Life after Mercy Ships....

My last week on board I was unable to blog, it got to the point when you knew every event would be your last. Last night at Obamas, Last late night Starbucks, Last shift, Last adventure to the market, Last taxi ride, Last Chaka Wakas, Last dance at Gardens of Guinea. Coming on board I felt serving for 4 months was a substantial commitment, but it was not nearly enough time.Four months was enough time to see one full speciality (plastics) and finish VVF ladies. It was enough time for your cabin to feel like home, the food to become boring and my 30 second commute to work to feel normal. I was comfortable on the unit, with the doctors, nurses, and patients. We had "our spot" in the comfy chairs in Mid Ships, where many of these blog's where composed over these past months.

Taboo Charades became a weekly tradition, as did schwarmas! Tailor 19 received all of our business, and rewarded us with "Cadeuxes!" (gift purses) as a thank you before we left. Our African dancing skills have been refined and after dancing at a wedding with other locals, one African lady complimented me on my African booty dancing skills, now that's a compliment! I even avoided gaining the "Mercy Hips" as they call it!

On our last week, packing was a dark cloud hanging over my head. Somehow everything fit back into the same bag it came in. We had one last celebration with all of the Day workers (locals) on board and danced to our last African worship music. One of the last evenings there was a "fake wedding" on the ward, basically an excuse to have a party on the ward with the patients who were left in the hospital. It was filled with laughter and dancing of course. We all sported our best African garb! Laughing and dancing with friends, and patients who had become friends. Saying goodbye was a daily occurrence as patients were being discharged from the ship. watching nurses saying emotional goodbyes to patients they have cared for for months was enough to make anyone watching tear up. We know we have the option to see one another somewhere in the world, however these patients are returning to their villages and we know we wont see them again.

Every night we took the opportunity to watch the sunset with our friends on the deck, socking in the last African sun.Nina and I watched the sunrise while sitting on the walkway in front of the bridge, and later that night 20 of our friends gathered on the deck and sang worship songs for an hour or so. how much more of a peaceful day could one ask for? My last night on board we made our way out to ChakaWaka to catch the sunset one last time at the beach. We then made our way to Garden of Guinea, where we joined the rest of our friends. With a little charades and a nod to the man leading the band dancing Spanish music (in french) rung over the court yard. First it was only Hope and I dancing, but in no time the rest of the crew joined in! The dance floor was packed, the evening air was hot, and we were soaking it all in. In traditional African way, the power cut out, we were left jumping and clapping as the drummer continued to hold the beat. The darkness was invited. Soon the generator kicked on and the band picked up where they left off. What more could I ask for on my last night on a continent that I love so deeply. Of course my last day was difficult, saying good bye as people left for overnight adventures and lunch in town. I was left with a few close friends to hug and wave goodbye to as I left the port one last time.

Mercy Ships is an organization that I will continue to follow, promote and pour into. I know I will see the Ship again. As some fellow crew leave and others have signed on to extend into the next field service to the Congo, I will continue to follow and pray for the progress that Mercy Ships does up and down the west coast of Africa.When I arrived on the ship I wrote about the strong sense of peace that I felt when flying towards Africa. Knowing I was in the right place at the right time. Leaving the ship I am sad to say goodbye but again, the second time in my life I feel the same overwhelming sense of peace about returning home. This summer I am working on the Health Care team as a first aider here at Camp Qwanoes in Crofton BC (on Vancouver island by Nanaimo) For the next 3 months (until September 1st). I know my family is thrilled to have me home, in Canada and away from the scary unknown. I will continue to follow the news of guinea and am curious how the elections will go. Keep the nation in your prayers as they continue to go through this stage of unrest. Keep our patients in your prayers too. They have returned home, however you all know after surgery it takes weeks or months to fully heal. People have asked how am I adjusting, well Ive only cried twice once in a grocery store over cheese and another time in The Gap. Since arriving home on June 1st its been go go go until arriving here at camp on June 5th then it was Jump right into work here. I think it is helpful that I've left one christian bubble and moved to another. shocks or society don't have a chance to set in. Reality of work is a distant concern.

Thank you to all of you who have supported me financially, in prayers and words of encouragement. It has been a blessing to serve with Mercy Ships. I highly encourage any of you to look into the opportunity to serve and share what you have learned about the organization with others too. The ship is only 50% hospital staff, the other 200 are food services, stores, deck hands, trades and more. They are always in need of IT guys, plumbers and electricians. Feel free to pass my info onto anyone having questions about Mercy Ships. nmoen@ymail.com

As I sit here in the porch of my lodge overlooking the ocean and salt spring island I am happy to breath in the fresh BC air, and hear the birds chirp. I have missed home, but I will miss the daily adventures that i got to fully participate in over the last few months.

Peace and Love to all, Thank you for reading and fallowing my adventures over the last 5 months.
Much Love,
Nicole.

Marla

We read, watch, and feel we have a grasp on what life is like for the millions on the other side of the world who live in war torn countries, however our imagination cannot even come close to what reality is for these individuals living lives in these areas.

There was a man named Marla that shook me to my core, and left me in tears and praying a number of nights. Meeting him before his surgery, I learned about his story.

Marla was a business man, his work lead him to cross between the Guinea and Sierra Leone border on a weekly bases. Even once the RUF (Rebal United Front) started patrolling the boarder Marla had to continue with his travels to continue to provide for his new bride. The date was the early 2000's. One day on a routine trip crossing the boarder the RUF arrested him and proceeded to torture him. They were demanding information from him and continued to torture him until he lost conciousnes. when he awoke he was left with a padlock in his face. The boys and men had smashed his hard pallet (the roof of his mouth) with a knife and put the padlock up his nose and out his mouth, crushing his bone and teeth. This was their way to stop Marla from talking about what he had witnessed and gone through.

Marla on his second visit to Mercy Ships for a couple more surgeries.

An aid organization in Sierra Leone found Marla and took him to local hospital in attempt to remove the padlock from his face. They were unable to remove the lock, he was moved from one hospital to another, but no one could help him. He was left with this giant medal padlock attached to his face crushing his tissue. Finally the aid organization brought him to Conakry, Guinea and payed for his addmitting fee to the hospital and promised reconstruction surgery. In the hospital they ware able to remove the lock, leaving behind a mangled face. However the aid organization left him to cope on his on, providing no help in locating his family if they survived or with any follow up surgeries. He was left alone in Conakry and remained around the area since.

Three years ago Marla arrived at a screen in Sierra Leone for a Mercy Ship screen. This started his road to recovery. Marla has had several surgeries reconstructing his crushed face. March is when we welcomed Marla on board the ship once again. He was smiling and so happy to be on the ship.The surgeon was able to reconstruct his nose out of a forhead flap through a series of operations. In addition he placed a metal plate on the roof of Marla's mouth to reform his hard pallet.  Marla was so thankfull for all the care he was receiving and would lift his hands and praise God for his blessings. He was a man of strong faith. But how? How can he be? He has seen the bottom of humianity, he has been treated like a cripple ever since. We are sitting in our confotable lives, having our faith never being tested and we find it terrifying to share the gospel or even show others our hearts and love for God on a daily bases. We have it easy, we should be giving thanks daily, not just after a difficult time. Marla raising his hands in praise will forever be a reminder of how we are told to be bold with our faith, and give thanks allways.

Marla had his last surgery a week before the ship closed the hospital. He was given two nosterals in his reconstructed button nose. When I walked up to him on the unit after his surgery he called me over and demonstraigted how he was able to exhale through his nose! He was so excited and proud of his new face. I love that I was able to witness his stregth and faith through his recovery. He is going home with two nasel trumpets in place (they hold the airway open until the nose has healed) He will remove these in a few weeks time. Such an aazing story of a man overcoming the circumstances given to him. I was only his nurse, he was an example of faith being bold and Gods amazing Love. I feel so blessed to have been a part of his story and will miss Marla very much, he will forever be in my thoughts and prayers.

Marla a few days before leaving the ship with a fellow nurse Joe-ella.

A big sigh...

Things I  miss about Ship Life....

1-Every outing is an adventure!

The constant guessing game as to what way to look while crossing the road, the argument that you have to work your way through when "discussing" taxi fare prices. Being greeted via megaphone upon entry into the local market, and witnessing a man carry an Oven on his head while walking down the road. Oh yes and finding porcupines in the courtyard of a random shop that does wood carvings.... I never knew porcupines grew to be so big! As soon as you step off the gangway you know the outing will be an adventure, with the right attitude, and a smile you are guaranteed to return to the Ship with a story!

2-Have a deck to sit out on.

I deeply enjoy the evenings spent out on the deck watching the sun go down and ships returning and leaveing the port. Most recently we had the french Navy as our neigbor here on the dock, a few of us had a great tour of the ship and visited with their nurse and electrician on board. It was great seeing inside the ship and check out their engine room, sick bay, radar room, the bridge and sit in the chair that controls the Giant Gun! This morning I watched as they headed out to sea from my spot on Deck 8. Last week the rain arrived in full force, Sitting out under cover on the deck listening and smelling the rain felt like home, it was so lovely. Every night lightning can be seen over the ocean arching in dramacic bolts in the distance. It is here on the deck where we can gather to sing worship, find a spot to be silent and alone, or chat with friends in the late night hours.

3-Living with so many great friends.

I feel like this is the living in residence at university experience I missed out on. It is so great having a ship full of friends. There is never a shortage of friends to hang out with. Charades, movie nights, or nights out on the beach are just a nightly given when living with great friends. The friends that I have made here are from all over the world, we have all been called to come and serve here on Mercy Ships. the sense of community and having Christ woven into all of our lives has been a privilege. It is easy to have community here while we are experiencing life together, watching patients life being transformed and ours being moved and changed as we serve.

4-Pediatric Patients I will miss greatly.

Having a baby nestle into your arms, or a young boy ran at you to start a tickle fight is not a part of my day to day job back home. knowing that the surgeries  are going to make a world of difference for these children is so moving. A baby who arrives severely malnourished and has their Cleft lip repaired they are given a new future, one their mothers never dreamed possible. I will miss Jaka, dancing and giggling, i will miss Lamine, his monkey skills, running around Deck 7, climbing up our legs to get onto our backs, i will miss them all!

The Countdown Starts...

Ward B, Where I met my fellow nurses for the first time. Where I bonded and hugged and saw the joy in all the lovely VVF ladies, wet or dry it was a day to rejoice as they left Ward B to head home to their villages. Where we cleaned and prepared for all of our plastics cases and prayed over the ward that healing would be abundant, and it was. Where I saw the strength of those who have been neglected, tortured, and abused come back to life and raise their hands in Thanks to the Lord for where their journey has lead them and the healing that has taken place. It has been a place for growth professionally and spiritually over the last 4 months. This weeks marks the closing of the Hospital here on Board the Africa Mercy and my departure from the ship to return home to Canada.

Over the last few weeks as the hospital winds down we have been displaced to different areas of work. Scanning, shredding,  bleaching and scrubbing. This sums up the lists of tasks us Nurses have been working on over the last few weeks. Some nurses headed to the Out Patient tent. It is here where a team of nurses and Day Workers see patients for follow-up appointments, dressing changes and Physio. Once all the follow up care is complete they are officially discharged and their file is closed. This leads to a "Special Project" as it is titled. At times instead of working on the wards or in the tent, you are assigned to "Special Projects". Some days this consist of organizing, labeling and scanning the patient files, or sweeping out the entire Cargo Hold of the Africa Mercy ship.... after a couple hours of sweeping and sweating you could eat your dinner off the slightly rusty floor!



One of my cute Ward D patients!

  In addition to cleaning, us Ward B nurses have got to dance and play our way through the work day on the other 2 units. Over the last few weeks I have spent a few shifts on Ward D. If you have seen any documentaries or the 60 min feature of Mercy Ships, you have seen Dr. Garry Parker. He has been here serving with Mercy Ships for 26 years. He is the head of surgery and our Maxillofacial surgeon on board. Maxillofacial includes cleft lip and pallet surgeries, re-building of noses, and removal of facial tumors. There are so many amazing stories and patients that I have only had a brief opportunity to work with. Here is a Blog that I would love to invite you all to read and learn more about the wonderful patients on D ward. It is written by a friend and fellow nurse here on the ship.

http://annaaboardafricamercy.blogspot.com/2013/04/marietous-story.html?view=magazine#!/2013/04/marietous-story.html

Let me Introduce You to a Few of My Lovely Patients

Over the last two months the ship has done 80 plastic procedures. Some patients are here for only a week, others have stayed with us for the entire service and still remain on the ward. Through the course of this time there has been a select number of patients who have taken a hold of my heart and I will miss them greatly and carry their stories with me for years to come. Here are a few to share with you.

Fidel

Fidel is a patient who came to Mercy Ships with a Neurofibroma tumor covering the right side of his face. A neurofibroma is a benign tumour originating in nerve sheaths. The ones that we have seen during plastics have been large and debilitating. Fidel's if left untreated would have obstructed his air way and he would have died due to suffocation. He received his surgery on the 4th day of the plastics service back in the beginning of March. In that time he has a number of barriers along the road to healing. We have seen great improvement and discouraging setbacks. He is a funny patient who has a deep chuckle whenever you call his bluff while playing cards or who lets out a little chuckle when you are scolding a patient in the bed next to his. He has been on our ward the longest and  has seen many patients come and go. He is not the loudest of them all but will always great you with a crocked smile and a solid hand shake every morning, evening or night,

Amiatu 

When I admitted Amiatu I extended my hand to welcome her and she placed her melted fingers in my palm. She had burned her right hand while cooking 10 years earlier.That night, before her surgery, I was talking with her what to expect and we were walking the halls looking at the OR entry and recovery room. I asked if she was scared and she said yes. She is 24, and had a 6 year old daughter who was staying with her parents. She was use to the hand and has been covering it with a scarf while in public for over a decade.We talked about the hospital and the skilled surgeons, reassuring her I would be there the following day once she returned from the recovery room, and we prayed.

Her surgery went well and her fingers were straightened and wires were put in place to hold them in the proper position for healing. A skin graft was taken from her thigh and placed over her joints in her fingers and wrist to allow the joins to fully extend once again. Once she was discharged I visited her often at the Hope center (Our rehab off the ship) and after she was discharged i still ran into her on the streets of Conakry on my way out of the port as she came for her daily physio appointments. We love running into each other and Amiatu greats me with a big hug every time. I will miss her greatly when we close the ship down and Leave Guinea. I feel so blessed to have met her and spent time with her during her recovery.

Nana

Nana had a similar story but she younger at 19, and loves to joke around and play Janga! Just think, before her surgery many tasks were difficult due to her crippled hand. Now she is regaining her dexterity and can have the use of her hand returned to her! I love this photo of Nana using her hand, you can even see the wires in the photo

 

 

Ousmone 

Yesterday i had to say goodbye who is another one of those patients who i have loved through his recovery.. Ousmone was a 19 year old who hated to wear his splints! He obtained his burns when his family home caught fire two years ago by a forgotten candle. 3 family members died and he was severely burned at 17, leaving his body and arms down to his wrist severely burned and contratures at his bilateral axillas and elbows. After the fire he received minimal medical care, was lucky not to surcome to an infection and returned to the village where his Mother looked after him. Everything was next to impossible without the use of either arm. Bathing became a chore for his mother and as she was aging he was feeling guilty being a young man, unable to care for himself. He became depressed, did not attend school, and of course was unable to work.

I was there when we received him back from surgery. Over the course of his stay I was his nurse many times. He had splits that he wore to promote the new scar tissue to heal with his arms fully extended at the armpit and elbow. The list of exercises were extensive and he was a trooper! Over the weeks he was with us he was always up for joking around. playing cards and dancing.Once he was released to the Hope Center (our rehab off the ship) some nurses and I visited him often. One time he showed me a video on his phone of me dancing to some random African music he had on one afternoon! You never know who is filming you, even in Africa their camera phones are out at all times it seems!Yesterday I saw him in the outpatient tent after his final appointment. He told me he was off, back to the village to care for his mother who had spent the last two years caring for him. Ousmone was happy to be discharged, we played a few rounds of Cards and said our final good byes. Wishing one another the best in what ever is to come next. He was such a character.

And then there was 12....  

Here is our Nurse Team leader With the patient who we are
praying blood supply returns to his foot and graft site.



The patients on the ward now have been with us for extended length of time. We are just waiting for the last of the grafts sites to heal. Two of the patients returned to surgery on Monday for re-grafting. With only 2 weeks left of hospital time we are praying they take. One of the cases is needing a miracle and that is what we are Praying for. Tomorrow we are committing to 24 hours of prayer for all of the plastic patients, for grafts to finish healing, infection to leave the wounds, and wounds to dry up. Specifically we are also praying for one of the young men who went back to the OR on Monday. His graft has a lack of blood supply and this will not result in good news if it doesn't change soon. We are praying for the blood supply to return to his foot. I would encourage you to take time on Thursday May 9th and Pray with us here on Mercy Ships for our Plastics patietns as we participate in 24 hours of committed prayer. 

A giggle that can only bring a smile to your face :D

Jaka is a beautiful girl 9 years old girl who greets you with giggles as she danced around the room clapping her hands each morning.

Step 1 Screening

In March on our grand screening day Jaka was seen by the plastic surgeon and the plastics team leader. She was a young child, full of life, dancing and spinning whith friends when the dizziness caused her to touble into a near by cooking fire at her Aunts house. Her left Armpit fell into the boiling water and she sustained burns covering her left amr and body. Her mother, Fanta came back from the market quickly to make her way to the hospital with her little girl, however the family did not have the $200 needed for any medical treatment. Fanta and Jaka returned home with no medical care. For the next 8 month Jaka would be left to lye on her stomach as Fanta would fan her trying to cool the young child and ease her agony slightly. With no treatment scar tissue healed in the position of a closed arm with the tissue from her armpit and elbow now connected, leaving her range of movement limited. As she was healing Fanta wanted to prevent the contractor and four seperate times tried to move the young girls arm extended away from her body. Each time mother and daughter would be be left in tears with Jaka screeming “If you try to pull it open again, I will die. The pain will kill me,” Jaka said. It seemed helpless, and Jaka was left with an arm that was unusable. She has never attended school. When news of the African Mercy sailing into Guinea came, it was a chance to be gifted a new life of hope and healing.

Step 2 Admission

The patients tend to be timid when they arrive on the unit, seeing the routine and talking to the other patients helps the adjust and prepare for surgery. Surgeries here in Guinea are not very successful when they do occur.  This results in a fear in some patients who have personal antidotes of health care and death. talking with the patients the night before surgery about what to expect and walking down the hall to show them the OR entrance and Recovery room helps ease the unknown and reassure them for the upcoming procedure.

Step 3 The Contracture Release

 

The patients going through contractor releases have skin grafts. Jaka received a split thickness skin graft. In the OR the surgeon uses what is like a cheese slicer to remove the top layer of skin from the upper thigh. They then roll it through a machine that flattens the slice of skin, and creates a meshed flap of skin, to place over the open released area. The left axillary (arm pit)  is cut and the arm is extended for the first time since the incident. The donor flap of meshed skin is placed over the released tissue. A bandage is placed over the thigh donor site and left in place for 10 days to decrease infection and the Graft site is bandaged for 5 days to allow healing to start. The patients are sent back to our ward to start their recovery.

Step 4 Healing on the Ship

 

Jaka quickly got comfortable on the unit. In no time we were all in love with her infectious smile. With a little bit of Tylenol and codeine she was up playing the day after her surgery. It amazes me how little the patients need in terms of pain medication! Taking care of pediatric patients is also a new experience, plus the language barrier always makes it interesting! While here on the ship, Jaka had her Mama here as her care taker, and of course with mama comes her littlest one who was still feeding. His name was Cabinet and he was a year old fussy toddler! When he was happy he was yet another blessing to have on the unit to play with and giggle with. My favorite part of caring for Jaka was all of the Dance parties we would have, there is something that is so easy when it comes to shaken you non-African booty with a giggling 7year old girl.

Step 5 Dressing Team

Here during the patients stay the dressing team is a key partner in their care. The dressings get changed every day or every 2 days. If this was left to the ward nurses, our days would only be filled with dressing changes and out patients would not have the amount of time and care that they require.It also is great to have the same team of nurses seeing the wounds and charting about the changes that they observe throughout the process.

Step 6 Splints and Physiotherapy

At first Jaka had a plaster cast on to keep the arm in the proper abduction position for the first 5 days. After the plaster cast is removed a splint is made for the patient to wear while at rest. We have an amazing Hand physiotherapist here who has a work history with burns and plastic rehab. The patients are given exercises to do routinely throughout the day.

Step 7 The Hope Center-Recovery

Once the patient no longer needs the special care from the dressing team, and any infection is eradicated they are discharged from the ship. If the patient is from the Conakry area they can return home and make their way to the ship for fallow up dressing changes and physiotherapy. However when the patients are from other parts of the country Mercy Ships has a large area at a local hospital that can fit 30 patients and their care givers. The Hope Center is a spot for patients to prepare for surgery if they are malnourished and to recover if they are needing more time before returning home. The Hope center is a 5 min drive or a 20 min walk from the ship, allowing easy transport back and forth for fallow up appointments, daily or every 2 days. After a month it was finally time for Jaka to move to the Hope center. I missed them on the ward. Coming to work and not being greeted with a big hug and smiles was an adjustment.

But with the close proximity of the Hope center I get to visit Jaka! I have seen here a few times, Just today i made my way over in the late afternoon and was greeted with a high Pitch "NICOLE" as Jaka jumped from her chair and ran into my arms! I love seeing her play and climb in ways she was unable to before her surgery. Reaching for a ball or even giving her brother a firm shove was next to impossible. Her future potential has shifted.


Oh Jaka, how I will miss her when she leaves the Hope Center