Friday, September 28, 2012

Screening video in 2 minutes

Nuff said. :) Video was done by the ever talented Josh C on board! Merci much!

Saturday, September 15, 2012

Screening day - Up Close and Personal

And then they meet me...

Here is a slide show of all the amazing photos our photographers (Deb and Michelle) took during the day. Grab a coffee, sit back and enjoy the pictures. Then go on and read some personal stories. N-Joy!

Our photo stand is the last stop before they leave the building. By then they are are extremely tired, both physically and emotionally. Most of them had been standing in line for a good 5+ hours and even though we were giving out water and sandwiches we couldn't protect them from the sun. They are exhausted emotionally as well; many of them are so used to hearing NO that they cannot afford to allow hope sneak into their hearts. As they get closer to the gate...inside the the pre-screener...GET PAST the screening station... escorted to the first station, then the second... all the time expecting to hear the dreadful word and yet a tiny hope is rising deep within as they get closer to the last station, our photo booth. It's hard to see their genuine smiles through the veil of wariness!

Outside there was some breeze that helped easy the discomfort of everybody, patients and crew alike. Inside, where we worked, it was hot, humid, stuffy, stinky… you name it. We tried to open the windows, but the generators were placed right outside the walls. We couldn’t hear each other’s words! I opened one slightly. Fresh(er) breeze entered our booth and we could all take a deep breath. Deb was standing 3 meters away from me and I saw her lips moving… darn, we must close that window NOW! :(

We have about an hour before the first patient makes it to our station so I go outside. Screeners stand in front of the patients' line, each with a translator. Their job is to decide if the patient has something we can treat thus sending them towards the building or turning them down. I stood behind Ans, who is a Chaplain on board now, but a nurse by profession. She raises her hand (saying she is ready for the next patient) and a young men steps forward. To my untrained eyes he looks fine. Of course I am neither a doctor nor a nurse, but I did learn a lot since I joined this unique hospital. Ans greets him and asks the standard question : what’s the problem. I can’t see the nurse or the translator as they have their backs to me, but I have a clear view of this man’s face. He is touching his head as he explains his reason for standing in line for so long. The translator conveys his words to the nurse. She nods, asks a few more questions in return. The man’s eyes grow narrow as he listen to the translator, clearly not liking the direction of the conversation. His behaviour changes: he puts his hands on his stomach, then on his back, his speaking becomes  fast, his gestures desperate. The nurse listens patiently, but I guess they both know the answer will be no. He desperately tries to convince the nurse, his eyes are begging, but the answer is still NO. We do not treat back or stomach pain and we do not give out free medicine. We are a surgical hospital!

It’s a tough call! Clearly it’s not the answer this young men was hoping for. His whole body looks broken all of a sudden. It’s a horrible feeling for everybody: for the nurse, for the translator, for the man, even for me, who is only observing the scene from afar. The nurse looks apologetic as she calls for an escort. The man sadly accepts the answer and starts to follow to escort towards the exit gate, which is opposite to the building. On his way out they stop at the prayer station where we offer prayer for those who got ’no’ and would like us to lift them up in prayer. As he walks out he keeps looking back towards the building; the building of hope… 

I go inside and embrace myself for a long and busy day. As the first patient arrives we jump into action. The 2 translators who were promised to us didn't show up so we have to do without a common language. I smile at the lady and force myself not to look at the massive goiter on her neck. I offer my little French to her (Good morning, how are you, my name is Reka, I don't speak French). When she keeps starring at me I realize that she doesn't speak French either. Oh well...

I take her papers and copy her name, patient number and surgery type onto a small white board. This will serve as patient ID and also as the "before picture". I motion to her to follow me. I take her precious yellow card and she looks at me worried. I desperately try to tell her I am not taking her card away, I just need to take a picture of it. I don't think I will ever be able to fully comprehend the significance of this small yellow piece of plastic. For them, it's their life line!

She sits down to my stool. I ask her to smile. She gives me the African smile. (very straight face, no showing of emotions). Suddenly the next patient shouts something at her in susu or pular at which point she offers a tiny smile. I go over there and ask in English if she understands me. "I de tak na sma-sma englis" I jump for joy! She speaks Krio, a language that I more or less understand!!! :)

This lady is from Sierra Leone. She came over the border just to be seen by our doctors. She, too, has a huge goiter on her neck, and to my amusement, her name is also Jane Kamara (well, it's not. I don't want to give out her real name, enough to say Kamara is a very common name in Salone and in Guinea as well. Imagine like Jane Smith x2) So, my first 2 patients had the same name and the same condition...

I happily accepted her help. She was translating my words to Susu as I later found out, one of the many tribal languages here in Guinea. When the first Jane Kamara left, she hopped onto my stool and gave me a wide grin. "Yu de make me pretty, yes?" Yes! :) I showed her the head shots I took of her and her neck from each angle; she approved.  She is scheduled for surgery in a few weeks! I am so looking forward to meeting her in the wards! She told me she had traveled for over a day to make it here. Last year when the ship was in Salone she couldn't make it to our screening and she was over the moon when she found out we are coming to the neighbouring country. Now she WILL RECEIVE a surgery! :)

The next 3 patients I photographed were also called Kamara - some spelled like Camara to show the French influence. Over the course of the day I think we photographed over 50 patients with goiters! Yay!!!
As we suspected, many came from Sierra Leone. Jess, our dietitian shared similar experiences. Last year she treated a little boy who was soooo malnourished due to a cleft lip and palate. He couldn't suck milk from her mum's breast and was too tiny for operation. Jess worked with him for months before he gained enough weight for a surgery. They fixed his cleft lip back then, but he was too young for the palate surgery. Jess told them last year to try to make it here for a second chance. She was looking out for them all day and finally she saw the mum! They didn't have any common language, but the joy in both their eyes spoke loud enough!

Later in the day this little fellow (now over 1 year old) ended up on my table. We had to photograph his palate. Now... THAT was a challenge, let me tell you! To begin with these babies have very tiny mouths! Even if you get them to open their mouths you still won't see the palate without tilting their heads back. Even if you tilt their heads back you can't keep them still long enough to take a picture. Even if they lie still with heads back and mouths open, the flash is not lighting the mouth up enough, because you have 3 extra people hovering over the baby: 1 to make them still, 1 to tilt the head back and 1 to hold the mouth open with a tung depressor. :)

If you stood a bit further away you wouldn't see the baby, just hear their cry and see 3 adults surround the table while I stand on a chair with a huge camera and flash in hand doing my best to get a sharp picture of the palate... Fun times! :) And to make matters worse in some cases the mothers didn't want our male helpers to touch their babies. I understand the whole Muslim thing and tribal beliefs, I really do, but what do you do when you have a long queue of patients to photograph and a reluctant baby with a difficult mother???

Another challenge presented itself in the forms of doctors' hand writing. (see my note on this matter here) Sometimes the condition is obvious, but sometimes the patient looks fine to me. Before I ask them directly, I try to look through their papers and decipher the doctor's scribble. NOT easy! :)

The other big challenge we faced was taking pictures of "Ponseti Kids". (Ponseti is a special technique to fix club feet of little children with a series of casts instead of an operation). The Ortho doctors requested a series of pictures (30+) in different positions and angles to test the abilities of the kids. Before the screening we asked one of the healthy kids on board to be our model so we could take test pictures of each angle and position, also bending and stretching each knee and ankle in every possible direction - it took over 25 minutes! And she understood English, she wasn't afraid of white people, we weren't foreigners to her and above all, her legs and feet were fine! Now, imagine this procedure with a kid who is the exact opposite in everything...

Maybe I shouldn't say it, but by the end of the day I "earned" the name "child torturer" :)))

All in all, it was a very rewarding day! Yes, it was long (we finished taking pictures after 9 pm), yes it was exhausting and yes, sometimes it made us cry, but it was all sooooo worth doing! :) I thank God I could be part of this day and see the Miracle in Action!

Thursday, September 13, 2012

Back to School for a Night

The Academy on board had an Open Day...
We all went back to school...
Should I say more?

(Click on the pictures to see the larger version)
Our ca. 50 kids come from all over the world
Me concentrating hard on solving a puzzle designed for ages 8+ :)

Size does matter - giant smart board for the kiddos
Darren and Carol try to play the hand chimes... Ray disapproves!

 Doctor Sean is sent back to school to work on his cursive writing skills. We - non doctors who have to work with doctors and decipher their horrible hand writing - appreciate his efforts to make his writing LEGIBLE! 

 Funny. In my country they had 1= failed 5= excellent. Twas much easier to memorize 5 numbers...

Ali and I managed not to break the tiny chairs as we worked hard with Play-Doh

Freddy wasn't feeling well. He was about to puke his guts out.
 I told him not to eat off the ship, but did he listen???
And that concludes our visit to the higher classes. We walked out and went to the next deck where we entered the younger kids' kingdom. Strangely I felt straight at home. :)

 Apparently I wasn't the only adult who fit right in... :)
My IT specialist husband was playing with the wrong toy. The computer was sitting behind him, untouched, while the pirate just got stabbed by his swords.
I don't see what's the big deal with this puzzle. I solved it flawlessly within 15 seconds!
... then the teacher told us we had to play together like nice kids so together we did...
... in fact the Hospital Director / my honorary Father on board also joined us!
Gerrit and I worked together to appropriately illustrate the story!

This is one of the teachers on board, she teaches second graders, currently 2 students. 
BTW, we need teachers on board! 
Come for a school year, it's great fun! 
Email me if interested!

Kindergarten at it's best - me eating dirt when the teacher is not looking! :)
Playing twister on the Alphabet mat... FUN!

Who said that we ever have to grow up???

Sunday, September 9, 2012

Life in a local hospital

The local hospital and its wings
This year our HOPE Centre is located within an actual Hospital unit. We were given parts of the ground floor of one wing to renovate it and create bed space for 60 people - 30 patients on beds and 30 caregivers who sleep under the beds on mattresses. Franck, my boss and his team from Benin has been working on it for several weeks now and our wing really looks stunning. It's such a striking difference from the wings around us or the second floor above us.

As our day-workers do some last minute cleaning before we receive patients, we sit down outside to have our weekly team meeting. Since the ship arrived the patients have seen many white people (yes, I could have written Westerners, please don't read more into my sentence than what it is. I simply pointed out the fact that our skin colour is different), but they still stop and stare at us - hopefully the sensation will be over soon.

I am about to speak when the door next to us swung open and they pushed out a bed with a patient on it. She is still sleeping and that's when I realize it: one of the ORs is just next door to us. They debate for a while what to do with her, then they lift up the bed and carry it up on the steep staircase (see photo). Above us I see vultures everywhere.

It must be noon as I can see people in the opposite wing are getting ready for the Dhuhr - noon prayer time for Muslims. Men come to the corridors, put down their rugs and bow down next to each other in a very organised manner. A few meters behind them ladies do the same. This solemn moment is broken when a bunch of street dogs scare the kids who walk in the courtyard. They run away shouting, while carrying heavy looking boxes on their heads - as it turns out they are bringing in food items for the patients to purchase, that is if they can afford to buy anything. If I didn't know better, I'd never have guessed that this is a hospital!

Our Team: Franck from Benin, Ryan from South Africa, Barry & Cheryl from UK and me
Franck was telling us horror stories, how the hospital was before his team started the renovation. Medical and surgical waste was quite literally 'just thrown out of the building' in open bags... Sometimes without the bags... More often than not these bags contained bloody rags and human tissue from the surgeries and were just put out onto the corridor - never mind the big trash container sitting 50 m away... empty. :(

Is it any surprise that this place is the vultures' favourite gathering place?

This lady is sleeping in front of the ward door outside, on the floor.
As we close our meeting the sun is out again after a quick and quiet shower. A boy is sent to the courtyard to collect the hospital sheets that are 'drying' on the ground. I can smell them as he walks past me - they STINK! Forget the 'fresh rain'smell from TV ads. These sheets are supposed to be clean and will be put on the hospital beds receiving the next patient straight form the OR with still open wounds and I don't even want to think about his/her chances of getting any infection from these clean sheets. No wonder Guineans don't like hospitals; one of them said that ''We don't go to hospitals, because that's where people die". Can you blame them for believing that???

This dumpster site is only 500 meters away form the hospital on the beach road... 

Wednesday, September 5, 2012

Hope Has Come... Screening thoughts

Yes. We made it! Again!                     Ok, let me re-phrase that!
Yes! God did it! Again!

I have tears in my eyes as I type when I think about the amazing things that happened on Monday. Somehow God just pulled it off so beautifully and perfectly against many odds...

To understand the Miracle, I need to go back a bit and share the Advance Team's experiences. Even though Mercy Ships offers FREE services, some people in town who were supposed to promote the event charged money for the information. Some government people, whose job was to promote the event kept it quite for selfish reasons. Sadly we were here, all of us working our butts off to make this day a success and we weren't sure if people got the message or not. Will they show up for our screening? More importantly, will the RIGHT patients show up?

Not the ones with a 'simple' back pain or the ones who could afford a good doctor here or in another country... NO! The ones who feel cast out of society because of a birth defect / obstructed labour while giving birth / burning accident that left them unable to move their limbs / cataracts / goiters / facial tumors...etc. The Invisible ones. The Silent cryers. The Untouchables.

For this massive operation we chose a nearby location called The People's Palace. The compound had fences on each side with small gates, a large open air area and a multi-floor building with exits to many directions. A perfect place for our purposes.

Darren was part of the overnight security team who left the ship Sunday night. Their job was to keep the early birds in line, send home the ones that we obviously cannot help and protect our gear that we left there a day before. He said that things were calm during the night, a couple hundred people showed up to secure a good spot in the ever growing line. And they waited...

5 am. My alarm went off. Outside it was dark, I could see raindropps on our window. I managed to put my clothes on and went for a quick breakfast. The dining room was full - but quiet. :) Some coffee and a muffin and we were about to load our vehicles. It never seize to amaze me - the effect of white Land Rovers one after the other roam through town. Those awake could see a sight they will surely not forget for a while. If they didn't know we were here before... they do NOW!

It's stilll dark when we arrive. The Landies drop us off and return for the second wave of people. I jog to my station, which is the coolest spot if you ask me! :) I am the one taking pictures of our future patients! These are not beauty shots, not emotional stories, just "boring" shots we take before surgery. Let me assure you now, there was NOTHING boring about it! But let's not rush ahead...

Setting up our area is always fun. We run around with head lights, stick pictures on the walls that will help the patients understand why we take these pictures. We put up stands and hang white sheets that will serve as backdrop for our photos and provide some privacy for the patients.

Here are some lines from my friend, Tiffany, who captured the moments so well:

"The fear - of seeing these faces that have been stretched beyond recognition by forces beyond their control - this fear, is gone. Now my face lights up with joy as I see these precious ones who have lived in desperation for years, ashamed and devastated by their own appearance. And they come, afraid to set their hopes too high, convinced that they are beyond help.

I make eye contact, finding the eye that has the best visibility - this can be the trickiest part. I smile from the depth of my heart. A smile that says, "You are welcome here! You are not forgotten! God has not given up on you. He sees! We are SO glad to see you!"

First by a trickle and soon a swiftly flowing river of patients make their way through the maze of stations we have. 4300 people have come through the iron gates onto the front lawn of the People's Palace. Nurses evaluate each and every person who has chosen to wait hours in first the drizzle, then the clouded humidity, and finally the sun. Over 500 people are screened by our eye team outside and determined that we could potentially help them further.

Those with other surgical issues we could potentially treat are escorted inside to begin the collection process on their information. Each type of condition is brought to see doctors, surgeons and nurses to determine the next step: schedule a surgery, xray, CT scan, waitlist or if we are unable to help. Escorts continue to guide the nearly 850 patients (plus their loved ones) through the three stories of stations.

Finally they reach the ground floor (Ground Zero) and they are nearing the end of their day with us. I await at the Card Issuing Station. And we see them all: Orthopedic patients: little ones with feet seemingly attached upside down, babies with Kermit the Frog legs whose knees look like they are reversed as they touch their chests effortlessly, twelve-year olds that measure three feet tall with legs bowed almost in a complete circle. Babies, children and teens with cleft lips and palates - their beautiful smiles of joy stretching even wider than our lips allow. Patients who had surgery on one of the previous Mercy Ships, the Anastasis, in 1998 to repair a condition and now have returned for their follow up surgeries. They have waited 14 years for our return! Sierra Leonean patients have crossed the border with their paperwork that states they will need a second surgery and even though that date is November or next January, they come expectantly, knowing the schedule is limited. VVF ladies have found there way here, with a big "YES!" written on their paperwork from our nurses. The crook of a burnt arm, the taut marbled skin of a burned cheek and eyelid, both young and old have suffered at the hands of an open flame. The embarrassed faces, the shame that has veiled them vanishes as I stretch out my hand with a "Bon Soir, comment ca va?" To be looked in the eye and treated as a valued equal, to know that there is a chance that help has arrived for them. This gives them a tangible hope.

They leave with a plastic card: PATIENT. They each have a name, a number, and the next step. For some it's another screening day (on a smaller scale, with a specific surgeon who will identify his/her own patients), for others it's being on a waitlist and they are told to keep their cell phones turned on. And for others they have an appointment on the ship - a Scan. An Xray. An admission!"

And then they meet me...

Stay tuned for 'My Personal Impressions and Encounters' coming up soon! So far the Communications Team released only a couple of pictures - the rest is coming in my next post!