Joy

My patients! The reason we are here and the source of so much happiness and joy! I thought I'd finally take some time to tell you about some of them.  This post will be on my plastics patients, who are almost all out of the hospital now (good for them, sad for us who love them so much!)

This first group of children were our first family of kids on the ward. Running around, playing with the nurses, practicing with our stethoscopes, using calculators as cell phones, putting stickers everywhere... the ward was so loud and happy.  We'd be gathering meds while holding a child in our arms with another tugging at our pants, grabbing our pens and stethoscopes, tickling the backs of our knees, giggling. Never a dull moment. These two brothers were so mischievous and all over the ward! They rapidly wiggled their way into everyone's hearts. Every time I would come onto the ward, they would look up and start yelling my name (kind of...)  "Mollo! Molloo!" and run at me with hugs and jump into my arms. I gladly accepted the new variation of my name, and actually find myself missing it from time to time.

This was one of my first pediatric patients.  She had come to the ship in 2010. She was badly burned as a baby.  The story I have heard is that she crawled into a bag of twigs and other garbage items to be burned while nobody was looking.  They put the bag in the fire as planned and she was inside.  By the time they saved her, she had been badly burned.  The whole village felt responsible and maybe this is why she had maintained so much of her beautiful character and does not seemed to be shy or ashamed of her outwardly appearance. In 2010 the ship did a surgery to release burn contractures and reconstruct her face.
This time around, her right eye was removed (she could not open and close her eyelid completely anymore, and this provided a better appearance), they created more of a nose from a rib graft (so cool!) and put a skin graft over the eye area.  She was running around, tickling the nurses, playing games with us, and teasing us constantly.  She has an amazing, infectious smile and laugh that leaves you giggling.  She will never look "normal", but from the time she came to the ship in 2010 to now, her outwardly appearance has improved a lot.  Her inner beauty is, however, undeniably perfect and has never required any repair.  :)  She sees so much more joy and beauty in this world out of one eye than many of us ever do with two.

 

 This next patient is one of very few that spoke English pretty well.  I was so happy to have time to get to know her and have good conversations with her.  She is so so lovely! She had a neurofibroma on her face near her eye that we removed and then basically gave her a face lift to help with the drooping of her skin and eye on that side. She was so full of love and joy, and always had such a beautiful smile.  She was incredibly patient and gracious and so thankful for all of her care.  I got to teach her how to knit! She picked it up so quickly and we had so much fun doing that together.  With each dressing change, her appearance approved and that smile just got bigger and bigger.  When she left, she looked for me, and I gave her a huge hug and my heart just sank to know I may never see her again.  How bittersweet.  I miss her and her beautiful, calming presence!

This next little one is undeniably one of the cutest patients we had on our ward! Just look at that face!!!  She had badly burned her feet and was left with burn contractures of her ankles and missing toes.  We did a release of the contractures to straighten her ankles and make it (hopefully!) easier for her to walk and balance, especially as she continues to grow. She has a laugh that will get you laughing and you won't even know why.  She loves to be carried, thrown up in the air (and caught), and she loves to tickle attack.  She is now discharged and running around on her personal boots fit just for her! SO cute!

   These are only a couple stories to tell, but there are so many.  I will try to do more another time.  These patients are so dear to me.  They have such trusting and loving hearts.  They so quickly and easily become a family on the ward and accept us foreigners with big smiles and hugs.  They take their medications, nutrition supplements, and go through painful dressing changes and don't complain (except maybe during the dressings!!!) but instead thank us and trust us and love us.  So much time was spent just playing and loving these patients, and I feel so blessed to have had them in my life, even if just for a very short time.

Ward Nursing!

I haven't written about my patients yet because, honestly, I'm just not sure where to start.
First of all, the patients here are among the most beautiful, joyful people I have ever had the pleasure to meet in my life.  I find it incredibly easy to love them.
Being on the plastics ward has been a huge blessing. We have such joy on the ward. Everyone quickly becomes such a little family. The sense of interconnectedness is really powerful.  All the patients and their caregivers help each other. If one needs help to the bathroom, another will quickly run to help.  Other caregivers will rub the back of another patient without question. They share their food, often offering to us nurses to come sit with them and eat. This is just how it works here, and I feel that we could learn so much from them.

Let me just start from the beginning and explain how things generally work here...
The wards are set up as large rooms divided into two sides, each with 10 beds per side (it's slightly different in D ward with maxillo-facial patients, one side has 10 beds, the other 5 beds, and then ICU off of that has 3 beds and 2 isolation room beds).  The beds can be put on risers to allow for space underneath to put a mat down where a caregiver for the patient can sleep.  For pediatric patients, they all must have a caregiver present. This could be a parent, an aunt or uncle, a sibling, a grandparent, etc... Also, caregivers may be children of the patients or younger siblings that come with the parents. This is the reason we had extra little babies and toddlers running around making our shifts more exciting, crazy, and joyful.  Now that I've been here for a couple of months, I find it hard to think of going back to the states where each patient has their own private room. It seems so sad.  There is always music, dancing, worship, games, etc in the wards and my heart is just smiling all the time.  I have learned how to be a pediatric nurse at times, how to care for patients post-op from surgeries I have never seen before, learned to break communication barriers with a sticker, a smile, or a hug.  I feel such a sense of family and feel so much love for my patients and their caregivers, and feel that love radiating back at me. I get daily hugs, arm rubs, butt pats, and cheek kisses.

One of my pediatric patients was a challenge when I first had her on night shifts.  She was very reserved, always looking at us nurses as if she were very unsure about us, sizing us up. She was vomiting for 2-3 days post-op and having diarrhea, and to top it off she was on bed rest. She hated the medicine and wasn't eating well either.  Having white people care for her probably didn't help much at first.  Her stomach issues cleared up on their own and after her first dressing changes she was able to be out of bed.  She was extremely hesitant to start walking on her bandaged feet, mostly out of fear of pain.  She would sit on the floor and her mother would walk away and the other patients would tease her, then she would reach for me to pick her up and carry her to the bathroom or the bed... We kept encouraging her and once she realized it didn't hurt and was nice to have some independence, we couldn't get her to stop walking back and forth around the ward.  Soon, her personality emerged and she was far from the shy little girl in bed in the corner.  She walks around to all the different beds, talking to all the other patients and caregivers, trying to learn English and yelling out any phrase she learns on repeat.  "How are you? Fine. Thank you, you're welcome!"  Every time she sees me in the hall, she yells my name, runs to me with open arms, and jumps into my outstretched embrace. Talk about a welcome! I am so blessed!

 

This is just one patient of SO many that I am so overjoyed to have met.  The plastic surgery patients can end up staying with us for a very long time.  Some of them get infections at their wound site which really delays healing time, some just need dressing changes for a long time until they heal well enough to be let off the ship into a very minimally clean environment, some have other complications that keep them with us for a little longer.  Either way, we get very close to them and they also become very close to each other on the wards.  The other day I was looking through photos with them and they would all call out each patients' names when they saw them and laugh, including old patients from a month ago that had since been discharged.  I loved it.  This place is just so full of joy and you can feel the love all around.  God is here and is doing great things and I feel so happy to be a part of it!

Benin!

February 25-27, 2012

Weekend off... How about we cross a border? Benin it is!
We had a pretty large group, 9 total, all excited and ready to travel.
The difficult part is trying to travel together in such a large group.
Somehow, it works out! After spending a couple of hours at the gas station working on getting a taxi or a bus, we met a man from Ghana who spoke English who helped us. So we jumped in two taxis to the Ghana border (yes, that's the opposite direction of Benin) with him in the front seat. When we arrived we got to a "taxi station" type of place where we got a station wagon that would fit all 9 of us and the driver, for a fee of 4,000 CFA each, to Benin. We piled in the schwagon (sweaty station wagon) and were off! At the border, we waited while "mom" and "dad" (Fiona and Nathan, occupants of the front seat) jumped out to sort our visas for us. All worked out and we made it into Benin (after a nice lunch of packed sandwiches and some Fan Milk... (ice cream/frozen juices/frozen chocolate milk/etc in a bag that you buy, bite the end of the plastic package off, and suck it out! mmm!)
 A couple of hours later, we found ourselves in Ouidah. We drove through and arrived at the gate of no return on the Atlantic Coast of Benin, significant during the Atlantic slave trade. This was the last place the African people passed through on their way to the ships.
The driver said he could not take us to the hotel we were trying to get to unless we paid him more because he had to drive down a sandy road to get there.  After trying to bargain, we decided it wasn't worth it and got out at the beach. We took some pictures, ate some snacks, stretched our legs, then tried to figure out what to do next.



Luckily, we came across a man in an Infiniti. He spoke some English and agreed to speak with the owner of the hotel to help us figure out where we were going. As he was speaking in French, one of us heard him say, roughly, "I found them wandering along the beach..." Ha! He ended up driving us back into town where we could more easily find a taxi to take us to the hotel.  We were dropped off at another place where, eventually, two taxis came to pick us up and start the (longer than expected) journey to our hotel.  It was a beautiful drive, all along the beach, driving on sand roads, looking at the stunning waves of the Atlantic ocean crashing on the shore.

When we made it to the hotel, we were pleasantly surprised by an enthusiastic greeting from the owner followed by a quick tour of the grounds and our rooms.  There were individual hut-like buildings for each room, a large open-walled, covered area for meals, a pool that was not currently full of water, and many recliners and huts out in front by the water.  Also, a horse! And many lizards. We gratefully put down our bags and sat down for dinner. We enjoyed our long meal and the company and were just so thankful to have made it safely to such a beautiful location and have wonderful food and incredible hosts. We agreed upon a plan for the next day and went to sleep.
In the morning, we awoke and went to breakfast. We were served a tray of fresh fruit - pineapples, mangoes, papaya, yum! Then some bread and mango jam and coffee.  Then came the omelets and fresh squeezed orange juice.  A feast! So good, and we ate every bit. We then took some time figuring out how to pay for everything and what to do next.  We had forgotten about the time change. The owner told us it was only 9:00 am when it was 10:00 in Togo, which confused us but we thought maybe we gained an hour? This didn't make sense in relation to our location, so we asked our waiter what time it was and he said 11:00.  In a matter of minutes, we gained an hour, then lost two hours. yikes!

We kicked it into high gear and left for a boat ride to Bab's Dock, a resort area on the water.  It was beautiful, had nice docks on the water, kayaks, a small sail boat to rent, and an outdoor bar to order drinks or food.  We soaked it all up. After a couple of hours, our boat came back for us and we returned to the hotel where we were waiting for taxis to take us back to town (3 of us needed to return to Lome to work the next morning and the border closed at a certain time).  Our hotel owner ended up taking us in her personal SUV because the taxis did not show up in time. We once again scrunched into a vehicle 10 people are not meant to ride in, and drove up the sandy roads back to town. We were short on time and worried about running into the police with too many people, so the 6 of us not going back to Togo jumped out, said a very quick goodbye, and went on a search for our next adventure.  We met a man who walked us to a moto/bus station.  We decided we had a couple of hours until sundown so thought we would be ambitious and try to go to the stilt village of Ganvie. 

After another very long conversation and bargaining, we ended up hopping into a lovely blue van with RAD on the side ("Read a Dream"). We went flying down the road to the place where we pay for a boat tour of Ganvie.

We decided upon the more expensive option of having a motor since the sun was due to set soon.  As we were boarding the boat, we noticed it did not have a motor... All of a sudden a man passes us on the dock carrying a motor and attaches it to the back of the boat. Voila! We climb in and are greeted by our tour guide as we start our boat ride into Ganvie.  The village is all over the water with each house, hotel, hospital, market, attraction set on stilts. Everyone has a boat that they ride from place to place to buy whatever they need or to go to and from town. Some people greeted us with songs of Yovos and laughter while others just stared, making it clear they did not want their picture to be taken.  We selectively took photos and took in Ganvie, a beautiful village on the water.

When the tour was over, we then had a man help us to find a place to stay in Cotonou that was not too expensive and was also safe.  He drove around with us and found us a wonderful hotel to stay. We had an incredible meal of rice, cous cous, amazing sauteed veggies, and, of course, french fries.  We befriended our new mom and dad, two of the owners (I think) of the hotel.  We had difficulty finding a person to drive us back to Lome in the morning (which was necessary as many of us had to work in the evening). The woman saw our stressed faces and said, "Don't worry, Mama is here, I will take care of you." She went on to say that if we could find noone, she would take us herself in her car. The man used our phone and talked to some people for us and arranged for a friend to take us back in the morning.  He had to go to Lome and needed to leave very early in the morning, so we jumped in with him! We didn't mind getting up at 4:30 am as long as we got back! We woke up early early, met with the man, said our goodbyes to our new friend at the hotel, and we were off. The car flew through the nearly-empty streets in the darkness of the early morning. The breeze was nice and cool, sheltered from the sun. We raced back in record time, spent only 10 minutes through the border with all 6 of us, and got back to the boat in 2-2 1/2 hours, in time for breakfast (served only from 6:30-7:30 am).  Success!
Actually, as Lina would say, an epic success.

Lake Togo and Togoville

Lake Togo and Togoville

February 22, 2010

I took a day trip to Lake Togo with a couple of friends on a day off.  We grabbed a taxi, bartered for a price, and took off.  It was a nice sunny day and the warm Togolese breeze felt nice driving down the roads. We drove past the fishing village and took in the sights of the ocean and the people getting ready for their long days of fishing... laying out their nets, repairing holes, chatting.  I have always loved car rides, having the opportunity to view the world and its inhabitants as they slowly pass by. There is such a sense of peace and connectedness felt with each wave, smile, or head nod.

We arrived at the lake and then bargained on a price for the boat ride to Togoville and back.  The boat was already packed with African people ready to go to Togoville for the day, staring at us Yovo's wondering what exactly we are doing. We piled in and agreed to pay on the way back.  The boat ride consisted of all of us sitting in the boat with a man in the back pushing a large stick into the bottom of the lake to propel us forward.  It was a nice, leisurely, and beautiful boat ride.  [As a side note, we could probably have walked across the "lake". We were about halfway across and saw a fisherman standing waste deep in the water. That doesn't mean that I would want to walk across the lake, or that it would be the smartest idea... ]

with our guide

Once we got to Togoville, we were swamped with people who wanted to be our guides of the village.  Our friends who had gone before had told us that a guide was actually very helpful so there weren't just wandering around the village. We again bargained for a good price to pay the guide and were proud of ourselves for decreasing the price by 500 CFA each from what our friends had paid (that's about a dollar each)... :) Off we went around Togoville! Our guide was very patient and waited as we took pictures and tried to understand a mixture of English, Ewe, and French (and the occasional make-shift sign language).

We saw a church with outdoor seating that was added on.  It was bench seating overlooking the lake with beautiful trees around, facing the opposite direction of the church toward a stage-like structure.

male voodoo shrine

female voodoo shrine

 We learned about voodoo in the village and saw voodoo shrines and trees, complete with dead birds at the base which had been used as a sacrifice.  They worship these deities. A month or so ago, we learned about voodoo on the ship and were told about Mami Wata, who is a chief deity, the Queen of Water - she is a powerful spirit here in Togo and resembles the Starbucks logo that we are so used to in the states. Therefore, the logo on the ship is different and does not look like a mermaid so as not to offend anyone.  I will take a picture one of these days and share it.


 We visited a large outdoor market swamped with people, food, and any items you can imagine you'd need to purchase.  One of my friends took a picture without asking first in the market (we are warned against doing this) and was quickly yelled at and the woman demanded money for her picture being taken.  My friend just deleted the photo and we moved on, but we didn't get any more pics at the market! :)  I didn't take any pics there even though I wish I could have! There is no way to describe the mixture of children, animals, fish, fried food, vegetables, toiletries, tires, clothing, etc... Bustling with people, selling their items... sitting on the ground or sitting on stools. Such a sight to see!

The chief of Togoville, Baya Mlapa V

We were also taken to the house of the chief and were told a small amount about the history of Togoville.  Togoville was the first village of Togo, now occupied by approximately 8500 people. It was originally just called "Togo", then the Germans invaded in 1910 and named it "Togostadt" (similar to Togo place/town) until the war when the French took over and it was renamed Togoville and the country was named Togo. We were also told about Pope John Paul II's visit to Togoville and shown pictures. Then we were asked if we brought a gift for the chief (even though we didn't see him, and did not know we would be taken to his house).  For everything we did, we were asked for a tip or gift in addition to the amount we had agreed to pay. They expected this for the tour, for seeing the chief's house, for taking pictures, everything.

We wandered through the village and saw our guide's house where we met his wife and baby.  We walked up a hill a ways where we sat down and had some cool drinks and a snack and headed back down to the water where we parted with our guide, then wandered back to the market for a little bit before meeting our boat to ride back. We found a taxi (eventually) and made it back in time for dinner!

boat ride back to Lome

How is Togo?

How are you?
What's Togo like?
How is life on the ship?
How are your patients?
What have you learned?

How do I find the words to do answer these questions?
There is no short answer to explain this experience.
the people.
the poverty.
the joy.

I can't quickly describe the culture on the ship
people from a multitude of countries,
of differing languages, customs, backgrounds, beliefs.
Bound by faith and the beautiful people of Togo.
Living together within the walls of a large ship
in 6-berth cabins
small bunks
tiny bathroom
communal meals
communal everything.
How can that work?
It works by the grace of God.

And then there's the Togolese people.
Beautiful
Smart
Creative
Joyful
Gracious
The list is unending
Walk down the streets
greeted by each and every person
Hello! How are you? What is your name?
The smell of food
and sewage
mix in the air.
the sounds of trucks, motorbikes, music, and people
Bustling, greeting, selling, playing

Smiles.
So many smiles.
Our patients, their families.
Patient, thankful, loving.
My heart feels full.
I wonder
Are they helping me
more than I am helping them?
It is so easy to care for them
to connect with them
to love them.
Despite the language
and cultural barriers.
That just doesn't matter.

They teach me so much
More than I have ever learned
or could learn
in a classroom.
How to enjoy life,
be thankful for what we have,
learn what is really important.
Care for everyone.
because we are all family.
Dance.
Sing.
Laugh.
Always from the heart.

And always, always
to LOVE.

Kpalime

February 11-12

A group of us were off work this weekend and went on a trip to Kpalime (pronounced Pal-i-may).  I unfortunately worked the night shift Friday night, so I left on Saturday morning on no sleep (not a good idea, but I didn't want to miss out!)  We had some plans, we had a contact of a guide that could take us to a waterfall on Saturday and a guide to take us to the mountain on Sunday. We knew we needed to get to the bus station to take a "bus" for 2000 CFA from Lomé to Kpalime. But first, we needed taxis to the bus station. As funny as this sounds, the taxis were probably the most difficult part. We walked to the gas station where it is easiest to find a taxi. First we had to find someone who knew what we were talking about and where the bus station was.  Then we began bargaining with drivers for how much we should pay to get to the bus station. Finally, we ran into one of our day workers from the ship who knew where the station was and how much we should pay, and she helped us. There were 10 of us, so we piled into two taxis (4 in the back, 1 in front), and off we went! Easy as that? Of course not! Once again, the police spotted us white Yovo's and we were soon pulling over again.  The police said we could only have 4 people in each taxi (guess we don't learn well from previous mistakes, huh?). One person from each car had to get out and take motor bikes (they are everywhere here), and the drivers each left to pay the fine to the police.  [As a side note, it is typical that many people ride with a lot of people per taxi here, however we are white and are stick out like a sore thumb.]  Then we all drove off again, 2 on motorbikes, and the rest in our 2 taxis. We drove for a little while then we saw the girls on the bikes stopped on a side road. We soon pulled over to learn that they were going to get back in our taxis and we would drive down side roads the rest of the way to avoid police. We made it to the bus station.

rear-view mirror. doesn't do the bus justice :)

There, we were greeted by many Togolese men who directed us where to pay. We each paid our 2000 CFA for our bus ticket and piled into a large van with 4 rows of bench seating inside, what we were told was enough for 19 riders: 4 in each row, 3 in front (including the driver). Needless to say, we were preparing to squish.  With just our group, we were a comfortable fit. Then we sat in the heat and waited. And waited. After about an hour and a half, we finally had enough people join our "bus" and enough cargo on top that we proceeded. We made stops along the way to pick up more people and to drop some people off.  We ate our snacks we packed for lunch in the bus.  We made one stop for the bathroom (they get out of the van, lift their dress, and go...). We all stayed in the bus :) The bus driver agreed to take us to our hotel if we would call him the next day to make our return trip. We obliged and dropped our stuff off at the hotel. The hotel was nice, we had 2-3 per room, with wall mounted air conditioners, running water, a flushing toilet, and a pool! We talked to our potential guide who told us the only way to the mountain was by motorbikes (you ride on the back of a motorcycle driven by a Togolese man), and they rarely have helmets available so we had to decline. Since the mountain opportunity was gone, we decided to just wander around and look in shops. When we finally lost momentum (mine was lost long before this moment...), we sat and grabbed some waters and sodas. The group was then ready to wander to dinner, at which point my body gave up and couldn't go any further, so I returned to the hotel for a nap.

When I got back, there were chairs and tables and music set up all around the pool for a Togolese celebration.  There was loud music and food and dancing and singing (for part of it, "Happy Birthday" was sung in Ewe for about an hour straight).  We quickly learned we weren't going to get to bask in the pool as we had been looking forward to for the long, hot day's end.  Surprisingly, I was still able to sleep a little bit, and my body was just thankful to lay down. When the group returned about 3 hours later, we all gathered for some games and snacks then went to bed.  They had met someone at dinner that was going to be our new guide for the mountain the next morning.
We all set our alarms and woke up ready for another adventure. 

measuring rainfall

thermometers and measuring humidity

Sunday went much more smoothly :)  Our guide came to get us around 8:15. We were able to take a bus up the mountain most of the way, then hike a little higher, and walk back down.  It was beautiful, I was so happy to be among so many beautiful, green trees, to breathe in what felt like fresher air than Lome, and to be away from the clutter and noise of the busier city (not to mention be OFF the ship!) On our little hike up, we came across a weather man. He showed us what he does daily.... He checks the temperature every hour, then also checks the temperature in the ground for farmers, etc.  He also measures rainfall when it occurs.  Also, he uses a globe-like device to measure what time sunrise and sunset are. The sun shines through the globe and burns little holes into the papers, when the sun goes down the burns stop, so you know what time it was.

"sunrise, sunset..."

We stopped at a hotel on the way down for breakfast. When we came, the owner offered us a choice of beef or chicken and rice. One of the girls asked if there was any breakfast food like eggs and toast. He agreed and went to prepare the food. About an hour and a half later (as we were all struggling to stay awake and carry a conversation), he brought out two pots of hot coffee accompanied by steamed milk (!!!) and sugar cubes. Then he brought out large platters of fresh, toasted bread with butter and jam on the side.  After that came our own personal omelets! They were plain with some seasoning and the perfect size... SOOOO delicious. Maybe one of the best omelets I have had.  We were very pleasantly surprised and our stomachs and hearts were filled.  We traveled down the mountain and came across a waterfall on the way down, where we stopped to take some pictures.
 

after breakfast - rejuvinated! with our guide.

The hike down ended up being pretty long and we were not meeting our timeline (as usual) to meet our bus driver for the ride back to Lome. So we called them and they met us at the bottom of the mountain, took us to the hotel to check out and pee, then we paid our guide and proceeded to Lome. Sweaty and tired, we were surprisingly upbeat from the adrenaline of such a positive day and nurturing breakfast. I enjoyed the ride home, got a window seat (yay!) so I could feel the breeze and look out at the scenery, the people, the animals, and take in all of Togo.  Amongst the heat and dust and noise, it felt so peaceful.