...Nursing Assignment #1- Play with the new patients...

1st Patients of the Sierra Leone 2011 Outreach



...nurses...nurses...nurses...

Hospital Staff- Management, Admission Nurses,OR Nurses, PACU nurses, Ward Nurses, Out-Patient nurses, & Pallative Care Nurses... 


                                                            ...home sweet home...

Port- Freetown, Sierra Leone- My home-Neighbourhood for the next 10 months while Mercy Ships is in Sierra Leone 

 

...the long & the short of it...

LONG- I have been working very LONG days and shifts lately. This past week I worked about 70 hours in a 5 day period. Yikes!


SHORT-This past Wednesday the captain informed the crew that we are once again experiencing a water SHORTage. The captain asked us to ration water and limit the use of water to only essential needs. The crew laundry room was closed. We started using disposable dishes in the dining room. We stopped changing bed linen in the hospital unless it was very soiled or a new patient was coming in. We covered all the shower heads in the hospital bathrooms with plastic bags and have implemented having our patients take bucket baths instead of showers. We were reminded once again to be taking true “ship-showers” which involves getting wet, shutting off the water, soaping up & applying shampoo, turning the water on to rinse off the soap, turning the water off, then applying conditioner, then running the water one last time to get the conditioner out. A process that SHOULD limit water use to less than 2 minutes total per crew member, per shower. (Because of my long shifts, & being too tired to shower, I personally haven’t washed my hair in a week, scarves work just fine& I have had baby-wipe showers since Tuesday. I was hoping for a longer shower this weekend, using a few of the minutes I didn’t use during the week, but that won’t be happening). We closed down part of Starbucks because it takes too much water to wash the blenders and coffee making devices (I don’t drink coffee anyway and cannot fathom drinking a hot drink when it is hotter than Hades outside, so this cutback hasn’t hurt my feelings too much, but I have some co-workers who seriously need their coffee every day, so this could be an issue). We were informed that when all the water sloshed out of the swimming pool that it would not be filled again. (I have dreamed of using the swimming pool, but have been too tired even on my days off to walk the 5 flights of stairs that would lead me to the swimming pool that is made out of shipping containers and sits on top of the ship, so even if I had the energy, I guess I won’t be using it anytime soon). We also started the “if it’s yellow, let it mellow & if it’s brown flush it down” motto.


With all these cutbacks we hoped that we would have enough water to continue surgical operations, run the sterilizer, cook, and maintain adequate amounts of water to drink. The captain requested more water trucks to come to the ship- knowing that even if water was delivered we would still need to ration water because it takes up to 72 hours to treat the water we receive to make it clean enough to use.


The water didn’t come. And even with all the cutbacks mentioned above, somehow we consumed 15% MORE water on Thursday and Friday than last year at the same time, on a busy day, with ALL usage of water permitted. Yesterday, the captain closed the crew galley, we are no longer allowed to wash personal dishes, or bake on our own, because this requires water usage. The galley won’t be allowed to serve lettuce & other fresh vegetables because it takes too much water to wash and clean them. The water supply to the showers was cut off. All hot water was shut off. We are trying to supply enough water to flush the toilets and wash our hands. The captain is looking at different ways to supply water to the ward and the captain is looking to see if there is a leak or if we are losing water somewhere. We are praying that we receive a water delivery, but were told that the sources that may deliver water are not as reliable as normal and the water we receive may be dirtier than normal, requiring more time to treat it and make it safe to use. ALL that to say- we are SHORT off water: please pray.


LONG- My orthopedic patients are getting LONGer legs & arms as we provide surgeries to straighten what was crooked, to re-align what was out of line, & to stretch what has been curved. I love my patients!


SHORT- I am not the only one working overtime, many of the other hospital managers are working crazy hours too. Tempers & patience may soon be running SHORT: please pray.


LONG- I LONG for God to continue filling me with his strength, wisdom, energy, patience, love, gentleness, kindness, goodness, and passion to continue serving the people of Sierra Leone!

Random Update Points

-The water situation is improving- normal restrictions continue to apply, but praise God, we have secured enough water to: drink, run our sterilizing machines, wash our hospital laundry, wash the dishes for our family of 400, to flush our toilets, to wash our personal laundry, and to have an occasional “ship-shower.”



-We have officially completed our first full week of surgeries. This year we are starting with the orthopedic, eye, and maxillo-facial, surgical specialties. We have some of the most beautiful children on-board right now. It isn’t a secret that I love the African children, but the ones with cleft lips, bow legs, and club feet are my favorite and my ward is full of them!


-This year I will be working as a ward nurse, a charge nurse, and during our 10 weeks of orthopedic surgeries I will be the Orthopedic Nurse Team Leader- which sort of means I am the nurse manager of the Orthopedic Ward. My ward has 40 beds and almost all are full! My responsibilities include organizing beds- admissions & discharges, rounds with the surgeons, kissing the babies, writing daily progress notes, sitting on the floor with the babies, assisting the ward nurses, blowing up balloons & making sure the little kids share them, answering questions, playing balloon volleyball on the ward, changing dressings, finding the elevator when it gets lost upstairs, sorting out the location and placement of supplies in my ward, assisting with patient allocations, kissing babies, arranging follow-up care for the orthopedic patients, orienting and welcoming our new day volunteers-translators to the ward and helping them find things, reminding them to wash their hands, & guiding them in the right direction when they are lost, working with our physical therapists, frequent runs from deck 3 where the ward is, to deck 6 where the only working ice machine is, to get ice for all my patients with aching legs, hugging the children, praying with the patients when they are in pain, answering more random questions, running to the lab to see the malaria parasites that my patient was just diagnosed with, talking with the dietician to see if we can order milk for my patients since the pharmacy has no great source of calcium supplements for the patients, trying to get the translators to distribute the milk to my patients instead of letting it sit in the kitchen all day, making post-operative checks, ensuring the patients are receiving adequate amounts of meds to relieve their pain, smiling at my patients, making sure the patients get craft supplies, delegation, putting up curtains with magnets around my patient’s beds for privacy, kissing the babies, dancing or attempting to dance when we have worship time, and of course any other task that may presents itself! I love my job!


-This past week I worked 69 hours in 6 days, averaging 11.5 hours a day. God has given me amazing strength! Unfortunately, I caught the respiratory bug that is spreading around the ship. My throat is as rosy as my sun-burned skin, my body aches all over, my nose is running, I feel feverish, but couldn't be happier! I love being back in Africa!  

All Mercy Ships' Crew Are Safe...but Prayers Appreciated!

Please Lift up the People of Sierra Leone & The Mercy Ships' Crew in Your Prayers...

A very sad incident occurred in the course of screening activities on Monday in Freetown, Sierra Leone of which you need to be aware.


Initial incident reports indicate that when screening personnel arrived at the stadium this morning there were 700 people already allowed into the stadium and a large crowd outside. Sometime after 9:30 events yet to be conclusively determined occurred to agitate the crowd and cause it to storm the gate. In response 200 more people were admitted to relieve pressure, but tragically 13 were injured, including one fatality and two life threatening situations. Mercy Ships personnel on site cared for the victims and accompanied them to hospitals. No Mercy Ships personnel were injured. Ongoing investigation will determine the facts. Please keep the individuals affected and their families in prayer, and pray also for the entire crew. This is certainly a time to pray and believe that God will work all things together for good in this tragic situation.

Mercy Ships is deeply saddened by the tragic events that occurred today during medical screening at the Freetown National Stadium when a crowd stormed the gate resulting in several injuries and one life lost.  Mercy Ships personnel working at the site attended the injured and accompanied them to local hospitals. "Our hearts and prayers are with the individuals and families of those affected by today's events. The occurrence of this incident in the course of activities intended to restore lives is tragic. We move forward with tremendous sadness, but great determination, to assist as many people as possible in the next ten months," stated Mercy Ships Founder, Don Stephens.


Mercy Ships exists to serve the forgotten poor and has served Sierra Leone five times over the past two decades, also helping establish two land based health care facilities. For the next ten months, Mercy Ships will be providing surgeries for qualified patients while working alongside the Sierra Leonean Government to support its five-year healthcare plan and strengthen the functions of the national health system.


All Mercy Ship Crew are Safe, but Prayers Appreciated!!!

a quick note

I am back in Africa!!!

I am in Freetown, Sierra Leone!!!

I arrived safely on the ship after a flight from London to Brussels, a layover in Brussels, and a sketchy, water-taxi ride across the river/ocean (more to come about this adventure)...

I love being back on the ship!!!

I/we need prayer...we are currently relying on a dwindling water supply that the ship carried with them from South Africa... our reserves are quickly running out...we have not yet been able to secure our supply of water with our host country, Sierra Leone, because we recently found out the local water is contaminated with e-coli...this issue presents a small problem... not only for the local people, but us...we are in need of extra water at this point in our outreach because we are in the middle of cleaning & scouring the hospital, sterilizing our surgical instruments, & cleaning all our equipment that was stored in containers while the ship was in dry dock. With the water shortage we have had to halt all but essential uses of water...

Intervention is needed from God in the area of the port. The day after the ship arrived in Sierra Leone, control of the port went from government owned to private ownership. This change is huge & the ship is in the middle of it! We need a mountain of shipping containers to move so that we can secure our dock & set-up our dockside units.

I/we/the people of Sierra Leone need your prayers....tomorrow & Tuesday...are the screening days for Mercy Ships. The day we triage and select those that we will be able to operate on during the next 10 months & those we will not be able to help. We are holding the screening at the local stadium in Freetown. Please pray that those we can help will come to seek help & pray that those we will be unable to help will stay away. Pray for divine intervention in the entire process...We expect thousands of people to come...

I must go to bed now. Morning is going to come before I know it!

Crazy Professors & Sterile Coconut Milk

 Only four short months ago I began my adventure of diving into the textbook world of tropical diseases and in two weeks that formal swim in a sea of unending information & knowledge will come to an end. I have been privileged to sit under the instruction of some of the greatest tropical disease doctors, epidemiologists, inventors, nurses, and adventurers of our time as I have studied at the London School of Hygiene and Tropical Medicine, here in London, England. I have sat in awe as I have listened to great minds explain their life work of trying to invent a malaria vaccine or a new treatment for one of the neglected tropical diseases. My professors are crazy (one of them purposely infected himself with worms to test the theory of their help in treating asthma and Crohn’s disease), but my professors are also crazy- passionate about making the world a better place, and so am I.

I have learned so much during my short time studying tropical diseases here in London. I have learned some incredible things that will no doubt help me in the future as I volunteer as a nurse in the remote corners of the earth. For example, supposedly coconut milk is sterile, so if ever short on IV solution, I can pop open a coconut and let the infusions continue. I learned how to deliver a baby in the bush. I learned how to numb & pull teeth. In war zones, diesel vehicles are safer than gasoline powered vehicles. I have learned how to identify parasites under the microscope & how to type blood.  Poo is the most dangerous thing in the world. And when in foreign countries, remember this saying to protect yourself from inevitable pain: cook it, boil it, peel it, or don’t freakin eat it!

I have also discovered some incredibly humbling things about the reality of our fallen world. The statistics about the numbers of those dying daily from preventable diseases is unreal. Also, although difficult to fathom, despite all the poverty and intensity of daily life for one group of African women, when asked, the one thing they wished for above anything else, was a safe, clean place to go to the bathroom. They didn’t wish for peace, air conditioner, food, clothing, washing machines, or a life free from war and pain, they simply wanted a clean, safe, place to go to the bathroom. Having a bathroom for them meant comfort, freedom from constant smells & flies, the chance to escape some of the horrible diseases caused by improper sanitation, prestige, the chance for visitors, and life… You see, because of their tribe’s beliefs, the women in their village were not allowed out of the house during the day. That meant they could only go out when it was dark. Living without electricity, the village latrine was located in the dark, outside the village boundaries, and all too often the village women were raped and killed just in the attempt to relieve themselves.

My eyes have been opened to more of the sad reality of this world and I am convinced even more that instead of constantly debating policy, politics, religion, and waving our fists in the air during those intense conversations with God when we yell at him wondering how he can even exist when there is so much suffering all around, that we need to get out in our neighborhoods, schools, cities, states, countries, and world and show them the love that God asked us to pass on. Hug a friend, smile at a stranger, heck, hug that stranger, mend those broken family relationships, visit the widow, cook a meal & share it, pray for your enemies, and love as if you have never been hurt.

I have only a few more weeks in London and many of those days here I will spend pouring over the facts and specifics about schistosomiasis, trichuris trichiura, leshmaniasis, plasmodium falciparum malaria, kwashiorkor, filariasis, hookworm, tetanus, lepromatous, loa loa worm, trypanosome rhodisiense, mycrobacterium leprae, hydaatid disease, entamoeba histolytica, trypanosoma cruzi, cholera, onchocerciacis, & tenia saginata, all in preparation for my final exams. There is so much I have learned and so much I still don’t know. There is so much my professors know and still so much even they don’t know.

Many times in our lectures, we have discussed the care of patients in remote, resource poor areas, and our professors have said, “what next?” and we would come up with some creative way in which we would deal with the situation without modern medical technology. Then the professor would say, “and what next?” the “what nexts” would continue on and on until even the brainiest student in my class didn’t have any more suggestions…at that point it was almost as if one could divide the room in two groups by simply looking at facial expressions…humanitarian aid workers versus missionary nurses… Although it breaks my heart when caring for patients and we run out of options because we lack simple supplies that are so readily available at home…I don’t have to feel defeated because it is when we are weakest that He is strongest and it is when we are at our breaking point, our whit’s end… that He carries us…

fancy playing dodge ball with bats?

 I inched my way through the tight space by crawling on my stomach. I sat up for a brief moment enjoying a bit of head room, but then in an attempt to keep up with the rest of my group, I continued creeping along the cool, rocky surface ever so carefully on my hands and knees. I could see the tiny cavern’s entrance ahead of me. I slithered across the rocks trying not to fall and started to make my descent into the cave. My heart raced as a swarm of slimy, black-winged creatures started flying toward my head! I screamed as one bat after another came rushing toward my face and body as I attempted to enter their sacred home. I quickly backed away from the cave trying to dodge the furious black, flying, freaky, animals that surrounded me.

My other friends, far more adventurous than I, were already inside the cave and I could hear them urging me to join them. I yelled back, “heck no, I’ll just wait out here!” My friend’s voices echoed from inside the cave assuring me the bats weren’t bothering them inside the cave, so I just had to be brave for a few minutes as I made the initial decent into the cave. I have never really cared about what others think of me and I didn’t fancy the idea of playing dodge ball with the bats again, so I had decided to sit this adventure out. I would wait for my friends outside the cave, but then out of nowhere, I was filled with a sudden burst of boldness (or stupidity) and I crept back toward the cave entrance. I agreed that if all my friends would point their flashlights toward the entry to the cave (bats don’t like light, so I thought they would leave me alone if I was in a spotlight of flashlights) I would try to join them.

This freaky spider was what
appeared on my camera after
just shooting a pic in
the dark.

With all flashlights pointing in my direction, I carefully descended into the blackness of the cavern. I breathed a sigh of relief as I was reunited with my friends, far away from where the bats were flying around. Linking hands with my friends we explored the tiny cavern that we found ourselves in. We were expecting a slightly bigger cave considering we had been told by our African tour guide, an old man that looked to be well over 75 years old, and told us we could just call him Boss, that this cave was one of the best in West Africa. A few paces to the right, a few to the left, one or two behind us, and one or two in front of us and we had seen the entire cave. We decided Boss has lied to us, or that West Africa’s caves were pretty pathetic. Either way, we took pictures into the darkness not knowing if the photos would even turn out, or what would be in them, but nonetheless they would document our great Ghanaian, cave expedition.

Before we left the cave, Boss called us all together in a circle to tell us some interesting facts about the caves in the area. Some of the caves had reportedly been used for hideouts or lookouts from enemies; others were used as prisons of sorts. Next, Boss grabbed some of the dirt from the ground beneath where he was crouching, he picked it up in his hands and flicked it in the air reporting, “And this…this is bat s*#t!” He repeated the phrase again and again. I started laughing, but then I remembered a bit of high school biology class and something the teacher had said about bat s#*t not exactly being a friend or something to mess around with. As Boss chuckled and flipped bat s#*t here and there, I decided it was time for my little cave adventure to end and my friends and I made a quick exit from the bat infested cave.

I hadn’t thought about my West African caving expedition (or maybe that over exaggerates the adventure) for a while, until this past week when I was sitting in class at the London School of Hygiene and Tropical Medicine. My professor said, “Nurse, what are you going to do? A 19 year-old male comes to your travel clinic reporting he is flying overseas for a spelunking trip, in less than 3 days, and he asks you if you think it is necessary for him to have any vaccines.” I had no idea what I was going to tell the young man, I knew it was something important otherwise the professor wouldn’t have asked the question, but I was clueless. My first inclination was to ask the boy why he waited until 3 days before he was leaving to seek travel health advice, but that really wouldn’t solve anything. I didn’t know the answer and that is part of the reason I am in this course. Tropical diseases are not something we cover heavily in North American nursing programs.

The professor went on to discuss rabies, the transmission of rabies, where rabies exists, signs and symptoms of the disease and treatment (of which none really exists especially after the first symptoms appear because at that point, death is right around the corner). The more my professor talked the more I realized my moment of boldness, in Ghana the year before, that led me down into bat mecca, was really a moment of stupidity. I had not realized or had totally blanked out the fact that bats carry rabies. The travel clinic I had visited before heading out to Africa asked me how likely it was that I would come into contact with dogs or animals on my time overseas. We decided it was highly unlikely for me to find rabid animals on the ship (because there is a no animal policy) and I’ve had a lifelong fear of dogs, so I assured the nurse I wasn’t about to go petting dogs in an African market. We didn’t even think about my potential contact with bats or monkeys for that matter (remember African Wildlife, October 21, 2008). So, I had headed to Africa unvaccinated against rabies. All I can say now is I’m signing up for a rabies vaccine and praise the Lord, I didn’t get bit by a bat or didn’t get any precious bat s#*t or spit into the open cuts and scratches I had acquired on my trek through the jungle that had led me to the “one of the best caves in West Africa.”

...the world is not fair...

I sat in one of the lecture halls at the London School of Hygiene and Tropical Medicine and eagerly waited for the professor to start his lecture. I had my notebook opened, ready to document every important piece of information the professor shared with us. He began by saying,

“…The world is not a fair place…

… Someone dies from HIV every 10 seconds…

…1 child dies from malaria every 30 seconds…

…1 child dies from malnutrition every 40 seconds…

…30,000 children die EVERY day from PREVENTABLE diseases…&

…4,000 people die DAILY from lack of access to clean water & sanitation...”

I sat in my chair and scribbled notes rapidly as the professor continued to discuss the tragic reality of our world today. The professor presented statistic after statistic describing the horrid, hellish situations many people face daily. If you are like me, you are skeptical of statistics and your brain kind of shuts off, when presented with a list of numbers… Sure, statistics have their place in the world, but what is more important is every statistic represents a precious, valuable life. The professor continued to talk, but my mind was far from the lecture hall… I was picturing the faces behind the statistics…


I was back in Africa. I was sitting on the dirty ground in the suffocating heat, dripping with sweat, cuddling the fragile, dark-skinned children at the orphanage. I was uselessly swatting malaria, mosquitoes away from the tribal children as they sat in the dirt with hungry, tummies rumbling. I was back on the Mercy Ship. It was late at night and in the shadows you could see a couple in a tight embrace. There was nothing but pure love in the embrace, but it wasn’t a romantic love holding the couple together. It was the love of a nurse for her patient, the love of an American girl for her African sister. It was the love of Jesus shown with human hands. It was me holding my 16 year old African patient in her bed, on the ward, as she wept in the middle of the night because she leaks urine all the time related to a traumatic pregnancy and the free surgery we gave her, did not completely solve her problem. I was back on the dock in war torn, Monrovia, Liberia saddened that we had to turn yet another patient away because the need is so overwhelming, but time is so limited. I was in Chile listening to story after story about the damage the tsunami had done and how with every aftershock fear, panic, and anxiety well up in the people’s hearts. I was in Bolivia hugging the Señora as she wept, explaining she didn’t know where her next meal would come from. I was in New Hampshire caring for my patient, a pastor’s wife, with a broken hip. She had already broken her other hip and arm. She was so discouraged, her pain increasing daily. She was barely 5o years of age, but the cancer coursing through her bones had weakened them to the breaking point. I was in Canada in my last year of nursing school, working in the adolescent psychiatry ward and caring for a missionary kid the age of 16 who had tried to take his life after being fed up with the legalism that his parents and church were imposing upon him… Memory after memory of the sites and scenes of suffering that I have encountered in my mere 28 years of life came flooding over me. My professor was right, the world is not fair.


I believe all of us are well aware of the suffering in the world. The question then becomes what does one do with this information. When looking at the statistics it is very depressing. It is easy to become angry with God. Sometimes we question how a loving God could allow so much suffering. At times we wonder if God even exists. We ask God why there is so much suffering in the world! I have wrestled with these very questions, but have realized we can question our lives away, but suffering persists. But, did you ever ponder that our questions could be reversed? What if God asked you why there is so much suffering in the world? What if God asked you why you didn’t do something about it? My challenge to you today: Be the change you want to see in the world. Show people that the world may not be fair, but that you still care.