Vignettes

Happy November, friends! Goodness, how time is flying. The past few weeks have been chock-full of so many amazing new experiences. Each one really warrants its own blog post, but for the sake of getting the info to the people, I thought I'd write a few vignettes to give you a glimpse into what life has been like here on the Africa Mercy.

{Screening}

A few weeks back, I had the opportunity to help out in screening. As I'm sure you can imagine, there is a great deal of work that happens before patients walk up the gangway for their surgeries. The screening team is in charge of selecting individuals who qualify for the services offered by the ship. After their initial round of assessments, there is a second round where the surgeons see each individual and make the final decision to go forward with surgery or not. Thousands upon thousands of individuals wait in long lines in cities around the country, simply wanting a chance to be seen & hoping beyond all hope that someone can help.

The screening day I was able to take part in was a small surgeon screening for gynecologic issues here in Tamatave. We saw 15 women who all came with obstetric fistulas. Vesicovaginal fistulas are a major problem in the developing world. In brief, when women suffer from prolonged labor and are unable to access adequate resources for timely cesarean section when indicated, the baby's head in the pelvis causes a breakdown of tissue, which generally causes a fistula (or hole) in the bladder wall (if you're interested in reading more about it, click here). Sadly, with prolonged childbirth the baby usually dies in the process. It's absolutely horrific. And that's not all, because of these fistulas, these women constantly leak urine and smell dirty. More often than not, they are ostracized from society and from their families. It's not uncommon for these women to be left by their husbands because of the disgrace of their medical problems. Clearly, these obstetric fistulas involve more than just physical pain - the women suffer from so much emotionally and mentally as well. I could go on & on about the plight of these amazing women.

Anyways, back to screening... We did an assessment on each woman: gathering her story, vital signs, labs & assessment. Then each individual went through a separate assessment by the surgeon. It was fast paced and super interesting. Hearing these ladies tell their stories absolutely rocked my world - so much heartbreak and so much strength. We were able to send 13 ladies on to surgery! We penciled them in on the surgery schedule and handed them their iconic yellow appointment cards. What a beautiful thing it was to see their faces fill with hope and joy as I shared the news. One woman stood up and danced around, giggling like a little girl. All were so very grateful and excited. It was absolutely beautiful to watch this all take place.

But then there were the two we had to say no to. Oh, it was so hard. They came with so much hope for a life-changing intervention only to hear a, "So sorry, but we cannot help you." One woman had advanced cervical cancer - it would have been unethical to operate when she has no access to follow-up care for chemotherapy or radiation. The other woman was severely anemic and needed iron supplementation before being healthy enough to undergo surgery. Even in the difficult "No's" I saw these women treated with so much dignity. They were told the truth and spared an intervention that would be harmful (many surgeons here perform unethical operations for the pay out). Not only that, but life was spoken over them. We did not give them a number on their days with a well-educated guess. We simply celebrated them and the life they still get to live, trusting the God who alone knows the number on our days.

///

{Dress Ceremony}





Just a few days after my day with OBF screening, I was able to attend one of the Mercy Ships dress ceremonies. These ceremonies are held twice a month to celebrate our post-op obstetric fistula patients who are able to be discharged DRY! After years and year of leaking urine they are finally able to have control over their bladders again. Many will have a second chance at motherhood and a normal life. For these women, being dry is a miracle. Each woman gets a new dress and hat, which is a huge deal. Before their surgeries they were not able to have nice clothes as they were constantly being soiled. At these dress ceremonies they are all dolled up with fresh hair & make-up and their new outfits - they are presented as restored women and it's breathtaking. You can just see the joy & radiance on their faces. Each woman gets a chance to tell her story in front of the crowd... The tears just continued to roll as these ladies bravely stood and spoke of their physical and spiritual healing. Some women had suffered from this condition for over 20 years. Can you imagine? Before they left, we all gathered to pray over them. The ceremony ends with dancing and music, rejoicing over the mercy and goodness of our God.

///

{Orthopedic Evaluation Day}





A couple weeks ago, I had the opportunity to be part of a small team for orthopedics evaluation from last years field service in Madagascar. All the patients that were treated in the 2014 orthopedic outreach were invited to come back to the ship for a follow up evaluation. We saw about 30 patients and it was incredible to see their transformations first-hand. Before they were seen by the surgeon and physical therapy team, we sat down with each patient and their parents to go through an evaluation questionnaire. Here's a few examples of the questions we asked:
How satisfied are you with the results of your procedure?
How much shame did you experience before your surgery? What about after?
How accepted did you feel by society before your surgery? What about after?
If you had never had surgery, what do you think the likelihood is that you would get married? What about now, after surgery?
How much of a role do you think Jesus had in your care and healing?

It was so fun to hear their responses to these questions - I swear I was hanging captive to their every word. What incredible testaments to God's redemptive work in their bodies and souls! By the end of the day I just wanted to stand on my chair and shout, "People! People! This is worth it! All of this is SO worth it!"

Thus says the Lord God to these bones: Behold, I will cause breath to enter you, and you shall live. And I will lay sinews upon you, and will cause flesh to come upon you, and cover you with skin, and put breath in you, and you shall live, and you shall know that I am the Lord. - Ezekiel 37:5-6

///

{A Ward Updates}



These sweet plastic surgery patients are all discharged and healing well. We miss their sweet faces (I mean, just look at those faces), but are thrilled that they are doing so well! A-ward is now in full swing with orthopedics, which has been a fun change. All I can say is that little kids with little walkers get me every stinking time... so cute! Check out this short video below for a peak into the orthopedic world on the ship.

I've started working as a charge nurse on the ward, which has been challenging but good. It's really not that much different from working as a charge nurse at home - just a bit of a learning curve getting used to the Mercy Ships way of doing things. 

///

{Data Entry}

A few weeks back, I was assigned to data entry for the day. I was given the assignment of entering patient demographic data into our computer database:
Married or single? 
Do you have kids? How many? Any deceased?
Where do you get water from?
What type of bathroom facilities do you have?
What amenities do you own?
How much education have you had?
Are you able to read?
What is your floor made of?
What type of access do you have to medical care?
What were your biggest barriers to receiving surgery?

As an example, this is just one that I quickly jotted down:
34 years old. Female. 6 pregnancies. 6 deceased children. Single. Water source: river. Bathroom facilities: pit latrine. No education. Unable to read. Floor made of dirt. Insufficient funds to have surgery.

As I input an entire stack of these forms, I realized how easy it is to get lost in the numbers. I tried my best to focus on each one as if they were sitting in front of me - treating it as a little snapshot into their lives. It was sobering, to say the least. My heart just broke as I wrestled with the realities of their lives. Here on the ship sometimes it's easy to separate yourself from those realities - they are here on our turf after all. But their lives, all of them, are hard. All of them have been burdened by disease and poverty and heartache. Sometimes the weight of it all feels like it could crush me. My bunkmate, who is just a gem, is quick to remind me of a quote by Dr. Gary Parker, one of the long-term surgeons on the ship... "We cannot change the whole world, but we can change the whole world for one person.. Then the next... Then the next." When the burden & heartache threatens to crush, this perspective is one that has kept me going. My day in data entry was humbling and difficult, but I certainly came out of it with new eyes.

///

{Mercy Ministries}

On our days off we have the chance to volunteer with local ministries in the city ("Mercy Ministries"). It's a fun way to get off the ship and experience local culture. I've had the chance to go to a local deaf school and to a local orphanage so far. The pictures above are from one of the days at the orphanage.

///

{Blood Donation}



In order for this to be a fully functional surgical ship, the volunteers are called upon to serve as the on-call blood bank. A few weeks ago, I got the call that it was my turn. I've donated blood at home before, but it was really fun to know that the blood that was running through my veins was going down the hall to a patient in need. A maxillofacial patient that I know and love. The Malagasy people have a proverb, "To give blood is to give life." I think that's really beautiful. It may just be the nurse in me, but there really is something important and symbolic about blood. Jesus' blood was shed for us in a perfect act of sacrifice. Though it's small in comparison, I think that donating blood can be a beautiful act of worship... a reflection of being poured out in love.

///
  

{Full-Time Nurse, Part-Time Barista}

I think I may have mentioned this before, but there is a Starbucks onboard the ship. We are lucky enough to have the cheapest Starbucks around... only $ 0.75 for a latte. Starbucks donates all the equipment, coffee & syrups to keep our little cafe buzzing. There are a handful of full-time cafe staff, but they also utilize other crew members on the ship. My friend Lindsey and I decided it would be a fun new adventure, so we signed up for the training a few weeks back. I'm scheduled for a few shifts in the coming weeks and am hoping to perfect my latte skills.

Bonus points for anyone who actually made it to this point. This was a long blog post & long over due. My sincerest gratitude for all your support & prayer. Know that it's the lifeblood behind the work being done here. We could not do this without you!

Sending love across the ocean,
Jarah