What's In Your Cast?

Some of my favorite patients on the ship are our pediatric, orthopedic, patients. My little coffee colored babies are so cute lying in bed with their tiny legs casted and elevated on pillows. Their legs are so small and and I love the fact that after a few months, they will be able to walk straight for the first time in their lives. When the surgical pain passes most of the babies don’t want to lie in bed anymore so we let them crawl. I laugh and laugh watching them attempt to crawl around with huge, florescent colored, casts on their legs. They don’t get very far and most of them end up content to sit with a pile of toys around them. (Toys many of you have donated!) After a few days, the kids are ready to go home and we give them appointment cards to return to the ship after a few weeks for a cast change.

It is priceless to see them tied on their mama’s backs when they come in for cast changes. All you see is a beautiful African women walking toward you with two huge, casted feet sticking out on either side of her hips. The little kids are all smiles until they reach the cast change room, which is right next to my cabin. Thank goodness the wall separating us is a firewall, or I would hear screaming all day long. It isn’t that the cast changing process is painful, but it is scary when a saw is coming toward your legs and you cannot stop it! Two of my friends are on the orthopedic team and they do their best to comfort the kids during the cast changing process, but sometimes screaming is inevitable. Once the casts are sawed open the screaming stops and the mood in the room drastically changes. The fear is gone and the babies stop howling.

When we discharge orthopedic patients from the ward, we teach them how to take care of their casts. We give strict instructions in oral and picture form instructing our patients and their parents to keep the casts dry, to keep weight off the cast, to elevate their legs, and to come back to the ship if the cast breaks. We also tell our patients not to put their hands, or sticks inside the cast. If you have ever had a cast you know how itchy the skin under the cast gets and you will try almost anything to reach the itch. In the States, most people would never imagine putting a stick down their cast, but if you don’t have something flat like a ruler, a stick is the next best option! In Liberia I could almost guarantee most people didn’t have access to a ruler because most of them struggle finding food, shelter, and clothing for each day, but apparently people here have access to rulers because we found bits of one in a baby’s cast! Finding stuff inside a cast isn’t funny because having stuff inside our patient’s casts, next to their surgical wounds, can cause infection. But, it has almost become a game where we guess what we may find in the next cast we open! My friends have started to take photos documenting all the random stuff our little African babies stuff down their casts. We are not exactly sure how the stuff gets in there, but it is hilarious. To date, we have found sand, CFA (the local money), chalk, more sand, a piece of a ruler, more sand, a smashed bottle cap, live worms, and more sand. We never know what may wait lurking underneath the surface of our patient’s plaster casts.

I guess in the future, we are going to have to be a little more creative and specific when we discharge our orthopedic patients from the ward and we teach them about caring for their casts. But that is why I love my job! Never at home, would I ever have the chance to tell a patient take your pain medicine, see you in a few weeks, and “Oh, yah, make sure you don’t put money, sand, dirt, smashed bottle caps, or chalk in your cast!”

If you want to talk about rice, chocolate, or diapers, I am willing to chat with you!

I have been back in Africa for almost four months now and I thought I should let you know how my French is progressing. You will be proud of me. My vocabulary is expanding daily. I am not progressing as fast as I would if I actually lived off ship and was required to speak French to survive, but I am slowly working on acquiring some useful phrases in French. One of my favorite questions is “Did you poop today and was it big or small?” Although this phrase does not appear on the “Top Ten List of French Phrases to Learn,” it is very important to me as a nurse. It does become awkward in conversation though when someone greets me and says,” how are you?” I can say, “I am doing well thank-you and you?”, but then the conversation ends because my only real conversation piece revolves around body excretion. Actually, my French isn’t that terrible. I can also ask, “are you feeling pain, did you eat, did you swim, and did you pray?” I pick up random words here and there, but my vocabulary remains small. I am starting to understand the majority of conversations, because of my knowledge base of Spanish and the similarities of French and Spanish, but I struggle to actually say anything intelligent in French. I want to respond to questions, but it almost always comes out in Spanish. You can pray for my desire to learn French and motivation to work on it. I have been reluctant to really dive into French language study because I am afraid I will lose my Spanish if I start to learn French and I still have a deep love for the Spanish language and Latin people. I also am so busy; it is hard to devote my free time to study, when I need to relax. A poor attitude, I know… I am working on it! Despite my poor attitude, I am eager to use the French vocabulary that I have so, if you want to limit your conversations subjects and phrases to talking about chicken, fish, rice, fries, apples, bread, water, chocolate, beautiful things, gifts, diapers, see you later, good-evening, Mr. & Mrs., my friend, or the word for dry (which is very important when assessing my VVF patients), I am willing to have a chat with you. If you use any words other than those I just mentioned; we will have to stick to conversing in English or Spanish for now.

WHY NOT GET INTO A HAND-CARVED BOAT WITH AFRICANS THAT BARELY SPEAK ENGLISH?

The stress level was getting pretty intense all over the ship, so a few buddies of mine and I decided we needed some distance from the ship and it was time for a break. Most people would aim to hit a white-sandy-beach or rent a room at a five-star hotel with room service, but that isn’t really an option on a missionary budget, nor is it likely in Benin. After checking out our travel options, we hired a local taxi driver to take us to PASSOTOME, a little village about 2 hours from Cotonou. Our taxi driver arrived at our pick-up point on time, which was surprising and a great start to the weekend. Although we thought we had booked the car for just the three of us, our taxi driver, being a businessman, thought he should fill the car and sell all the “space” in the car, not just the spaces with seatbelts. He was lucky we had some thin passengers in our group and that we are flexible, in every sense of the word. The car ride was incredibly smooth. We picked a great taxi, the car had air conditioner, clean seats, space in the trunk ( and he didn’t carry extra gasoline in glass jars in the back of his trunk, like in Liberia), and he had a great taste in music, slightly out-dated, but all my favorite songs from high school! It was great getting to see more of the local countryside. I find pure joy in just observing the African culture. At one point we were stopped at a stoplight (an amazing invention, pretty much non-existent in Liberia, but quite common here; even more incredible when people obey the lights.) Anyway, I looked up and saw something moving in the back window of the car in front of me. I turned to my buddy and said, “What the heck is that?” Oh, yah, it was a goat. The cutest little goat was just chillin in the back of the taxi cab and was staring at me. I couldn’t help but laugh my head off. (I guess some goat therapy is just what the doctor ordered, my brother had some and now I got some too). You don’t see goats in the back of taxi cabs everyday! I turned my head away in another direction for a moment and when I looked back, I saw my little goat friend wasn’t alone, there were at least two other goats in the back of the car with him. Great times! We stayed at a very modest hotel in PASSOTOME on LAC AHEME. The main attraction at PASSOTOME is the lake itself. We had heard about the opportunity to join some local fisherman for a few hours out on the lake and despite my fear of water, I thought the idea sounded great. Why not get into an amazing, hand-carved, fishing boat, with my buddies and a few Africans that barely speak English? It was an incredibly hot day, so being out on the water was ideal. We had done some research and learned that LAC AHEME was supposedly parasite free and we could actually get in the water if we desired. I decided I would most certainly not touch the water, but I would ride in the boat. One of the first things I noticed on the water were random areas all over the lake that were closed off by rings of wooden poles sticking up about a yard above the water level. The fishermen explained that each village surrounding the lake had designated rings of wooden poles that belonged to them. Apparently, the villagers believe that the water inside of the ring is sacred and the “spirits of the water” reside there and it is forbidden to fish in that area. The worldview of these people is obviously very different from Western worldview. Saddening to me in many ways… The fisherman explained to us the lifestyle of local fisherman. They told us to observe the red areas on the water; those were the best fishing areas. I was sort of confused, I thought the water just looked absolutely filthy, manky, and polluted, I didn’t see any “red” areas. We rowed all over the lake and watched the fisherman cast his net and pull in load after load of tiny fish. I thought he would throw back the tiny fish and only keep big fish, but he kept all the fish and there weren’t any big fish to speak of. After an hour of watching him, the fisherman turned to us and said, “It’s your turn!” We each took turns casting the net. It is heavier than I expected and to throw it properly you have to stand on the edge of the boat. I was afraid I was going to throw the entire thing in the water, or I would go in with it. I was congratulated on my casting technique. I didn’t catch anything, but I was the only one out of my group of friends to actually have the net hit the water in the proper manner. I was proud of myself! The fisherman showed us another technique of catching fish. He cast the net into the water, tied one end of it to the boat, and then jumped in the dirty, cloudy, water. This mystified me. The fisherman dove under the surface of the water and a few minutes later, he came up with a handful of fish and threw them into the boat. Then he continued to dive again and again, bringing up handfuls of fish with each dive. Apparently, when only fishing with the net, some fish can escape as you pull it in. On the contrary, when the fisherman throws the net in, lets it sink to the bottom, then dives in and finds it under water with his hands; he can pull the fish out that would sneak out. With this technique he catches more. The entire process still confuses me and I want to know how he sees anything in that dirty water. The fisherman invited us in to swim with him and try his fishing technique. I thought, “Yah right!” But then the blazing sun’s intensity increased and in some freak moment of mental deterioration, I decided it would be great to cool off. And after a few deep breaths and a “self-pep-talk,” I slowly, lowered myself out of the boat and into the water! An act of faith, craziness, and an attempt to conquer more of my fears! Wow! The coolness of the water was refreshing but its consistency was slimy. Yuck! My fisherman friend swam over and started telling me how to dive under the water to catch the fish. I just laughed at him and smiled (there is no way on this planet that I was going to stick my head under that dirty water.) It was a big enough step for me to get into the dirty water; I wasn’t going to immerse my face and head in it. I did rally enough courage to hold one of the little fish he caught, but it scared me and made my insides squirm. I don’t like to eat cooked fish, or even smell it, let alone touch it when it is wiggling and squirming! The rest of the time I was in the water, I just kicked my feet around and held them close to my body so that nothing would nibble on them! The fisherman kept coming in and out of the water with handfuls of fish; I stayed in one place very close to the boat, treading water. The fisherman saw me kicking around a lot and said, “Can’t you touch?” He then showed me that although he was shorter than me, the water only came up to his chin. I knew this the entire time, but wasn’t brave enough to put my feet down onto the mushy, gooey, lake bottom. I am stubborn! After hours out on the lake, the fishermen were finally content with their catch of the day and they rowed us back to shore. Maybe the trip would have ended sooner if my buddies and I were any help in the process, but we didn’t catch anything. I guess I won’t be giving up my nursing job anytime soon! We thanked the fishermen for sharing their time with us and we went back to the hotel. I concluded my day of adventure with a cool shower and prayer that I won’t get any parasites from my day of conquering fears and exploring Africa!

Are You Being Fished???

Although it is obvious to many of you and has been for a number of years, there are many others who are just picking up on the fact that I am young, female, and single. How people have missed this fact until recently, I am not sure, but nonetheless, it is true. Apparently there are a number of men in Africa and on the ship that have totally noticed that I am single and that I am not a beauty queen but I don't look like a troll either. YIKES! My male friends on the ship, use the term "fishing" to describe relationships. Girls are "fish" and guys are "fishermen." Are you fishing? Or are you being fished? Are some of the questions I am asked frequently. Although I am so honored to be fished, it is complicated. It gets really confusing when some "fishermen" come from cultures where it is perfectly acceptable to throw a net and catch a few fish at a time. It is also complicated when these "fishermen" claim to live under Biblical standards, but they don't apply these standards in their "fishing-practice." Oh, my goodness, it is really burns my biscuit to find out that many "fishermen" here just view "fishing" as a sport! It intensifies the situation when the "fishermen" use a lot of flattery and are skilled at catching fish, but their intentions are impure. Yikes, what's a "fish" (girl) to do? Pray for my head and heart as "fishermen" cast their hooks in my direction. I ain't near ready to nibble on any hooks, but it is complicated when I just smile at a "fisherman" and then he thinks I am on his hook. Sometimes, I cannot walk down the hallway without getting tangled up in the mess of "fishing-hooks" being cast all over this ship. All this fishing mess makes me want to swim alone in my own pond (my cabin) and not come out, but I cannot do what God has called me to do from my cabin! Next time you think of this "fish," could you pray for some still, peaceful, waters. And pray for that poor "fisherman" that God may have for me in the future; his "fishing" process is going to be a lot harder because this "fish" has retreated to deep waters!

OUT MY FRONT DOOR

What do you see when you look out your front door? What do you see when you stare out your bedroom window? Well, I don't have a bedroom window and when I look out my front door (the gangway of the ship) I see the beautiful, Atlantic ocean speckled with huge ships coming to port. I also see tiny fishing boats bobbing up and down among the waves. If I stand in my driveway, I see the fishing village that is pictured here. It sure is great to live near such beautiful landscape!

The Top 10 Reasons I Haven't Written:

1. It is hot in Africa- when I get hot I don't want to do anything. 2. I got tired of running from all the men chasing me, I slowed down, let one catch me, and I have been spending all my time with him. 3. The Internet hasn't been working. 4. The ship sunk and my computer went down with it. 5. I ate too much local food and have been spending all my time in the bathroom. 6. I got stung by a huge bug and my fingers swelled so much it was impossible to write. 7. I decided to fast from the Internet 8. I have been working on creating this list of reasons I haven't written. 9. I am busy working on learning all of the 162 tribal languages in Benin and I've been busy trying to vacuum my cabin with a lint roller. 10. Okay, I have never really liked to complain, well, I change my mind, actually I do a good job at whining sometimes, but I always try to mix a little humor with everything. The truth behind why I haven't written is because I am having an incredibly difficult time. I guess it all started with working night shifts again and then the long stretch of 8 shifts in a row. The stress, the different culture, the intensity of the situations I face here, the lack of private space to relax in, and all that jazz has finally gotten to me. Add to that situation the fact that the doctor and I have been making some adjustments with medicines that I have taken since I was in 9th grade. The adjustment process did not go as well as hoped for. I have not been feeling like myself and I have been exceptionally sad and depressed lately. So, I guess I am saying I would appreciate your prayers. I know this too shall pass and God has taken me through a lot more in my life, but I wish this time of feeling less than my best would pass quickly. I said I wanted adventure in life and I've got it! When I am weak He is strong! I love all of you!

SO HUMAN

If any of you were every tempted to call me anything more than human, like a hero, or amazing; don't. I know some of you may want to call me an alien, but we can discuss that later. I am so human and this past week has reminded me of that in more ways than one. I am weary and worn out after my last stretch of shifts. Well, pure, extreme, total exhaustation might be a more accurate description of my current state of being. I had a few days off, which were a blessing, but I am back at it again. Today we had another VVF screening day. We had two new surgeons fly in last night and today we examined and took medical histories on 40 patients. Wow! We are starting another 6 weeks of VVF surgery. Therefore, I am back to balancing three roles again. Charge Nurse, VVF Co-Coordinator, and Ward Nurse. Please pray for my endurance, my roommates (I feel bad for them having to live with a frustrated, tired, stressed Laura), our patients, and my patience, strength, renewed passion, sweet restful sleep, and my relationships with crew. Pray that I may have patience with myself considering I get frustrated with my own human limitations. Oh, dear, just pray. I have so much more to say, stories to share, but what I really need is to sleep right now. I love all of you!

I AM TIRED

I am on my 7th shift in a row. Your prayers would be appreciated. I worked an evening shift as a ward nurse last Wednesday, evening Charge Nurse shifts Thursday and Friday, day shift Charge Nurse shifts Saturday and Sunday, yesterday I worked a day shift from 8:00-5:00pm as VVF Co-Coordinator and today and tomorrow I work evening Charge Nurse shifts. Wow, I am sorta feeling exhausted. Pray for my continued strength, patience, and endurance. I don't want my lack of energy to come across to the patients I am here to serve. I want my conversations to be flowing with grace and love, but when I am tired, that is harder! I am looking forward to a few days off starting Thursday, but Thursday seems so far away right now! Yikes! I love you all!

Mindboggling Differences

I knew Benin was vastly different from Liberia the moment I stepped off the airplane. Over the past two months more and more of the differences between Liberia and Benin have become apparent to me. I know each country and part of the world is unique and has certain cultural practices, but naively, I expected there to be a lot more similarities between Benin and Liberia. I mean after all, they are both West African countries, they are both on the list of the poorest countries in the world, and geographically they are not that far apart. But, I am totally shocked over the diversity between Benin and Liberia. Where to start? Well, one of the first things I noticed was the roads. Most of the roads in town are paved and without portholes to China (there are almost no potholes)! I remember last year in Liberia when we would hit a pot hole in the road and I wondered if we would come out on the other side of it in Liberia, or China, considering its depth! There are also designated driving lanes on the roads and surprisingly, most drivers follow them! The traffic lights work! I am not a ship driver as of yet, but I am not near as excited about driving as I was last year. I don’t want to follow traffic laws. I prefer the “make your own lane”, “make your own way”, of driving in Liberia. This may be my slightly rebellious side coming out! My home and driveway: In Liberia, we had the luxury of our own dock. The port in Liberia is very quiet, and we had the blessing of our own secured private dock. Here we share our port with a number of other ships, boats, a fishing industry, and a cement plant of sorts. How and why they are making cement at the water end of our dock is a mystery to me, but I guess that is not my concern. Development; pure and simple, Benin is advanced and developing. The streets are not lined with people sleeping on the dirt or sitting in wheelbarrows. The crowds of people are moving, not stagnant groups of people without places to go, activities to attend, or jobs to get to. There are not near as many cooking fires on the sides of the streets in town. And astonishingly, there are few rubbish piles or liter heaps lining the streets. There are actual neighborhoods and in general, it appears housing conditions are almost 100% better than in Liberia. From the number of houses, to the general structure and building material available and used, housing conditions are significantly advanced. The market and economic status of Benin is incredible. I am embarrassed to admit that I had stereotyped all of Africa as, poor, undeveloped, and behind the times. I was so wrong. But, I have to say I honestly miss the simple, mobile markets of mamas carrying the grocery store on their heads. Wheelbarrow markets are almost non-existent here. There are actual proper stores and fixed locations for buying and selling. Don’t get me wrong, there is still a small population of street vendors and rickety wooden market tables covered with crazy gadgets and second hand items for sale, (items most likely donated from Europe and North America and now being sold again instead of being given to the poor). But, the differences are just amazing. At times I have to pinch myself to remember that I am actually still in Africa. Of course, obviously I am surrounded by a sea of black people, which is a good clue that I am not in Idaho or New Hampshire anymore, but I dare say I am almost colorblind now and I think there may be more shopping options in Cotonou, Benin than in Rupert, Idaho! The other day I went into town with a friend to get some photos taken for a visa in hopes that I get the chance to visit Togo, Ghana, or Nigeria while I am here. We had to wait a few hours for the photos to develop (a 3-hour photo studio; not quite a 1-hour photo studio like at Wal-Mart, but who would have thought… any kind of photo studio in Africa)! Either way, we decided to walk around town while we waited. It was fun. We wandered in and out of a number of stores. I cannot believe what is available here! There were only two small, modern, supermarkets in Monrovia, Liberia and I think I went into at least four on just one street here. The vast array of available products here is astounding. Dial soap, Garnier Fructis hair care products, Pringles, and other name brands from America. Where am I; America or Africa? There are multiple fabric stores with the most amazing beautiful fabric prints. I am doing everything possible to curtail my addiction to African fabrics, but I don’t know how much longer I can hold out. The craziest thing, that still bewilders me, is one of the last stores we moseyed into before returning to pick up our photos. I couldn’t believe my eyes. I stepped off the dirty, hot, African street into an IKEA/Pier One Imports/Ace Hardware combination type store. It took my breath away. Mikasa fine crystal, chic household decorations, table centerpieces, candles, cleaning products, garden hoses, work gloves, light bulbs, you name it. I cannot describe how I felt walking through this store. I never imagined walking in a store like this in Africa. It was mindboggling. My mind is all muddled up from this experience. More and more differences. The streets are busy, but a different kind of busy. There is a serious lack of children running around and most women on the streets do not have precious cargo (little chocolate babies tied to their backs). My personal theory is that the developmental status and educational level of the general population of the people around Cotonou directly correlates with the population size. Basically, in Liberia there was little opportunity for recreational activity other than personal relations, thus a greater number of children born. This makes me sad, although it shouldn’t. I mean it is great that the people in this area have opportunity, education, and careers; I just miss all the beautiful kids from Liberia that would run into my arms and fight for my attention (White people and white skin are not a big deal here). It is great that I don’t see children on the street during the daytime. In contrast to Liberia, there are a number of schools here and the majority of children in the city have the opportunity to attend. This should not frustrate me, but it does because it proves I had a stereotype of Africa and I was wrong, and no one likes being wrong. Will this in mind, I often feel puzzled, perplexed, and mystified as to why the ship is docked here in Benin? I look around town and think, “These people don’t have it that bad off, why are we here? MOST of their basic needs are met.” But, in reality, I would complain if I had to live like they do. I must protect myself from being hardhearted and insensitive. It is true, Cotonou, Benin is much more affluent than Monrovia, Liberia, but the NEED here is still REAL and great. If one travels a few hours from where the ship is docked, EXTREME poverty is waiting. There are hungry, sick, poor, and lonely people dying daily. I just see a distorted view of the economic status of Benin because I am in the capital city and living directly on the water where all the import and export takes place. We are blessed by the luxuries that surround us here in town but, it would almost be better if the ship could grow wheels and move up country about seven or eight hours. But since that is not possible, our job just requires more creativity in how to get the word out to the needy people up country and how to get them here for the care they so desperately need. One important piece of information that I am reminded of and must not forget is the horror and devastation of WAR. Liberia is recovering from the BRUTALITY of over a decade of civil war. Liberia was essentially destroyed. It is now rebuilding itself, but it is a slow, slow process. Because of the war, there is a gap of about 14 years of un-educated individuals and that certainly has an incredible impact on the community. War is horrible, but just because Benin hasn’t faced war recently, doesn’t mean the people here don’t need us. As I ponder all of this, the words of our dear surgeon that just went home with the diagnosis of cancer, keep echoing in my head. “At the end of the day, it does not really matter how many goiters, cleft lips, hernia, or club feet operations we perform, if at the end of the day, a patient leaves the ship physically healed, but not touched spiritually we have done wrong. If we heal physically, but leave people eternally lost, we have done an injustice.” I am left with the conclusion that it doesn’t matter where I am. I could be in the African wilderness, the frozen regions of Siberia, a small, rural, farming community in America, or living in Paris surrounded by all the material luxuries one could hope for. At the surface level, it doesn’t look like help is needed, but reality screams there is a lot more to see than meets the eye. Our world is broken and at the heart level, we are not really that different from each other. And we are all called to fix the brokenness in Jesus’ name. For now that means I live with the luxury of an African version of IKEA/Pier One Imports/Ace Hardware just down the road and that is okay. I am here to bring hope and healing in every aspect and to everyone I meet from the store clerk at my African IKEA store, to the mama stirring rice in a dirty pot on the side of the road.

NIGHT SHIFTS

Don't worry, I did not fall off the face of the earth, I don't have the swine flu, and I have not forgotten all of you at home. I am in the middle of my first row of night shifts since returning to the ship. I haven't worked night shift since November (one benefit of my new role as VVF Co-Coordinator and Charge Nurse; I don't have to work as many night shifts! ) As you may recall, last year I was freaked out about working night shifts because I did not do well with night shifts in university, so never worked them. Prayers were answered last year and I did extremely well on every night shift and actually started to enjoy them. I am currently on a rotation of three night shifts in a row. The past two night shifts have gone well, one more to go! I always pray that God will give me enough energy and that I will not fall asleep. I didn't expect to have that prayer answered by me running all night long, without a chance to sit down, let alone a chance to fall asleep. Funny how God works and answers prayer, I may need to change the way I pray!Thanks for your prayers, but maybe we could ask God to sustain me and give me a chance to sit down during the shift ( I know I am asking for a lot)! Take care all!