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