The end has come

A statement I am not sure I ever really envisioned writing. When I started my adventure on this ship it was for a year. Then it extended to two. A long time in some ways, not so long in others. But, I never really thought about the end. If I did, I think I was afraid that I would disconnect to what was going on here and start living at home; something I did not want to do. I wanted to fully take in my time here. I began the

"whole trying to find a job" thing a few months back. That didn't work out so well. I started too soon and was basically told to try again when I returned to the US. That seriously freaked me out in a few ways. I am one who loves my "ducks in a row". I want to know where my next meal, paycheck, shower etc is coming from. I like to be prepared. I don't want to be a burden to my family once I am home because I did not plan in advance. So, I tried. I failed. I can't really do anything else till I get home. But, what that has given me is a freedom to stop looking to home and living where I am. Currently ,on a storm tossed, flat bottom, converted train ferry somewhere off the coast of Southern Africa. But, it also will allow me to enjoy my safari in South Africa and my time traveling with friends in Europe without the anxiety of planning for home. It has also reminded me that God is in control, no matter where I am. He knows where He wants me and when He wants me to get a job. He knows when my parents need to move and where they will find a house my Mom can decorate to her hearts content. He knows that Gabe is also starting a new season as a college student. He KNOWS. and I don't have to worry. I don't have to fret. I can enjoy the time I have left with my friends and know that God is preparing a place for me back home with a job, friends and a church. A place I can set up my "home base" , that as I live my life of missions and travel, I have a place to call home and to return to. So, though my season here is drawing to a close, I don't really know what is next. I don't know what job, what apartment or what church. But God does. So, I'm OK.

God's Timing

"Rachel, I had this baby born yesterday............. " This was the start of my day on Monday.

But before this story, let me bring you back a week to last Monday. I was in the middle of the biggest screening of the year. General. We can do 6 general surgeries in a day, as opposed to 3 with most surgeries. So, we need more general patients to fill the schedule. So about midway through the 98 patients a member of the crew came to me and said, Hey, Rachel we have this lady here getting a CT, she has a large abdominal tumor. Can Frank (the surgeon) take a look? My response, " Sure, he can look, we won't do it. We don't do abdominal tumors" I put it out of my mind and went on with my morning. My screening team and I got through all 98 patients in 3.5 hours. Very excited that everything went so well, I was finishing up details and Joy (my boss) came to me and said, " So, the lady with the tumor, she is being admitted to the ward. Frank wants to do her" I could not believe it. Her tumor was huge. She looked like 12 months pregnant. But, it was one of those times, where God gave me peace and said, " This is Me" So, I got excited about what was going to happen. On the 9th of July, we removed a 37 pound tumor from this women. It was a fibroid that had been growing for 12 years. As I looked at amazement at her in her bed recovering and praising God I though back on the events that brought her here. First, she is from Benin. Her husband knew a few crew members. They came to visit on the day of a general screening. She was able to be fit into the CT schedule despite the huge numbers CT's being done that day. Frank was the surgeon here. The surgeon who was supposed to be here ended up incredibly sick and did not come, so Frank agreed to stay and do our General surgeries. (Frank had been here doing VVF surgeries, but is a general surgeon). But, God orchestrated everything to have her here at the right time with the right people to change her life. She was discharged today, healing well. (See pictures at the end. Warning: They are graphic)

This past Monday started with a phone call from Russ, a American Baptist missionary in Togo. He is a pediatrician that runs a hospital about 3 hours north of Lome. We have been in regular contact with him and have seen and done surgery on many of his patients. He called Monday to tell me about a baby, born on Sunday with a large cystic lesion (fluid filled mass) on his tongue. He could not breastfeed . In Africa, that is instant death. If they cannot nurse, formula is not available. Mom's don't really pump or express milk to feed the baby. Russ was taking a stab in the dark. Our surgery schedule was full. He knew it, but tried anyway. I went to speak to the OR, to see if there was a remote possibility that the baby could receive surgery. Leo, one of the Max fax surgeons, happened to be in the office. I presented the case to the OR supervisor hoping the surgeon coming next week might be able to see him. The OR then said that the surgeon next week was only 50/50 that he would do a baby so young. But, Leo............ So, we ran it by Leo who was very happy to look at the baby and though he should probably be able to do it as long as anesthesia was OK with anesthetizing a baby that young. Everyone seemed in agreement and the baby arrived yesterday (Wednesday) A strong healthy baby boy. The plan is to do surgery tomorrow, because one of Leo's cases did not come, so we have room in the schedule. God is good and this baby should be able to get surgery, be able to feed and grow up strong and healthy. Weeks like these remind me who is in control, both of the world and my life. As I look toward home and the prospects of finding a job, apartment, church, car etc, I am reminded that God is in control, that his timing is perfect.

Before After

Update

Hi there All,

I'm so sorry it has been a month since the last post. I have been a bit busy, but in all I think I've just been struggling with what I am supposed to be posting. I have been stressed and tired and not feeling like anything I would be saying would be the least bit interesting or uplifting.

VVF is going well. We have done 5 weeks and have one left. We got a second VVF surgeon 2 weeks ago, because the Max Fax surgeon that was supposed to come had to unexpectedly cancel. So we have 2 wards full of VVF patients and one half full ward of left over Max Fax, Plastics and eye patients. The VVF women are going great, most going home dry. Amongst the many joys and successes there are tears. Women that are so damaged that making then dry is not possible, infections that we are having a hard time treating and even pregnancy. I do a lot of the arranging for the women's transport back home. I get to see then joyfully leaving the ship to rejoin the village as a legitimate member of the community. I see them go home with their heads still down that we were not able to help.

Tani is beautiful!!! Her little nose is healing well. She will go home at the beginning of next week. She is a bundle of energy always looking for something new. Ali, one of the Assistant Ward Supervisors has done a wonderful blog on her a few time. www.alirae.net She is so much more eloquent than I am in sharing stories. (and pictures).

I'm just asking for prayer for peace and guidance. Peace while I finish out my time here and guidance on what to do once I am back in the US.

VVF

Ali, another OR nurse with a VVF patient.


VVF starts tomorrow!!!!!!!!!!! We have an invasion on women from the North. 30 of them came last night, my trusty translator Sam leading the way. Sam is a Togelese man who lived in the US for a number of years as a child and teen, and now lives back in Togo. He is one of the only people who actually understands my English at my normal rate of speech, so naturally I'm a bit bias. He is originally from the north of Togo, so he speaks a lot of the languages of the women from there. The women who we have asked to return from Benin started arriving last night also. It is an exciting time. There is an air of anticipation, knowing that a lot of these women will be changed for life after their time with us.

Bonnie with one of the VVF ladies. Notice the patient's small stature, very typical for a VVF patient and why they have had problems giving birth.

I have struggled in caring for these women since the time I started on the ship. Even at home I have always preferred male patients. I just have always seemed to get along with them better. I have said in my prior post these VVF patients are STUBBORN!!!!! They are survivors and determined to make a life for themselves, a great quality (one I have myself), but they don't make wonderful patients. But, despite my fears and reservations going into VVF each time, God has always given grace. I have always found I connect with one or two, I have fun laughing each day with them, trying to mime how to do care or ask a question through charades. So I'm looking forward at what God will do this time. Keep Maggie and Lindsay (the VVF coordinators) in your prayers, they have a huge task in front of them. Also, my friend and roommate Allison, she is the VVF team leader in the OR. The nurses have incredible hearts for these women and have a long 6 weeks in front of them.

Maggie with Ramatou, a VVF patient turned translator, who is back again this year to help is translate.

Up and Down

Me with a little guy I was screening

This has been a week of ups and downs. We are having to make changes in the surgery schedule due to the lack of surgeons. The balancing of the OR schedule is a task I will never undertake and have no desire to. The complexities of what types of surgeries certain surgeons can do but others cannot, balanced with the mixture of boney vs soft tissue surgeries, balanced with what anesthesiologist can assist with what patients balanced with nurse specialities is simply mind boggling. Too much to think on. The OR has had its hands full this week trying to fit is as many patients as they can. Stretching nurses, sterilizers and doctors farther than ever before. With all this a lot of patients have been said No to. A lot have not been able to be scheduled. Surgeries, that if the patients had come a month ago, would have been done. It wears on you. It makes you want to cry. I hate saying no. That is not why I became a nurse. That is obviously a down.

Maggie Praying with a VVF Patient

There is also an up...... Remember Tani??? The little girl with the severe facial burns?? I was talking to one of the nurses and she told me that Tani had her surgery. Hesitantly, I asked "Did they make her a nose?" I didn't want the answer to be No. On that day I'm not sure I could have dealt with the answer being No. But, Thanks the Lord, the answer was yes. It is little, but she has a cute little nose, with nostrils and everything!!!!!!!!!!! That made my day. I went over to A ward. She has a cute little nose and a head covered in bandages. There is a flap over her eye right now from her scalp providing the blood supple to her new little nose. That will be released in a few weeks time. I can't wait to show pictures. This little girl is a gem.... Cute and shy. Never been out of her village till now. That is why I am here. To touch a life. Tani life has been touched.

Little Baby with a cleft

Here are some pictures of screening. Screening is almost over. The North screening will be done by weeks end. The schedule is almost full to busting. But, God is in control. He knew what would happen even before it did. He knew patients we would see. He knew the surgeons who would come. I know he has a plan!!!!!

The whole Team!!!

Relationships

Hi there!!

I apologize for my long absence from the blog. I have seem to have been wrapped up in work. The Giles, a Max fax Surgeon and his wife have arrived and now have left. They are having a lot of success in finding Max Fax, VVF and general surgeon. I'm really excited about being able to serve the ones that are least likely to have access to care. We have a great team of translators up there with them also.

Since I don't currently feel like talking about work and my last screening was Friday, I'm gonna change the subject. What has been on my mind lately is relationships. With family, with translators, with roommates and with friends. Since work has actually been winding down a bit I have more time on my hands. I find that I don't know who to talk to, who to hang out with. I'm not on the wards, so I don't have a relationship with the nurses like last year. The friends I have outside the ward are wonderful, but young. They are 18 to 20 years old, were I just celebrated my 30th birthday. They are also all "coupled". So, I don't quite fit.

I'm and currently also in the process of trying to figure out where to live when I return to the US in October. Should I stay in New England near my family?? Should I try and branch out and find a new place to live?? Right now it is between Denver CO and Portland ME. I do fear, though, that not living close to my family will fracture my relationship with them. I don't want a niece that doesn't know me or that I never see. But, going back to New England feel a bit like going backwards.

Everyone needs a place. To belong. And it is hard when you don't quite know where that is. I trust that God has a great plan and I'm firmly in his grasp, but I'm curious where I am to fit.

Anyway, that is where I am personally.

On the patient front, there is little Tani. Tani is a 9 year old from the most northern part of Dapong. I received a picture of her in the first few months here. My heart went out to her. She was severely burned years ago. She is now missing her nose, her lip and an eye. Despite the deformities she is full of joy and mischief. She loves to play, to steal memory cards and chase balloons. Before a week ago, she had never been outside her village. She is here in hopes that our plastic and Max Fax surgeon can rebuild her nose, lip and cover the place her eye should occupy. Pray that they have the tissue to do all that they want to. I'll keep you updated on her progress.

I'll have pictures of the last screening soon.

God's provision

Ans examining a patient

I have never been one to doubt the existence of God. I have known from a very young age that he is alive and well and in my life. The thing with God is, that, he isn't all that pushy (most of the time). He waits for me to seek him, to ask him, to acknowledge my need for him. Then, he reminds me that he is there, always watching, protecting and providing. The latest evidence of this started last Friday. Last Friday was a speciality orthopedic screening. I was worried that we would have far more patients then we had surgery spots. I was sick of saying No constantly. I didn't want to have to do it again. So, my solution, I prayed for rain. Torrential downpour, wind type storm. Then, in my logic, the patients may not come. Well, I showed up on Friday to the screening to a full sunny sky and 300 people under an awning. About 1 hour into the screening the black clouds arrived. The wind started, the thunder rolled and the downpours started. All I could do was laugh. I was like "very funny God". In that small voice, God said, "I am listening, here is your rain, but I want these people here." Just a small reminder that we offer so much more than surgery, we offer Him. The great physician, the ruler of all.

Jean (one of out translators and Ganash one of our security guards)

After Fridays screening I was talking to the OR. They said that they were a few Max Fax patients short (due to a few no shows and sick kids). So, I was praying over the weekend for Max Fax patients. Monday was a orthopedic physician screening. Twice, we had t

old Mom, "Sorry, we can't help your child's leg" just to have Mom say "Can you look at their mouth, food comes out their nose and they don't speak well?" Both of those children turned out to have cleft palates. 2 kids to fill the slots on our Max fax schedule. At an Ortho screening. God's Provision.

Linda with a patient

In the last blog I talked about relationships and people management not being a strength of mine. 2 days ago I spoke at programs reporting time. As I was speaking I came to a slide in my presentation that had pictures of my team. God then reminded me of his provision once again. In the first week, when I was learning what screening was all about, God gave me Esther and Ans, two women who have been screening for years. When I was struggling to hire and manage day workers, God gave me Joy. Joy loves to people manage and she is awesome at it. When screening began my friend Linda started working with me. Linda got the whole data entry aspect of screening up and running, then when Joy was asked to take another position, Linda stepped up and took over the people management and the running of the screening site. Again, God provided what I needed when I needed it. Why I ever doubt I don't know. I am just thankful He keeps showing up.

Joy examining a patient