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” (Philippines 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 some 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 dessert, 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.
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