I met Sunday Morning a little
earlier than planned, my body was still on Singapore time (8 hours ahead of
London and Here!) so 2:30 I was wide awake even though I didn’t have to leave
the hotel until 5am! Checking in at the airport was smooth. Terminal 4 at
Heathrow Airport is defiantly not a place you want to hang out in too
long!
The plane ride to Paris was quick. I
tend not to look to closely at things, I thought my flight left Paris at 12ish
and I didn’t know Paris was 1 hour ahead of London so when we arrived I thought
it was 830 but then saw that it was 930 as we landed, and then a bit later once
I was off the plane since I was at the rear of the plane. I checked on the
screen to see what Gate my flight was at and noticed that the departure time
was at 1030! It was already 945, and I was in an unfamiliar airport that seemed
to be bigger than metro Vancouver! I quickly asked for directions and jumped on
a tram to another terminal and stood in line for another Security check, and
hurried my way to the gate where they were already boarding! The flight was
uneventful, the food was good and the movies were even better! See this is why
I don’t get a chance to Blog, the wonderful blockbuster hits like Pitch
Perfect, and Lopper hook me in!
I arriving to Guinea, had my Customs
card half filled out (I was yet to get a visa) and my stack of papers the
explain who I am, who I am with and Government papers stating that I should
receive a visa exempt pass into the country. It was hot and sticky as we stood
in line for customs, the smell of Africa was in the air, and it reminded me of
Tanzania. As I watched other passengers get quizzed and having to spend time
explaining their reasons for coming into the country I was surprised when I was
at the booth for not even a minute! On the other side I collected my bag, passed
through another security point and was out of the airport! I was met by a Nurse
from Mercy Ships that was sent to collect the two of us who were
arriving.
We made our way across town from the
airport to the Port (about 30 min drive). Everything seemed familliar to Dar es
Salaam. The streets where filled with aggressive drivers, the roundabouts have
opposite rules; those coming into the roundabout have the right away! The
streets were lined with homes, shops, and people. From the Plane I was able to
see Africa Mercy (the name of the Ship) at the port. We pulled up in our Land
Rover and walked up the stairs to deck 5! Security greeted us and reception
registered us in. Hospitality brought us to our rooms and then up to the dining
hall. My room is a 6 person berth. There
is currently 5 of us, but on Saturday 2 will be leaving and 3 will be arriving.
There are three little cubbies I guess you could say, each with a bunk bed and
two closets and 1 desk. Space is tight but hey no mosquitoes and air
conditioning!
Monday was full or Nursing
Orientation, Official Ship tour, IT getting my computer online, visiting the
bank to set up accounts, and ship orientation. By the end of the day I was more
than ready to go to bed! Tuesday was my first day on the unit. Today I worked
with a fellow nurse on the unit learning the routine, and where everything can
be found.
The unit I’m working on is B; it is
a 20 bed unit with VVF patients (Vesico-vaginal
Fistula (VVF) is a hole from the bladder to the vagina). There is a wall
down half the room and 10 patients on one side and 10 on the other. The ladies
are all so lovely. The beds have a foot and half between one another, there are
no windows on the unit (being that it is on the third level, the same as my
cabin!) and the curtains for privacy have magnetic hooks and we move them
around to a bed when we need to do personal care. So these ladies do not have
much privacy at all. But for the culture they come from this is ok. They have a
community approach to life. Even discharge teaching can be done in a group
setting. The ladies speak different languages from the regions they are from;
few speak broken English or French. On the unit there are 2 or 3 translators to
help communicate with the patients. Most of the time we can use hand signals,
common words and signs to get our messages across. For example a hand to the
mouth is for water where as a hand going from the mouth means vomit or
spit!
If you are wondering what type of
surgery these ladies are having read the next paragraph, if nursing details
bother you then skim it. “In developing countries, the predominant cause (97%)
of VVF is prolonged, untreated, obstructed labour lasting anywhere from 2 to 10
days. During labour, the infant's head presses against the soft tissues of the
mother's pelvis, causing a decrease in the blood supply to these areas. If the pressure lasts for more than 3 hours,
the tissues die creating an opening between the bladder and the vagina. In 95%
of the cases the baby dies during this prolonged labour. The mother is left
with a continuous trickle of urine leaking from the fistula. Occasionally the
prolonged labour also causes a hole between the rectum and vagina - a
recto-vaginal fistula (RVF) - causing feces to leak into the woman's vagina as
well.” (Mercy Ship Surgical Orientation PDF) “Socially,
over 90% of women affected by VVF are rejected from their husband and society
due to their childlessness. They become social outcasts, isolated from family,
friends, village society, and religious life. They work alone, eat alone, and
are not allowed to cook for anyone else. They sleep in separate huts and often
end up on the streets, begging for their survival, with the repair Emotional and spiritual hope and healing can
restore women to their families and societies. After a successful
intervention, 90% of women are accepted back in their communities.” (Mercy Ship Surgical Orientation PDF).
Coming on board and having already
read about the unit I was assigned to and the work that we would be doing I was
looking forward to working with this vulnerable population. Having all the
ladies fall under the same surgeon and procedure I feel will be helpful as I
learn the routine on board and get use to things in the hospital. Sitting at
the ends of the beds reading their histories and how the young women in front
of me was married at 13 and had a baby the same year, however the labor was at
home with no one to help deliver, the delivery was 4 days, and the baby was
stillborn and she ended up with a fistula, resulting in her husband abandoning
her and leaving her hopeless, as the scum of society.
In Canada this doesn’t happen
because medical interventions occur when the baby and/or mother are in danger.
We come from a society where education is available and marriage is not forced
and certainly sex and pregnancy is not a normal occurrence for 13 year old
girls. But it is not just the young girls, other patients where in their late
20’s and in a government hospital, nothing was done for days, the baby died and
wouldn’t advance down the birth cannel so a cesarean section was preformed
(this was her 4th pregnancy) and still she was left with a
fistula.
These girls are not coming for
repairs right after it occurs, they have lived for years or even decades with
urine and sometimes feces too leaking from them. Some of the girls have had
local hospitals and other foreign doctors attempt surgery on them already,
leading the area scared and more damaged. The success rate for the surgery is
between 50-90% of the time. When the ladies leave if the surgery has worked we
are giving them a new start, they are no longer burdens on relatives, and they
can work and live a life back in society. The stench of rotten urine is left
behind as the hole has been repaired.
Working here at the hospital is
different. No one commutes to work, we all are volunteering to be here, coffee
breaks are optional, clocks are never set or watched, at lunch hour we just
take turns, somewhere around 20-30 min. At shift change there is 1 ½ hour
overlap from day to evening shift. Report is given from the day staff to the
evening staff, then the day staff walks with the patients, takes them outside
if they are allowed, and plays games with them. It’s a time to help out if need
be. It is relaxed. Right now there is a full staff of nurses on the ship. Last
fall Mercy Ship was short nurses, and had to shut down 20 beds for a couple
months. That’s hundreds of people that were not able to have surgery. I am so
blessed that I am here now, and that I get to work with this team of nurse.
Already I’m learning things, and it is amazing working with people from
different countries and education systems. On the ship there are 40 different
nations represented in the 500 crew that live on board.
I still feel new and awkward on
board. Getting lost as to what stairs lead to deck 7 and what ones to take to
the dining room, learning where all the extra bathrooms are on the ship so I
don’t have to run down to my cabin every time I need to go pee! The next two
mornings I have fellowship training and tomorrow I have an evening orientation
shift, then I am done with all the orientation! Friday I start my rotation on
my own on the unit. 5 evenings in a row then 2 days off then 4 nights in a row
then a couple days. My first weekend off is February 16th I think,
There are islands close by where a boat takes you to spend the day, everyone
has been telling me to go there when I get a chance.
This evening after work I came to my
unit to write my blog, but half way through it one of my roommates told me she
was heading to the market and asked if I wasn’t to join. Next thing I know we
are jumping in a cab and heading into town. She was meeting with a local man
who does sculptures in wood of a picture she brought. All of his work was
beautiful. I imagine I will return to him for something in the near future. We
walked around a big, and saw some lovely leather purses. The man was sitting in
front of his stall hammering into the fresh leather and braiding the sides.
There was a large strip of snake skin waiting to be made into a purse dried
hanging in the back. These were amazing to look at. A bit over priced but
defiantly anti PETA. We then went to head back to the ship (dinner is over at
630 and it was already 6) we waved down what we thought was a cab (it was just
a man needing gas money) and headed towards the Port. The traffic in Guinea is
odd; roads change directions for rush hour. Sometimes the main road is 2 lanes
each way, other times its one way 4 lanes. We drove in a couple circles getting
stuck in the horrible traffic and finally made it to the ship, the guard
wouldn’t let him drive us in, even with our badges so we had 4 min to make it
across the port, we ran! Finally at 630 we made it. There was no more chicken
left but rice and onion sauce was good enough. (Tuesday is African themed
dinners). Oh did I mention that my pants split at the market! About a 5 inch
tear at the seam of my but crack! So everyone saw my great undies and some very
white bum cheek! In a country where knees are scandalous I was flaunting my bum
to the world! Luckily one of the girls I was with noticed and gave me a scarf
to wrap over my pants! I’m the one that just arrived and already my clothing is
falling apart! (Ruhina; these where my bright colored capri that the rat chewed
on while in Tanzania! They now have been blogged about twice!)
Well I’m tired of writing and I’m
sure no one has read this all the way through. Did it take you 3 or maybe 5
times returning to finally read this entire string of posts!? I’ve arrived, and
there will be more to explain but for now I’ll leave it here. I’m still Jet
legged but am already starting to settle into my new home. Keep Mercy Ships and
me in your prayers as I find my spot in the amazing work that is being done
here in Guinea West Africa.
