Wednesday, August 22, 2012

more excitement than on christmas eve

     100’s of meetings have taken place over the past few months. A registration process for Mercy Ships’ dentists, nurses, and doctors has been agreed upon. Legal surgical consent age has been discovered. An oxygen supplier has been located incase of failure with the ships’ supply of oxygen to the wards. Pharmacy import licenses have been obtained and Mercy Ships “should” now have no trouble with customs to import the drugs needed for Mercy Ships’ patients. A local pharmacy that appears to be reliable has been found and agreed to sell Mercy Ships medicines if something goes wrong with our import of pharmaceuticals. The pharmacy appears to have a constant supply of Levothyroxine (Thyroid medication) required after removal of goiters, so thyroid surgeries can be performed on the ship this year. Local Tuberculosis and HIV clinics have been located if patients come to Mercy Ships needing treatment (considering we are a surgical ship, not a clinic providing primary health care services, but we are happy to refer patients to available resources in their own neighborhood that they may not be aware of). Local surgeons and doctors have been met with; Mercy Ships has taken their partnership requests and is seeing where we can learn from each other. Ways for collaboration with local hospitals and medical staff have been sought. Surgeon training and anesthetist training experiences are being organized. Permission to use the ship’s incinerator to burn Mercy Ships’ medical waste has been granted.
     We have a place to “park” our ship for 10 months. The ship should be supplied with water on a regular basis. We have contracted with a security team to keep us safe in the port. Over 24 Mercy Ships’ land-rovers should be registered in Guinea so we can freely drive around the city. Customs procedures “should” be ironed out so that our frozen containers of food from Holland and medical supply containers from the USA should be given to us without delay when they arrive. Over 200 local day volunteers have been interviewed for translation skills, tested for TB, and given initial training for volunteering/working alongside Mercy Ships crew over the next 10 months and assigned to various departments on the ship.
     A site off- ship has been located for Mercy Ships’ Dental Clinic. Half of the building that was not in use because of its condition was renovated with the promise that it will be borrowed and returned to the clinic after Mercy Ships’ departure from Guinea. The site now has working electricity and water. Denture makers have been found so that Mercy Ships dental team can contract for making about 500 prosthetic teeth, implants, dentures for some of the patients Mercy Ships will treat needing tooth extractions. Emergency medical evacuation procedures have been discovered in case Mercy Ships’ crew members needs those services. A few sites around the city have been identified and the site directors have agreed to let Mercy Ships’ Eye Team hold mini- selection days throughout their stay in country in their buildings free of charge. Security reports about the sites have been written and turned into Mercy Ships’ Security Team for approval because at times over 1,000 people have shown up to Mercy Ships’ eye screenings, looking for help, so security is paramount. Prosthetic eye makers and glasses grinders have been found. A ward in a local hospital, not far from the port, has been renovated and loaned to Mercy Ships so that they can provide off-ship housing for 40 patients from the interior that come to Conakry seeking treatment from Mercy Ships. Since many of these patients will travel days to reach the ship, the commute isn’t realistic for them when they need to come back and forth from the ship for weekly post-operative checks, so they now have a place to stay, a “Bed & Breakfast” of sorts. After the ship departs, the hospital gets their newly improved medical wing back! Prosthetistis and Orthotists have attempted to be located so that Mercy Ships’ orthopedic patients can obtain braces, splints, and such after club foot surgeries and correction of certain bone deformities.
     VVF surgeries have been discussed with Engender Health and USAID (NGO’s that provide funding for helping women with fistulas). A list of over 113 women currently living with fistulas too difficult for local Guinean surgeons to treat has been presented to Mercy Ships and Mercy Ships is seeking ways to assess as many of these women as possible to operate on them. The concept of Palliative care has been presented to multiple doctors and NGO’s with little response or knowledge of “hospice” or “home-healthcare” being found; identifying a knowledge gap and teaching opportunities for Mercy Ships’ Palliative Care Team. A morgue has been identified and “rough” price estimates have almost been obtained if the unfortunate situation arises in which Mercy Ships needs local morgue services.
     The 1,200 volunteer crew members, from over 36 different countries around the world, who make their way to Guinea in the 10 months the Africa Mercy is parked here, have been granted free visas and “should” be able to enter the country with their luggage and without being hassled for bribes at the airport. The local police “should” be starting to understand that those driving Mercy Ships’ land rovers around town do not pay bribes, will not put up with corruption, and stand for integrity, if they are guilty of a real traffic violation they pay, but if they are being hassled and detained for money, they will not pay (multiple personal experiences have lent to achieving this goal). Government officials, customs officers, and port workers “should” be starting to understand that Mercy Ships does business differently, striving to be people of integrity, no matter what, no matter how many times, they have to visit the same office, or put in the same request for an item, they will not pay into the cycle of corruption that brings one to the front of the line.
     A farm has been identified where Mercy Ships’ “Food for Life” project can work; a project aimed at increasing food security for Guinea and teaches local farmers organic agriculture skills in nutrition and crop production. Missionaries living in the interior have been met, what Mercy Ships can and cannot do has been explained so that hopefully Mercy Ships will be connected with patients they can help and others know who to refer to Mercy Ships. Peace Corp volunteers have been briefed about Mercy Ships and emails from them are flying in with potential patient information. Orphanages, prisons, schools, and NGOs have been found to see if Mercy Ships crew can volunteer their time with them and help in any manner while the ship is in town for 10 months. Press releases have been written, and a huge convention center has been granted to Mercy Ships to use for free for their main screening day that is just around the corner! Much more has been done, but at this point it is minor because the culmination of the last 3.5 months of work will come together tomorrow as the Africa Mercy sails into Conakry, Guinea! The excitement in my heart is more than that on Christmas Eve! The past 3.5 months have not been easy, challenges have been faced, tears have been shed, I have learned much about my character and undergone some “character formation school” (something prone to happen when living with such a multi-cultural team full of “leader” personalities in such a small space), and I have made it to this point…
     Father God, it was in your strength alone that what has been done has been done! As my ship, my home, sails in, may there be a tangible sense falling on this country, that something great is about to happen and may your kingdom and grace pour down on Guinea as hope and healing are unleashed!

Tuesday, August 21, 2012

it is raining goats & chickens

     In America when it is raining very hard, we sometimes say, “it is raining cats & dogs.” But what does one say when they live in Africa and it has been raining for almost 2.5 months straight??? “It is raining goats & chickens”??? Oh, who really cares anyway…but now that we are on the topic of rain…It has been raining here in Guinea almost every day for the past 2.5 months! It has been a new adventure experiencing rainy season this way…normally I am on the ship…floating in the water…and the rain doesn’t really influence my commute to work…or my life….but oh, the adventures rain can bring…
*****Laundry is almost impossible to get dry. My team and I hang our clothing outside at any glimmer of blue sky. Almost as soon as the laundry is hung, torrential rains coming pouring down. We rush to move our laundry in-doors and drape it over every stool, chair, and raised surface in the house; we have even resorted to laying it on the cool tile floor. We point the few fans we have at the clothing and hope for the best. Then the power goes out, forget the fan idea, we are left with wet clothing hanging in the humid air. As the day goes on, the less than sweet aroma of “wet dog” begins to fill the air! Oh- bless! My once excited feeling over freshly washed clothing has disappeared. I sniff each article of clothing before I put it on and decided if perfume will cover-up the smell or not…what fun! It is all about perspective….Once upon a time, a shirt was deemed only fit for the laundry pile if it smelt of body odor or was visibly soiled, not any more… Now that same BO engulfed shirt smells like heaven compared to the lingering smell of “wet dog!” The only question that remains is to wash the clothing or not was the clothing…lately I have been going with the latter.
*****With rain being our constant companion, my team and I have come to only one conclusion…no point complaining about it….play in it! I mostly definitely was caught the other night outside my house here around 10:00pm dressed in swimming shorts, an old t-shirt, and rain boots, jumping in the puddles in the street while getting a refreshing shower from the heavens. My buddy and I stood waiting by the biggest puddles in the street waiting for cars to come by and splash the daylights out of us! We were sorely disappointed that only one car took us up on the offer to splash us! We were hoping people wouldn’t see us near the puddles and would keep driving at full speed and spray us with a wall of water, but we figured out we don’t blend in to the dark very well considering “we glow in the dark” as one of my African friends told me, when talking about my flaxen skin tone. We did get drenched & had a wild good time in the process! Maybe not the brightest idea in the book…but too late now…Dear Jesus, please forgive my moment lapse of judgment as I was just looking for some clean good fun…and I forgot the puddles I was jumping and splashing around in might have been sewage laden…
*****A day at the swimming pool is always fun! And why should one avoid the pool if it is raining, you get wet in the pool anyway, so what’s a little more water? If there isn’t lightening, why not have a really good, wet time? The other day we put that exact philosophy to practice. I took the role of camera woman as my two of my team members jumped into the pool in the pouring rain, in their swim suits, and rain boots just to for a fashion statement. Rain boots are supposed to get wet…so why not jump in a swimming pool with them? We laughed and laughed as they attempted to do handstands in the pool with boots on their feet, as soon as they got their feet up in the air, water would coming pouring out of the boot and knock them over.
*****And finally, back to those puddles again…some of the puddles in the street have been knee deep. The local cars and taxis struggle to traverse around the city when the rain persists. I on the other hand….am blessed to drive a brand-new land-rover that was donated to Mercy Ships and shipped here for my team’s use. I had some fun driving like wild through some awesome, deep puddles in town the other day. One of the puddles was so fantastic; my friend got out, sacrificed herself to the rains, and took photos of me driving through the muddy ocean…
*****Oh-what fun and adventures rainy season in Africa can bring... “I bless the rains down in Africa…I bless the rains down in Africa…Africa, “it’s gonna take a lot to drag me away from you…there’s nothing that a hundred men or more could ever do…I bless the rains down in Africa… I bless the rains down in Africa…”

Monday, August 20, 2012

"it's me...it's me...it's me...oh, Lord- standing in the need of prayer"

     I approached the secured compound surrounded by huge concrete walls lined with razor wire. After passing security checks I was allowed to drive into the compound. I got out of my car and prayed for safety as I approached the second check-point leading into the entrance of the prison. It was there that I was met by a lawyer, whose number had been given to me by the German Ambassador’s wife, this lawyer had been volunteering in the prison for over 15 years, and he had agreed to introduce me to the prison captain, take me on a tour of the prison, and help me suggest to the prison that a hospital ship is coming to town and the volunteers on that ship are interested in visiting the prisoners.
     After brief introductions to the prison guards and captain, I followed the lawyer to where he and local Catholic priests hold weekly mass for some of the men in prison. I was ushered into a structure in the center of the prison where multiple benches, filled with men, were sitting under a metal roof, canopy of sorts. There had to be at least 120 men seated for the service. I was led to the front of the room and given a real wooden chair to sit in, “a chair of honor” as is very common in Africa whenever a foreigner or white person attends a service or meeting. Everyone else in the room had benches to sit on; my colleague and I were the only ones with a “real” chair. I sat down and tried not to be a distraction because the service had already started, but it was almost impossible not to be a distraction when I was one of the only females in the room and my skin is so white it can blind someone.
     I sat and quietly listened to echoes of deep baritone voices singing beautiful worship songs in tribal languages. After the signing finished, scriptures were read and the priest preached a sermon on Moses and the slavery and captivity of the Israelites. The prisoners listened attentively and there was a divine sense of peacefulness under that metal structure. I was impressed with the advancement of my French language skills as I could basically tell what was being said without translation. The priest talked for awhile and my mind drifted in and out of the room something I find still happens easily when I don’t actively and intently try to focus on the French being spoken.
     I looked around the room and wondered what had brought the men to the prison, what they were feeling, what they were thinking, how long had they been there, if they had been to court, and what they were serving sentences for. I felt no fear, I only felt for them. Some of the men had probably committed heinous crimes… My heart, mind, and feelings were divided as I felt some of the men probably deserved to “rot” in prison because justice and I are close friends….but there is grace and I am in need of it no less than others… but at the same time my God is just too and stands for justice… But, I couldn’t help but hurt for the prisoners. 1200 men, women, and minors, living in a space built for 400 and the reality in Africa and not Africa alone is many people are often imprisoned and they have committed not offense nor been given the chance to defend themselves or have legal representation to plead their case. They are jailed and forgotten.
     The next portion of the service included communion and more singing. I stood with the incarcerated and prayed for justice…for peace…and for God to make sense of all I was seeing and experiencing. I was pulled out of my prayers and ushered back into reality when I recognized some familiar words being sung….at first I thought the words were being sung in French and I was just understanding every word that was being said, but no, the prisoners were actually singing in English. I heard the group united in chorus singing, “It’s me… it’s me…it’s me…oh, Lord…standing in the need of prayer…it’s me… it’s me…it’s me… oh, Lord, standing in the need of prayer…”I sang my heart out with the prisoners.
     The closing statements of the service were being said and I was asked if I wanted to address the prisoners. With a frightened look on my face, I told my translator, “no, no way,” I didn’t want to speak…What could I possibly say to so many who lived in cramped quarters, who only receive one small portion of cooked rice and a tiny breakfast, which is a recent improvement, the small bit of rice used to be the only meal? What could I say to those who were of the 144 minors living in a room maybe 25 meters x 25 meters sharing maybe 15 beds and two toilets? My heart was heavy, what could I say? I decided in that moment my presence would have to speak for me…my mere human words could not be formed into anything that would have mattered at that moment. I felt ashamed that I had nothing to say…but I couldn’t change that, I was speechless…
     After the service, my translator was approached by a few people; they reached for his hand, longing for interaction with someone “from the outside.” He couldn’t believe it when he turned in response to tap after tap on his shoulders and was greeted by at least 5 people he knew, but hadn’t seen for a long time. He hadn’t known they were in prison. My translator scribbled down phone numbers that they gave him and I believe he was taking pleas to not be forgotten and to greet family members. I looked all those in the eyes that approached my translator and I shook hands with them saying in my poor French accent, “courage, courage…” What can one say???
     I toured cramped room after cramped room, only the minors and the women in the prison shared beds, the rest of the approximated 900 imprisoned men slept on the floor; some on thin mattresses, some only on sheets, living with maybe 75 people crammed in a 10 meter x 15 meter sized room. Some of the doors were locked on such cells and I saw only hands reaching out the bars that were at the very top of the door, reaching for something, grasping for anything….hope deterred…
     The guards in the different wings of the ward all stared at me. I greeted them and smiled… They just stared…The lawyer I was with introduced me to a few detainees and I could tell he was discussing legal matters with them and updating them briefly on the status of their situation. I shook hands with a gentleman, a prisoner, dressed in a leisure suit.
     After we left his presence and moved to a different part of the prison, my translator looked at me with the look of a “deer caught in headlights” and said, “that man… the one you just shook hands with…I recognize him from the news… he led the attempted assassination on our president not long ago…”
    When I reached yet another part of the prison compound I saw another white women chatting with a detainee. A badge on her shirt read “Geneva Convention.” The Geneva Convention and its articles is the cornerstone of international humanitarian law, protecting those in war zones or caught in the nature of war even if it has not officially been declared. Ensuring…

“Persons taking no active part in hostilities, including military persons who have ceased to be active as a result of sickness, injury, or detention, should be treated humanely and that the following acts are prohibited:
* violence to life and person, in particular murder of all kinds, mutilation, cruel treatment and torture;
* taking of hostages;
* outrages upon personal dignity, in particular humiliating and degrading treatment; and
* the passing of sentences and the carrying out of executions without previous judgment pronounced by a regularly constituted court, affording all the judicial guarantees which are recognized as indispensable by civilized peoples.”

Although Guinea has never declared official war, this country has been laden with military coups after coups, rebellion, unrest, and is also a home to many refugees from its neighboring countries of Sierra Leone and Liberia. I recognized Liberian English and Krio, the languages of Liberia and Sierra Leone being spoken amongst some of the prisoners. No doubt they felt in limbo being imprisoned a country that is not their own. I prayed…for what exactly….I don’t even know…but I prayed…
     I finished the tour of the entire prison. I thanked the prison captain for letting me visit and told him Mercy Ships would be in contact with him after showing him pictures of what Mercy Ships does, he pleaded with me that the prisoners not be forgotten by the Ship. I received an open invitation for Mercy Ships to hold any program they desired for the prisoners.  I walked past the first guards I had meet and stepped back into the “free” world. I looked behind me to ensure my translator had come with me and noticed he continued to have the look of a “deer caught in headlights look.” He only said, “It is a different world in there.”
     As we drove out of the prison, my translator said nothing more, but I am almost positive I saw tears coming down his face. I don’t know what he was thinking or experiencing…it is very likely many of those he had encountered that he knew had committed no offense…We neared the house I am living in and I asked him if he was okay…he just asked me not to say anything and said he was very sorry, but couldn’t work anymore for the day…I assured him our work was done for the day and that he could tell me anything he wanted to or didn’t have to saying anything at all…he quietly left with the “deer in headlights look” still plastered on his face.
     Once back inside my current home, I pulled aside my good friend and teammate and we took time to pray…we sat in silence before God for awhile…we prayed for my translator…. I cried… and we prayed for all the prisoners…we prayed for justice in the world…I cried…and we prayed that if the day ever comes when we are jailed or face the threat of jail versus denying faith that we will have the strength to stand…I cried…and we prayed…I cried….and we prayed…and the echoes of the prisoners song rang through my head…. “It’s me…it’s me… it’s me…oh, Lord….standing in the need of prayer….it’s me…it’s me… it’s me…oh, Lord….standing in the need of prayer…”

Sunday, August 19, 2012

blessings in "crappy" situations

     An article on mayoclinic.com/health/cholera suggests the last major outbreak of cholera in the United States occurred in 1911… Cholera, a bacterial disease usually spread by contaminated water often leads to severe, rapid, dehydration related to diarrhea that can cause one to toilet up to (as much as a quart or .95 liters and hour). In my tropical disease course in London, I learned that NO ONE EVER needs to die from cholera, even in the most remote areas of the world, if those who have the disease are given enough fluids and a simple, easy to make rehydration solution; NO ONE EVER needs to die from cholera.
      My instructor talked about a cholera camp she worked at in Ethiopia a few years back. There were thousands of people infected with the bacteria, her team dug a pit for the waste a fair distance from the camp, and worked non-stop to keep the spread of infection down. Just when the staff thought they were getting on top of the outbreak, the heavens unleashed gallons of rain and the sewage pit that had been dug, flooded the camp. The patients were literally lying in crap and the nurses were wading through it to treat the patients, but because the medical team ensured clean water and simple rehydration salts were given to all the patients, no one, no matter how young, old, or mal-nourished, died…NO ONE EVER needs to die from cholera…
     A disease that was last in outbreak stage more than 100 years ago in the USA has been raging through Guinea and since February of this year, 1463 cases of cholera and 50 deaths were reported in the area surrounding Conakry, Guinea! With rainy season and the almost non-existent sewage system here (observed once again today by one of my co-workers when she happened to be at one of the hospitals in town where Mercy Ships is doing some renovations. She observed a few “plumbers” taking care of the sewage at the hospital, by pulling bucket after bucket of human waste, out of the ground, in buckets, like one would use to get water out of a well. The waste was then poured into another bucket, and carried by another man to a truck. None of the workers had gloves on or any protective clothing, or masks) the waterborne disease is on the rise.
     Doctors without Borders or Médecins sans Frontières (MSF) has a white, emergency treatment, outbreak, tent set up at the local hospital that is just down the road from where I am living. I have only ever seen those types of tents in news reports on refugee situations around the world, or in movies, not in my own backyard. And even though I saw it with my own eyes, it is hard for me to comprehend, that people in this city around me are currently dying from this disease that is SO preventable and SO treatable and this is the situation in the capital city where there is “access” to at least some sort of healthcare…the situation in the interior is much worse…it is too much…
     Last week when I was curled up in a ball on my mattress on the floor between every time I was running to the bathroom myself, I cried related to the pain and nausea I was experiencing and for those around me who are needlessly dying…Since I have recovered and am feeling much better…I cried again...But this time I cried because I am so blessed…not blessed because I had diarrhea….that is never a blessing…but blessed to have shelter even though it is in a 3 bed-room house with 11 other people…blessed to have a mattress even though it isn’t very comfortable and it is on the floor… blessed that I have a toilet in my house that flushes (most the time)… blessed that I have water to wash my hands with… blessed that I have soap to use with the water…blessed that I have toilet paper… blessed that I have nausea medicine…I cried because God is so good and I am so blessed…
     As the cholera outbreak continues to claim lives of those around me, my prayer is that those who are currently fighting cholera will be strengthened and recover…that those who have lost loved ones related to cholera will be comforted… my prayer is that I never forget that I am blessed…that I will have the chance to bless others…and that those around the world currently in “crappy” situations will KNOW God’s blessings in a new way and feel his hand of blessing upon them in this very moment… Be blessed…

Sunday, August 5, 2012

clashing worldviews & the beauty of grace

     As my airplane made its decent out of the clouds, I could see the landscape below speckled with large and small structures alike, many with 2 spires pointing heavenward. As my airplane neared touch-down I scanned the horizon of my new home for the next year and from the airplane windows alone, I counted more than seven of the structures with minarets. As my airplane taxied toward the airport, mosque after mosque came into full view.
     After being picked up by my fellow Advance Team members, we loaded our borrowed sport utility vehicle and slowly made our way through the crazy traffic in town, toward the apartment we were renting. I took in all the sites around me. The streets were lined with liter, motorcycles, market stands, mosques, taxis, goats, wheelbarrows with items for sale, and men in loose, dress like shirts with pants underneath, all topped off with kippah or taqiyah caps; male prayer caps. Scattered amongst the men where women veiled with hijab, or head coverings that coordinated with their brightly colored African fabric dresses. In the crowd, I also picked out a few women shroud in black burqas and a few others with only their dark, forlorn eyes showing through their niqab or face veils. I had arrived in Conakry, Guinea, where the population is roughly 85% Muslim and the remaining 15% a syncretism of Catholic, Christian faith, Traditional African Religion, Fatalism, or Animism.

     Everyday I hear the call to prayer and see a host of people in tiny mosques around the city, on the side of the street, or in offices ceremoniously washing their hands, forearms, head, and feet with water in preparation for their 5 times a day prayer rituals. In some areas of the city, around the time of prayer, all activities cease and traffic comes to a standstill as many people prostrate themselves before their god. In a city where there majority of people have no running water in their homes and the water they do have access to is contaminated with bacteria and parasites, I am left with a feeling of confused-frustration as I see people spending the little money they have on bottled or bagged water or their energy on carting bucket after bucket of water from a well to use for a ceremony mandated by their religion.
     Over the past few months it has been interesting to enter meetings where those we are meeting with eagerly greet my male colleagues, but when it comes to me, at times I am not given a handshake and my presence isn’t even acknowledged even though I may be leading the meeting. I thrive on the challenge of learning about new cultures and I am embracing the diversity of my new home, but praying for God to make sense of all I am encountering in my life where one of my constant companions remains the consistency of changing geographical locations and encountering clashing worldviews.
     As I pass the women enveloped from head to toe, I cannot help but wonder how “she” feels behind the black veil that is heavy upon her and has to be uncomfortably sweltering in the hot African sun. I don’t know why, but I make a point of it to say “Bonjour” to every woman hidden behind the veil of her culture and religion. I never hear “her” answer back, but I persist in my little practice, maybe one born out of my own egocentric opinion that feels “she” has to be angry, alone, or crying out to be acknowledged, but I think it is more than that….
     The 9th month of the Islamic Calendar began just a few weeks ago, ushering in Ramadan; a month of fasting from dawn to sunset for many around me. There is a tangible difference in the Conakry air since Ramadan began. The compulsory fasting (even from water) has left many of those I interact with on a daily basis fatigued, irritable, distracted, and challenging to work with. In the middle of important conversations with governmental officials, about immigration, clearing Mercy Ships shipping containers of medical supplies or medications through customs, training of potential surgeons, locating patients desperately needing help, getting visas for the 1,200 Mercy Ships’ crew members that will pass through Guinea in the 10 months the ship is stationed here, those we are conversing will all of a sudden leave our meetings to wash and pray, they fall asleep, or remain so distracted that we end up repeating ourselves multiple times just to get simple points across.
     The ship arrives in less than three weeks and it has been interesting to try and coordinate many tasks with touchy, lethargic, and unfocused government officials. Much is to be done and the time frame is critically short. I want to get the million things crossed of my “to-do-list” that remain… but more than that… I want people to know freedom from mandated rituals, spells, charms, and legalistic actions...I want people to know the beauty of grace...and the God who loves the oppressed… lonely… forgotten…and hurt, as well as the proud… popular… famous… and strong…the God who loves all equally, whether rich or poor… healthy or sick… black or white…male or female…