Nearing the End.

It is so hard to believe that my time here on the Africa Mercy is coming to a close…

When I arrived on November 30 the end seemed so far away.  And now here I sit, with three work shifts left with our patients and a couple days of cleaning and shutting down the hospital to go.

I have loved my time here for so many reasons:

The patients, their families, the day crew of Malagasy people I am blessed to work with.

The sisters and brothers I have met and lived community life with from all over the United States and the world.

The support I have had of so many people around me here in Madagascar and back on the home front, constantly reminding me of the love that they have for me and the prayers they are sending up for me.

Tangible love has become so more real to me here on this ship.  Love of friends.  But also love of strangers.  The kind of love that Jesus talked about and demonstrated 2,000 years ago.  Love above all else–no matter who, where, or when.

I think this love is only possible when we are able to know and feel the depth of God’s love for us.  The God who made the universe, who gave us the wonder we feel when we gaze at the earth and the sky… this God loves each one of us.  Perfectly.  Wholly.  Not because of anything we have done.  With no ulterior motive.  With nothing to gain.

“For while we were still weak, at the right time Christ died for the ungodly.  For one will scarcely die for a righteous person–though perhaps for a good person one would dare even to die–but God shows his love for us in that while we were still sinners, Christ died for us.”  – Romans 5:6-8

Just as this love was shown to me, I am compelled to show this love to others.  That is the main reason I came here to Madagascar.  This feeling of so much love and blessing in my life that it needs to go somewhere.  I know my parents would be much happier if I just showed this love in Milwaukee, or even somewhere else in the States, but I felt that it needed to be further, away from my normal life, even for just a short season.  I was drawn to Mercy Ships, and God worked out my coming here.

I have felt God’s love for me immensely in this season of my life.  Love not through just the good emotions and beautiful things I have witnessed here, but rather through it all.  Through the missing of my family and friends.  Through the brokenness I have seen in people’s lives.  Through my feelings of longing for justice here and around the rest of the world.  Through my close proximity of the poverty that so many live in.

With the further realization of this love in my life, I have been able to show it to others more fully.  I am by no means able to love perfectly (just ask those I am closest to…), but I hope that my love is becoming more and more complete in Him, that I am starting to love others more and myself less.

“A new commandment I give to you, that you love one another:  just as I have loved you, you also are to love one another.  By this all people will know that you are my disciples, if you have love for one another.”  John 13:34,35

I know that much change will happen for me in the coming months as I readjust to life in the States.  Readjust to my old job and changes that have come down the line there.  Readjust to my new house and new roommate.  Readjust to my family and friends’ presence.   Reacquaint myself to everyones’ lives after the seven months I have missed out on.

Overall I am just so grateful.  Grateful to everyone for their support and prayers.  Grateful to all the people here who have made this experience unforgettable.  Grateful to my Lord for showing me more of himself throughout this season of my life.  I know that His love will lead me through the rest of my life–through the joy, the heartbreak, and everything in between.

I think that Don Miller says well a lot of what I have been thinking and feeling:

“And so my prayer is that your story will have involved some leaving and some coming home, some summer and some winter, some roses blooming out like children in a play.  My hope is your story will be about changing, about getting something beautiful born inside of you… about learning to love others more than we love ourselves, about learning oneness as a way of understanding God.  We get one story, you and I, and one story alone.  God has established the elements, the setting and the climax and the resolution.  It would be a crime not to venture out, wouldn’t it?  It might be time for you to go.  It might be time to change, to shine out.  I want to repeat one word for you:  Leave.  Roll the word around on your tongue for a bit.  It is a beautiful word, isn’t it?  So strong and forceful, the way you have always wanted to be.  And you will not be alone.  You have never been alone.  Don’t worry.  Everything will still be here when you get back.  It is you who will have changed.”  (Through Painted Deserts, Donald Miller, pages xii-xiii)

I don’t know what the future holds for me, but I do know who holds it, and I am thankful for that.  Thankful that I don’t have to worry.  Thankful that I don’t have to perform.  Thankful for all the beauty and goodness I have been blessed to receive so far in the short twenty-six years of my life.  Thankful for this time to leave, but also thankful for a time to come home.

Photo Credit Deb Louden, Mioty (MGB14013) and Jaclyn BLIEVERNICHT (USA) Ward Nurse, play on the ward together.

Photo Credit Deb Louden, Mioty (MGB14013) and Jaclyn BLIEVERNICHT (USA) Ward Nurse, play on the ward together.

Photo Credit Deb Louden, Mioty (MGB14013) and Jaclyn BLIEVERNICHT (USA) Ward Nurse, play on the ward together.

Photo Credit Deb Louden, Mioty (MGB14013) and Jaclyn BLIEVERNICHT (USA) Ward Nurse, play on the ward together.

Photo Credit Deb Louden, Nurses, Hospital Day Crew, caregivers and patients from the Maxillofacial ward.

Photo Credit Deb Louden, Nurses, Hospital Day Crew, caregivers and patients from the Maxillofacial ward.

Photo Credit Catrice Wulf - Clarinette (MGB16302) and Ny Anjara (MGB14057) on Deck 7

Photo Credit Catrice Wulf – Clarinette (MGB16302) and Ny Anjara (MGB14057) on Deck 7

Photo Credit Catrice Wulf -

Photo Credit Catrice Wulf – Jean Florent and Anna Iraggi (USA).

Photo Credit Catrice Wulf - Ward nurse Katie Ten Hoeve (USA) with Lixia (MGB12462) and her sister on Deck 7.

Photo Credit Catrice Wulf – Ward nurse Katie Ten Hoeve (USA) with Lixia (MGB12462) and her sister on Deck 7.

Photo Credit Catrice Wulf - Ward nurse Rachel Eason (GBR) with Lauren (MGB16252) on deck 7

Photo Credit Catrice Wulf – Ward nurse Rachel Eason (GBR) with Lauren (MGB16252) on deck 7

Photo Credit Katie Keegan - Judlin (MGB16064) on the dock

Photo Credit Katie Keegan – Judlin (MGB16064) on the dock

Photo Credit Catrice Wulf - Ward nurse Heather Morehouse (USA) with Stani (MGB16286on D ward.

Photo Credit Catrice Wulf – Ward nurse Heather Morehouse (USA) with Stani (MGB16286on D ward.

Photo Credit Catrice Wulf - Ward nurse Heather Morehouse (USA) palys with Mioty (MGB14013) on Deck 7.

Photo Credit Catrice Wulf – Ward nurse Heather Morehouse (USA) plays with Mioty (MGB14013) on Deck 7.

Photo Credit Katie Keegan - Amy Jones (GBR) and Mioty (MGB14013) color in the wards

Photo Credit Katie Keegan – Amy Jones (GBR) and Mioty (MGB14013) color in D Ward.

Photo Credit Catrice Wulf -

Photo Credit Catrice Wulf – Olga in D Ward.

Photo Credit Catrice Wulf - Jacques (MGb16284) and Stani (16286) on Deck 7 together with their new noses.

Photo Credit Catrice Wulf – Jacques (MGb16284) and Stani (16286) on Deck 7 together with their new noses.

Photo Credit Deb Louden, Heather MOREHOUSE (USA) Ward Nurse, holds Bienvenue (MGB16273) while playing with Mioty (MGB14013) and Jaclyn BLIEVERNICHT (USA) Ward Nurse.

Photo Credit Deb Louden, Heather MOREHOUSE (USA) Ward Nurse, holds Bienvenue (MGB16273) while playing with Mioty (MGB14013) and Jaclyn BLIEVERNICHT (USA) Ward Nurse.

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Blessed. Beautiful. Beyond.

The last few weeks have been filled with taking care of my beloved patients, lots of Parks and Recreation (new show addiction), and the best vacation I think I have ever had…

I was privileged, along with five friends, to take five days of leave from the ship so that we could go to a beautiful island called Sainte Marie.  Sainte Marie is a small island off the eastern coast of Madagascar.  It was once home to pirates in the 17th and 18th centuries, and currently being filmed there is a show related to pirate ruins–and we were privileged to stay at the same hotel for a couple nights as some of the diving and film crew.  It was pretty great to meet some fellow Americans (and some fellow Brits, for Rachel) and speak English to people off the ship!  The show will air on the History channel in June, so I am looking forward to checking it out then.

Our Monday through Saturday trip was filled with so many blessings, so much beauty, and so many things that we experienced seemed to be beyond what we had imagined or hoped for.  It would be quite the lengthy post to tell you all that happened, but pictures will suffice–a lot of them!

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Pink Mercedes vans make the best Taxi Brousse rides.  Here we are at 6 am, ready for our 6+ hour trip to Sainte Marie.

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Our large beach bungalow… six single beds, two bathrooms.  Bertran and Catherine were our lovely hosts.

This was my afternoon view as I read, sunned, and just relaxed…

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I have seen some great sunrises here in Madagascar, living on the east side of the island, but this trip was filled with gorgeous sunsets since we stayed on the west side of Sainte Marie.

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Sunset #1.

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My beautiful friends: Katrina, Rachel, Abby, Marta, and Gigi.

Day two was filled with moped adventures around the north and central island.  We visited the natural pools on the northwest side of the island first, walking the beach, then swimming in the biggest, natural wave pool I have ever been in.  Also, we visited our tour guide’s village which was near the wave pools.

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Island beauty.

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Beautiful coastline.

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Looking out over the pool where we swam.

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Hiking through the woods to Nerson’s village.

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Nerson’s village.

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Laughing village kids.

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Two “vazahas” each per moped was quite the sight…

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A quick picture stop while mopeding.

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Afternoon pizza and soda snack at another resort.

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Most incredible sunset I’ve seen in my entire life.

After staying two nights at Sainte Marie Lodge, we headed south to stay at Princesse Bora.  This place was fabulous to say the least…  We enjoyed three nights here before heading back to the ship.

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Awesome bungalows–with the best shower we’ve taken since being in America!!

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Sparkling wine, compliments of Fifou, the owner of Princesse Bora.

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We spent a lot of time in this pool…

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Light and dark sunset… so cool. No filter here!

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Beautiful dock and natural swimming pool.

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Trio of chocolate desserts–yum!!

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My sisters.

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Early morning in the natural swimming pool off the dock.

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Ile Aux Nattes–a small island just off the southern tip of Sainte Marie. We enjoyed our last afternoon here.

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A treehouse bungalow on the island! Right on the water…

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A beautiful swim after hiking the island…

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This trip was a blessing… I got off the ship and closer into God’s creation.  I had time to relax and rejuvenate so I can finish my last month strong working as a nurse on the Africa Mercy.  I was blessed by my friends’ laughter, kindness, and words of encouragement.

This trip was beautiful… I saw the beauty of two islands that I will probably never have the opportunity to see again in my life.  I saw the beauty of the Malagasy people in their smiles and kindness.  I saw the beauty of the people who blessed us with free gifts to show their appreciation of the work we are doing in Madagascar–which is just God’s work that we have been privileged to be a part of.

This trip was beyond… Beyond anything I thought it would be.  I thought I would have an enjoyable beach vacation, but instead I was blessed with absolutely everything beyond I could imagine–free dessert, free transportation, free sparkling wine, and even a free night of lodging–along with so many memories of fun, laughter, and moments of experiencing God with my sisters.

What a beautiful blessing, beyond anything I could imagine.

“Now to him who is able to do far more abundantly than all that we ask or think, according to the power at work within us, to him be glory in the church and in Christ Jesus throughout all generations, forever and ever.”  – Ephesians 3:20

New Noses, New Friends.

Jacques and Stani are both 18-year-old guys that had noma at an early age.  They were admitted about a week or so apart and have both had scalp flap reconstructions to correct their disfigured faces, just like Mamisy had done earlier in the field service.  (I don’t have any photos of these guys yet, but will be sure to post when I do!)

The following is a graphic that Mark Stradiot, a graphic designer with Mercy Ships, designed to explain to the Malagasy people how people are coming away from the ship with new noses.

11002695_348546815354581_6429137910126339157_oThe people here in Madagascar know so little of modern medicine.  There were rumors when the ship arrived here in Madagascar that we were coming here to steal people’s internal organs–that we would put patients under for surgery and take things from inside of them while they were out.  I don’t know if this has ever actually happened, but there are rumors of this happening in Africa.  It makes sense that the Malagasy people, then, would naturally wonder where these noses are coming from!  Animals?  Other people??  I love that this graphic is able to so clearly depict the truth.  (Plus it gives you a good look at the Malagasy language!)

Jacques had his surgery first.  When Stani boarded the ship with his uncle a few days later, Jacque had a tracheostomy because his lips were sewed together to form an Abbe flap, and he had his scalp pulled down over his face to form a nose (like image 3, above).  When these patients are in this stage, they look horribly disfigured–and they stay looking like this for three weeks.  I’m sure it’s not easy to look at yourself like this, and the attitude and demeanor of the patients is pretty somber to begin with.  As time goes on, they seem to be in better spirits, which is a huge blessing.  Mamisy was the first patient who had this full reconstruction this past winter and it was awesome to be able to show pictures to Jacques and Stani to show what the progression of surgery is.

Both Jacques and Stani had these flaps at the same time, and they started to bond over their togetherness in the journey.  Last Wednesday, April 8, Jacque had his flap released.  I was privileged to take care of him post-op.  Sadly, Jacques’ mother had died a few days before his second surgery, so his brother that was here with him made the long trek home to Mahajanga (a two day bus trip).  It was bittersweet to take care of him postoperatively, knowing that his brother–who was often his voice as he couldn’t speak with his trach–wasn’t there to help us nurses determine his needs, and his mother wouldn’t be there to welcome him home when he is fully recovered.  Thankfully, Jacques is doing great six days out, and we will continue to pray for peace in his life as he goes home to his town soon.

The night Jacques came back from surgery, we welcomed him into the Ward with his new nose.  “Tsara be orona!”  I said (really nice nose!!).  I gave him some morphine, urged him to open his mouth (for the first time in three weeks), and even gave him Ensure to start drinking that night as his feeding tube was removed.  It was so awesome to see Stani and his uncle come over and encourage Jacques, especially when he got really anxious as he felt like he couldn’t breathe with his new nose and no nasal trumpet.  Stani got down to his level with a concerned look in his eyes and reassured him in their Malagasy language, something that I couldn’t do by myself.  I could look in his eyes and tell him he was doing well, that he was breathing well, but it was even stronger coming from his Malagasy brother–someone who looks like him, speaks the same language as him, whose face was as distorted as Jacques’ had been previously.

Jacques calmed down.  He closed his eyes and rested peacefully in his bed, D2, while Stani crept from D5 over to the charge nurse, asking through an interpreter when his surgery was.  He was excited about Jacques’ new nose and couldn’t wait to see his own flap released.  We told him six days, and the next day proceeded to make him a balloon countdown, where he would pop a balloon everyday until it was the day of surgery–which was yesterday!  I worked all weekend and he was so cute when he popped his balloon each day–getting shy as we all watched and cheered.  I just stopped by the Ward today (since I’m off work) and saw his new nose.  “Fali be ianao?”, I asked (“Are you very happy?”)… to which he nodded vigorously.  It was awesome to see him off to surgery yesterday, after we prayed with him for a safe and well done procedure.  My heart was also warmed as he prayed out loud (which I had never seen him do) with chaplaincy and the rest of the patients in the morning before his procedure.  I don’t know where these guys are spiritually, but I do know that God is working in their lives in big ways while they are here with us on the ship, and I am so grateful to be a part of it.

Yesterday, as I was explaining to Jacques that he would leave the hospital soon and go to the Hope Center for a week or two before going home, the first question he asked was if Stani would be there, too.  I have loved seeing these guys unite in brotherhood and bond over their commonalities.  I hope that they get to come back to the ship at the same time next fall for their checkups and possible revisions, so that they can continue their friendship.

I’ll leave you with some pictures…

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View of Deck 7 from a visiting Italian cruise ship. This is always a great hour of play and exercise (hospital is on Deck 3!) for the patients!

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Francina and her momma on Deck 7 with my friend, Marta.

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Deck 7 pampering for Lydie by Rachel and Amy. What great nurses!

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What do you do during rainy season when Deck 7 is too wet?? Have a parade up and down the hallway and stairwells! Duh!

Photo Credit Ruben Plomp, Erissa (MGB16062) Ortho Patient. Rehab appointment.

One of the cutest little girls ever… Erissa.

Photo Credit Ruben Plomp, Erissa (MGB16062) Ortho Patient. Rehab appointment.

Erissa and my roommate, Danielle, getting some physical therapy time in on the Dock.

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A Safe Anesthesia Course that was led by Dr. Michelle White, our head anesthesiologist (on left). Mercy Ships does so much more than just do surgery and leave… this is just one example. 🙂

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Dr. Jerry Putman and the first VVF ladies to go home from this field service.

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The ladies all dressed up and ready to go home–new women after being healed from their fistulas. I will talk more about a VVF Dress Ceremony in a later post!

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Some of our awesome D Ward day crew–from left: Nate, Joelle, Giara, Elianne, Roger, and Le Bien. So blessed to call them coworkers and friends!

Photo Credit Justine Forrest, D Ward Nurses

D Ward nurses–the lovely people that I get to work with and call friends, representing 7 countries, currently!

This is Mioty.

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Mioty and Heather.

Mioty is a five-year-old that has been with us for nearly a couple months now.  I wasn’t her nurse ever until just last week, but her story is something… this poor girl has had so much brokenness, but we have seen her come alive in the last couple weeks–singing, dancing, blowing bubbles, playing tag, saying words and phrases in English.  I would love for you to know her story, and know I will do it injustice if I tell you myself.  Check out my friend, Heather’s blog post from March 29 for the deets…

https://heathermorehouse.wordpress.com/2015/03/29/to-the-terror-of-a-5-year-old-in-bed-d9-you-have-changed-my-life/

Little Blessings.

So many things have been going on here recently.  Here’s an update…

Last week I said some goodbyes to some great people, including a roommate, Jessica, who lives in New York City.  There are always many hellos and goodbyes on the ship, just one hard part of living here.

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Going out for Jessica’s going away dinner.

An awesome part of living here is enjoying the beautiful beaches in Madagascar.  This weekend I was able to go up the coast to Mahambo with five friends.  We had a great time enjoying the beach and just hanging out.

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Sunset-ish.

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Beach views with our Sunday lunch.

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Beautiful day in Mahambo.

This week, I have had the great privilege of being all over the hospital!  I worked evening shift Monday, Tuesday, and Wednesday, and worked each evening in a different Ward.  I got to work with plastics, general, VVF, and maxillary-facial patients of all ages.

On Monday I worked in A Ward.  I took care of a plastics patient who has a slow healing wound, a VVF patient whose platelet count is currently too low to do surgery (so we are running some other labs and she’s on medicine), and admitted three general surgery patients who were to have surgery the next day.  My night was filled with giving meds, doing pre-op teaching, and putting IVs in.  It was much busier than I expected!  But so great.

On Tuesday I worked in D Ward, my home.  Normally there are one or more pediatric nurses working, but it was just me and two other adult nurses on Tuesday, therefore guess who had all the babies?!  This girl!  I took care of three one-year-olds–two cleft palate repairs that were post-op days 5 and 6, and a newly admitted baby who was getting his cleft palate repaired on Wednesday.  My other patient was a 19-year-old who had excision of a cyst and I cared for her immediately post-op, along with her mother and three-month-old baby.  Can I tell you?  I loved every minute of it.  These babies are adorable.  And thankfully far enough post-op that they weren’t very cranky.  I loved playing with them, giving them stickers and balloons.  I walked down the hallway holding Florent, my pre-op, singing with the VVF ladies in the evening.  He loved it even more when I decided to carry him on my shoulders and proceeded to cry and grab my head when I tried to take him off.  He eventually did come down, so I didn’t get to take him home with me.  😉

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Florent–a little one-year-old who had webbed fingers (syndactyly) repaired earlier in the field service, who now had his cleft palate repaired yesterday.

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Clarette–one of the one-year-olds I took care of on Tuesday–with her mama.

On Wednesday I worked in B Ward, where the VVF ladies are staying.  At first I felt like I had no idea what was going on (which is never a great feeling as a nurse…) but after getting report and reading a short pamphlet on nursing care for these ladies I felt a little better.  I always ask a lot of questions when I’m working (better to ask, then do something wrong!) and it hasn’t been different here in Madagascar.  One super nice thing is that each ward is really one big room, making finding someone to help you or ask a question to very easy.  Plus, we have day crew who are great help with language and cultural questions.  I learned two important words in the Malagasy language for this specialty:  mina and laina, dry and wet.  Most of the women who have received surgery are dry, but there are a few who have had unsuccessful first surgeries.  The women I cared for are thus far dry, being anywhere from post-op day 2 to post-op day 13.  The women liked laughing at my “tsara be!” (very good!) answer to everything and talking amongst themselves–about me I presume!  It was a joy to make sure these ladies catheters were flowing and the pads on their beds were dry.  It was great to learn more about VVF and keep these ladies’ catheters flowing!

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VVF ladies at dockside screening.

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First VVF ladies on the ship this year!

This is Lixia.

Photo Credit Catrice Wulf - Lixia (MGB12462) has fun on Deck 7

Lixia.

Lixia is a sixteen-year-old that I have cared for a few times now.  She was badly burnt and had plastic surgery to her right arm and hand to regain function.  She has had a rough go of it, with poor healing due to infection and a wound vac placed recently, but thankfully it seems as though things are going better of late!  She was in our isolation room (D Ward/ICU have the only two in the hospital) so I looked after her and her sister a few days.  Thankfully, she is now out of isolation!  Last week I took Lixia and Nene up to Deck 7 around 7 pm in the evening.  We laughed so much–it’s amazing how much fun you can have when you can barely understand the words you say to each other!  I learned some new Malagasy, Lixia and Nene learned some new English, we walked and ran, we sang songs in both of our languages, we painted each others nails, we yelled greetings to the people on the dock below.  It was one of the those moments that I thought… “Whoa.  Is this really my life?!”  And it is.  And I am so thankful for the times like this that I will remember forever.

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Ella, a nurse in A Ward, with Lixia and Nene.

Please continue to pray for the work we are doing here in Madagascar.  Pray that we continue to show Jesus’ love with all those we meet and care for as patients.

Also, check out this video of Sambany… a patient I have talked about in previous posts.  His story is incredible and may just bring you to tears…

Normalcy.

I don’t know when it happened, but life here has become normal.”  I have my routines.  I have my friends.  I am comfortable caring for our patients.  It is nice to feel this way, but also so very weird.  I feel like at any time I could wake up at home in the States, driving my car to work in my ICU, listening to my favorite tunes loudly with my sunroof open, sipping on my morning coffee.  I know that many things will be the same when I get home, but yet I know that much will be different–including myself.

Life will have thrown every single person I know different things in the last seven months that I wasn’t around to experience.  My nephews and niece will be sooo much older (and hopefully they will remember me from FaceTime!).  My apartment in Wauwatosa and my previous residence at Mike and Katie’s house won’t be where I’m living.  My parents will even be living in the Milwaukee area and my mom will be working at my hospital!  Life will be different, yet who I am at the core hasn’t changed.

“Fear not, for I have redeemed you; I have called you by name, you are mine.”  Isaiah 43:1

I would not trade my experience here in Madagascar for anything.  I have learned so much about myself, God’s love, and His work in my life.  I have seen so many people, bruised and battered by their diseases, find healing and a renewed smile and sense of self-worth.  I have seen people go from hiding under blankets on admission, to kicking a soccer ball around with me, playing Jenga, and joking around with me and other nurses.  There really is no way to understand the transformations that happen here without being a part of it–but I hope you have gotten a small glimpse from my blog posts over the last few months.

Tonight’s post is simply an update to let you all know I’m doing well.  I love working in D Ward.  I love being a part of amazing transformations.  I love living with and near some of the best people I have ever met.  Community life is hard at times, but overall I am so grateful for the experiences I have had and will continue to have through May.

No crazy stories this time… just some beautiful pictures to share.

This is Windy.

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He was badly burnt, resulting in the contractures you see here.

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Windy had surgery done by Dr. Tertius Venter on the Africa Mercy, and his life has been changed.

Photo Credit Katie Keegan

He and his buddy, Fandresena, are so full of joy.  They were my favorite kids to play with at the Hope Center for awhile.  And Windy is exceptional at English, learning so much from the nurses that cared for him while he was here.

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Photo Credit Katie Keegan - Fandresena (PAT14327) plays at the HOPE Center

This is Erissa.

Photo Credit Ruben Plomp, Get Well Soon Cards From Holland

So excited to receive a get well card from some Mercy Ship supporters in Holland.  What a cutie…

Photo Credit Ruben Plomp, Get Well Soon Cards From Holland

This is my friend, Mark, with one of my previous patients and his wife.

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Fernan didn’t have a nose before he came to us.  He was brutally attacked last summer, leaving his face badly scarred and without a nose.  Look at him now!!  What a beautiful nose he has…

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Please continue to pray for the surgeries here on board the AFM.  Pray for our maxillary facial program and vesico-vaginal fistula surgeries that have now began.  Pray for the health of our crew as many continue to be sick with gastrointestinal and/or respiratory illnesses (myself with a nasty chest cold currently). Pray that us nurses would continue to have the drive to do our jobs well and constantly show the love of Jesus to our patients as the mundane sets in and we increasingly miss home.

“I thank my God every time I remember you.  In all my prayers for all of you, I always pray with joy because of your partnership in the gospel from the first day until now, being confident of this, that he who began a good work in you will carry it on to completion until the day of Christ Jesus.”  Philippians 1:3-6

February lowdown.

Hi friends!

How is it already almost March?!  The month of February has flew!  Our plastic surgery service has now ended and VVF will start in a couple weeks.  B Ward is filled with plastic patients that are being discharged day by day.  A Ward is filled with plastics overflow and goiter patients.  I got floated to B Ward this past week and had so much fun playing with some adorable kids who were well in the recovery period after their plastic surgeries.  It was a joy to work with a different patient population–and was it loud!  D Ward is usually a medium level of noise… but B Ward was pretty crazy, to say the least.

Photo Credit Justine Forrest

Dyllan, one of the sweet little kids I got to take care of in B Ward.

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Empty B Ward. Caregivers sleep under the patient bed on a mattress.

Last week we were privileged to have the Minister of Health of Madagascar visit the ship.  Prof. Mamy Lalatiana Andriamanarivo is a surgeon himself, and Dr. Gary Parker gave him a tour of the Wards, showing some of the amazing transformations that these patients have experienced.

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Dr. Parker and Prof. Andriamanarivo in the hospital hallway.

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Explaining Fernan’s surgeries.

Roland Decorvet, our managing director, then gave a presentation in our International Lounge, highlighting what we want to achieve in Madagascar upon the end of our field service in June 2016.

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Prof. Andriamanarivo was very impressed and made this speech at the end:

“Many people have come to Africa to help the people
There were missionaries before you
There once was a missionary called David Livingstone
He did great things for the people, providing Hospitals & clinics
And he talked about Jesus
When other missionaries came after him
They talked about Jesus
But the people said we know about your Jesus, we heard already about him
And they thought Jesus was David Livingstone.
Ladies & gentlemen, my point is
There’s a major gap between saying something and doing it.
Many people are talking
Many people are saying a lot of great things
When it comes to actually doing it
Very few can actually do something
You are a true example of great missionary work
And you are actually doing Jesus’ work
 
In the name of the President,
In the name of the Prime Minister,
In the name of everybody in the Ministry of Health
In the name of all 22 million Malagasy people
I really want to tell you from the bottom of my heart
What you are doing is amazing
I can only promise you the Ministry of Health will do everything to allow you to do your work in the best condition possible.
Thank you so much, you are such wonderful people.”
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Recently I have had the privilege of taking care of some awesome patients.

Billy is a sweet 12-year-old boy who had his cleft palate repaired.  He was pretty somber the first few days after surgery, having issues with some pain and nausea, but he has now just come to life.  I walked into the Ward yesterday for my shift and Billy ran over and gave me a fist pound, “doona”, with a huge smile on his face.  We kicked a small ball around in the hallway and played some Dominoes, after he did his cleft palate exercises of course!  These consist of saying sounds, moving the tongue repetitively to gain strength, and breathing through the mouth instead of through the nose.  Billy’s dad has also been great to hang out with.  He is so grateful for the care we are giving Billy, even making a sign above Billy’s bed that says:  “Greeting with peace.  We all thank God and the Mercy Ships crew as well.  God Bless you all.  Amen.”  He knows some English and is teaching me some Malagasy words.  We were playing Dominoes and I was counting up our points in Malagasy… but the numbers just won’t stick!  I guess I should put in some study time…..

Another patient I have enjoyed is Hery.  I have talked about Hery before.  He had noma as a child and had three surgeries with us to repair his nose and eye.

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His last surgery was last week Thursday, and he is being discharged to the Hope Center today!  He was excited to get to see his friends, Mamisy, Fernan, and Fali (who have all been discharged there), but sadly I had to tell him that Mamisy went home!  A couple days travel away… I wish Hery would have been able to tell him goodbye, because sadly these guys will probably never see each other again.  😦  It is great to see patients be discharged to the Hope Center or to home, but it is also sad after seeing the relationships that are formed between the patients and families from different provinces, speaking different dialects of Malagasy and having different customs.  Hery and I have enjoyed a few games of Jenga recently.  He put some stickers I got in a package from home on his forehead yesterday (crazy Hery, as always).  He was taught to do his own wound care and eye drops yesterday.  He is ready to go!  It has been so cool to see his transformation…

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Heather, Hery, and his bling.

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me and Hery yesterday.

Sambany is still doing great!  He is working on his physical therapy exercises and can hold his head straight quite well.  Wounds are healing.  Skin is tightening up.  And he is well on his way to discharge soon.  His 18-year-old grandson is learning to read and write from an outpatient nurse who volunteers her time after her shift is over.  Yesterday he was laughing at me as I read phrases he had written in Malagasy, such as “Get out of here!”  What a blessing to be able to care for Sambany and see his grandson flourish, too.

Photo Credit Katie Keegan

me and Sambany–post 7.4 kg tumor removal!

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Sambany’s grandson, Flavy.

These stories are ones that I love to report!  But sadly, we can’t always provide the healing we desire to.

Yesterday evening I admitted a young 14-year-old girl, Elizette, for her surgery today.  Elizette, although quiet, seems to be a very proud and brave young girl.  She does not attempt to hide her facial tumor at all, as others do.  She barely flinched as I put her IV in (18 gauge, nonetheless).  She sat still as the doctors probed her face and mouth to determine tumor borders.  She listened intently as I did her preoperative teaching.  Her father is a kind and very thankful man.  He said “misaotra betsaka” to me so many times last evening as I cared for her and him.  Elizette had been screened in the past by nurses and a surgeon and had CT scans done, but after further review by a couple surgeons and anesthesiologists yesterday it was decided that surgery was too risky.  Elizette has a tumor with a seven year history.  The tumor appears to be underneath her chin and jaw mainly, but on CT examination it extends into her neck and even her chest wall.  The tumor is very vascular and full of lymphatic drainage.

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Beautiful Elizette.

Elizette is being told this morning that we are unable to operate on her due to the extensiveness of the tumor.  What sad news to deliver to this young girl, so full of hope and promise.  Depending on how quickly the tumor grows, Elizette will more than likely die from suffocation.  I have been grieving over this young girl and her hopeful father last evening and today, but this morning I was reminded that God is faithful.  Even though I don’t understand why this young girl will not be relieved of her suffering in this world, I know that God is faithful even through hardship.  Psalm 86:15 says, “But you, O Lord, are a God merciful and gracious, slow to anger and abounding in steadfast love and faithfulness.”

Please pray that the love and kindness we are able to give Elizette and her father in the short time they are with us on the ship will be a reassurance of God’s everlasting love for them.

Who shall separate us from the love of Christ?  Shall tribulation, or distress, or persecution, or famine, or nakedness, or danger, or sword?  No, in all these things we are more than conquerors through him who loved us.”  – Romans 8:35,37

A few more pictures of things you should see…

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Singing telegram ambush on Scott, one of our hospital supply guys, in D Ward during Valentine’s week! Nice job, ladies.

Photo Credit Katie Keegan - Mamisy (PAT16100) at the HOPE Center

Mamisy at the Hope Center. He will have one more small surgery next year on his lip.

Photo Credit Katie Keegan - Hope Center after renovations

Hope Center accomodations.

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Mona, another sweet, sweet patient I have had the privilege of caring for.

Photo Credit Katie Keegan - Mamisy (PAT16100) and his mother

Mamisy and his mama on discharge HOME!

the Palmarium and Max Fac Screening.

This last week has been a great one.

After recovering from my night shifts and working a couple more evenings in D Ward, I was privileged to get away for the weekend with eleven friends.  We went to a place called the Palmarium, which is over three hours south on the Pangalanes canal.

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We love our Chacos.

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Our group on arrival!

We left around 0830 Saturday morning, so we were able to get to the Palmarium in time for lunch and a little beach time on the lake.  I enjoyed some late afternoon sun and the warm lake water.  (The water is never cool enough here!  it just makes me want to jump in some freezing cold water on Two Sisters up north.)  We then went on an aye-aye lemur tour, which involved us taking a short boat ride to an island.  We hiked around the island a bit and then watched as the noctural lemurs came out for the coconuts we had brought.

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An aye-aye lemur.

They are peculiar-looking for sure!  But they were really cool to watch as they jumped from tree to tree and then cracked open the coconuts with their teeth, and something I’m sure I will never get to see again.  It was a beautiful night, with lots of stars to see.  We then got back to the Palmarium and enjoyed a song and dance performance from a local village group.

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We then had a great dinner, and sat by a fire on the beach for awhile before heading to bed to catch the sunrise at 0500.

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The sunrise was followed by a great breakfast and had a guided lemur tour where we saw multiple types of lemurs!!  Thanks, Bruno, for being a great tour guide and lemur caller!

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a “dancing lemur”–you should see them hop/dance!

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Indri lemur selfie.

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It was a great weekend with some awesome people, and this week has started off great, too.

On Monday I was privileged to work on the Max-Fac screening team here in the port.  Patients who had already been through one round of screening by our screening team now came to the port warehouse to be seen by our surgeons for further screening.  We had over thirty patients here.  They had come from here in Tamatave, from Tana (the capital city, eight hours away), from Toliara (three DAYS travel away!), and everywhere in between.  There were patients of all ages, from six months to their 60s.  Some were here alone, some had a family member with them.  Some had cleft lips and palates, some had lipomas, and some had ameloblastomas.  But everyone had something in common:  they were here in hopes of having surgery onboard the Africa Mercy.

I gathered mini health histories, took blood pressures and weights, drew lab work, fetched medications from the pharmacy on the ship, and–last but not least–got to deliver the good news of surgical appointments to many patients.  There were many people that were just so grateful when I told them their admission date for surgery–many smiles, “misoatra betsaka’s” (thank you very much), and hugs ensued.

My favorite was a twenty-two-year old woman who came to the ship with her mom.  She has a cleft palate, and therefore her speech is very poor.  She and her mom were both overjoyed when the maxillary-facial surgeon told them we could fix her cleft palate and improve her speech.  She started sobbing right there in the screening tent!  And we all subsequently got tears in our eyes.  She kissed the surgeon on both cheeks when she left the tent, and just kept saying thank you with the biggest smile.  I was so happy that I could bring her her patient ID card with the date of her admission written on it, and tell her I will see her when she comes back for surgery!  She and her mom left with big smiles.  I can’t wait to see her again!!

To update you on last week’s post, Sambany is doing great!  He had a rough end of the week and weekend as he was dealing with much confusion, but his mind is now clear and he was a joy to take care of yesterday on the Ward.  Physical therapy is working with him to regain strength in his left neck, as those muscles have not been used for years because he had to constantly hold his head up with the tumor on its left side.  He also is working on facial exercises to regain strength in his left face.  It is so great to see him tumorless and “fali be” (very happy)!

Photo Credit Katie Keegan

Sambany’s first look after surgery.

Photo Credit Katie Keegan - Sambany (PAT16203) meets many of his blood donors!

Many (but not all!) of the people that donated blood for Sambany.

Please continue to pray for the patients we are taking care of here on the ship–that surgeries go smoothly, patients heal well with minimal pain, and that they are shown a massive amount of love from everyone they come into contact with here on the ship.

Mercy Ships Happenings.

Hello from Madagascar!

Things here have been going well.  I am continuing to love working on D Ward, even after working four night shifts this last weekend.  Nights went well overall and now I am just adjusting back to a normal daytime life.  🙂

Last week I went to a training called “Equipping to Serve” for two, four hour days.  The two days were filled with ship safety information, information about Mercy Ships support programs, and Madagascar cultural information.

Operations in general go like this in order for a field service to take place:

An assessment of the country is done usually 11-18 months in advance.  This team determines the needs of the country based on what their current healthcare and population are like.  The Advance Team then comes in about four to six months in advance and prepares everything related to the arrival of the ship and the beginning of the field service.  These assessments and preparations are vital to the ship’s arrival and timeliness of hospital and support operations.  But guess what?  This didn’t happen in Madagascar.  The ship and organization were prepared to go to West Africa again, but with the Ebola outbreak worsening, a decision was made to come to Madagascar just in September.

Because this decision was made without much advance time, things have taken awhile to get rolling here on the Africa Mercy.  Surgeries started the first week in November, but things like the dental clinic and Hope Center (Hospital Outpatient Extension Center) weren’t completed until mid to late December.  The Hope Center, which has 150 beds, is where pre-op and post-op patients stay who do not need medical care, but need a close, clean place to stay as they wait for surgery or during their recovery.  We also were not prepared for a few things related to the patient population.  The Malagasy people have much better eyes then the people of West Africa!  Our eye team has been struggling to find patients to work with… Also, there are many, many more women who suffer from a vesicovaginal fistula (VVF).  We do our VVF service starting in March, but the number of women we can accommodate this year is far fewer than the need, therefore it’s such a joy to know that we are returning next year and making many more open slots for VVF surgeries!!

Even though the ship and its operations were delayed this year, we have still done the following surgeries:

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I am so grateful that I am privileged to be a part of healing the Malagasy people who so desperately need it.

I also just want to tell you about other programs that are taking place with Mercy Ships.  There is an agricultural program, called Food for Life, that is based near the capital city of Antananarivo.  This is a Biblically-based training program for local farmers or for those who want to become farmers.  It involves teaching the people responsible, organic farming and also involves yogurt making!  There was recently a leadership course offered here for local government, community, and church leaders that over two hundred people took part in.  This same course will be offered in Tana soon.  Two weeks ago we were privileged to have ten Peace Corps volunteers on board for a couple days.  They participated in a “Helping Babies Breathe” course, which was aimed at teaching them about simple resuscitation techniques after delivery so they can go back to their respective towns and villages and share what they learned.  There have also been a basic surgical skills course, safe obstetrics and pediatrics course, and will be a primary trauma care course here in March.  There is also a nurse mentoring program where some of our nurses are going to the local hospital, Hopital Be, and where their nurses are coming here to the ship for a few days.  All of these programs are helping to bring hope and healing to Madagascar, a country that has much need.

On another note, D Ward has been great.  Mamisy, who I wrote about in my last blog post, was discharged to the Hope Center on Monday!!  He underwent his third surgery last week Monday, then had his trach removed the following day.  It was so great to hear him talk, saying my name and other words in English that he has learned from listening to us.  I am hoping to get to the Hope Center soon to visit him and the other patients that are staying there.

Hery had his second surgery last week and is recovering well.  He, too, will need a third surgery, as currently he has a scalp flap connected to his left nose and lower eyelid.  He has been in good spirits overall since this surgery!  Since I was working nights we didn’t play Jenga this weekend, but that will occur soon.  🙂

This is Sambany.

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Sambany and his grandson arrived on our dock about a week and a half ago.  They walked for over three days to get to the ship in hopes of our surgeons removing the tumor that has been growing on his neck and face for over nineteen years.  Sambany’s hemoglobin was 3-point-something on his arrival to the ship–and he walked here!!  (This is extremely low, you non-medical people… normal is 12-16.)  Sambany made this quote preoperatively: “I know without surgery I will die. I know I might die in surgery, but I already feel dead inside from the way I’m treated. I choose to have surgery.”  It took a little while to figure out if we would be able to operate due to comorbidities and the extensive surgery needed, but thankfully the surgeons were able to successfully remove his tumor yesterday!  The surgery to remove the 7.46 kg tumor took over twelve hours, and he received eleven units of blood during the case, but he is recovering well in ICU.  Sadly, I don’t work today so I haven’t seen him yet!

Last night I was out to dinner with some friends for a friend’s birthday, and when we got back one of our lab technicians was in search of my friend Marta because they needed her blood.  We yelled down the gangway, across the dock, to Marta, who was walking back with another group.  When she heard us yelling and understood that they needed her blood, she sprinted to the ship and up the gangway, ready to help Sambany with her own blood.  She chugged my bottle, full of water, then immediately gave blood in the lab, which the anesthesiologist picked up and promptly hung in the OR.  How cool that she, and multiple other crew members were able to give their blood for Sambany, and for other patients that have received blood on the ship??

This reminds me of Jesus, and how he shed his blood for every single person in the whole world.

“For you know that it was not with perishable things such as silver or gold that you were redeemed from the empty way of life handed down to you from your ancestors, but with the precious blood of Christ, a lamb without blemish or defect.”  – 1 Peter 1:18,19

He is the reason that I am here in Madagascar, to show his love to those that are so less fortunate than me.  I pray that my words and actions with my patients and their families, with our day crew, and when I am out in Tamatave reflect the love that Christ has shown me.

“Thanks be to God for his indescribable gift!”  – 2 Corinthians 9:15

Noma patients.

The last time I blogged, I was just finishing up in PACU and getting ready to move to D Ward for the rest of my time here.  I enjoyed my time in PACU and learned much about the surgeries we do here on the AFM while working there.  I didn’t know much about orthopedic (tibial osteotomies, anyone?), max-facs (karapandzic flaps, oral commissurotomiesand scalp flap reconstructions), and plastic surgeries (polydactyly, syndactyly, and split- and full-thickness skin grafts for burn contracture releases).  It is amazing as I think of the majority of surgeries we do here, that they are ones we rarely have to do in the States for the reasons we see them done here.

Take scalp flap reconstructions, for example.  I have taken care of two patients now who are at some point in these multi-step reconstructive surgeries.  Mamisy is an 18-year-old who had a disease called noma as a child.  Noma, of Greek origin, meaning “to graze” or “to devour”, is a disease that is most common in children aged one to four, but can also happen during adolescence and adulthood.  It has been called “the ulcer of extreme poverty” (The New England Journal of Medicine, Jan 19, 2006) and most commonly occurs after an acute, debilitiating illness, such as measles, malaria, tuberculosis, or necrotizing ulcerative gingivitis.  These illnesses, combined with severe malnutrition, unsafe drinking water, poor sanitation, and poor oral health practices cause the characteristic facial “holes” seen with noma.  Noma often starts as a gingival ulceration that could be treated easily at the early stage with local disinfection, antibiotics, and nutritional rehabilitation, but is not often treated due to the poverty-stricken places in which this disease generally occurs.  As this intraoral ulcer is left untreated, it progresses rapidly to involve the cheek or lip, where tissue is lost permanently.

Meet Mamisy.

Photo Credit Amanda Wilder

Mamisy came to us looking like this, due to noma at age three.  (He lived fifteen years like this!)  His first surgery involved taking a large scalp flap from his head, twisting it around, and then sewing it to the hole on his face that used to be a nose.  Mamisy’s lips were also affected, so he had a tracheostomy placed at that time as his lips were near sewed closed for their reconstruction.  This flap stayed in place, twisted down over his forehead, for about three weeks before he was taken back to surgery.  The top and sides of his new nose were then cut out of this flap, and the flap was pulled back over his head.  He now looks like this.

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Mamisy! Two surgeries down, one to go.

Mamisy’s third surgery, to finish his lips, is taking place as I type this post!  He is often lively on the unit, drawing and coloring, dancing to the music we put on, or pestering Dory, the one-year-old daughter of a patient that is our resident toddler.  I can’t wait for him to be able to talk again!  We have told him that we will let him talk to us nurses all night to make up for all the time has hasn’t talked during his reconstruction process.

This is Hery.  He’s been with us for about a week now.

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Hery is a 21-year-old who had noma at age seven.

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He has only had his first surgery so far, which involved taking a skin graft from his left neck/chest area, and sewing it underneath the skin on his left scalp.  This will then be used as a graft to his left nose and eye area.

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Playing Jenga with Deb and Hery on Deck 7.

Hery loves Jenga and trying to teach me Malagasy words.  I am excited to see how we can provide healing to him in the coming weeks.

On another note, these past two weeks have been filled with many fun times.  One that stands out specifically is our time on Deck 7 on Thursday last week.  All the patients and their caregivers (who are able) from the Wards are taken upstairs, from deck 3 to Deck 7 for some exercise (four flights of stairs!) and fresh air everyday from 1430 to 1530.  On Thursday we happened to just have a big song and dance party on the deck for the majority of the time we were up there.  Someone had brought a guitar up and we sang songs in Malagasy and English and danced around like crazy.  So many patients and day crew and families joined in, it was just awesome.  There was a huge cruise ship next to us in the port, and many people were looking over at us from their upper deck, waving and taking pictures and videos it appeared.  This was the most fun Deck 7 experience I’ve had thus far.

On Saturday, me and three friends went to two of our day crew’s house, Nate and Le Bien.  They are both from Antananarivo, the capital city, who are here to work on the ship.  They invited us into their small, one room home and gave us fruit, fried bananas with chocolate, peanut brittle type stuff, and some other dessert-type-thing that is baked underground for hours.  They were so generous!!  We played Bananagrams and Uno with them and just hung out before walking back to the ship for their night shift they had to work.

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Tuk tuk ride!

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Nate and Le Bien outside their house.

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Abby, me, Marta, Anna, Nate, and Le Bien

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Beautiful evening walk home to the Port and the Africa Mercy.

If you can, please say a quick prayer for me and many others on the ship who have been sick recently.  There has been some pretty nasty stomach bug going around and lots of people have been affected… Thankfully, I seem to be turning around pretty quickly.  Pray for continued healing for me and all those who are still sick so we can continue to provide great care to our patients.  Thanks!

***Information about noma researched from–

Noma – The Ulcer of Extreme Poverty.  Cyril O. Enowonwu, M.D.S., Ph.D., Sc.D.

N Engl J Med 2006; 354:221-224.  January 19, 2006.  ***

Life on the AFM.

Now that I have been here for six weeks, I thought it would be nice to tell you all about life here on the Africa Mercy (AFM) in Tamatave, Madagascar.  The ship itself is rather large–decks two through seven have many cabins to house 400+ people, a cafeteria and galley, a Starbucks cafe area, laundry facilities, a “ship shop”, offices, some meeting rooms, and last but not least, a hospital.  The hospital has five operating rooms (or operating theatres, for anyone not from the States!), a post-anesthesia recovery unit (PACU), three patient Wards (which each hold approximately twenty patients), a room used for outpatient appointments, a pharmacy, sterilization area, and lab and radiology areas.

Photo Credit Josh Callow - The Africa Mercy arrives in Toamasina, Madagascar.

The Africa Mercy

My daily life has looked about like this…

0517:  Wake up.  Change into workout clothes and put contacts in.  Attempt to hydrate last-minute and wake myself up as I ascend from the cavernous deck 3 where I live (no windows here, folks).

0530:  Run.  It is HOT in Madagascar.  High 80s, with near 100% humidity.  If you want to do physical activity outside, it has to be early.  I have been running out of the port and into Tamatave, on Beach Road, with some friends about three times per week.  I am not a runner.  I have never liked it, unless I was dribbling a basketball and driving hard up the court.  Here, I am changing that.  I am beginning to enjoy our morning runs (just a little bit… and I can’t believe I’m admitting this).

0615:  Workout class.  Monday, Wednesday, and Friday I have been going to a body weight workout class that a fellow crew member leads.  It involves a lot of push-ups, sit-ups, squats, etc.  It has been nice to have someone telling me what to do so I actually am working out!!

0715:  Breakfast.  Served from 0645-0730 everyday in the cafeteria… therefore I need to wake up (on days I don’t work out) if I want to eat!  I recently bought some cereal from the ship shop, though, so I can have a day to sleep in if I want to.  For those of you who know me, you know that I can’t skip a meal… Food and I get along very well.  Breakfast always consists of yogurt (made on the ship twice a week), oatmeal, hard boiled eggs, and toast, along with one or two different things everyday.  Pancakes on Wednesdays are the best!  If I don’t get to the cafeteria early enough, there are limited options.  But thankfully there is always peanut butter toast!

0900-1730:  Work in PACU (the last six weeks–I go to D Ward on Monday).  It was great to have a start time of 0900, 0930, or even 1200 while working in PACU.  The latest I had to ever stay at work was 2050, and I never got called in at night.  Work here consisted of taking care of many different types of patients postoperatively.  The first couple weeks we still were doing orthopedic cases, along with general and maxillary facial.  Currently maxillary facial and plastics are going, with VVF to start in two months from now.  The following are some pictures that a ship photographer took of us this past week.

Photo Credit Katie Keegan, PACU Nurses care for their patients

Recovering patients in PACU.

Photo Credit Katie Keegan, Jacklyn BLIEVERNICHT (USA), PACU Nurse

Counting drip rates.

Photo Credit Katie Keegan, Jacklyn BLIEVERNICHT (USA), PACU Nurse

Fist bumps, “doona” in Malagasy, are the best.

Photo Credit Katie Keegan, Jacklyn BLIEVERNICHT (USA), PACU Nurse

Even this patient can smile a little after having a major surgery–not to mention a nasal trumpet in!

Photo Credit Katie Keegan, PACU nursing crew playing around

Photo Credit Katie Keegan, PACU nursing crew playing around

Me, Krista (Canada), Anja (Germany), and Claire (England) with our interpreters and some sterilization staff.

Evenings are spent in many different ways.  When I’m not keeping in touch with people back home via iMessages, Google hangouts, and the writing of blog posts, I usually enjoy activities with friends.  Sometimes we’ll play games, like Balderdash or Euchre.  Sometimes we’ll watch a movie.  There are mandatory community meetings on Monday mornings and Thursday evenings, and a ship church service on Sunday evenings.  There is always some kind of ship activity on Monday nights.  I have been hanging out with a group of women on Wednesday nights (which is the same night my small group from church at home meets!).  We have been studying women in the Bible, and also discussing our lives as women of God in this world.  We come from all over–Wisconsin, Indiana, Virginia, New York, North Carolina, Washington, Oklahoma, California, Canada, Australia, and England. It’s been really awesome to share our perspectives and things we have learned just since being here on the ship.

Other places I enjoy on the ship include…

The “Boutique”:  It’s like Goodwill on the ship.  You can take anything there, and can take up to three items when you visit it during the three times it’s open per week.  I have gotten a couple shirts, a yoga mat, and an iPad mini keyboard case there.  I’m sure I will be leaving some stuff there when I leave to come home too!

The Ship-Shop:  Always a good place to buy toilet paper (if we have any at the moment…), cake mix, earplugs, chips, a highlighter, etc.  There is a nice variety here.  It isn’t quite Target, but it’s perfect for #shiplife.

The Crew Galley:  You will often find me and some friends making smoothies or some dessert in the Crew Galley.  There are even two KitchenAid mixers that have been donated by someone awesome.  🙂

Deck 8:  There’s usually a decent breeze on Deck 8, where I can sit in a chair and just enjoy looking out over the Indian Ocean or towards the beach and city of Tamatave.  Again, it’s HOT here, so this only happens on an overcast “cooler” day or in the evening.

The pool:  The pool is pretty nice, and definitely a place I hang out at a lot.  There are about three-foot wide, shallow areas on both ends of the pool.  The rocking of the ship causes small waves most of the time, so it almost feels like a beach sometimes.  🙂

As I’m sure you can tell, daily life here feels kind of like college, work, and church camp all rolled into one.  Most days are great, but some days I miss home.  A huge blessing has been the awesome people that I have met and work with here.  Without them, I would be on a flight back to the States for sure, but together we know we are doing something great in our care of those who need the free surgeries we can provide.  I will leave you with some pictures of the precious orthopedic patients we have had the privilege of caring for while here in Tamatave…

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Dr. Frank, an orthopedic surgeon from Colorado, fixed this little girl’s bowed leg. This is her at Screening.

MGB141114_RAJO_PAT12311_DOCK_JC0001_LO

Cute kids in their casts…

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Photo Credit Catrice Wulf - Ortho patients walk in the hospital hallway.

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This is the gangway that leads to healing–and hope–for many people we have met here in Madagascar. Please pray for more and continued surgical successes here in Tamatave.