Same Ward 17 Years Later

 Ludwig’s Angina my nursing report read as a diagnosis for the patient in D1. I gulped, “angina, means chest pain, I am not a cardiac nurse. I didn’t think we did cardiac surgeries on the ship. I have no idea how to care for this patient,” I thought to myself. I can picture that first shift on D Ward, Deck 3, in the hospital on the Africa Mercy, like it was yesterday. Yet, it was 17 years ago in April 2008! I had been a nurse for just over 2 years, the minimum years of experience required for a nurse on the ward aboard the Africa Mercy.  That diagnosis for my first patient ever in Africa was the beginning of many “firsts.” Conditions I had never heard about or ever were even discussed in Canadian nursing school. Yes, I am American, but my nursing degree is from Canada. The vast sea of medical conditions to cover cannot be covered in a four year nursing degree.  Nor would we focus on diseases and conditions we were unlikely to see. Diseases of poverty, tropical diseases, and diseases simply caused by lack of access to medical care.

I went on to learn that Ludwig’s Angina had nothing to do with cardiac concerns or chest pain. According to the Cleveland Clinic, Ludwig’s Angina is a bacterial infection that starts in the mouth. It is a fast spreading cellular infection that makes it hard to breathe. It is a life threatening emergency. It causes swelling in the tongue, throat, and face. It often originates from an untreated tooth infection.  My patient had a bandage wrapped around his face from chin to forehead. He had 9 small drains in his face, constantly leaking pus, and requiring frequent bandage changes. I had never seen anything like it! All his suffering was from a lack of access to care and a dentist. His toothache could have suffocated him and taken his life if it hadn’t been for Mercy Ships. 

17 years later I found myself on D Ward, Deck 3, in the Africa Mercy hospital again for my first nursing shift as a ward nurse. D Ward remains the maxilla facial ward and I couldn’t have been happier to land there, in the middle of cleft lip and palate surgeries! Cleft lip babies are my absolute favorite. Well, club feet babies are pretty adorable as well. Make that ALL the babies are adorable, but back to the cleft babies. Their smiles before their lips are fixed are priceless and huge! Each bed was filled with an adorable patient. Some patients were waiting for surgery, happily driving little bikes, in their tiny hospital gowns, down the hallway waiting for their turn for surgery. Other patients were sleepy in bed post surgery with newly stitched up lips.  A few post-palate repair patients were crying because they wanted to eat rice and they are not allowed rice for a few weeks to protect the surgical site from infection if a piece of rice got stuck in the palate. We even had a few adults that never had access to care in their many years and were finally receiving cleft lip surgery. See this link https://www.mercyships.org/eta-cleft-care/ for stories and a video from our incredible communication team. The very surgeon in this video from 2016 is the surgeon currently operating on board. Some of the interpreters in the video are my current interpreters. Some of the footage was filmed in D-Ward! I hope to get some photos of me with my patients, but photo policy has changed over the years. 

 An absolute beauty of a little girl, maybe 3 years in age stared at me with deep brown eyes. She was wearing a puffy pink princess dress. She had a cleft palate repair a few days prior. She was getting ready for discharge. Her curly hair was in two puff ball ponytails on either side of her head.  The interpreters joked that her name was Moana, like the Disney character. She also just happened to be coloring a Moana coloring page. The Malagasy people have ancestral roots that are a blend of Southeast Asian and East African origins. Leaving some with a dark chocolate brown skin completion, others with cappuccino colored skin, some a light caramel color. They are all uniquely beautiful! This little girl had the complexion and dark brown eyes like Moana. She was a doll and my world felt complete to hold her in my arms.

I heard the interpreters yell, “Marche, Marche,” in French, which means “Walk, Walk.” The patients got out of bed and joined the nurses, interpreters, and their family member-caregivers in the hallway as the song “Waka Waka, This Time for Africa” by Shakira blared on the speaker one of the nurses held in her hands. Everyone danced and marched rhythmically down the hall. It was exercise time! No better physical therapy and blood clot prevention post surgery than to dance down the hallway together! I smiled ear to ear. I am out of shape and still have zero rhythm. I hadn’t heard this song since 2013 when I left Africa. The patients still love it. We walked back and forth, up and down the hall for around 5 songs. The goiter-thyroid surgery patients joined us from A Ward and walked with us. They are smiling despite having stitches and steri-strips around their necklines where goiters, once the size of huge mangos, melons, or even the size of American footballs filled their neck space, suffocating them as they lay down. Goiters are caused by a lack of iodine in the diet, chronic malnutrition in the diet, and effects from cassava, one of the main dietary staples in these regions, among other things. 

As if my memories made the song play, “I Like to Move it” from the Madagascar movie came on the speaker. I just smiled. Apparently, it was still a patient favorite, too. The deck department hotel engineer from the Philippines joined our dancing group as he passed through the hallway completing his duties. The hospital director from Holland-the Netherlands, who was my hospital director on the ship from 2011-2013 and just returned to volunteer with his wife, popped out of his office and danced a few steps with us on his way to a meeting. The eye team leader from Sweden, who happens to be my dear friend that I met in 2008, carefully walked a patient with eye bandages from the OR to the eye room where they would recover from cataract surgery. Out of breath, we made it back to the ward from our Marche, Marche and carried on with the shift. How thankful I am to be back onboard. This place is amazing.

The Second Edition of "5 Thoughts from Dustin"

Welcome to the second edition of “5 Thoughts from Dustin.” We hope you enjoy the inner workings of my calm, collected, introvert husband as he processes life on a ship, in Africa, serving as an electrician. Again some days his five thoughts are more like two or three. He doesn’t often volunteer his thoughts without me asking. Thus the gap in thoughts when I was on night shifts last week.  His thoughts are in black and my extra information is in (green). 

September 13th

1. I definitely prefer when we are not around tons of people. After taking Dustin to the local market for the first time. Mind you this was a CALM market. It wasn’t shoulder to shoulder, hip to hip people as in some of the West African Markets. 

2. My artistic crafting abilities are amazing! Many people wonder if we are allowed off the ship and what we do in our free time. A few weekends ago eight of us from the ship went to learn the art of papermaking from a local gentleman. He explained how he dries the bark from the local Avoah or Havoah tree. The bark is then cooked to soften it. The cooked bark is then pounded into a pulp consistency. The pulp is then spread into thin sheets on a wooden frame or canvas. It is decorated with flowers and leaves. Then dried in the sun. Dustin was hilarious and had all the gals with us laughing. He was the first to start decorating his paper and exclaimed, “My artistic crafting abilities are amazing!” As he threw pieces of leaves and flowers randomly on his paper and the rest of us painstakingly arranged flowers to attempt to make a beautiful creation such as the examples the papermaker displayed for us.  

3. I miss Idaho Pepsi. Wandering in town a few weeks ago, we had a Pepsi Sighting! Dustin was elated! Going weeks without any caffeine and working in the heat, was wearing on Dustin without his daily dose of Pepsi. We were wandering down a dusty street, turned the corner, and like a lighthouse shining the way on a dark night, I spotted a Pepsi logo! Dustin was so excited. We bought a few bottles to take back to the ship with us. The elation faded as Dustin learned the local recipe for Pepsi is not the same at his beloved Pepsi from home. They add fake sugars, sucralose and aspartame, which Dustin calls rat poison. They add these to regular Pepsi, not just diet Pepsi! He’s very disappointed. He tried a few bottles, they hurt his stomach. So, no good. 

4. I definitely need a haircut. I woke up from a nap to find Dustin in the bathroom trying to cut the back of his hair with his lanyard around his hairline to make a line to follow. Ha-ha. I offered to help him and go with him to a local place. He’s not yet up for that adventure. 

5. Who knew 7:30am is sleeping in? Dustin, thankful his body clock finally allowed him to sleep in until 7:30am on a day off, he had been waking up before 6:00am and didn’t need to. 

September 14th

1. I have a lot of food for thought. That’s all he said, nothing more. 

September 16th-September 19th- I worked my first night shifts in 7 years! Dustin got off easy as I didn’t ask him many questions those days as I was working and sleeping. 

September 19th

1. The thoughts were slow coming, so I asked a few questions to see if that prompted any conversation from Dustin. “Did you enjoy your day?” “I guess.” “What did you do?” “We played with the lifeboat some.” “Was that better than sitting in your closet all day?” “No, that would have been cooler.” “Oh, sweetie, we can’t win for you!” 

2. “I was trying to look for fuses in the operating room. Learned that a fuse would never work since the solenoid valve burned out a coil.”  “Was that fulfilling work?” “I don’t know. I was outside the entire time.” “What did you mean by that?” “I thought it was going to be a quick deal. It wasn’t.” “So, you didn’t go into the OR?” “ I didn’t have to.” “So, did you help solve the problem and trouble shoot?” Well, it was helpful that I was outside and could run for parts.” “So you were the gopher, gophers have a purpose too.”  After this Dustin told me the OR has Reese’s Peanut Butter Cups. He spied them when helping down there with the electrical job. Reese’s are his absolute favorite. Dustin’s lunch snacks every day at home consisted of either a Reese’s Peanut Butter Cup or a plain Hershey’s Chocolate Bar. We have had no sightings of either Reese’s or Hershey’s up to this point. The ship shop used to import them for crew to buy, but none to be found this time around. As a loving wife, I went to the OR office to get Dustin’s Gatorade bottle refilled with distilled water from the Sterile Processing Department. That’s how we are getting distilled water for Dustin’s CPAP machine. Had I known we needed to provide our own bottle for the distilled water before coming, I would have brought a different container. Alas, a cleaned out, empty Gatorade bottle works as well. When I was waiting for the distilled water to be brought back from Sterile Processing, I asked the OR staff if they still had Reese’s and if I could buy one from them. Sadly, they were all gone. I told them they are my husband’s absolute favorite and he saw them when on the electrical job a few days before. They said he could have had one; all he had to do is ask! 

September 20th

1. I wasn’t looking for it. Dustin’s response to seeing the end of a breastfeeding session live and in person on the side of the road. We were in a tuk, tuk, local transport, and I saw an adorable baby with their Momma. I waved, and then realized I saw a giant breast, the baby’s cute little face, and a sewing machine as the Mom sat in the dirt. This is VERY common place here. Breasts are not viewed as purely sexual here. They are nutrition. In West Africa, I saw breast feeding moms and topless moms frequently. This was the first time in Madagascar. I wanted to check if Dustin was okay. He first denied that he saw the breast. I assured him, he was not in trouble if he saw it. I didn’t know how he couldn’t have seen it. Then he admitted, he saw it, but “I wasn’t looking for it!” My sweet man. 

2. It was bumpy. Dustin talking about the bumps, humps, potholes, and weaving in and out of traffic, riding in the tuk tuk from destination A to B in town. I told him he liked four wheeling and off-roading, so we’re doing some of his favorite things. Although we were ON the main road. 

3. I hoped the tuk tuk was taking us where we wanted to go. Dustin was a tad wary that the driver of the local transport would actually deliver us to our desired destination. He did. 

4. My wife is an extrovert. I know Dustin loves to play card games. In the evenings on the ship, many gather to play cards and board games. Dustin was invited to play with a gentleman from South Africa and I told him to go. He wanted me to go as well. I told Dustin I would be very happy having a nap and a quiet evening in my cabin. But, I wanted Dustin to enjoy something he loves. So I went, so he’d go. Then he calls me the extrovert! 

5. I don’t know if I want to make friends. A reality of ship life, an ever revolving door of crew arriving and departing. Your 3 months commitment will not be the same as another person’s. Their two year commitment could end as yours is beginning. The challenge of embracing each day, where you, with the knowledge that we may not have tomorrow. But, self protecting knowing grief may come if you make a friend and then they leave. Shakespeare continues to provide the question to this: Is it better to have loved and lost than to never have loved at all? I am going to love!  

6. We could take out the toilet paper and Kleenex from the bathroom and make it a giant shower. Dustin reflecting on the VERY small shower size and the fact that a lot of the water escapes the shower curtain at times. His solution. Why use your two minutes to fight keeping the water in the miniature shower stall. Just remove the permeable items and enjoy your shower. Everything else is waterproof! 

7. “Did it bother you that someone asked you what language was your first language?” “Nope.” My sweet, soft spoken husband has a great filter, he is an internal processor, and thinks before he speaks. Someone on the ship asked him today what his first language was as they were expecting him to respond faster.  

September 22nd

1. “Even in Africa a little rain must fall.” “Are you being poetic?” “I guess so because we were trying to work on a system that is like 400 volts.” “So what are you saying by this statement?” “It was wet. It wasn’t hot.” 

2. I don’t have many thoughts for today.

3. There’s a big empty box and it’s huge. “In your head?” “Yeah.” 

4. It will get easier sometime. 

5. Communication. In marriages, departments, the ship as a whole. I love hearing Dustin talk about the importance of communication. It is actually one of my favorite words. I ask him to communicate more with me, to others, for our business, explaining that a lot of tension and concerns can be easily avoided or maneuvered with clearer communication.  

September 23rd

1. I don’t have any thoughts yet for today (at 1025am).

2. “What are you working on today?” “Lights on deck 4.” “Well, does that feel good to be doing electrical work?” “Yes.” 

3. I found an area on the ship that’s hotter than the shop. (That’s where I was working today). ☺ 

4. What are more thoughts I could have? 

5. Profound thought. This is probably why I don’t write on my Facebook page. Because when the top of the page on Facebook says, what’s on your mind, I’ve got …Nothing! 

September 24th

1. It’s chicken strip day! The menu has been stretching for Dustin’s plain palate. He is thrilled when we have chicken strips! He was very pleased to have lasagna on the menu a few days ago. He grinned ear to ear and rated the meal 10/10 when we had hamburgers and fries! I gave him my portion to save for another meal. He was VERY thankful. 

2. Nice to see my team members happy today. He noted a pep in the step of his team members that he hasn’t seen lately. Happiness breeds happiness. 

3. This could be the calm before the storm. Dustin is noting the ebb and flow of his position. More relaxing days are not a bad thing when having to scurry on other days when things need rapid attention.

4. I wish my Scutie wasn’t sick. Over the past few years, when Dustin would text me or call me he would refer to me as Sweetie or Cutie. One day autocorrect got the best of us and wrote “Scutie.” A combination of Sweetie and Cutie. He has referred to me as Scutie since then. I have been sick since Sunday evening. There’s a respiratory bug going around the ship and it’s found me. I am more than just post night shift worn out. I am exhausted. Napping most of the day and sleeping at night as well. Coughing a lot. Bless my poor neighbors. Dustin comes in the cabin for a break and says he can hear me coughing from down the hall. Please pray for a fast recovery. I want to work and serve! Thankful for the window in our cabin. I have a precious, coveted view of the dock. We are in the middle of maxilla facial surgeries. I can tell this by watching patients come and go on the dock. This is an incredible patient population. To an untrained eye, one might not notice anything. But, after pondering for a second, one remembers it is hot; there is no reason to wear scarves this time of year. These scarves are not part of attire known for those from Middle Eastern religions. Behind those scarves are incredible humans, made in the image of God, but hiding tumors protruding off their faces, the size of cantaloupes, some bigger. Some patients do not have their faces covered. I love that they have felt a sense of peace, acceptance, and love here allowing them to feel free to come out from hiding and take their seat at the table of the human race. I asked Dustin if he saw the patient on the dock on Friday with a large tumor. I said, “it was big, wasn’t it?” He said, “Yup.”  See the VERY moving attached videos. Stories captured by our professional communication team here in Madagascar years ago. All credit to the communication team. Warning the videos show real images of humans with large tumors. Mercy Ships receives permission to share the story of patients as their surgeries are free and we raise money on behalf of patients by telling their stories. Part one and two of a maxilla facial surgery patient’s journey in a few years ago https://www.youtube.com/watch?v=fAjBo7ybCWA and https://youtu.be/I0cVIbIkR-0?si=c0M5Tisd8r0WmOYc

5. My pinkies are ridiculously short. They barely make it out of my coverall sleeves. I guess sometimes it may be better not to ask what Dustin is thinking about. Ha-ha. Yes, he has very short pinkie fingers. We measured them and compared them to my second toe. My second toe is longer. It appears Dustin is missing an entire knuckle’s worth of finger on his pinkies. I love him! 

Our Paper Making Host Explaining the Process	The Paper Pulp
More Paper Pulp	The Host was very kind and wanted to offer a hat for shade. I encouraged Dustin to wear it.
Our Art Work	After the Designs are in place, more water and paper pulp are added on top.
Dustin said his Mom would be proud of his work!	Some work done by our Host.
We were informed the paper in this market is not our Host's. It is a "knock off." Still beautiful!	PEPSI! PEPSI! PEPSI!  The excitement was short-lived related to the fake sugar additives in the regular Pepsi.
Tuk Tuk Ride!	The Tuk Tuk driver delivered us to our destination of lunch with friends near the beach. Dustin enjoyed fish.  I ate Zebu for the first time!

Flight 5 Photos

 

The airplane for our final flight on August 30th from Antananarivo to Tamatave, Madagascar!	Slightly smaller than our other airplanes thus far!
Dustin is more than ready to get to our destination!	Flight #5 of 5! But it looks like we are waving  at the camera!
Flight #5 of 5 photo- take #2!	Flight #5 of 5 photo- take #3!
Flight #5 of 5 photo- take #4! Oh, who cares!	Our names on the arrival's board on the ship!

Starfish, the Twilight Zone, and Home

August 30, 2025

We were finally on our 5th flight and the final leg of our epic travels to Toamasina, Madagascar, the Malagasy name, for the chief seaport of the country. The city is also known as Tamatave, the French name. Around 9pm, we boarded a small turboprop plane to our final destination. The flight was less than an hour and Dustin did not have any Pepsi sightings on this flight, but not a worry, neither of us were really awake for this final flight. We landed and were told not to move as we landed to not tip the airplane. We collected our luggage and were only missing one bag. It appeared no one had helped themselves to any of our material possessions inside the luggage as the zip ties I had placed on the bags days before remained intact. From past experience, I learned securing my luggage was required. I saw the familiar white Mercy Ships Land Rovers that were picking us up from the airport. We safely made the 20 minute drive to the ship. 

 It had been 12 years since I walked down the gangway from the Africa Mercy in Brazzaville, Republic of the Congo. It was surreal to be once again walking up the gangway, greeted by the Nepalese Gurkhas, the ship’s security guards. According to Google, “Gurkhas are special due to a combination of factors: their legendary bravery and loyalty, a grueling recruitment process that selects only the fittest, their exceptional physical fitness and endurance developed from their mountainous upbringing, and the distinct cultural value placed on honor and duty.” I didn’t recognize any of the Gurkhas on duty, but was pleased to learn two of the incredible men that stood watch by our ship daily when I was aboard 12 years ago are still onboard! 

The gangway to the ship lands you on Deck 5. The reception area remains identical to what I remembered. I didn’t get the opportunity to take my epic, jet lagged, bedraggled, exhausted rat looking, badge photo when I came onboard as they had  my awkward photo from 15 years ago already printed on a badge for me this time.  The hospitality team greeted us and ushered us into the dining hall for basic orientation mandated by maritime regulations.  I remember many a meal and the laughter shared with friends in this location. I remembered late night talks with my friends. Discussions on life, love, and loss, three questions my friends and I used to ask one another at meal times. We had to say one sentence with each of those words. Many days it was,” life is great.” There were times that life was “hard”. I recollect that I often said, “Love is real, alive, complicated, or distant.” Loss was “imminent” or “raw and fresh” with friends leaving daily and the reality of the colossal need of those around us. Some even would say futile. 

The “Starfish Story,” a portion of a literary work by Loren Eiseley, was often quoted by Dr. Gary Parker, a world renowned maxilla-facial surgeon, my friend, who volunteered as a surgeon with Mercy Ships nearly 40 years, https://www.mercyships.org/dr-gary-parker-honored-2025/. The “Starfish Story” remains a powerful force in my life. At times it has energized my life’s work in face of all the pain and suffering observed in war torn Liberia and Sierra Leone and in the face of horrific poverty in the African nations I volunteered in and the brokenness of people worldwide. The “Starfish Story” is moving, but let there be no mistake, I am not moved by a story alone, and it’s not the fuel for my perspective on life, love, and dealing with loss. A moving “story alone” would never be enough for me to reason with all there is in this thing called life, love, and loss in the world. I am compelled and following the 2000 year old motto of Jesus, bringing hope and healing to the world’s forgotten poor (Mercy Ships’ Motto) and Jesus was more than a story.  

One adaptation of the “Starfish Story” reads: 

One day an old man was walking along the beach in the early morning and noticed the tide had washed thousands of starfish up onto the shore. Ahead, he spotted a girl gathering up the starfish, then one by one tossing them back into the ocean. He approached the girl and asked why she spent so much energy doing what seemed to be a waste of time. The girl replied, “The starfish cannot live if they are left out in the sun.”

Then the old man gazed out as far as he could see and responded, “But there must be thousands of miles of beaches and countless starfish. You can’t possibly rescue all of them. What difference is throwing back a few going to make anyway?” The girl bent down picked up yet another starfish and threw it as far as she could into the ocean. Then she turned, smiled, and said, “It made a difference to that one!

I reflected on conversations with folks back home over the last few months as we told them of our anticipated volunteer work in Africa with Mercy Ships. Some applauded the sacrifice and guts to take on an adventure of this sort. Some expressed sadness, fear, or anxiety with the distance, unknown lands, and status of the world. Others shared the sentiment of the old man in the “Starfish Story” and noted the absurd waste of time, money, energy, and futility in an undertaking of this sort. 

More memories flooded in. I reminisced about the line dancing classes I once taught on my evenings off. Memories that have replayed in my mind on a regular basis over the last 12 years continued to enliven, growing stronger and stronger.

The basic layout of the dining hall had remained the same, but there was the addition of booths, sound barriers, new paint, more partitions, new tables, and a few other structural changes. Bread is now available 24/7 next to the famous “cheese toasty maker” also known as a “grilled cheese sandwich maker” for Americans that revolutionized dining experiences in 2009. It became the backup meal for anyone not pleased with the main course that was offered. The “cheese toasty” line used to be a hurried gathering point as around 600-650 crew eat three meals a day on the ship. I remembered the creativity my friends and I had in inventing the “apple slammer” as we called it. This was our attempt for the taste of a homemade apple pie with sliced apples, cinnamon, and sugar squished between two pieces of bread, and topped with some caramel sauce highjacked from the Starbucks Café on the ship.   

Covid had brought in hand sanitizer bottles to every table, plexiglass dividers on the new booths, the implementation of mandatory washing and disinfecting at the dining tables after you were finished eating. Those practices remain. 

The hospitality team ushered us to our cabin on deck 4. The cabin looked exactly how I remembered when I had visited other couples on the ship during “open house-cabin” events we used to have. I remembered my weary state of arriving to Monrovia, Liberia in 2008 for the first time. I was sick to my stomach for most of my flights. I arrived into my 6 berth-person cabin on deck 3,  was sick in the toilet, couldn’t figure out how to flush the toilet, thought my new cabin mates would hate me for what I left in the toilet, as no one was there to welcome me, or teach me how to use the toilet. I recall tripping up the steep stairs on my way back to the dining hall to get water, and then returning to my cabin and bursting into tears wondering what the heck I had done with moving to Africa for 8 months. Oh, the fond memories. 

I fully anticipated crashing in bed immediately, but was hit with a second wind as a mental cyclone of memories rushed through my mind. I asked Dustin if he was up for a tour of the ship. I showed Dustin the five cabins I had lived in during my years aboard. I showed Dustin where to get water, the ship shop, the laundry room, the library, the bank, the post office, and the gym. I was pleasantly surprised to see the gym had doubled in size and was no longer a small sweaty closet. I took Dustin up to the outer decks on the ship, deck 7, and deck 8. I was pleased to see permanent hammocks on deck 7 and the addition of a porch swing. I frequently checked in with Dustin to assess if he was in sensory overload, or if he could handle more of the tour and my memories. 

We made our way back to the cabin and settled in for bed.  I felt like I was in a “twilight zone” but “home” and ready to “throw starfish back in the ocean.”