Speaking Life at the Chicken Pox Hotel

 I sat on a little, 4 post, woven stool in the sunshine in Mercy Ships scrubs next to 4 huge plastic washbasins. My new friend and Malagasy interpreter/Day Crew at one of Mercy Ships HOPE centers sat next to me. The HOPE center stands for the Hospital Out-Patient Extension unit. These locations are the onshore housing units we use as hotels for patients that have traveled hundreds of miles and days to get to the ship. The patients stay at the HOPE center when they are healthy enough to be discharged from the inpatient side of the hospital, but are still needing physical therapy, bandage changes, and suture or staple removal. Our main facility has around 300 patients/caregivers and the other facility has around 20.  I was washing dishes with one of the HOPE center interpreters.

I am not even certain how the conversation started, but as we washed dishes we discussed life, cultural differences, experiences, and the reason I’d come to the ship. We laughed at some of our differences. In America if we lose a tooth, we put it under the pillow and a “tooth fairy- our parents” come and give money in place of the tooth. In Madagascar, they throw the tooth on the roof of their house.  We were washing all the dishes the patients had just used for their afternoon meal. We had a soapy basin, and 3 rinse basins, with bleach to thoroughly clean the dishes before they air dried. 

I discussed with this individual that I came to the ship because I wanted the people of Madagascar to know that God had not forgotten them, they were loved and cared for, and I was here to show God’s love through my nursing skills. I must have said something that helped my new friend feel safe and at ease to share some of her story with me because our conversation turned to emotional, mental, and spiritual pain and needs. We discussed anxiety and worry at length. I discussed some common reasons for anxiety such as thyroid conditions, heart conditions, or even consumption of caffeine. I talked about coping strategies for anxiety and worry. I discussed a favorite passage in the Bible that reads: 

“Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus” (Philippians 4:6-7).

I discussed that I too deal with worry. I worried if I’d be healthy enough to complete my job here, if my plane would crash on the way here, or if my husband hated his time here. The list goes on and on. I noted at times we worry and our brains may not shut off when we try to sleep at night. I told my new friend, yes, she may be worried about how to pay for school fees, how to come to her Mercy Ship job when she is tired and has not slept well, she may be concerned about the status of her country, there’s been a lot of “parades” and “gatherings” lately some “parade” participants attended with devices loaded with bullets. The leader left the country and the military and people have “selected” a new leader in his absence. Some use the term coup others do not. This happened the day I was meeting my new friend. We chatted about worrying over finding food for each day, not having a job when Mercy Ships leaves; all very valid concerns and worries. My friend asked incredible questions as we washed the dishes. She said she had been too afraid to discuss some of her concerns with other people as they may label her “crazy.” 

I assured my new friend she was not crazy and there are many people in the world that deal with invisible hurts and pain. I told her she was most certainly not alone in her feelings. I told her it is often misunderstood in my country as well. We discussed that the patients on the ship with huge tumors may have people feel sorry for them and have compassion for them because their pain is visible, but the pain one deals with inside can be just as painful. She said, “I am SO thankful I met you today.

I took a break for a second as the duty HOPE center cell phone in my pocket rang. I was the only nurse on site at this secondary HOPE center location today. In fact, I was the only Mercy Ships crew member at this facility today.  This secondary center opened to house some patients with active chicken pox and close contacts to those with active chicken pox. Although “chicken pox parties” were a thing when I was growing up in the USA, patients needing surgeries and recovering from surgeries do not need a surgical postponement or post-operative complications as their body fights chickenpox. With delays for our incoming surgeons related to flight cancellations related to the “parades” in the country, we did not need as many nurses in the hospital and we were asked if we’d be willing to help at this secondary HOPE center. I volunteered. We nicknamed this location the Chickenpox Hotel, not a politically correct term at all, but a term of endearment, no judgment. 

Earlier in the morning I had already had conversations with all 10-14 patients and caregivers assessing if there were any new symptoms of rashes or chickenpox present. I spoke from the balcony with those dealing with chicken pox and made sure they were okay. We had loaded 20 empty plastic Jerry cans  into Mercy Ship’s Land Rover to be refilled for clean safe water at the HOPE center. Now, I walked around the building which was a clinic not in use that Mercy Ships is borrowing for our time here. I checked the patients with close contact to chickenpox were in their allotted color coded zones and those with confirmed cases were in their colored zones. For our illiterate patients, because education is a gift, although I wish it was a right, colored tape clearly marked which toilet, shower, sinks, and laundry sink was for each group for the best infection control and prevention of spread. Some patients sat in the grass braiding hair, 2 sweet twin girls around the age of 7 practiced PT exercises on their brand new legs. Their legs had been casted for over 3 months and now they were learning to walk. Riding the tricycles around the compound was great PT for them to try to bend their knees to peddle. One got bored with the tricycle and found a seat in the shade next to a bongo drum and she sang some song in her local language and giggled and giggled as I tried to dance along. Another group of young boys with new legs as well, played dominos and Connect Four.  The other day crew folded laundry. I thanked them for their hard work and gently asked them if they thought it would be a good idea to put a clean garbage bag under the clean scrubs they were folding instead of putting them directly on the floor to prevent infection. They agreed it was a good idea. One little girl refilled her plastic water bottle and put the part she drank out of directly in contact with the spout dispensing the clean water. I had an interpreter ask her how she was, told her I was proud of her for drinking her water, and suggested next time to help keep her body strong and her friend’s bodies strong, she should leave a space between her drinking bottle and the tap from the clean water dispenser. She nodded her head and said she would. An ounce of prevention is worth a pound of cure as the old saying goes. 

I made my way back to the dishwashing and sat back down on the little woven stool next to the gal I had been working alongside before the duty phone rang.  I continued washing dishes with happiness. She had a few more mental health questions. I assured her I was happy to answer any questions she had. I discussed again that she was not alone. I discussed techniques that anyone can try if they are feeling too overwhelmed and their body is stressing constantly. We discussed that sometimes the “roads” in our brain get all jammed up with traffic and the “roads dead-end’ or twist all into one another. That is the easiest way I can describe the complexity of serotonin, dopamine, and other brain neurotransmitters. I noted our bodies have the natural job to tell us to get out of the road if a Tuk Tuk driver is coming and we are going to be in danger and we are going to get hit! Sometimes this safety response in our body is stuck and won’t turn off, I explained. I described natural ways to turn off this “alarm” in our body’s fight-or- flight response, if it is stuck. Humming is a great way to “flip the switch.” I was not certain the word “humming” translated so I started to hum the tune Jesus Loves Me, she started to hum along. I mentioned splashing her face with cold water over and over can also help her if the switch is stuck, unless she had a troublesome situation in the past with cold water, such as near drowning. She paused and said once again how thankful she was that she got to meet me that day. 

I told her I have had to get up in the middle of the night at my house and take extremely cold showers to help my body turn off the false alarm signal in my body that was telling me there is a big bear or scary animal to be afraid of, when there is no bear present. She looked at me as if she was soaking in every word I was telling her. I shared how if I feel that just too much is going on, my brain is running, running, and I feel foggy, and disconnected from the world, where life is happening around me and not with me, it can be because of “monthly times” for women. These “monthly times” can cause happiness one moment, tears the next, joy one moment, and sadness the next. I did my best to explain the complexity of hormones and PMS to one who may have never heard terms like that. 

I explained she is not alone if she feels like that. I told her a counselor once told me to think of 5 things I could smell, hear, taste, touch, and see in those moments. I asked her what her favorite food was. She said she loved cassava and meat. I told her if she was overwhelmed to think of taking a deep breath in smelling the cassava and meat cooking. I explained to imagine breathing in the smell of it cooking through her nose and to breathe out of her mouth. To then think of 4 other things she liked to smell. The tropical flowers around, clean dishes we were washing, and so on. Then think of 5 things she could hear. We heard children giggling around the corner, a bird chirping in the trees, men on the construction project next door, the sound of me sloshing the dishes in one of the washbasins…We moved on to thinking of things she loves to taste. The cassava, cold clean water, fresh fruit…We talked about things we could touch and feel. The sunshine on our skin, the cool breeze around us, the dish water, the woven seat under us… We noted what we saw… 

I thought back to all the sensations, sights, and sounds I had seen during this day God had given me in Madagascar. I was blessed to be in the great outdoors and sunshine for my nursing shift. My view for this shift was unique and I’d trade it any day for the windowless department I work in at home. A rooster crowed in the dusty field next to me. Laundry was drying on the piles of weeds and brush in the sun. A little bare bummed, chocolate skinned toddler toddled chasing a partially flat soccer ball while his mama washed and I could hear her slosh clothes in a washbasin next to their corrugated galvanized iron/wriggly tin, plastic tarp, old wooden pallet home. 

It was hard to take in all I saw in the roadside stores and market on the drive to the HOPE center. I saw piles of fresh produce in an array of colors on top of a dusty ripped tarp atop weathered tables and benches made from old wood pallets. 5 small chickens hung open in the air from another little store made from dilapidated pieces of wriggly tin. Flies swarmed the chickens and other various cuts of meat lying on a humble table. I am uncertain what types of meat were being sold on the table, but it could have been anything. Zebu, pork, “bush meat” and other unknown “meat” items. Women stood next to their table with fresh fish caught out of the ocean behind them. The fish were arranged neatly in a row on giant green tropical leaves. The women scooped water that appeared clean, but was full of invisible water borne pathogens that would make one very ill, on top of the fish to keep them wet. The women fanned the fish with huge tropical leaves in attempts to keep flies away from the fish. I saw bright yellow tuk tuks driving to and fro with an interesting approach to traffic flow and speed. I am pleasantly surprised at the organization of traffic here and it does not appear we are the classic 1980’s arcade game, Frogger, where a frog tries to cross the road alive in a hazardous flow of traffic.  (Stay tuned for some old videos to be posted soon). This traffic is nothing compared to those Frogger days. I saw the children.. Oh, my heart.. These children bring me smiles I can feel in my toes. Children playing in the middle of the dirt with a simple stick set up as a “soccer goal” and running barefoot, dirty, partially clothed, with rounded bellies from malnutrition and a burden of intestinal worms, chasing another deflated ball. There were babies with stocking caps on although I have sweat dripping down my back. 

I then came back to the present conversation. She expressed extreme relief and gratitude to me for the information I shared with her. We had just rehearsed a “5,4,3,2,1 grounding technique" or as in the case I explained to her a “5-5-5-5-5 grounding technique” without giving the technique the technical name in our chat. I am extremely thankful for those who have prayed hours with me and for me in my struggle with anxiety. I am beyond thankful God led me to an app called Dare to help me deal with intense anxiety I have dealt with in the past. The kind of anxiety that makes you want to never leave your room or safe place to cancel all your plans with others, or to curl up in a ball of tears and fears. I shared with her much of the information I have found healing and helpful to me in my own pain. I told her I know what some of it feels like and she is not alone. She looked at me and verbalized she was taking in all of our conversation and was SO thankful. 

The dishes were done, but we continued talking as she asked me more and more questions. I asked her if she had read the Bible and heard of a story about a man named Elijah that God took care of when he was depressed, struggling, fearful, and he had so much worry and stress that he actually wanted to die. She said she didn’t read the Bible as much as she should. I noted neither do I. But I recalled the story from 1 Kings 19: 3-8. Elijah was overwhelmed and instead of stressing too much and taking things into his own hands, he lay down for a nap. God provided for him and woke him up and fed him via an angel and then let him rest more. Then an angel fed him again! I know it was God that brought this story to my recollection at this time because I was afraid to tell someone in a country where many are starving and malnourished that they can just nap and then find a good meal. But… GOD!!! If He can bring angels to feed Elijah in the desert, he can provide food miracles for those in need as well. Rest is not to be underestimated nor proper nutrition in the fight against depression and anxiety symptoms. 

I exchanged Whatsapp phone numbers with my new friend so I could reach out and encourage her in the future. I told her how thankful I was to have met her as well. I picked up the handle to a little plastic wagon and did a few laps around the compound with one of the little twins inside. She laughed and laughed as I raced her around and exaggerated the motions as I pulled her over bumps. The Mercy Ships Land Rover pulled into the gated compound and I waved good-bye and thanked the team for letting me spend time with them that day.

As I write, the words from a popular TobyMac (2014) Song repeat in my head. Speak Life…

“…Yo it's crazy, amazing
We can turn our heart through the words we say
Mountains crumble with every syllable
Hope can live or die

So speak life, speak life
To the deadest darkest night
Speak life, speak life
When the sun won't shine and you don't know why
Look into the eyes of the broken hearted
Watch them come alive as soon as you speak hope
You speak love, you speak
You speak life, oh oh oh oh oh
You speak life, oh oh oh oh oh

Some days the tongue gets twisted
Other day my thoughts just fall apart
I do, I don't, I will, I won't
It's like I'm drowning in the deep

Well, it's crazy to imagine
Words from my lips as the arms of compassion
Mountains crumble with every syllable
Hope can live or die

So speak life, speak life
To the deadest darkest night
Speak life, speak life
When the sun won't shine and you don't know why
Look into the eyes of the broken hearted
Watch them come alive as soon as you speak hope
You speak love, you speak
You speak life, oh oh oh oh oh
You speak life, oh oh oh oh oh

Lift your head a little higher
Spread the love like fire
Hope will fall like rain
When you speak life with the words you say
Raise your thoughts a little higher
Use your words to inspire
Joy will fall like rain when you speak life with the things you say…”

We don’t need to travel to Africa, volunteer at a soup kitchen, or give away all we own. Although it’s the thrill of a lifetime. We can make a difference wherever we are. How many of us are speaking life to our spouses, children, co-workers, neighbors, and the drive through attendant, cashier, or waiter. “Spread love like fire…mountains crumble with every syllable…Hope can live or die…” I’m thankful when I woke up today; I got to Speak Life at the Chickenpox Hotel. 

D Ward Roolz & Droolz

I will take a patient assignment with vomit, diarrhea, urine, blood, or pus any day. I really dislike giving intramuscular injections known as IM injections. I think they hurt and I do not want to cause that pain for anyone else. The nurses I worked with in the ER loved that I was willing to gladly take their mental health patient assignment all shift if they would give IM antibiotic shots to my patients. A perfect swap for both of us.  Even with my extreme dislike of IM injections, I would still prefer to give an IM injection over dealing with spit, sputum, or saliva/drool. I shudder when someone clears their throat forming a glob of sticky, sometimes colored, moist, mucus from the back of their throat into a mass of salvia and phlegm that needs expectorated. My face is all cringed up even as I type describing the action of basically hawking a loogie.  If you are still with me, reading this blog post, I can only guess you might be showing some expression of 'yuck,' as well.

Tracheostomies, life saving holes in the windpipe, allowing people to breathe and live with certain medical complications, are not my thing either. The fragility of a patient after a recent trauma with a brand new tracheostomy is fascinating and frightening. I remember working with trauma patients at Dartmouth in New Hampshire as a brand new nurse. It terrified me. You had to give extra oxygen before you dared to suction their airway or they were in serious trouble, then you could not suction for more than 10 seconds, or they were in serious trouble, and then you’d have to give more oxygen after suctioning. Life is beautiful and fragile. 

Earlier this spring, through much prayer and tears, I was prompted to leave one of my nursing roles that I had for the last 3 years. Much to my own surprise, I took a private duty nursing job for pediatric/children patients that live at home with medically complex conditions. My dear friend, prayer warrior, former NICU (neonatal intensive care unit nurse), Chandra, had been trying to talk me into joining the homecare company she worked for over the last few years. Every time she asked, I had the same reply, “No way, I am not gifted in that area of nursing, I have always loved kids, but ill kids scare me and I do not do SPIT!”  These kiddos have tracheostomies, some are ventilated, some have nasal gastric (NG tubes that go from their nose directly into their stomach and that’s how they get food), some had gastric tubes (tubes surgically inserted in their bellies and that’s how they get their nutrition). My only experience with tracheostomies was the trauma unit that I worked on in New Hampshire from 2006-2008. I ended up shadowing Chandra for one of her shifts with a precious little 2 year old patient and somehow God talked me into taking this nursing role on. It was a joy! It was incredible to give the parents that are on 24/7 a break to pee, shower, eat, and sleep, in peace knowing their little one was cared for and all in the comfort of their home. It’s a fantastic nursing job I have come to love and enjoy. 

Related to many moving pieces and complexities with the “parades” out and about in my current home country, there have been major fluctuations in the surgeries we are currently able to provide. I am on an island in Africa, on a ship, but surgeons cannot just hop on a ferry to get here. I was assigned to B Ward, the pediatric surgical specialty unit, for my time aboard. I have been here 6.5 weeks now and have only worked 2 shifts on the pediatric surgical specialty unit. I worked 1 shift, on A Ward, with our goiter patients and yes, I managed to give 3 of them rides in a little plastic wagon on deck 7. We take our patients outside for fresh air each day. I called my wagon the “Mercy Ship Tuk Tuk.” The very petite ladies with steri-strips across their necks, were at first timid, refusing to ride in the wagon pulled by a ridiculous white woman.  One by one they worked up the courage to get in my “Mercy Ships Tuk Tuk” and I pulled them back and forth on deck 7. Through an interpreter, I asked the patients if they preferred riding in the motorized local Tuk Tuk in town, or if they preferred my “Mercy Ship Tuk Tuk”. 3 out of 4 voted for me. The petite women actually fit perfectly in the wagon as the average height of Malagasy women is 4 feet 11.5 inches. Smiles replaced their former skepticism.  All of my other shifts have been on D-ward with maxillofacial surgical patients.  

D ward is a transformative place. For those without a medical background, imagine kiwis, coconuts, cantaloupes, and honeydew melons, oh, my!  Now imagine a growth the size of a kiwi or bigger coming out of your head in front of your ear; a parotid tumor. Picture a coconut sized ball coming off your face under your eye, on the side of your nose, and protruding out of the skin;  a maxilla tumor. Picture it expanding and then starting to shift the angle of your eye to make it appear your eye is on top of the coconut and it then starts to twist your nose. Visualize your chin and a cantaloupe sized mass originating at your chin bone and growing into your lips, distorting your face so your nose turns angles looking like a pig snout and your tongue shifts and your mouth is filled with the cantaloupe and you can no longer shut your mouth. You cannot eat.  You cannot keep the saliva in your mouth; these are mandible tumors, ameloblastomas. Envision a tumor so big it’s the size of a honeydew melon and now your airway is at risk as it takes over your face. Imagine the biggest smile you have ever seen in your life, now double the size of it because there is a hole, or a cleft in the lip making it split down the middle, sometimes even all the way up into both nostrils; you have a cleft lip or bilateral complete cleft lip. Picture a tiny jaw that appears smaller than normal and offset, a grimace through clenched or missing teeth; ankylosis, which causes the jaw to be unable to open, often from untreated dental infections, the teeth were purposefully pushed out to allow the individual to be able to eat. Finally, think of a hole in the side of your face. Your teeth are exposed, you can see your tongue moving, spit and saliva run down the side of your face, because there is no cheek or skin present; noma (a Greek word in origin, meaning “devour”, a gangrene facial infection. Often starting in the mouth it eats away the facial tissue- Source Doctors Without Borders). These are a few of the medical conditions surrounding me as I show up for my shift. I glance through my patient’s charts and read 4 of their medical histories.  6 years…13 years…10 years…5 years…This is the length of time they were suffering, waiting, and praying for help.   

There’s something different in the air on D ward. It happens slowly, over a matter of days and it’s unreal to witness as the history of suffering, agony, pain, and hurt give way to allowing emotion, anticipation, and hope build in the complicated recovery process.  We gather for shift handover and there are nurses from Tasmania, Belgium, Denmark, and Holland alongside me coming on for the shift. We receive report from Swedish, Kiwi-New Zealand, Canadian, and South Korean nurses who are finishing their shifts.  I saw the patient I cared for a few nights before when he was anticipating surgery the next day. On that shift, I helped him tie a blue surgical cloth around his face, like an American child may tie a handkerchief around their face if they were playing dress up as an old west bandit. He’s not playing dress-up, he’s ashamed of his face and doesn’t want to see it, nor have anyone see the honeydew sized tumor distorting his face and overtaking his mouth, so it won’t close. He was intubated in our ICU for a few nights and has moved to the status of a high dependency unit patient and my past experience in the ER and recent care with trachs and vents, means, I am the most qualified nurse to care safely for him tonight. I am honored as I repeatedly help suction his airway from stringy clots in the back of his throat and suction salvia dripping down his face as the post operative swelling is at its peak. I prepare multiple NG feeds for him over the night. I am not bothered one bit by replacing his dressing 3 or 4 times because of the drool saturating the abdominal pad thick gauze under his pressure dressing because we need to keep his steri-strips and suture line dry to heal and prevent infection.  We removed half of his jaw in a procedure called a hemi-mandibulectomy, and we’ve replaced it with a titanium plate. Infection prevention is paramount. Nursing tasks that I once shuddered at and would hand over to anyone else, if possible, are now my joy to complete and with confidence. My patient holds a mirror in his hand many hours of the shift. He looks at himself in the mirror and I see a light in his eyes and a smile comes across his face.  I have no doubt in my mind God was preparing me for where I am now even through some of the heartache of leaving my other nursing position this past spring. I am thrilled to be a part of the D Ward team and have a sticker the team leader/manager of D-Ward gave me that reads “D Ward Droolz” and I agree wholeheartedly! D Ward Roolz & Droolz! 

I Live in a Gated Community in Africa

I live in a gated community in Africa. To be more accurate, I live in a double gated community. The Africa Mercy ship is nestled in the port in Madagascar. The outer gate to our community is guarded by a combination of local maritime police, port facility security officers, and the Gendarmerie, a military style police force common in French speaking countries. No one enters the port without proper identification. We have a lovely driveway, as I call it. There’s a fair walking distance from our gangway to “actual Africa.”

The roads in this port are very well maintained.  There are huge cargo ships unloading containers for delivery.  Last week there was a massive Roll-On/Roll-Off Ship (Ro-Ro) “parked” behind us. It was from Norway and the port filled up with new vehicles from all over the world. There are tractors driving to and fro. Motorcycles with port workers zipping around, giant semi-trucks with containers of imported supplies headed out for distribution to the country. The activity in the port resembles scenes in books from my childhood by Richard Scarry. Hopefully, everything gets to the correct location, owners, and those needing the delivery. I learned that in other African countries, items the USA sends over from Goodwill and other thrift stores, meant for donation, are often “sold” once they arrive here. It is fascinating how things travel around the world. I recall walking down the busy market street with a friend in Sierra Leone and my friend saw her high school shirt on an African man on the street. Not just her high school shirt, but HER senior shirt with her name on the back from years before! I also bought a brand new scarf from a dirty tarp on the ground, in the middle of the market with the tag still on it from Wal-Mart (see my blog from Saturday, July 14, 2012 titled A Little Piece of Idaho and the Africa Market).

There are a few buildings with wooden scaffolding constructed for upcoming projects. A pile of scaffolding sticks, carefully carved into roughly the same shapes and sizes are wheeled along in a wheelbarrow to be used for more scaffolding. An ambulance sits in front of an official looking building.  Dustin pointed out; the local ambulance has the word ambulance, written incorrectly on the front. I just learned this week that apparently, in the USA, we write “ecnalubma” on the front of our ambulances so when a driver looks in their rearview mirror, the reflection reverses the image again making the word ambulance spelled correctly. I thought Dustin did not pay attention to a lot of details. Boy, I was wrong.

There’s even a pedestrian sidewalk in the port. Many countries do not let pedestrians walk freely through the port for security reasons and safety. This is a busy port, so I am glad we are allowed to walk in the port, some countries do not allow that. I enjoy walking in the port for exercise. No trouble getting in 10,000 steps a day around here. I greet the workers I walk past by saying “Salama” pronounced “sah-LAH-mah.” Dustin is getting good at his greetings as well. There’s a mix between French and Malagasy here for the main languages. So, it’s very common to hear “Bonjour” as well and it takes me off guard when someone says “hello” in English. There is a group of beautiful local women with caramel-cappuccino colored skin, and in my mind, the perfect hair, in matching housekeeping style dresses sweeping the sidewalks to keep the port tidy.

There are a few areas of beautifully manicured grass, tropical flowers, and baby palm trees. Colorful lizards scurry through the grass. I can safely meander on the port sidewalk as a woman in daylight hours without concern for my security. I live in a gated community in Africa.

To approach our ship, one has to pass a second gated area guarded with pedestrian and vehicle boom barrier gates. Our area is secured and only crew, our local interpreter team, and day crew team are allowed past this point. Our area is blocked by a container wall to allow privacy and another level of safety. We have an incredible team of Gurkhas, Nepalese Soldiers, keeping us extra safe and secure before anyone is allowed on board.

My house-ship in this “gated community” has a constant supply of water. Not only water, but clean water, in both hot and cold temperatures. Thank you to the hotel engineering team. I have electricity, most of the time, thanks to the electricians, (Dustin) and the engineering team, who keep the lights on. I have air-conditioning, most of the time, thank you HVAC team, and all technical crews. I have plenty of food, not only food, but nutritious food, clean, free from worms, parasites, and damaging invisible toxins and health risks related to the practice of using “nightsoil” human excrement for fertilizer. Thank you to our incredible galley team and dining room team.  I have access to world renowned medical, ophthalmic, and dental care. I have a pharmacy, medical supply, CT scanner, radiography, lab, and walking blood bank. I have clothing, clean water to wash it in, and soap, not a muddy river with more tropical diseases that is my only option for bathing or washing clothing. I have a roof over my head and shelter. I am extremely blessed.  I live in a gated community in Africa. I am in one of the safest places in all of Madagascar.

If any of you pay attention to global news, you may have heard there is excitement and lots of “parades” and “reunions” of passionate folks in my corner of the world. It is true. This is not uncommon in this part of the world. The first “parade" was on September 25 and initially was triggered by grievances over chronic power and water outages. The “parades” got a little more enthusiastic and spread around the country to include grievances over corruption, poverty, and the cost of living. Some of the “parade” participants and those not liking the “parades” became animated and gas that created tears, along with other methods to stop such “parades” were initiated. The Bible Society building in the capital was engulfed in flames in the process. They donated Bibles in the local language to the ship. The majority of these “parades” and “reunions” of passionate individuals are taking place 12 hours via land from my location in the city with the seat of government. Some people have left the “parades” for alternative activities such as pillaging.

Again, I am VERY safe; I live in a gated community in Africa. Mercy Ships takes extra layers of precaution to keep me safe. When necessary, the captain of our ship advises us if it’s better for us all to spend time bonding in our gated community rather than wandering to the grocery store, tailor, or beach for a little R&R. Life in my gated community continues with minimal interruption. We are extremely blessed. Concern has come from countries servicing our location with incoming flights and airlines not wanting to land their planes with animated “parades” and “gatherings” of people. This has created unique opportunities for prayer for our crew and those we are here to serve. Hearts and hope have been set on anticipated surgery dates.  We have had surgery delays, a return of flow of crew arrivals and departures, and now more surgery delays. This is devastating for those waiting for intervention, especially for those near suffocation from tumors encroaching on their airway. Please join us in prayer. Please pray for this area. Pray for the “parades” and those participating and those who are not fans of the themes of the “parades.” Those participating in the “parades” have been carrying signs requesting the leader of the country to take an “early retirement.” He already gave an “early retirement” to many in his leadership team a few weeks ago. Yet, the “parades” continue with “reunions” as well. Life has been lost at these “parades” by a clash with those not appreciating the “parades.” Tragic.  I am safe and unafraid (Matthew 10:28 is my inspiration for being unafraid). I told Dustin, I only fear “irrational” things. Ha! Thanks OCD, anxiety, and my extra, overactive mind. Please pray for my friends and those really struggling that live just outside my gated community in Africa.  

Third Edition of "5 Thoughts from Dustin-9 Pictures from Dustin"

 

The Africa Mercy Electrical Team Nationalities represented left to right: Philippines, United Kingdom, America, and Romania Dustin noted that the "office-breakroom" for the electricians in 88% humidity and 80 degree weather on the dock is cooler than their actual workroom near the engine room on the ship. The boys posed for a picture after I insisted. Missing their fellow electrician, a rockstar gal from Switzerland, who departed a few days prior to this photo. I told the boys to smile so I could send this picture to Dustin's mom as she would appreciate it. Then the chief electrician from Romania, said, his mom would actually appreciate a photo too. The other guys chimed in that their families would actually love a photo of them as well.  Will need to get an updated photo as we now have a new Chief Electrician serving on board and he is from the Ukraine.

My handsome electrician headed down toward the engine room and his workroom. Although Dustin sometimes feels "unimportant" Mercy Ships could not complete it's work with out every crew member aboard.	Dustin and the chief electrician- his supervisor during a fire drill on the dock.  We have mandatory fire drills every week.
I know Dustin has given up a lot of his personal comforts to be here. I asked for a fellow crew member coming from the USA to bring him some comfort from home. It'd been 48 days since Dustin had a Reese's or Hershey's Bar. It's been 48 days since he's had a Pepsi from the USA. He called his wife "a little blesser" for arranging for these comforts from home to travel here. Thanks Mom K & Scout Master Kent, my "adopted family "from Vermont for sending the treasures.	Related to shift work, Dustin and I do not always get days off together. I wander into town with friends when able. I found a little bakery that looked lovely, clean, and safe the other day. I brought Dustin back a donut. He was excited and ate it as an "appetizer" for dinner.
Our friend Sonja left on Sunday to start her journey home to Switzerland. She was an ICU nurse and member of the dive team. She invited us to visit her sometime. She lives very near a town called "Suhr" Switzerland.	Dustin and I were able to join 11 other friends for a birthday dinner/good-bye party a few days ago. Dustin was surprised when his fish came out with the skin still on and a full head and tail. I just told him to smile and thank the waitress. He did, then gave me this expression for a photo.
Another Pepsi Miracle for Dustin! We found regular Pepsi in a tiny store here that does not have the fake sugar additives! It appears to be from Pakistan. It says "Stronger Fizzier Tastier" at the top of the bottle in tiny letters. That's the only way we were able to tell it was different from the other "regular" Pepsi. After Dustin's disappointment with the fake sugar additives in the other "regular" Pepsi Dustin asked if we could adventure back to the little store to see if the other Pepsi was different. It was! It apparently is sorta "flat" tasting, but Dustin is mighty thankful. On my days off, I find a friend to walk to the 3 plus miles with me to the store for Dustin. I load my backpack up and trek it back for him. Last time the store only had 2 bottles total left. We bought them out!	All rights to whoever made this meme. It is not mine. Dustin sent me this picture the other day and I cracked up laughing. He was hinting that his hair is WAY longer than he wants and we need to find a solution. I keep rooting for a "man bun." Dustin will not comply. In an odd way, this lion sorta resembles Dustin. Hahah! He's REALLY wanting a haircut soon. I am working on solutions.

The Blame Game or Be a Door

 Pain and Suffering are everywhere around us. No one is immune to the reach of pain and suffering. We experience pain in our personal lives, family units, extended families, friendships, churches, villages, communities, provinces, states, and countries. We turn on the TVs and watch more pain and suffering. Someone once told me the world news is “what’s wrong in the world” and the local news is “what’s wrong near you!”

 Pain and suffering are HUGE philosophical topics. The reality of pain and suffering make many even question the very existence of God. Then people move to determine IF God exists, He is not a kind and loving God, or there would not be pain and suffering.

 I’ve had life VERY easy compared to many in the world. When I went to Liberia for the first time in 2008, I saw suffering unlike anything I had ever seen before in the poverty stricken, post-civil war-torn, country. It rocked my world and beliefs. (See a brief snippet of some of my thoughts in my blog post from Friday, May 2, 2008 titled Reality.)

I remember going to the Chaplaincy-Counseling office on the ship full of questions related to the inner turmoil my heart and soul were experiencing related to all the agony, sorrow, grief, hurting that was tangible in the air around me. The stories of the utter torture my patients had been through, the fact that many of them were literally suffocating behind tumors the size of basketballs. Or mamas telling how they bravely choose the life of their child born with a cleft lip and lost their village, food, marriage, and a hut home because of the belief that cleft lip babies were demon babies and should be left to die.

 A World Health Organization report in 2008 noted Liberia had a population of 3.5 million and “only 3 Liberian surgeons and no Liberian anesthesia providers” (Google and WHO report from 30 September-3 October, 2008- all my professors forgive me for not including a proper citation, I can’t even remember how to right now, nor do I want to be bothered, but know that is not my personal knowledge).  Then the fact that I toured the JFK Memorial Hospital in 2008 and it was an empty shell of a building. I met 1-2 nurses that were loyally going to work every day, but had not been paid in years. There were no supplies in the hospital. These nurses went in hopes that one day they would be paid to work again and have supplies to provide care. There was no running water and no electricity. The nurses showed up to give what they had to anyone who might show up in need. So if people had the chance to accesses a surgeon, there might not be anesthesia, or supplies, and most do not have the money to afford care. (See my blog titled The Neurosurgeon and One Single Light bulb from July 3, 2012 to understand the desperate situation a little more).  Let’s not even approach the topic of 26 year old me learning what child soldiers are and the Liberian Truth and Reconciliation Project, a commission that was formed to investigate more than 20 years of civil conflict in Liberia and the human rights violations and war crimes. A former child soldier even spoke at one of our community meetings.  

Mind blowing, earth shaking, matters of the heart and I thought it was a big deal to share an air-conditioned cabin in tight quarters with 5 other girls. To be restricted to 2 minute showers, with not only running water, but clean water, and not cold water, but hot water if I desired. The chaplaincy-counseling office on the ship gave me a number of resources and welcomed my questions.  I was connected with a copy of The Problem of Pain written by C.S. Lewis and published in 1940. I also borrowed a book called The Gift of Pain by Philip Yancey and coauthored by Dr. Paul Brand, a famous British surgeon published in 1997. I took the books to a quiet corner on the ship and started to thumb through the book by C.S. Lewis. I quickly realized I was in over my head and with my poor attention span, I set that book aside. Then I picked up the book by Philip Yancey and Dr. Paul Brand. I read the back cover:

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“A World Without Pain?

Can such as place exist? It not only can-it does. But it’s no utopia. It’s a colony for leprosy patients: a world where people literally feel no pain and reap horrifying consequences. 

His work with leprosy patients in India and the United States convinced Dr. Paul Brand that pain truly is one of God’s great gifts to us. In this inspiring story of his fifty-year career as a healer, Dr. Brand probes the mystery of pain and reveals its importance. As an indicator that lets us know something is wrong, pain has value that becomes clearest in its absence. 

The Gift of Pain looks at what pain is and why we need it. Together, the renowned surgeon and award-wining writer Philip Yancey shed fresh light on a gift that none of us want and none of us can do without.”

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Being a nurse, this resonated with me. I dug into the pathophysiology of leprosy and all of sudden, the intellectual waves that were battering against my worldview and causing soul upheaval calmed. Pain was not the enemy. In this soul searching someone gave me one of the most influential quotes of my life. I cannot even remember who, or if I read it in one of the above mentioned books, but it has stuck with me for 17 years…

“You ask, God why is there ALL this suffering in the world and WHY have YOU NOT done ANYTHING about it! Well, what if God asked YOU the same question? WHY have YOU not done ANYTHING about ALL the pain and suffering in the world.”

As I finish writing this post at 2:52am because I just came off night shifts and apparently my body wants to be awake, the words to a song by Jason Grey titled With Every Act of Love run through my mind. “God put a million, million doors in the world for His love to walk through. One of those doors is you. I said, God put a million, million doors in the world for His love to walk through. One of those doors is you…”   

The choice is yours. Point a finger at God and blame him for all the problems. Or be a door for His love to walk through.