Thursday, March 28, 2013

A new thumb and a new future!



This is the story of a young man who I had the privilege caring for these past few night shifts, it is written by the writers here on Mercy ships. Mamadou has now received his second surgery for relocating his index finger as a thumb! I look forward to seeing him through his recovery and writing a celebratory blog post once he is discharged with a new left arm and a public image that allows him to accomplish what he knows he already can! Enjoy!




Mamadou prayed silently to himself, asking God for just one more ounce of courage as he waited alone at the Mercy Ships patient screening in Conakry, Guinea. Mamadou tried to blend in with the other adults, silently shifting from chair to chair as the line-up of patients advanced.As he waited, Mamadou held his arms, bent inward at the wrists and elbows, close to his chest. He felt awkward and uncomfortable. So many times in his life people had insulted him and chased him away as they yelled, “That boy is cursed! His arms are devil arms!”


Mamadou had not told his family – including his Aunt Hadja, with whom he lived – that he had come to the Mercy Ships screening. He did not want to disappoint anyone if he could not have surgery. Mamadou lived with his aunt in Conakry so he could beg on the traffic-choked streets. His mother and father, in the city of Mamou, had tried to find an apprenticeship for him so he could have an occupation, but his arms were not strong enough to carry wood or hammer nails. So, because the family was desperately poor, they relied on their eldest son to use his deformity to earn money for the family by begging.

But Mamadou wanted something much different for himself, and all he needed was arms that looked normal. If he had no deformity, he would not be expected to beg. He wanted to use his sharp intellect to learn English, as this language came easy to him. And if he looked normal, it would not be strange at all if he supported his family through his own business.Mamadou knew he could do those things now, even with bent arms, but he was the only one who could see past his deformity. As Mamadou confided to the Mercy Ships nurse who examined him, “I can do much more than people think.” He added proudly, “I make good use of my arms to take care of myself and help support my family. I do not want to beg for the rest of my life, but I have learned to do it very well. With the money I earned from begging, I bought sheep. Now, the lambs from those sheep feed my family.”
Mercy Ships was Mamadou’s only hope, and he was grateful to be accepted for treatment. He now felt comfortable sharing the good news with his parents. Mamadou explains, “My condition was a huge burden on my parents. There was so much disappointment and shame that I had to beg for the family to survive. I wanted to be certain that Mercy Ships would do my surgery before I said anything to them.”

His mother and his one-year old sister came to stay with him. His father assured him that the family would get by during the many months that Mamadou would be in the hospital and recovering. Relatives would be called upon to help, and Thierno would find extra work in Mamou. They wanted to support Mamadou’s dream of having his own business and living like any normal young man. Onboard the Africa Mercy hospital ship, volunteer plastics surgeon, Dr. Tertius Venter, explained Mamadou’s rarely seen condition. “Mamadou was born with radial club hands and only four fingers on each hand. The front sides of his hands are underdeveloped and bend downward on an angle. His elbow joints have also been affected. On his left arm, the joint is working fairly well – but, on the right side, the joint is stiff and cannot bend all of the way.”
 
Since Mamadou’s left elbow was functional, Dr. Tertius proceeded with a two-stage rehabilitation of the left arm.In the first surgery, Dr. Tertius aligned Mamadou’s left hand with his forearm. In six months, when Dr. Tertius returns to Mercy Ships, he will take Mamadou’s index finger and reposition it to create a thumb. Mamadou’s left arm will look and function almost completely normally. Sadly, Dr. Tertius determined that no surgery could improve the functioning of Mamadou’s right arm. He explained to Mamadou, “With your right elbow joint in its bent position, like it is now, your right hand is close enough to your body and other hand to be of help. But that right elbow joint can never be made to move and flex. All I can do is set the elbow joint so that your arm is straight. But then, your hand would be out of reach of your other hand and your body and be far less useful to you. The best thing I can do for you is to leave your right arm completely as is.”
For Mamadou, the prospect of one normal arm and one still misshapen arm did not dampen his determination to learn languages and have his own business. He had already proven himself quite capable by becoming a successful sheep owner and lamb producer – even with two bent arms. Just think of what he could accomplish with one fully functioning arm and a hand that could continue to help!

Mamadou looked forward to the months of recovery time before his second surgery. He spoke excitedly to his mother, “I want Uncle Alpha to teach me all about his clothing business in the big market. But most of all, I want to learn how to say something I have in my heart in English: ‘Thank you, Mercy Ships, for giving me the hope and courage to show the world that I, like any normal eldest son, can support his family with the many abilities God did give me.’”   

Mamadou came to the Mercy Ships patient screening day on his own, not wanting to disappoint his family if he could not have surgery. When he was given a surgery date, he joyfully informed his mother and little sister, who came to stay with him during his two surgeries and recovery.  
Mamadou has been a diligent patient, faithfully completing his required exercises. Volunteer doctor Lydia Marx shows Mamadou his latest x-rays that confirm that his healing is on track.
 
Mamadou’s follow-up surgery, planned by Dr. Tertius, will take Mamadou’s index finger and reposition it to create a thumb so that Mamadou’s left arm will look and function almost normally. Dr. Tertius decided to leave Mamadou’s right arm as is. The only other alternative in Mamadou’s situation was a straight arm without the ability to bend, which would have kept his right hand out of reach to be helpful.

Story by Joanne Thibault
Edited by Nancy Predaina
Photos by Debra Bell, Michelle Murrey, Bright Efflowe


Monday, March 25, 2013

What is "Plastics"?




You read about my my time working with the VVF ladies and now we have transitioned onto Plastics. What does that include? One person thought it was surgeries that included the materiel of plastic, like amputations and prosthetic. Here on the African Mercy we have been blessed to work with three talented Plastic Surgeons and a resourceful plastics team leader Nurse.

Here is a snap shot of the surgeries that are being preformed at this time
Cleft Lip
Lip reconstruction
Burn Contractures (Hand, Feet, Axillary, Elbow, Face, and Knees)
Eye lid reconstruction
Cysts
Keloid
Neurofibroma
Noma

With surgery burn contractors are released and skin grafts are done to restore use of limbs that have been contracted for years. With out proper care after a burn has occurred the skin heals in the position that is has been held in. resulting in loss of range of movement and use of the limb.

There are so many new surgeries, and care plans. The age range is 4-50+ years old. Now a day at work can include walking into the unit to receive report and having two young kids run at you for a good morning hug. You pick one up and place them on your back while you pick the second up into your arms. I love the mix in patients, it is so refreshing. I hope to tell the stories of patients and more about the surgeries in future blogs. This was just a snap shot of the work that we have moved onto.

Please keep these patients in your prayers as they are all needing smooth recoveries and we need to pray against any infection and discouragement we may come across along the process. I'm excited to share some of their stories in future posts!! Until then have a wonderful week!
 


Seeing the Country Side and saying goodbye



  This week one of our dear roommates (my bunkmate) Christel departed us since her time has finished here on Africa Mercy. She returned home on Sunday the 24th. The week prior to her leaving we crammed as much as we could. On one of the days we left right after a day shift at 4pm and headed once again to Madina Market. Since this was my second time going up country i was feeling confident in our ability to pull everything together. It was easy to find a public taxi up to Madina, we sat in the caged in Van for 2 hours as we made our way out of Conakry and towards the mountain. Once arriving in Coyah we started on foot towards a hotel that was on the outskirts of town.



Along the way a lovely driver offered us a ride. Through broken french we figured it was safe, there was a Red Cross on the vehicle so he must be good right? funny logic. We arrived at Parc Milley Mamadou and checked into our Bungalows. Along on the trip was myself, Nadine, Jillian and Christel. We enjoyed Bruchetts (steak skewers) for dinner in a garden area with candles and the stars above us. From dinner our friend who we met that day (the man who picked us us) asked if we would join him and his friend sitting down my the creak. They were lovely men who were Doctors here in Guinea. Their job has them traveling 5 days a week visiting the prisons and working with the doctors stationed at each one. Through no English, little french and lots of hand gestures we all chatted for an hour or so about Mercy Ships and Guinea and maternal health. It was very interesting and we hope to arrange for the men to come on board for a tour of our hospital in the near future.

After retiring to our rooms Nadine and myself had a chase with the frog who lived in our toilet, with the use of brooms, sticks, a bedside table and a shoe he was safely outside and we were inside. falling asleep under our mosquito nets, wearing minimal clothing reminded us of some of the reasons we appreciate the Ship. In the morning we awoke to a swarm of wasps building a nest at our window and a door that would not open. after 5 min and tossing the key under the door Christel released us from our room. Its a good thing there was no emergency during the night!



The previous night the Doctors told us about a trail head that was 1km up the road. We set out after our breakfast of Fig Newtons along the road. After 45 min-1 hour we still saw no trail and turned around. It was a pretty road, nice view of the hill tops surrounding us. After returning to Parc Milley Mamoudou we sat by the creak and enjoyed the midday sun before setting out on our hour walk back towards town. Watching people go about their lives is so fascinating, kids bathing in the front yards, square plots of freshly planted seeds, schools in session, goats passing by. Everyone greets you as you pass by and at times a whole slew of bathing naked children are interrupted and come running to shake your hand. We hopped into another public taxi making our way back to Conakry. We all enjoyed our quick one night trip up country.



 We spent Friday night watching the sunset at the beach at a little place called Chaka Waka. It is an amazing food truck run by Sierra Leone people. They make great pizzas and Bruchetts (steak skewers). We had a lovely table of girls gathered to enjoy the evening together. Saturday night we returned to the Chaka Wakas for a last farewell to those volunteers leaving this past weekend. We were in good luck since another Mercy Ship worker was celebrating a birthday. We arrived to an already set up DJ booth, combed out sand for a dance floor and tons of people. We spent the evening dancing and singing to all the songs. Looking up at the stars and around at all of our friends I felt so blessed to have all these girls to share my time here with.Sunday was Christel's last day on the ship, we said our goodbyes. I believe her journey home will be just around 24 hours. She was a great bunkmate and I know we will get a chance to meet again in the future!

Now I am rundown and a bit sick, among everything i have mentioned above I have been working 8 hour and 12 hour shifts! I guess that tends to be my norm, no slowing down.

A trip of yander... Kindia


When sleeping in a metal box becomes too much a trip upcountry is called for. On March 15th to 17th myself and a 3 other nurses, Stephanie, Elerie and Amy made our way up country!

Friday was a busy day, 3 out of 4 of us were working. once we were off shift we shoved what we would need into our packs and headed off ship! We had tried to arrange for a day worker (the local translators who work with us here on the units) to aid in organizing transportation but everything seemed to fall through. After debating to take a taxi or the bus we decided to hop on the bus and head towards Madina Market.
It was 4pm on a Friday afternoon and the but was packed with commuters! After jamming ourselves into a spot we stood shoulder to shoulder with all the fellow riders. We were covered in sweat, mine yours ours! After 30 min on the bus we arrived to the market and were quickly spotted and escorted towards a Local Taxi that was headed to Kindia.

You are able to take a privet taxi and pay 300 000+ GF for your trip up country OR cram into a public taxi for 24 000 GF. Public taxi it is! We had a lovely station wagon taxi that restricted any leg or neck movement. Through the course of the journey my hair decided to make its way into a lovely Fohawk rats nest! Stephanie sat in the middle with other local travelers and had to stick her head out the window if she wanted any personal space! After 4 hours, 2 Road Blocks and a few cold bags of water (500 GF for a 500ml bag of water!) we were dropped off at a truck stop in Kindia, Guuinea's third largest city at 200 000. Kindia was built up around the surrounding banana plantations and the old rail road tracks run into and out of the city. The majority of the population is Susu and there is a strong Sierra Leonean population. A quick taxi ride dropped us off at our hotel located in the outskirts of the town close to the Guinean Armed forces base. The man who ran the Hotel was very proud of his rooms with running water, electricity (most of the time), AC units, and warm water: in most rooms, the ones without hot water heaters he offered to boil a pot of water for us! After a freak rain shower (it typically only rains June-September) we made our way down the road to a local pub and had amazing Brochettes.

Sleeping at the hotel was a treat, being able to hear nothing except for crickets or the odd motor bike passing, I did not miss the constant rumble of the ships engines or the random alarms that seem to constantly go off in the engine room! Even if the power did go off and on, Its "Earth Hour" every day over here!

Saturday morning we enjoyed our cheese and bread on the patio looking over the back courtyard. After our meal us 4 ladies made our way into town on foot. We walked just shy of two hours to the main market in Kindia. The market was similar to Madina, with the hustle and bustle of daily buzz. We purchased some fabric and found a little hole in the wall to eat a lovely local lunch of rice and beef. A few of the kids fallowed us around. After lunch we made our way to the Grand Park to find a taxi to show us the Mariee Falls (waterfalls) and other local sites. After a heated yelling match between the motor cycle taxis and car taxis the car taxis won. We were still being pinched, pulled at and yelled at as our taxi rolled out of the grand park.




Our taxi made its way out of town and toward the waterfalls. It was a lovely park with a small entrance fee (well a man demanding money who we proceeded to pay). We climbed up behind the waterfalls to get a bit wet without going all the way into the pool of water below. While at the falls we saw another group of Mercy Ship people! It is a popular tourist spot in a country with little to no tourism!


 


From there we engaged in a game of charades to communicate that we wanted to visit the Serpentorium to see where they study snake venom. Surprising our reenactment of a snake biting a person was clear enough to our driver! Upon arriving the Serpentorium was an older complex of run down buildings. The Serpentorium is only open during the week, so Stephanie shimmied up the drainpipe to catch a peak inside of all the snakes in their wooden boxes. In addition, on the property there was a Zoo! About 10-15 empty cages, 1 bamboo that was very lonely, and two pens with crocodiles! It was a aery place to walk through with rusty fences and broken glass.


We made our way back towards Kindia market and bought a few more things and made our way back towards the motorcycle Taxis. Yes that's right, we rode 3 per a bike (driver and two of us girls) to save a dollar of course! We made our way on the short 5 min drive back to the truck stop! The motorcycle ride was scary and fun. No helmet and many speed bumps made it more exciting! Once we were dropped off we ate dinner at a local restaurant and walked down the little side road 20 min to our hotel. After a much needed shower my rats nest in my hair was finally worked out and my skin returned to white from the rich red dirt color that it held onto from the days journey. Saturday night was relaxing, playing cards, star gazing (shooting starts!!) and enjoying the wonderful company of the lovely ladies we were with.
Mount Gangan
Sunday started off quietly with breakfast on the patio then another 20 min stroll to the main truck stop once again. We hopped on motorcycle taxis and headed towards Mount Gangan. after making our way down a bumpy village road the men parked the bikes in someones front yard and we made our way on foot through the field towards the mountain! Initially when bartering for our motor-taxis we had agreed on taking a short walk, however the guys seemed to enjoy the stroll up mount Gangan so we continued until we reached a Plato between two peaks. We overlooked the valley, seeing the village below and Kindia in the distance was breathtaking. Behind us sat villages built along Banana Plantations. Below us we could see caves, and farms, while above us were young boys leading their herds of cows up the rocky trails.




We shared our snacks in our group of 8 and enjoyed the view before making our way back down towards the valley. Once back on the motorcycles we made our way to the main road, waving at all the little kids as they ran out yelling Forte Forte! Once on the highway the men made a wrong turn and returned us to the truck stop, after clearing up the confusion we got back on the bikes and headed for the Grand Park. On our way we came up to a political rally of 40 bikes and 10 Vans full of people waving banners about the upcoming elections. (Yes the ships
security has recommended that we avoid large crowds and political demonstrations) and yet we find ourselves in the center of one! As the crowd became thicker we ended up separated and the motor bike i was one kept stalling, My driver was so apologetic but i was feeling confident and not scared. After going down a one-way road and back up towards the proper road, we arrived at the Grand Park where the other three girls were anxiously waiting. From there we stopped in for a quick lunch and had a "burger" (it was a round ground beef ball with a hard boiled egg inside that was luke warm, served with cut up veggies and a baguette it was quiet good!)



We then found a public taxi and started our drive back down to Conakry. Our driver was quiet aggressive and we were making good time, we were smushed in like sardines and the chickens would let out a squawk every now and then. about 2 1/2 hours into the drive we had to make a stop to repair our very flat tire, even after the 15 min quick repair it continued to be a problem and we had to stop for air a couple times. Upon arriving at the Conakry airport it was a quick walk across the street to catch another public taxi to the Port. We arrived to the Port gates with 10 min to spare, we made it back onto the ship just in time for dinner and a quick shower before church!

All four of us agreed that the entire weekend fell together so well when so many variables could have gone astray. We felt blessed and rejuvenated after our weekend and ready to get back serving and working with the patients on board the Africa Mercy!