepared for the kids part...I'm not sure how I will handle this. Lots of prayers, please. Liberia has no healthcare system so cancer is a terminal condition always, even the kinds that are curable or treatable in the U.S.

The second part is developing a sustainable hospice program that will remain in place after Mercy Ships leaves Liberia. Working through churches, we want to create a program where terminal patients can seek care. While we have many of these programs developed in the U.S., the West African culture is far different from ours and we don't know what will work. For example, West Africans do not talk about death - they live only for today. So if the topic is taboo, creating a program for such a topic will be difficult at best.

It feels good to be way out of your league, as I am. It's much easier to rely on God and His direction when you don't have a clue what you are doing. I'm glad to be back in such a position. West African medicine frequently involves the occult as many people seek treatment from witch doctors, especially people who live in rural villages.

So for any of my counseling, chaplain and nursing friends, I would be interested in hearing about any resources that may help me (books, websites, magazines, support groups, etc.). You can email me at mzeller27@yahoo.com.

Jean will be leaving Mercy Ships in December after 10 years. I don't know what my long-term plans are yet but this may evolve in to something permanent. We'll see what God has planned!

Peace,
Michele

More about George

2007-08-19T10:28:00.000-07:00

My 9 year old friend George is still here, delayed by mechanical problems with the Red Cross airplane that was supposed to take him home last Friday. See the photos in the previous post of George. He has become quite popular onboard the ship and he loves the attention. Last night, he came and ate dinner with me in the dining room (rather than eating the African food we serve on the hospital ward).

It was his first experience eating at a table, he said. He doesn't have a table in his house. Dinner was ribs, french fries and peas. He liked the ribs but absolutely loved the french fries (hated the peas). I guess fries are universally loved by all children. As we walked through the dining room, many people stopped us to say hi because everyone knows George.

After dinner, I took him to the internet cafe. He hadn't seen a computer before and didn't know what it was. I showed him how to play a computer pinball game. He quickly caught on to how to use the mouse and the keyboard. He played for an hour and a half and I had to peel him from the keyboard! When he got the high score, he typed his father's name as the winner. His father was killed by the rebels when he was very young.

I took him to the Academy and the library onboard. He was amazed. He goes to school but his school is outside (no building) and they have no books. Our school has thousands of books and about 12 computers, taking up many large rooms on the ship.

He saw the laundry room where we have 10 washers and 10 dryers. He wanted to know how they worked. He washes his clothes on a washboard.

I took him to the snack shop where I bought him some M&Ms which, of course, he loved. I asked him where his family got their food. He didn't know where it came from but he said there wasn't a market close by. Makes me wonder how far his mother has to walk to buy food.

I wonder how these simple exposures might change him. He has been exposed to many new things and ideas over the last week and a half and I wonder if it will make him less satisfied with the simple life he has now. I hope not - I don't think we should impose our Western lifestyles on African culture. But I hope his viewpoint is expanded so that he knows he doesn't have to settle for an impoverished, unemployed life. Maybe he'll be one to make the difference in his country.

Saturday, I went back to God's Childrens' home, an orphanage I previously wrote about. We sang and played with the 50 or so kids. They are energetic, happy kids who are loved by the people who care for them. This isn't so in all the orphanages. The Liberian government had to put laws in place that prevent NGOs (non-governmental organizations - Mercy Ships is one) from supporting orphanages that do not meet the laws as there are apparently hundreds of orphanages that are exploiting children rather than caring for them.

At the orphanage, I met Joshua. He's 14 and he says he's named after Joshua from the Old Testament. He brought out this huge children's Bible and he told me the story behind every single picture in the Bible. He knew all the famous Bible stories (Adam and Eve, Noah's Ark) but he also knew many, many other stories that aren't usually a point of teaching to children. Some I will have to go back and reread to remember. He said he is going to be a pastor - I believe him.

After he told me all the Bible stories, he and two other boys platted (braided) my hair. I didn't know boys could do that but they all knew how. Almost all African women where their hair platted - mine didn't exactly look like theirs. Sorry, I didn't take a picture - it wasn't my best look!

Peace,
Michele

More about patients

2007-08-17T08:36:00.000-07:00

It looks like I'm going to have a change in my job duties sometime in September. They were looking for another nurse to work in palliative (hospice) care and I volunteered. It was great how this came about (God, of course:). I had been praying last weekend about how I could get more involved in the community because we kind of live in this westernized bubble of a ship and the Liberians come to us rather than us out with them.

So Tuesday, I listened to a presentation about all of the community projects Mercy Ships is involved in and one was about palliative care. I talked to some friends about how I had been thinking about doing hospice nursing when I got home and said I'd really like to get involved in this ministry. So about three hours later, the nursing staff got an email from our supervisor saying there was a position in palliative care and did anyone want it. So I volunteered.

I don't have any details yet but I know the current palliative care nurse goes out to her patients' homes 3 days a week to care for them. It just occurred to me that I may have to drive here - that is a horrible thought. Hopefully, I'll have more details in the coming week. I am really, really excited about this (except about the driving).

I've had a lot of fun with my patients lately - really getting to know them rather than only caring for them. I have a few photos to share.

This is Jo (my roommate from Wales), me and George. George is a 9 year old who has been with us for a week. He was badly mutilated by rebels when he was two (they killed his dad) and his mom came hoping we could help him. We couldn't help him physically but he has been a huge joy for all the nurses. He never, ever stops smiling. He has been well-loved by all of us, helping us with our nursing duties, playing with us. George and I like to play soccer on the ward (with a balloon). He loves soccer. He has had lots of moms over the last week!

Here's another one of George. Even though we couldn't help him, he and his mom spent a week on the ward waiting on a way to get back home. The Red Cross picked them up today (Friday) to take them home.

This is Peter. Peter is 33 years old with three kids - he was born blind. We removed the cataract in his right eye and he will be fitted with a prosthetic eye in the left side. He left before I found out if his eyesite was restored. We had a long walk up and the down the hallway so I got to learn more about Peter. He liked to say 'Praise God' after every sentence.

Every afternoon, we take some of the patients up to Deck 7 so that they can get outside. The hospital is located on Deck 3 and has no windows so this is their opportunity to get some fresh air. Usually one of the translators leads us in singing for an hour which absolutely helps in the healing process (spiritually, emotionally and physically).

This is 6 month-old Junior. He came with his mom who had surgery. He has been with us about three weeks and the nurses like to 'fight' over who gets him. He is about the size of a two-month old due to malnourishment so we have him on a feeding program. His mom was in obstructed labor with him for four days and his brain was damaged - he can't hold his head up and his eyes don't track. Junior and his mom, Amelia, left today. She was physically healed - I don't know what the future will be like for him.

Here is Jo with Kou (left) and Mary. Kou has been here about 6 weeks due to a burn contracture wound that won't heal. She has a 10-month old baby waiting for her at home named Maurice. He has been able to come and stay with his mom for a few days but he doesn't like the nurses much! Mary left a couple days ago physically healed. She has been such a mentor and mother-figure to the ladies on the ward. She has tremendous faith. She's the one who called me 'her daughter.'

That's all the photos for now. As I sit here in the internet cafe looking out the portside window, I'm laughing as I watch my nursing supervisor, Judith, learn how to change the tire on one of our Land Rovers. They require that anyone who drives a car here must know how to change a tire so she is learning. I wish I had my camera! That will be me soon if I have to drive here.

Peace,

Michele

Story of Benedict

2007-08-13T05:53:00.000-07:00

I'm reprinting a story of one our young patients that was posted on our intranet. We have a PR department and the story and photos are by staff members in that department.

16 July, 2007 — Liberia Field Service
Story: Mike Osborne
Photos: Debra Bell
© 2007 Mercy Ships Int’l.

16 July – Benedict Menkoah is one tough little boy. But if you think Benedict is tough, wait till you meet his big sister! Determination runs in the family.

Benedict suffered a birth defect that doctors refer to as bi-lateral club feet. In the womb, the boy’s feet turned so far inward the toes were left facing each other. His feet also rolled forward, leaving the soles facing upward.

Now nine, Benedict has learned to walk on the curled-under tops of his feet. It’s hard to watch him shuffle along. It looks so painful. But it’s clear from the calluses on his feet – rock hard knots of scarred and discolored flesh where the heel should land – that the handicap hasn’t managed to slow Benedict down too much.

His sister Beatrice, 26, says Benedict refuses to surrender to his handicap. She notes his love of soccer by way of example. He continues to play the game even though he rarely gets anywhere near the ball; he runs and falls, gets up again, runs and falls, gets up again.

When he’s not playing soccer, he’s climbing trees. Perhaps it’s more peaceful up there…high above all the people who laugh and call him hook-foot.

Benedict gets angry when people say things like that. Sometimes he even gets in fights over it. Beatrice gets a little angry too. When asked to describe what Benedict has endured, her eyes flash fire; she’s suddenly talking much louder and very fast. She’s especially hurt by the way her family has treated Benedict.

Their father has two wives and a total of sixteen children. Benedict is the youngest. When the extent of his birth defect became clear, Benedict’s father lost all interest in him and much of the family followed suit.

Beatrice eventually became so concerned about this neglect, that she brought Benedict to stay with her. They now live about a 90-minute drive from Liberia’s capital city, Monrovia, in a small community with the unlikely name of Taste-No-Smell.

In a country where eight people in ten are out of work, Beatrice managed to find a job. She teaches at a school operated by the YMCA of Liberia. She continues trying to better herself, taking computer classes in the evening.

Still, her meager salary would never have stretched far enough to provide corrective surgery for Benedict’s feet, so they were both excited when the Mercy Ship arrived in Liberia. The pair attended an orthopedic screening and Benedict was accepted to receive a free operation on the floating hospital.

As the surgery date rolled around, Beatrice realized she didn’t even have enough money for bus fare into the capital. She asked her eldest brother for the fare but he refused. He told her to forget about the surgery and leave Benedict as he was.

But Beatrice was determined and defied her elder brother, vowing she would get Benedict to the Mercy Ships for surgery even if she had to carry him there. Her defiance may eventually prove costly. The eldest brother becomes family patriarch when their father dies.

Beatrice finally talked an older sister into providing bus fare, and Benedict was one of the first patients to receive orthopedic surgery onboard the Africa Mercy. An operation to correct his left foot was completed without complication and Benedict spent a few days on the recovery ward.

Beatrice said of the free surgery Benedict received, “I couldn’t do it myself. I didn’t have the means. It was too big. So I say thank you. God bless you.”

Benedict is going to need every ounce of his determination to get through the next year. He’s working with Mercy Ships physical therapists now to learn how to walk on his newly corrected left foot; a slow and painful process.

Early next year he’ll have to travel to the neighboring nation of Sierra Leone, the ship’s next port of call. There he’ll have the right foot straightened and the process of learning to walk will begin all over again.

But there’s little doubt Benedict will succeed. After all, he’s just as tough as his big sister. Determination runs in the family.

Our Patients

2007-08-10T14:12:00.000-07:00

We have some amazing patients here on the ward and when you hear their stories, you think that they just can't be true. Stories I couldn't dream up if I tried. Women who were in obstructed labor for days on end, alone, out in the bush (that means basically in the forest or the woods) while surrounded by rebels as young as 9 years old who are trying to kill them. That is the same story for many, many of the ladies I've cared for. It sounds like the plot of a horrific movie.

Our ships surgeons have done amazing work and our latest VVF surgeon, Dr. Brian, is no exception. He took on some fistula repairs over the last two weeks that he didn't know if he could fix. Some he could and some he couldn't. Many fistulas are easy for our surgeons to fix and many are beyond repair. I've been caring for one lady named Fatamata who is 30 years old. She was in obstructed labor for 8 days. With any lengthy, obstructed labor, the baby dies after the first two or so days but even after the baby dies, it can still take many more days to give birth. Fatamata came to the ship last time it was in Liberia and the doctors told her they couldn't fix her. She tried to kill herself right there on the dock in front of the ship. She came back again this year and Dr. Brian said he would try but he wasn't able to fix all the damage. She will live the remainder of her life leaking urine and living with all that means (skin breakdown, smelling horrible, an outcast). Please pray for her as we all have been doing. She has received much counseling from our chaplains and counselors but we just have to put her in God's hands and know he loves her more than we ever could.

In contrast to Fatamata, I've been caring for a spunky, older woman named Mary. Once I told her that was my mom's name, she has called me 'her daughter.' She was fixed by Dr. Brian and we had her dress ceremony today. For an hour, we sang worship songs to God, she gave her testimony, she hugged all of us and thanked us and I got to present her with her new Bible, a bar of soap and a mirror all representing new life. Every dress ceremony is unbelievably emotional.

During the ceremony, I sat on one of the beds and I just kept looking between Fatamata (who was watching the ceremony) and Mary - just back and forth. And I just couldn't grasp the 'why' of this whole situation. I was so happy for Mary and then would just feel so sad for Fatamata. This happens in every dress ceremony - we celebrate for those who are physically healed but there are always one or two who can't be healed at the same time. Just so you know, all women are invited to participate in the dress ceremony, not just the ones who are physically healed. I don't know if Fatamata will.

Anyways, I don't have any answers and I'm not going into all the theological reasons on why God allows bad things to happen. I know all those answers but on days like this, it isn't enough. So I just continue to pray and know that I will never be the same.

The Orphanage and Pizza!

2007-08-06T09:09:00.000-07:00

Saturday I was able to venture off the ship again. Saturday morning, a group of 11 crew went to God's Childrens Home which is an orphanage run by a lady named Mama Vera. The orphanage has about 50 awesome kids! I don't have any pictures so I can only describe it. It is a Mercy Ships policy that we cannot take photos at any of the ministry places because we don't want them to feel like they are a tourist attraction.

I guess when I pictured an orphanage, I thought of ones I had read about in China where there are too many kids with too few caregivers and babies in cribs that never receive any attention or love. This place is the opposite of what I expected. While the facility certainly isn't a five-star hotel, it is clean and meets the needs of the kids.

Each bedroom has 15 bunks (three high) with mosquito nets over each bunk and windows to the outside. Then there is one large room where we played with the kids. There is also a place to eat, a school and a playing field but I didn't see that part. We sang, told Bible stories, played games and just hung out. One of our crew members is a clown and he made balloon animals which was a huge hit.

As soon as we walked in, we were each swarmed with tons of children hanging on to us. These kids are well-loved, well-fed and had smiles on their faces. I plan on going back every other Saturday (I have to work the other Saturdays) to really build some relationships with the kids.

After the orphanage, I went with a group to a restaurant called Mona Lisa to celebrate a birthday and my roommate Michelle's going away. It was a really nice restaurant - like something we would eat at in the States. This restaurant serves ice cream, pastries and real food! I actually got to eat pizza and it tasted exactly how I would expect pizza to taste. One of the problems with the food here on the ship is that you expect something to taste a certain way (like spaghetti) but when you bite into it, it has a completely different taste. I'm mostly living on peanut butter.

The taxi rides to and from the restaurant were very eventful (and tiring). They jam as many people as they can possibly get into one taxi and it is sooooo hot. Plus they have the radio blaring. And for some reason, taxi drivers won't pick up white people so we always have to have someone who is just hanging out on the street to get us a taxi and then we have to pay that person. Plus it takes two different taxis to get there.

On the way to the restaurant, my poor roommate Michelle got smashed into the middle of the front seat and the Liberian to her right tried to get her to go out with him the entire time. He just wouldn't take no for an answer. Then he was going to hang out in front of the restaurant to wait for her to finish her meal. I'm not sure what she said to get rid of him but he finally left.

As much as I enjoyed the pizza, the taxi rides almost make it not worth the effort. It will probably be awhile before I head out on an outing that requires a taxi.

My roommate Michelle (from Chicago) left Monday after being here for six months. She was ready to go home. We got another roommate named Joy from Ireland the same day Michelle left. It is now Thursday and I still haven't met her. It just shows how different our schedules are since nurses work shifts that cover 24 hours in a day. My room now has representatives of all of Great Britain (Scotland, Wales, England and Ireland) plus two of us Americans.

I have a few more photos of areas on the ship:

Here's the dining room. Meals are only between certain hours and you don't have much choice on what you eat. It's the same food every day and for every meal except the main dish varies each day. Breakfast is always only cereal or bread. I only make it to breakfast on weekends because they don't serve lunch on the weekends. We have to make our lunch at breakfast time. For me, that means peanut butter sandwiches.

Here's a view of my cabin from the front door. There are three cubbie holes, each with two bunks, a wardrobe, a fold-up desk and a four-shelf bookcase on the wall. The first two cubbies are maybe about 6' x 7'. I live in the penthouse (as my roommate calls it) in the back. It is maybe about 9'x9' and its desk doesn't fold-up because there is actually enough room to have it stay open. In the other two cubbies, if you unfold the desk, then there is zero walking space. You can also see our clothesline on the right where we hang wet clothes. There is also a small bathroom as you walk in the front door.

Here is the internet cafe. There are 21 computers here. We also have wireless abilities in our cabins and in the lounge areas.

Here's another view of the internet cafe. There is a lounge area next to it as well as on the other side (where I'm standing as I took the photo). There is also a lounge area directly below on deck 5.

Here's my roommate Megan at Starbucks cafe. It is the only official Starbucks in West Africa. Each ingredient in a drink is $.25 so my usual latte costs $.75. To the left of Starbucks is the Ship Shoppe. It's not very big but has toiletries, food and gifts.

We like to joke about how we are suffering for Jesus. In all seriousness, there are so many people in the world who are suffering because of their love for Jesus. However, while we might be doing mission work for God, you don't need to feel sorry for us - the extent of our suffering is our two-minute shower limitation and the lamb that they serve 2-3 days a week.

Oh, I gotta go - the fire alarm just went off (it's a drill) so we have to muster on the dock (and it's pouring down rain:(

Peace,

Michele

Random pictures

2007-08-03T02:41:00.000-07:00

Thanks everyone for your emails and prayers for the crew. It has been a difficult week here on the ship. So, in light of that, I'm posting just some random, fun photos of friends I've met on the ship.
Megan (r) and Michelle - two of my 5 roommates. Megan is from Bucks County, PA (apparently the best place on the planet:) and Michelle is from the Chicago area. Megan is here for one year and Michelle leaves on Monday. Both are nurses.

This is Dorothy, another roommate and nurse. She is from Canada but originally from England. A cake to celebrate her birthday - notice the fake candles since we can't have any kind of fire on board. I have two other roommates (no photos yet) - Jo (nurse) is from Wales and Sarah (doctor) is from Australia (but originally from England).

Some of the nurses I work with: Helene from Germany, Sandra from New Zealand, Melanie, Crystal and Laura, all from the U.S.

This is Captain Jurryan (r) who is in charge of the ship and crew. He doesn't usually dress this formally except for special events and meeting dignitaries which happens quite frequently. The former president of Liberia was here on the ship two days ago for a tour. I never saw him but I wondered why there were so many UN peacekeepers on the dock with their guns.

Here is Megan with one of our VVF patients, Quata. Quata has been here for over one month as she has some open wounds that have not healed very quickly. Unfortunately, her surgery did not work and she has to return in October for another attempt. She's pretty quiet but had quite the laugh at me last evening while I was attempting to feed the 6 month old baby of one our patients. It didn't go so well.

This photo was taken by our Mercy Ships photographer. The middle girl is Mary who is 17 and spent about 3 weeks on the ward. She had extensive damage that we couldn't repair. She will also return in October and hopefully we can fix her. She lost her baby during childbirth and then ended up with so much damage that she constantly leaks urine and feces. I can't imagine facing that kind of life at only 17.

Here is Dr. Steve and six of the ladies he repaired. They are in the new dresses they received at the Dress Ceremony which symbolizes new life.

Patients waiting in line for eye screenings. We do about 20 or so eye surgeries per day.

Another screening in front of the ship.

That's all for now. I'm going to an orphanage tomorrow to play with the kids so I'll have photos of that this weekend.

Michele

It's been a horrible day

2007-07-29T15:32:00.000-07:00

Today has been horrible. One of our crew members drowned today while at the beach with a group of friends. He was 21 years old and from Texas. Please pray for his four friends that witnessed the drowning and his parents and two sisters in Texas. Also pray for all the crew here as he was well-loved and there is so much sadness. It's going to be a really tough week.

Thank you Father that You are in control even when we can't possibly comprehend the 'why' of this. Wrap Your loving arms around his family and friends and draw them close. Thank you that we know that Collin is now in your awesome presence.

Make sure you hug your kids today and tell them you love them.

The Night Shift

2007-07-27T18:13:00.000-07:00

I'm working my first night shift tonight and you can tell how busy I am since I'm writing an update here. When I worked nights back home, we rarely had time to sit down so this is very different. We can even sleep for an hour or so if we need to - we'd get fired for that in the States. I guess things are different when they aren't paying you.

I have orthopedic patients and children tonight, neither of whom I am comfortable with. My twelve year old patient David had a club foot repaired. Club feet are relatively common in the U.S. but we fix them when they are babies. Here, they can only get it fixed if they happen to get to a Mercy Ship. Mercy Ships generally focuses on kids with club feet rather than adults - mainly to give kids a better chance at life and adult repairs are more difficult and require ongoing care. Here are two little ones with club feet that will have repairs done sometime in the next two weeks.

Another of our younger patients is 11 year old Jarwee. He actually came to the ship for his surgery alone - really...he traveled from his village to the ship alone. He arrived a day early as most of them do and he was very shy and scared. A family member came for a short time during his surgery but then left so Jarwee woke up from surgery alone, in pain with a bunch of strangers around. It's just so hard to believe. It makes me think of my 11 year old friend Parker traveling for hours alone to a big city, showing up at a hospital and then going through the admission process, surgery and recovery alone. He's 11. I can't imagine. Jarwee has really opened up to the nurses and is a very playful, ornery kid. He asked his nurse tonight to pray with him at bedtime.

Here's a couple of our younger patients recovering from their club foot repair surgeries. Most of them don't have blocks or puzzles or toys that we are used to so they love our toys.

One of my older patients is 70 year old Mary. She had a repair of a non-union femur bone. Do you know what that means? It means her thigh bone broke in half completely and she has been walking around with that broken leg for 10 years. Yes, she walked here with it. I feel a little bad for her - she's in a ward with 7 little kids.

On another note, we had a Celebration of Sight last Friday for all eye patients. We want eye patients to return to the ship for a follow up exam but most of them won't do it because of the difficulties to get here (cost plus transportation). The eye team decided to have a big celebration to entice people back to the ship and it worked. 185 eye patients returned for the celebration. These 185 people were blind from cataracts and all received their sight back. It was a day of African music, food and eye exams. Here are some pictures from the celebration.

These ladies are all waiting to board the ship. Notice all the sunglasses!

More people waiting to board the ship. We wouldn't be so patient back home if we had to wait in a line like this.

Here's some celebrating.

I better get back to work!
Peace,
Michele

The pediatric hospital

2007-07-25T16:16:00.000-07:00

A few days ago, a group of about 20 Mercy Shippers went to the pediatric hospital here in Monvrovia, called Island Pediatric. It is the only pediatric hospital in the country and it is run by Doctors Without Borders. We went to entertain the kids and their mothers for a few hours.

It was both a fun, heartwarming experience as well as a sad and overwhelming experience at the same time. Doctors Without Borders is a wonderful mission organization that brings medical care to the least advantaged people in the world. Unfortunately, they have to work within the limitation of money and resources and the hospital reflects the fact that they are working in one of the poorest countries in the entire world.

Unless you've been to a country like this, it is very difficult to comprehend the magnitude of the poverty. When we think of poverty in the U.S., we often think of areas like the Appalachian regions of Kentucky, W. Virginia, etc. The people in those regions would be considered wealthy by Liberian standards.

We pulled up to the front of the hospital and had to be let in through a gate. There were only two cars in the parking lot which were probably hospital staff cars. Here are two pictures of the entrance.

The hospital is made up of several buildings and the staff have painted the walls to try and give it an upbeat, childlike atmosphere. I have no pictures of inside the hospital as we weren't allowed to take them but, let me tell you, the paint doesn't help. For some reason the place made me think of old prison cellblocks you see in the movies.

The main building was one long corridor and as you walked down the hall, you could look in the rooms (the rooms have no doors). What you generally saw in each small room were 3 - 4 beds with no linens or pillows and mosquito nets hanging over them, a small window that was open to the outside and 2-3 small children lying in each bed with their mothers sitting in the room on the beds. This hospital has 120 beds but usually has 240 kids in there at any given time.

There is no such thing as a private room or television or water pitchers or flowers sent by family/friends or couches or recliners or clean linens daily or a bathroom in the room with running water for drinking. The kids aren't in clean hospital gowns surrounded by toys - they are in whatever clothing their moms brought surrounded by nothing. In the building with the sickest kids, the kids just laid there unresponsive in their beds.

When we arrived, we went out into the courtyard and many of the kids and their moms came out to join us. We each had a project or craft ready - I was in charge of the coloring books and colored pencils. Since I'm not very crafty, I felt like that was all I could handle! Actually, they weren't even coloring books. They were pictures that one of our artist type crew members had drawn that the kids could then color. We also had face painting, bracelet making, stamps, stickers, balloons and kickball.

The kids were so great, smiling and just having fun. I had one child latch on to me right away and he wouldn't let me go anywhere without him. His name is Seku and he is 6 years old. Seku is developmentally delayed and couldn't talk and had some physical disabilities but he smiled the entire time! We sat next to each other and I found out that he could say his ABCs so we did that a lot. But he couldn't say any other kinds of words, not even his name. But then a group of moms started singing a praise song (not started by us as this is a secular-run hospital and we weren't supposed to do anything but entertain the kids) and Seku jumped up and started singing the song - well, kind of. He was singing some words to the tune they were singing but the only word I understood was Jesus. It was the only word I heard him say the whole time.

I met so many kids - Salome, Jibah, David, Blessing...and we had a great time. I got to hold a baby for about 15 minutes while his mom did some of the crafts. They wouldn't let me bring him home, though. When it was time to go, Seku ran up to me and I picked him up - then I swung him around in circles and he laughed hysterically. They had to pull him off me so I could go.

Sadly, while we were all congregated outside in front of the emergency room getting ready to leave, we all knew the doctors and nurses were inside the ER performing CPR on a very tiny baby that was in cardiac arrest while the mom was looking on. We never found out the outcome of that little baby - all I can do is put my faith in the God who created him or her.

This might be a good time to thank God for the healthcare we have in the U.S. despite its flaws. I will never complain again about having to wait in a doctor's office.

Peace, Michele

Out on the town

2007-07-22T09:02:00.000-07:00

I finally made it off the ship this week. First, I walked with two friends (Gea from Holland and Helene from Germany) to the supermarket. It was quite an experience during the 45 minute walk to the store. It's very hot and muggy and there are tons of people in the streets as well as lots of taxis driving like crazy people. And for some reason, the Liberian men like to yell at us and make disgusting sucking sounds with their teeth. Fortunately, there was a Mercy Ship car at the supermarket with a dental team so I hitched a ride back with them. Here's a picture of the supermarket. It was pretty decent - kind of like a smalltown grocery store - it has everything you need but just not the brands you like.

My second outing was to a pediatric hospital. Riding in a car here can be a scary experience! The roads are horrible - full of potholes and it doesn't appear that they have any road rules (although I'm told there are actually traffic rules). Here are some pictures of the streets of Monrovia as we were driving to the pediatric hospital.

You can see in these pictures that there are people everywhere. The unemployment rate in Liberia is about 85% which may be why so many people are out in the streets and not working (I'm speculating:).

It takes a long time to get anywhere because the potholes in the roads are so big and they are everywhere. You have to weave in and out of them and try to avoid oncoming traffic. You can see how bad they are in this photo.
The markets are outdoor markets and they go on for what seems like miles, stand after stand selling almost anything you would ever need. This lady is selling fish and what looked like chicken. I can't imagine buying meat like this on the street. I wonder how old it is and how long it's been sitting out in the 90 degree heat?

Here's a couple more random photos taken from the car.

That's all for now. I'll post about my trip to the pediatric hospital maybe tomorrow. The internet is painfully slow tonight and I'm out of patience for uploading photos!!

Peace,
Michele

Ship Life

2007-07-16T06:21:00.000-07:00

Now that I've been here for two and 1/2 weeks, I feel like I've settled in and life has become more routine in a good way. I don't have to constantly find out how to do something (like receive mail), where to find something (like the laundry room) or who to ask if I need to know something. I have most of the answers I need in order to live here.

It's a pretty simple life, living on a ship in the port of a country where you can't just hop in a car and go somewhere. I don't have any of that busy-ness we live with in the U.S. I don't have a car to drive or maintain, or fill with gas, there's no grocery shopping or cooking (not that I did that anyways:). There's no commute to work - mine is to walk about ten doors down the hallway. There's no tv watching or going out to restaurants or movies. There's no house cleaning or lawn work. There's no doctor or dentist appts or running errands like running to Target or Home Depot.

What there is a lot of is relaxed, free time. I have a hard time figuring out what day it is (is that what retirement is like?). Unless I'm working a day shift, I sleep in without setting an alarm clock. I have read more books since I've gotten here than I did all last year (if you haven't read Three by Ted Dekker, I would highly recommend it). I spend a lot of time hanging out with people, talking or playing games. I attend 5-6 different worship services a week. I check email or read the news on-line. I walk up and down the dock for exercise when it's not raining or go to an aerobics class. I'm reading through the Bible and at the rate I'm going, I will be done in about four months. I pray a lot with people and alone. I'm in two small groups - one is social and the other is a Bible study with one of the chaplains.

When I'm working, I don't have to work that hard (as a nurse). I take care of our patients' physical and medical needs but once that is done, I get to hang out with them. The ladies are here for two weeks so we really get to know them. As nurses, we hang out with them on their beds and talk to them. We paint their nails, read to them, pray with them, even color with them (they love to color). We sometimes dance with them - they sing a lot. The singing is a funny thing - most of them can't really sing but they don't care. I can't sing so I would never sing out loud alone like they do. I guess no one ever told them they shouldn't sing if they can't carry a tune:)

Here are some pictures of a few ladies I've come to know. We aren't allowed to take photos on the ward unless the patient asks and my friend Korto asked if I'd take a picture. The first photo is a picture of Korto and me. She doesn't speak English and I don't speak Kpelle so we just talk to each other without ever really understanding.

This photo is Korto and Quita. Quita speaks Korto's language plus a little English. So this is how I talk to Korto: Korto says something to Quita in Kpelle, then Quita repeats it in Liberian English to a translator who then repeats it to me in English. It's very funny that the translators have to translate their English to us and our English to them. Liberians speak English as their official language but they don't say the final part of words so I usually can't understand them.

This is a photo of my friend Ans, Korto and four of the translators. Ans is a nurse from Holland who lives in Sweden. She and her husband have been missionaries for Youth With a Mission for 23 years. Her husband and daughter are currently serving short-term in Uganda while she is in Liberia. She is becoming a good friend but she will only be here a few more weeks.

For some, this life will sound boring and others might think it sounds relaxing (who doesn't want to give up some of the drudgeries of life). I personally have found it to be very relaxing, calming and healing. I have a lot of time for reflection and prayer. While I miss my friends and family, I don't miss much of my old life. I love this life so far and I wouldn't trade this experience for anything.

I'm going to a pediatric hospital this Saturday to play with the kids in the hospital. Hopefully we can take pictures or videos and I'll post more about that trip. Peace.

First week in Liberia

2007-07-08T07:03:00.000-07:00

I've been here on the ship for 9 days now and it is going way too fast. I have met so many interesting people from all over the world - there are many people here from the U.S., Canada, Australia and most European countries. I've also met people from Nepal, Sri Lanka and The Congo to name a few of the more exotic locations.

Many, many of these people have been on one of the Mercy Ships for years. Volunteers can come for as little as two weeks (usually these are medical types such as surgeons, dentists) but it seems the majority are here for anywhere between 2 months to a year. If you're interested in a slightly longer short-term mission trip, I would highly recommend applying to the ship. All gifts can be used in some manner!

I have worked four shifts now and it has definitely been a learning experience. While the surgical teams have state-of-the-art equipment, it seems the ward has only equipment other facilities didn't want. This means nursing is done manually without the aid of computers, pumps or machines (except for patients in the ICU) and none of our supplies are consistently the same. You basically scrounge around for something that will work and make it work. This is good in that I've been forced to learn new skills and it also gives me much more time with patients (rather than charting on the computer).

As I said in my earlier post, the majority of surgeries right now are VVF surgeries. This is just a horrible disability that is just never seen in developed countries. Women have obstructed labors for days and days (in which the baby dies) and internally tissue dies and fistulas (or holes) are created. This causes them to leak urine (or feces - sorry for the graphic descriptions but it's true) 24 hours a day. Many have had this condition for years. Can you even imagine living like this? They can't work, their husbands leave them and they can't be around others because they smell horrible. They resort to begging or many live hidden away for their entire lives. It almost seems as if it couldn't be true but I have heard their stories first-hand.

After their repair surgeries, when they are ready to go home, there is a Dress Ceremony on the ward. The ladies receive a new dress (to represent new life) and they have a chance to share their story. Here is a picture of three ladies who have been given a new chance at life. Sadly, some women are so internally damaged that they cannot be repaired. So far I haven't seen that happen and I hope to not ever see it.

It is the rainy season here so it rains pretty much all the time, with a few periods of sunshine. It has made it difficult to get off the ship to go into town but I hope to do that sometime this week. Apparently there are markets, restaurants and beaches that we can go to but I haven't experienced any of those yet. I'm not sure I'll be eating in any restaurant because of my experience in Ghana after eating a hamburger at Popeyes!

Now for a little education on Liberia. Liberia was settled by freeborn Blacks and former slaves from America in the early 1800s and they consider themselves the 51st state. I found this statement very sad considering I don't think the majority of people in the U.S. have ever heard of Liberia or know anything about this country (including myself until I got here). The people of Liberia were emotionally devastated when the U.S. did not come to their aid as they expected during the civil war and there is a sense of sadness now when Liberians talk about America.

In 2002, the country ended a 14 year civil war where some of the most horrific atrocities known to man occurred. We watched a movie last week about the war and I can't even bear to type some of the things that have been done to the people in this country. The former president, Charles Taylor, is now on trial in The Hague for war crimes. Liberia now has the first female elected head of state in Africa. Her name is Ellen Johnson-Sirleaf and she is a Harvard trained economist.

Their life expectancy here is only 41 (males) and 44 (females). That means most of my friends would be dead by now and I'd only have two more years to live! They are ranked fifth from the bottom for child mortality out of all the countries in the world.

There is definitely hope here. Mercy Ships has many, many, many off-ship projects going on to help the people of this country including the creating of mental health programs for the hundreds of thousands of people traumatized during the war. It's a huge undertaking but all things are possible with God - that is why there is hope.

That's all my teaching for now. I'm feeling compelled to talk about what has gone on here, mainly because of my own ignorance about this country. They love America and I didn't even know they existed.

There will be more later! Thanks everyone for your comments and emails. It makes me feel connected so even if you want to send me an email with boring details about your life, I'd love to read them. Even tell me about any great restaurants you've been to - the food here is absolutely horrible and it has definitely taken away any desire I have for food (that's a good thing:).

Peace,
Michele

Pictures

2007-07-04T09:27:00.000-07:00

This is one of the hospital wards I am working in. It is very close quarters and our Western sensibilities would be very offended by the lack of privacy (because of that ole HIPAA law). Our African ladies love it because they all sit around and sing and do each other's hair.

Here's my bed - I'm very grateful that I got the bottom bunk!

The dock -nothing like Navy Pier in Chicago but it lets us get out and walk around. This is one of the places the kids play (there are around 50 kids on the ship, most under the age of 8).

This is Suah who was blind and received sight. She was the first surgery on this new ship. They are celebrating in the ward. Africans love to celebrate by singing and dancing.

First weekend in Africa

2007-07-01T07:42:00.000-07:00

I arrived in Monrovia, Liberia safely and uneventfully after a 24 hour trip that took me through Chicago, Brussels, Senegal and then Liberia. Thank you to all of you who were praying for my safe arrival.

The ship is bigger than I imagined and has quite a few amenities. We have an internet cafe, Starbucks cafe, a small grocery store, a gym, a laundromat and a fully stocked library. In addition, it has a fully functioning hospital with about 84 beds, including ICU beds and 6 operating rooms.

The hospital just opened last week and is not working at max capacity yet. Currently they are doing VVF surgeries and eye surgeries. VVF is a fistula women get after prolonged labor that causes urine to leak out of them constantly. It is a very stigmatizing disability and women are very often shunned and left by their husbands because of it.

God is so alive and at work here on the ship, you know it the minute you get here. People seem to be on a constant God-high, the kind you usually see on mission trips. Everyone is here because of their desire to serve Him and He is openly and frequently the topic of conversation. Obviously not like any work environment I have every been in.

I have met so many people from all over the world. I went to church today with a Ghanaian, Nigerian, South African, German, Canadian and three Americans. We went to a Baptist church with a service that lasted 3 hours (yes, 3 hours - that is not a typo). Two hours was singing and dancing and the other hour was preaching. It is so inspiring to see people worship so freely - it definitely was a joyful noise considering the sound system was not of the quality I am used to:)

I start work Monday with two days of orientation. All non-ICU nursing is done manually without the aid of pumps, computers and nurse's aides so it will definitely be a learning experience.

So far everything has been far better than I had imagined (including my room). God is good.

2007-04-27T19:31:00.000-07:00

I've recently gotten some additional details about my upcoming year in Africa. First the bad news - I will be sharing a room with 5 other people and we'll be sleeping in bunk beds. Yes, bunk beds - just like camp! I expect to meet some really interesting people from all over the world and now I'll be sharing close quarters with some of them.

Now for the good news. I will be spending the first five months living on the ship in the port of Monrovia, Liberia. Then sometime in early December, the ship will be sailing to the Canary Islands for about two months. The Canary Islands are owned by Spain and are located off the coast of NW Africa. During this time, the ship will be in dry dock (meaning it will be undergoing maintenance and stocking of supplies) and I will be living off-ship. I assume I will be working during those two months but I'm also envisioning plenty of beach time!!

After the break in the Canary Islands, we'll sail to Sierra Leone where we'll remain until I leave in July, 2008. Mercy Ships has an existing land office in Sierra Leone that focuses on the rehabilitation of land-mine victims. I haven't had much time to research Sierra Leone yet but I know they have spent many years in civil war until 2002.

After Sierra Leone, I hope to do a little traveling in Africa and then return home sometime towards the end of the summer of 2008.

2007-04-05T19:50:00.000-07:00

My plane ticket is bought and I'm one step closer to Liberia. I leave Des Moines on June 28 and arrive in Monrovia on June 29. That will give me two days to recover before I start working. Here's my flight itinerary:

AA446 Des Moines to Chicago 12:45 pm to 1:59 pm
AA088 Chicago to Brussells, Belgium 4:30 pm to 7:40 am
SN235 Brussells to Dakar, Senegal to Monrovia Liberia 9:40 am to 5:50 pm
(Airline SN is called SN Brussells and it's the only non-African airline that flies into Liberia)

Thank you soooooo much to all of you who are supporting me financially and prayerfully! Less than three months to go.

2007-03-11T21:23:00.000-07:00

Finally! After six long years of preparation, I'm finally ready for my journey to Africa. I'll be leaving for Monrovia, Liberia at the end of June, 2007 to work as a nurse for Mercy Ships for 12 months. I'll be living and working on the Africa Mercy while it remains docked in Monrovia. The Africa Mercy is the largest non-governmental hospital ship in the world and it will be in its maiden voyage starting in Liberia. Following the example of Jesus, Mercy Ships brings hope and healing to the forgotten poor. One way Mercy Ships brings healing is by performing free surgeries aboard the Africa Mercy for those in need.

To learn more about this amazing ministry, checkout www.mercyships.org. Look at the Success Stories and you will be shocked and saddened at the types of hardships people endure in developing countries. I am posting a before and after picture of Edohm, a young girl with an unbelievable tumor. I know the picture is shocking - can you imagine living like this? I am posting this photo because I hope it triggers a spark that will make anyone who sees it want to reach out to a person in need - maybe someone at work, or a neighbor or someone halfway around the world.

May God's peace and mercy be a reality in your life today.