Make a joyful noise, and thank the cook?

For those who do not know what obstetrical fistula is, it is an injury that occurs during childbirth where no emergency obstetrical care is available.  It happens more often in younger women who physically are not developed enough especially with a full-term infant.  During the prolonged labor, a hole develops in the birth canal which creates a passage through urine and/or feces can leak.  It is a devastating injury as these women leak; they smell, and they are often cut off from their family and friends, even abandoned by their husbands. To think that these women go from the joyous expectation of giving life and then become outcasts – it is heart-wrenching to hear their stories.

The second full day I was on the Africa Mercy, I was getting ready to start a case, when I heard singing.  Now on the ship, the hospital is on Deck 3, and I was sure that I heard it from the side of the patient wards.  “That’s the OBF ladies,” said one of my co-workers.  The OBF ladies?  I knew what the acronym stood for – obstetrical fistula, but why were they singing?  “They walk the hallways and sing every Friday.  I couldn’t understand the words, but the singing was beautiful.  I was humbled by their singing because these women have already been through so much, and yet their response was to sing. My own response in the face of a huge problem is more along the lines of “Why me?” and not singing.

In spite of all their pain, the women on B ward on Mercy Ships develop a sisterhood of their own. They fix each other’s hair, sing songs and even redecorate their ward.  One woman who had certainly seen her share of pain, actually volunteered to adopt one of the youngest OBF patients, a fourteen year-old whose own physical ailment was magnified by the fact that she had been sexually abused by a relative who then “shared” her with others, getting her pregnant in the process.  This other patient was so moved that she told her that she had a new family, one that understood her in ways that she had never experienced.

I was privileged to attend the OBF dress ceremony, which is an event that the people of the Africa Mercy produce for these women as they prepare to return home.  Each woman is given a new dress and a new hat as well as a gift bag.  It is held outdoors,

©2016 Mercy Ships - Photo Credit Katie Keegan - Angeline: suffering | happy

©2016 Mercy Ships – Photo Credit Katie Keegan – Angeline: suffering | happy

©2016 Mercy Ships - Photo Credit Katie Keegan - Celine: sad | happy

©2016 Mercy Ships – Photo Credit Katie Keegan – Celine: sad | happy

©2016 Mercy Ships - Photo Credit Katie Keegan - Marie: alone | peaceful

©2016 Mercy Ships – Photo Credit Katie Keegan – Marie: alone | peaceful

and each woman is given the opportunity to speak about her testimony.  Each one got up and started their talk with, “Hallelujah” and then proceeded to tell their stories.  Many of them told of being abandoned, rejected and being treated like garbage.  They would then thank Mercy Ships, the doctors and nurses, but many also thanked the chaplains, their drivers and so on.  However, the one person they all thanked was the cook.  When the cook was first mentioned, I thought, “How sweet,” but the more I thought about it, the more I realized that these women, in spite of all their pain and difficulties, were taking the time to thank the person we often overlook.  They were not treated to gourmet meals on fancy tablecloths – this was basic food served cafeteria style, but the cook got the recognition from these thankful ladies.

Going on a medical mission often gives one a new perspective and is frequently humbling as well.  It is my hope that when you read this, will take a page from the OBF ladies and when faced with an insurmountable difficulty, make a joyful noise to the Lord, and while you are at it, don’t forget to thank the cook!

 

It takes a village, or so it seems!

Many people do not realize just how many people it takes to keep a vessel like Mercy Ships going.  When I tell them that there are an average of 400 people on board at one time, they are astonished.  Working in the operating room often gives one a sense of isolation – after all, access is restricted, and you must have the right clothes and credentials to enter.

When arriving on Mercy Ships, we are advised that while we may take photos of the ship and the surrounding area, we are not to take photos of the patients and their families in order to respect their privacy.  They do have photographers on board who are part of the Mercy Ships team, and we are allowed access to their photos for the purpose of spreading the message about what they do and the people who serve.

©2016 Mercy Ships - Photo Credit Inna Mocharnaya - B Ward Nurses and Day Crew

©2016 Mercy Ships – Photo Credit Inna Mocharnaya – B Ward Nurses and Day Crew

The wards on the ship – there are five including the ICU are just like the old-fashioned patient wards, with several beds in each room.  One of the most surprising things I found was that when the patient has a family member they want to have with them in the ward, the family member sleeps on a mattress beneath their family member’s bed!  It gave me quite a start when I saw feet sticking out from under a child’s bed for the first time.  The day crew in the credit above have various functions – many are the very necessary translators needed throughout the day.  Malagasy is language with occasional terms that resememble French and others that resemble nothing I have ever seen.

Saturday I was on call and thus I could not leave the ship or at least the perimeter of the ship, so I was walking around the top deck in the afternoon when I heard noise below.  I asked someone what was going on, and they said that on Saturdays, they try to take patients to Deck 7 to get outside and enjoy the fresh air.  On Deck 7 there is a swing set and a play area for the children on board, so there are a number of children who enjoy this outing, but the adults enjoy it too!

©2016 Mercy Ships - Photo Credit Inna Mocharnaya - Deck 7

©2016 Mercy Ships – Photo Credit Inna Mocharnaya – Deck 7

©2016 Mercy Ships - Photo Credit Inna Mocharnaya - Ward Nurse Lisbeth Harveland (NOR) with Edmond (MGC12418)

©2016 Mercy Ships – Photo Credit Inna Mocharnaya – Ward Nurse Lisbeth Harveland (NOR) with Edmond (MGC12418)

With all of the orthopedic cases as well as the plastic cases involving burn contractures, much of the healing and therapy occurs in the rehab center.  There, they are put through exercises and routines to assist them in using their new limbs or to regain function after surgery.

©2016 Mercy Ships - Photo Credit Inna Mocharnaya - Rehab tent

©2016 Mercy Ships – Photo Credit Inna Mocharnaya – Rehab tent

One of the famous patients on board is Elina – it seems that almost everyone knows her.  She has had multiple surgeries to correct severe contractures that resulted from a very bad burn.  She is going non-stop and loves playing pranks on the staff.  Her indomitable spirit in spite of all that she has endured is truly humbling.

©2016 Mercy Ships - Photo Credit Inna Mocharnaya - Elina (MGC07074) coloring during her therapy

©2016 Mercy Ships – Photo Credit Inna Mocharnaya – Elina (MGC07074) coloring during her therapy

©2016 Mercy Ships - Photo Credit Inna Mocharnaya - Physical Therapist Hannah Rutherford (NZL) helping Jimmy (MGC07174) walk for the first time with a temporary prosthesis

©2016 Mercy Ships – Photo Credit Inna Mocharnaya – Physical Therapist Hannah Rutherford (NZL) helping Jimmy (MGC07174) walk for the first time with a temporary prosthesis

Words we can all stand to remember!

Photos of Antananarivo, Tanarive, or more simply, Tana

While I know that many of you want to hear stories about my mission, I also know that almost all of you want to see more photos, so I thought I would give you some shots of my two days in Tana.

View of the water, including rice, from our guest house.

View of the water, including rice, from our guest house.

Bananas growing outside the guest house

Bananas growing outside the guest house

Local bus - one person hangs out the back to allow passengers to board when it stop!

Local bus – one person hangs out the back to allow passengers to board when it stop!

While visiting the Queen's Palace, I snapped a photo of some children at the statue - soon I had a crowd wanting their photo taken!

While visiting the Queen’s Palace, I snapped a photo of some children at the statue – soon I had a crowd wanting their photo taken!

View of Tana from the Queen's Palace, the highest point in Tana.

View of Tana from the Queen’s Palace, the highest point in Tana.

The ubiquitous red clay is used to make bricks and often sold from the roadside.

The ubiquitous red clay is used to make bricks and often sold from the roadside.

Believe it or not, the stone you see is granite - mined by hand by the locals - also used to dry their laundry!

Believe it or not, the stone you see is granite – mined by hand by the locals – also used to dry their laundry!

Photo of the traveller's palm - a feature of the Madagascar flag

Photo of the traveller’s palm – a feature of the Madagascar flag

On the road again! March 30

Last night we were told that our bus for Tamatave would be leaving at 6:30 – breakfast would be at 6:00, and we were to have our luggage ready at that time.

Trying to some precious sleep, I fell sound asleep only to be awakened by a local rooster crowing at 3:00 – the sun was not even close to being up, so it must have been one confused rooster.  Of course, other roosters, not wanting to be outdone, soon joined him – so much for a decent night’s rest!  I read for a while and finally got up around 5:00 to shower and get ready and provide a fellow traveler with a wake-up call.

At breakfast we met some more of our travelers – our tiny group of five had grown to twelve!  We made hasty introductions as we ate our breakfast, and before we knew it, the vans had arrived.  It was a bit chaotic as we loaded up the various vehicles, and as we started on our way, we turned off on another road which said, “Chez Jeanne”.image  I was confused – we had stayed at a guesthouse , Chez Jeanne.  Were we going in circles? No, as it turned out, this was an annex to our own guest house, and we were there to pick up more Mercy Ships volunteers.  We now numbered fifteen!

The fun began as we unloaded our vehicles and then had to reload the luggage onto the bus that would take us to Tamatave. image After a few adjustments, we finally set off on our way.  The traffic getting out of Tana was bumper to bumper in spots, and how anyone manages to drive with no lane markings, bicycles, dogs, pedestrians is a mystery to me.

Finally we got out of Tana, and the breeze was a bit cooler, and we were able to see more off the countryside.  There were the proverbial rice fields and fishermen of all ages. image We were also able to see more of the traveller’s palms which are featured on the Madagascar flag.   Additionally, we saw more of the pousse-pousse cabs than we had seen in our brief stay in Tana.image

This all might have been a great tour except that our bus ride took eight hours, and the initial thrill of it all began to fade around hour four.  Most of us tried to sleep intermittently and work out the inevitable kinks that were forming along the way.

We finally arrived in Tamatave and at the Mercy Ships, where for some unknown reason, we had to wait almost half an hour before anyone came to greet us – another lesson in patience it seemed.  After our initial meeting with one of the officers on board, we went to our cabins. image I thought that I might have time to rest, but my cabin phone rang as soon as I walked in, and it was one of the anesthesia staff asking if I could work first thing in the morning!  I was given a whirlwind tour of the ORs – since I had been here before things were rather abbreviated.  It seems like I am going to hit the ground running . . .

No penguins but lots of lemurs!

After a brief rest, we went to dinner where we met three other Mercy Ship volunteers – Annie from Australia, Jana from the UK, and Girannie who lives in New York.  They have been in Tana since Saturday, so they have had time to explore the area a bit as well as acclimate to the time change.  All are volunteering with Mercy Ships for the first time.  We asked them what they had done in the meantime – particularly what we should see tomorrow as it would be our only full day in Tana.  They all recommended the lemur farm just outside of town.  After dinner, we arrnaged this with the front desk as it requires hiring a driver for the day.  The Queen’s Palace was also worth a visit, so we put it on our list.

The next morning, we had scarcely finished our breakfast when we were told that our driver had arrived.  We grabbed our things and were on our way to the lemur farm.  We had been warned that the traffic could be bad getting out of Tana, but even by their standards, it was incredibly slow.  We would travel about fifty feet and then stop for about five minutes.  What should have taken about half an hour took an hour and a half.

There are several lemur farms in Madagascar which are entirely supported via tourism and donations.  Back in 2001, the one near Tana was established.  Madagascar is the only country with lemurs, and as such, there is a large need to protect this species which has been threatened from hunting as they have served as a source of food for the Malagasy in the past.  The other danger has come from those who have taken them from the wild and raised them as pets.  There is actually a readaption cage at the lemur to help rescued lemurs re-enter their society.

At last we arrived at the lemur farm.  We had been told that we would have to hire a guide (noticing a trend here?).  Princia was our young guide who led us around the farm.  She led us only about a hundred feet when we saw our first lemurs.  They were the Cockerel Sifaka lemurs which are known for their sideways walk on the ground.  They seemed to be natural hams and performed for our cameras.

The next group, the ruffed lemurs, whose name is not hard to discern, were a little more reticent but still seemed to enjoy our presence.  These lemurs, unlike the sifaka variety, are able to walk in a straight line when on the ground.

When we encountered the crowned sifaka  lemurs, it seemed that while we were asked to stay two meters from them, these lemurs had no compunction about getting closer than two meters to us!  Like the first group, they seemed to enjoy being entertainers.

Earlier in our walk, we had tried to see some ring-tailed lemurs, but they were too high in the trees.  This time, however, they were ready for us, including a pair of lemur twins.  The ring-tailed lemur made famous in the movie, Madagascar, with King Julien, is an active group, and the twins were like small children getting into mischief.

Other features of this park included the baobab tree, the Napoleon’s hat plant and the traveler palm which is featured on the Madagascar flag.  There is also an area with two types of tortoises, the radiant tortoise and the spider tortoise – the radiant tortoise has been threatened because of the demand for its beautiful shell.

We continued from there to the Queen’s Palace, which is the highest point in Tanarive.  Interestingly, in Madagascar, it is a matriarchal society, so the queen’s palace is much bigger and more lavish.  Sadly, it was damaged significantly by a fire set by insurgents, so the repairs are still ongoing.

 

 

Welkom! Kuwakaribisha! Tonga Soa! – my welcome tour

Last evening, after I had rested a couple of hours in my berth at the Yotel, it was time to seek out the next gate.  At first, I was one of the few waiting at the gate, and then the crowds appeared.  For a while, I thought I might be the only native English speaker on board as they were several Kenyans and several Dutch who waited with me.

Upon boarding, my seat was on the aisle of a group of three in the middle – it was a 787, and the first time I had flown one to my knowledge.  We were nearly boarded, and the two seats next to me remained empty.  I had high hopes that I might be able to stretch out for a while on the flight when the overhead announcement said that a connecting flight from Paris and London would be bringing our remaining passengers.  Ah well, at least the couple that sat next to me were enjoyable.  They were part of a small group from the UK who have built a school in the slums two hours outside Nairobi.  They come at least twice a year to check on things and make improvements as needed.  This time they were bringing two of the youth from their church who had raised their own money to come on this trip.

After leveling off, they proceeded with the meal service, and I was famished.  I realized that I had not eaten anything all day while in the Amsterdam airport – what with going to church and finding my way around and taking a nap, all thoughts of hunger had dissipated until someone mentioned dinner.  The food was surprisingly good, although I’m sure that the spice of starvation added to its tastiness.

Sleep was still elusive for the most part and realizing that I would have a five hour layover in Nairobi, I opted to purchase a one-day pass at their lounge which gave me a comfortable seat and even a shower!  Even when sleep-deprived, it is amazing what a shower can do to revive one.  I even managed to call home before heading to my final flight of this journey.  Walking to the gate, there seemed to be a constant stream of announcements usually starting in Swahili, then in French with occasional English to add spice to the mix.  I was starting to get a headache from trying to listen to each one.  Of course, the only Swahili I know is hello, so it really didn’t get me very far.

When we finally boarded our flight for Antananarivo, I felt like I was almost comatose.  I just wanted to sit in my seat for the next three hours and sink into unconsciousness.  I was struggling to get my carry-on into the overhead bin and got it wedged under the seat in front of me when my seat mate sat down and starting talking to me in French.  Without thinking, I responded to her in French.  She was pleased that I spoke French, and I hastily tried to tell her that it had been a long time, but she took that as encouragement to talk more to me.  I desperately scrambled to find words and phrases that sounded coherent, and I thought she would give up on me, but to no avail.  I think she felt like she was doing me a favor talking to me, and all I could was try and hang on.  After our meal, I lapsed into unconsciousness – I think I was more exhausted from talking in French for two and a half hours than being awake for two days!

We arrived at last in Tanarive (the French version of the capital’s name and easier to spell).  There seems to be one runway which requires the plane to turn around at the end and go back up the runway to turn onto the tarmac.  There were about thirty workers that came out to meet the plane, but for the life of me, I could only see two of them that actually did more than stand and stare at us as we disembarked.

While waiting in line for passport control, I met another Mercy Ships volunteer – an anesthesia assistant if you can believe it.  It was her first time with Mercy Ships, so we chatted in line and found our way out to the main area and met our contact for the guest house.  We were told that there was another person coming, so we waited out in the van for over an hour in the hot, humid afternoon, but the person never showed.

We took a scenic route through Tanarive – I will attempt to post some photos, but while I do have wifi(!) at the guest house, I am uncertain as to how things will upload.  By Wednesday I should have better connections, but I will do what I can.

And the journey begins!

It has been said that the journey of a thousand miles begins with a single step.  If that is the case, then I guess that the journey of over 10,000 miles begins with ten steps, right?  Well, maybe not – but in any case, my journey to join Mercy Ships in Madagascar is beginning.  My trip starts this afternoon from Portland with a almost ten-hour flight to Amsterdam.  There I will have a twelve hour layover – more or less.Portland to Amsterdam

Finally, a mostly clear day for the drive to the airport.  You could at least see the base of Mt. Hood – although not the pointed peak at the top.  On schedule the plane left, and I was left with the problem of entertaining myself for the next ten hours.

Thankfully, my neighbor on this flight, Mona, was engaging, and she seemed truly interested in knowing more about Mercy Ships.  She is actually headed to Paris where she will taking a river cruise to Normandy.

It wasn’t long before she looked out the window and exclaimed, “What a great view of Mt. Hood!”  It was indeed stunning, and we both quickly took photos of the mountain which has been rather absent with all the rain we have been getting.

Believe it or not, the ten hours passed fairly quickly – maybe all those trips to Alaska and North Carolina have given me endurance.  Of course, after arriving in Amsterdam, I again had the task of keeping myself occupied for the next twelve hours.

A few weeks ago, I came across an option for the Amsterdam that seemed to be the solution:  Yotel.  It is a hotel in the airport but without the hotel amenities you usually see.  You can reserve a two-room cabin or a single.  Much like you see on trains and such, the room is tiny, with just enough space for you to sleep – there’s even an en suite bathroom with a shower, which was invaluable after the long flight with only another one on the horizon.  It wasn’t cheap, but in my case, I thought it was definitely worth the cost, considering that I have to be bright-eyed and bushy-tailed to work in the operating room in just a couple of days!

It is Easter Sunday, and while I am sorry to miss the service at my own church, I was able to find a solution right here in the airport!  It has a chapel, and with most of those that I have seen in the past, they are some sort of darkened room with little to draw anyone.  However, at Schiphol airport, they have what they term a meditation center, where all faiths are welcome, and wouldn’t you know it, they offer Sunday services at 11 a.m.  I went there expecting to see a handful of people, but by the time it started, the room was standing room only.   We were asked to introduce ourselves, and not surprisingly, there were people from all over the world.

In just a few hours, I’m off on another eight and a half hour flight to Nairobi.  I will close for now and attempt to get this posted since I have good wifi in the airport.  Many thanks to all who are praying for me and have wished me well!

 

Madagascar: “Love, fatherland and progress” Salama!

 

Several years ago, my nephew was a huge fan of the DreamWorks movie, Madagascar, which revolved around Central Park zoo animals who made an escape and ended up on the island of Madagascar.  Little did I know that about ten years later, I would be planning a trip there myself – minus the zoo animals.  Next month, I will be leaving for another medical mission with Mercy Ships which has been serving Madagascar for over a year now.  When the Ebola crisis erupted, Mercy Ships had to quickly change their proposed field of service in Guinea, and so Madagascar became the new destination.map-of-madagascar_large

Like many of you, I knew where Madagascar was – I even knew the capital, but I’ll have to admit, I did not know much more.  So in the spirit of gaining (or at least relearning) geography, I bring you tidbits about Madagascar – some may be new, others will be review.

Madgascar, or the official title, the Republic of Madagascar, has also been known as the Malagasy Republic.  It is an island country in the Indian Ocean and is the fourth largest island in the world.  The Republic of Madagascar actually includes the large island as well as several smaller islands.  Its capital is Antananarivo and its official languages are Malagasy and French.

Up until the late 18th century, Madagascar was ruled by a series of alliances, but in 1897 with the collapse of the monarchy, it was absorbed into the French colonial empire and stayed with it until its independence in 1Siegel-Madagaskars-300x300960.  Since then, there have been a series of constitutional periods.  During the period from 2009 – 2014, there was an uprising, forcing Ravalomanana to resign, largely viewed as a coup d’etat.  In 2014, Hery Rajaonarimampianina was named president through the process of an election.

Interestingly, the name Madagascar is derived from a confused Marco Polo.  Thinking that he was in Mogadishu, he gave it the name Madageiscar.  Other explorers had other names in mind, but Marco Polo’s name remained the popular one.  The island has remained remote for much of its history, and as  a result, its diverse animal and plant life are unique to the island.  In fact, over 90% of its wildlife are found nowhere else – including the lemurs.  The traveler’s palm, or ravinala, is distinct and is prominently featured on its national emblem.

Not surprisingly, Madagascar’s abundant natural resources comprise much of its economy.  Raffia, fishing and forestry are three of the main economic resources.  It is also the principal supplier of vanilla and cloves worldwide.  Of note, the discovery of sapphires near Ilakaka now make it the world’s largest supplier of these precious stones.  France remains Madagascar’s largest trading partner, although the United States, Japan and Germany have strong ties to the island.

The explanation for the title?  Madagascar’s motto is:  “Fitiavana, Tanindrazana, Fandrosoana” or in French, “Amour, patrie, progrès” or in English, “Love, Fatherland, Progress”.  And Salama?  It is how you say “hello” in Malagasy.

Mercy Ships: Volunteer on the Vessel of Hope

File Jan 25, 15 43 01Those who know me know that I have been on several medical missions – to Ecuador, Zimbabwe and most recently, Congo – with the international organization, Mercy Ships.  I am often asked about medical missions in general, and particularly about Mercy Ships as it is one of the mission organizations that is more familiar.  It has been around for some time – over 35 years and has been to several countries, most notably in Africa.

Unlike other missions I have been on, Mercy Ships functions as a long-term mission partner with its host country, staying in port for an average of ten months.  During that time, over 400 people serve on board in all capacities – not just medical.  There are those who work in the galley, handle security both on and off the ship, run the ship store, bank and post office, as well as taking care of running a ship of its size.  Oh, and I did I mention that there is a fully accredited K-12 school on board?  IMG_0737When I first heard that there was a school on board, I pictured a room with one large table and three or four students sitting around it.  Instead, there are over 40 students enrolled, and yes, you can volunteer to be a teacher on Mercy Ships.

Of course, the work doesn’t stop on the ship – part of the mission of Mercy Ships is educating those in the country where it is serving.  Medical personnel are brought on board and education opportunities are sought whenever possible.  There are also a number of locals who work on board each day, giving a boost to the local economy.  In addition, the dental teams are busy every day going into the nearby villages to perform much-needed dental care.  Facilities are built when needed, and even agricultural techniques are presented.

To say that living in community with four hundred individuals is a challenge would be an understatement.  Being in close quarters day and night, working with them in close proximity, can all take its toll. To that end, Mercy Ships has several opportunities to allow those on board for some relaxation – there are day trips into the local countryside, even train trips to other villages.  On board, there are several organizations that are represented, including Toastmasters. Bear in mind that several individuals spend several weeks, months or even years, as volunteers, and you can quickly see the need for rest and relaxation on and off the ship.

Despite the challenges, those of us who have served with Mercy Ships say that we come away with far more than we brought.  Ever think of going on a medical mission, I heartily encourage you to give Mercy Ships a strong look.  For more encouragement, see this segment seen on 60 Minutes:

Mercy Ships on 60 Minutes

In March, I will be returning to Mercy Ships for an assignment in Madagascar. Hurry – go get your atlas!  In the next few weeks, I’ll be highlighting this area of the world, and with the permission of some on board, I might even get a glimpse or two from them about their lives on the Africa Mercy.  Naturally, when I go, I’ll post daily (if possible) about our time there.  Now, get back to that atlas!