Saying Goodbye.... Again

Team A Ward

It is that time of year again... the time to say goodbye to the people here in Congo and pack up our sailing hospital. It never ceases to surprise me how quickly the time passes. Wasn't it just yesterday that we sailed into Pointe-Noire and held our first screening day here? Where did the time go?

This week we had our last A Ward team dinner together at our favorite local Indian restaurant.

Our Last A Ward outing

Last week we said goodbye to our day crew. After spending the last ten months together working in the hospital, we took the time to say "Thank You" for all that they had done. We could never have accomplished our work on the ship without them. We hugged, cried, and waved goodbye as they left the ship for the last time.

Saying Goodbye to our Daycrew

The hospital is empty. The last patients have been discharged. Over the last two weeks we have been packing up the hospital and preparing for the ship to sail. I and one other nurse were placed in charge of the hospital pack up this year, and I am loving it. I have always had a knack for cleaning and organizing and puzzling. Packing things well, with as little wasted space as possible is something I am good at, and I love that I can use these skills to benefit the ship as well as I use my nursing skills.

Cleaning and sorting toys for packing

Soon I will be going home for a short vacation, before returning to the ship for the sail to our next destination, Benin. We say goodbye to the people of Congo, and look ahead, to what the Lord will do in Benin.

Merveille

One look at her and I fell in love....

For a six month old, she was a tiny little thing, weighing only 3.9kg (8.5lbs.), with big brown eyes that fixed themselves on my face. She was beautiful.
Her name was Merveille, which means "marvel" or "wonder" in French. She had come from an orphanage in Brazzaville, in the care of a nun named Sister Angelique. At first I didn't notice anything wrong with her, and wondered why she was on the ward at all. Until my gaze moved away from her face. Then the tennis ball sized lump at her throat was all to obvious.
She had a goiter, which was very rare for an infant. She had come to the orphanage when she was two months old, severely malnourished. I saw the photos of her as she had looked when she had first arrived at the orphanage, all skin and bones, with the goiter protruding form her neck. The nuns had done a wonderful job of feeding her to get her to her current weight. Now she was having breathing difficulty, though it was unclear if the cause was the goiter, or some other illness.
She had been brought on board to have a CT scan to determine whether she could be operated on. She would need to have contrast injected during the CT scan, so we had to start an IV on her.
It had been a quiet day on the ward, and I had completed everything that needed to be done for may patients. They would not need anything from me for at least an hour. So I volunteered (my nice way of saying that I grabbed hold of her as soon as I had the chance and then never let go) to help get her prepared for the CT scan.
As tiny as she was, it took 6 tries before the doctor was able to get an IV cannula in her hand. She screamed and cried, while I helped hold her still and tried to sooth her. As soon as the IV cannula was properly secured, we gave her medication to sedate her so that she would stay completely still during the scan. Then I wrapped her in a new clean blanket (her own had gotten blood on it when we were inserting the IV cannula) and cuddled and soothed her until she fell asleep.
I wasn't ready to relinquish my hold on her, so I carried her down the hall to radiology for her scan. There I finally had to release her, and laid her gently into the foam mold that would hold her still during the scan.
While she was being scanned, I returned to the ward to do my afternoon med pass. Shift change was coming soon, so I did my final chart checks. Then she returned to the ward, in the arms of the charge nurse. The effects of sedation were already beginning to wear off, and her eyes were open again.
It was now shift change, and Merveille was ooohed and aaahed over by every nurse.
I reported on the patients in my care to their evening shift nurse and then, as is the duty of the nurses coming off of day shift, I took my patients up to Deck 7 for some fresh air and sunshine while Merveille stayed behind on the ward with her new nurse cooing at her.
When I returned my patients to the ward an hour later, I learned that Merveille was going to be admitted to the hospital. The admission nurse (one of my friends, Chris) had arrived to take her to another room to complete the admission process. I eagerly volunteered to assist.
While Chris, with the assistance of a translator, obtained Merveille's medical history and other information from Sister Angelique, I cuddled her.
While the physician did his assessment, I cuddled her.
While Chris measured and weighed her, I soothed her, and as soon as that was done, I cuddled her.
It was decided that we would need to do some bloodwork and after that, a chest xray. I held her still while she was poked with even more needles, then when that was over, I cuddled her.
I carried her to the radiology room and help the technician (my friend Jeremiah) to position her for the xrays. When that was done, I cuddled her.
She fell asleep almost instantly in my arms. It had been an exhausting few hours for her. So, I cuddled her for as long as I could.
By now it was time for supper, so I reluctantly returned her to her nurse and went to dinner, but not before not-so-subtly hinting to the charge nurse that I would be very happy to be her nurse when I came in for day shift the next morning. I returned to ward later that evening to check on her, and learned that the xray had showed that her lungs were clear, and the bloodwork showed that her thyroid hormones were within range for surgery. She had been scheduled for surgery in three days.
When I reported in for work the next morning, I was thrilled to see that I had been assigned as her nurse. I was surprised to learn that the surgeon had decided to operate that very day. She would be the first to go to surgery that morning. I finished preparing her for surgery, and all too soon, the OR nurse arrived to take her to the operating room. I would not be her nurse after the surgery, as she would be taken to D ward after surgery so that she would have a pediatric intensive care nurse looking after her if she had complications after the operation.
For the next several hours I tried to focus on my other patients, while wondering how Merveille was faring in the operating room. After a few hours, I started wandering past D ward every thirty minutes or so to peek through the door to see if she had returned from surgery. Finally, I saw her laying in her bed when I peeked through the door. She was breathing on her own and aside from the IV fluids going into her arm and a drain coming out of her neck where the goiter had been, she was tube free.
For the next three days I visited whenever I could, to feed and cuddle her. At first her neck was swollen and puffy, but the swelling slowly decreased. The drain was removed from her neck, and all that remained to remind us that the goiter had ever been there was the neat line of sutures across her neck.

While Merveille was in the hospital, the President of the Republic of Congo came to the ship. Merveille was one of the few lucky patients who got to meet him. He came down to D Ward, and even had his picture taken holding her! Sister Angelique was so excited to tell me all about it when I next came down for a visit. Merveille also got the opportunity to meet Mama Claire, who had been invited to return to the ship for the President's visit.

Merveille and Sister Angelique

Merveille and Mama Claire

Merveille with the President

When Merveille was sent to the HOPE Center after her discharge, I went to visit her and Sister Angelique there. She was my little princess. Coincidentally, that particular week at the HOPE Center the lesson and corresponding craft were about Queen Esther, so I made a paper crown and she was Princess Merveille for the day.

 

I am going to miss my little princess deeply, but she will be in my prayers for a lifetime, and I hope that she will one day be adopted by a loving family.

Happy Goodbyes

Life on the ship is full of goodbyes. But those goodbyes are not always sad and sorrowful events.

Plastic surgery finished a few weeks ago. The surgeon who had been operating on our patients with burn contractures, extra fingers or toes, gigantism of various limbs, etc., returned home. But many of his patients remained in the hospital, their surgeries were complete but their wounds still requiring daily dressing changes and special care.

The Plastics Team

For some, struggling with infection, or slow wound healing, it seems as if they would never go home. This week we celebrated with two patients who had been in the hospital for over two months. Finally their wounds were healed and they were ready to leave the ship. They will still return to us several times a week,for physical therapy so this is not yet a final goodbye, but we will no longer see their faces on the ward.

Saying Goodbye

One of the patients that left this week was young Benjamine. Benjamine came to us with severe burn contractures to her neck and both arms. She had been burned when her clothing caught fire. But she still had a beautiful smile.

Benjamine at screening

Benjamine was with us for so long that she knew almost everyone in the hospital and believe me when I say she was loved by all. On the day she was discharged, we had a surprise goodbye party for her on Deck 7. Many of the nurses who had cared for Benjamine came to wish her goodbye. It was a time of smiles, hugs, and laughter. And perhaps also a few tears.


Goodbye Hugs and Smiles

She still returns to the ship for physical therapy, and always stops by the wards to say "Hello" to the nurses, with bright smiles and hugs for all.

Healing with Love

Recently I have been thinking about life down in the hospital, and why we (the nurses) are here.

Of course, we are here to provide the obvious medical care that is needed before and after surgery, but that is only part of our job. True, our patients need their medications and wound care, and we need to do our assessments, but often what our patients need more than any medication is love and unconditional acceptance.

Many of our patients come to us nervous, frightened, and ashamed. Nervous and frightened, because they have never been this far from home, have never been on a ship, and definitely not a hospital ship full of white people. For some of the children, it is there first time to every see a person with white skin. I have smiled at a newly admitted toddler before, only to have her scream and run away crying to her mother. Then there is the upcoming surgery for them to worry about. Add to that the shame that they bear because of their condition. Often our patients have been laughed at and ridiculed for their condition, if not outright rejected because they are thought to be cursed.

As the ones who will have the most interaction with the patients, we have the honor and privilege of being the ones who will have the greatest impact. We do what we can to make them feel safe. We are kind and gentle. We treat them as people of value. We laugh with them, smile with them, encourage them when they are down. For some of our patients, this is the most valuable thing that we can do for them. We cannot remove scars, and we cannot always make a person look "normal" Our surgeons do what they can, but they cannot work miracles. But with our love and encouragement they can still leave the ship with heads held high, knowing that they are not cursed. They are worthy of love and acceptance. And this will make more of a difference in their lives than any surgery. 

The Faces of Hope

Plastics patients and family with their surgeon and nurses

Recently we invited our patients from the first round of plastic surgeries to come back to the ship for a final evaluation and to say goodbye and thank you to their surgeons and nurses. It was such a blessing to see them with new life and new hope because of their surgeries. Some faces stand out most clearly in my mind. I would like to introduce you to them:

Sabrina and Brenda



Sabrina and Brenda

Sabrina and Brenda are sisters. They were both born with congenital syndactyly. Each of their feet only had three toes, with a large cleft between the large toe and the other two, looking something like a bird's feet. Some of their fingers were also fused together. 

I met Sabrina first. I was the nurse to admit her to the ward with her mother before her surgery. Sabrina and her mother were concerned for the welfare of the younger sister who was still at home, and was scheduled to come to the ship two days later. Because both daughters had been born deformed, the family had been ostracized, and there was no one to make sure that she would make it to the ship safely.

Of course, we made sure that Brenda did indeed make it to the ship and both girls had their surgeries. The surgeon closed the cleft in both girls feet, giving them feet that would look more "normal", though missing a few toes. The surgeon also separated Sabina's thumb and forefinger which had been fused together since birth, giving her a hand that was more functional and also looked more "normal".

Me with Sabrina, Brenda, and their Mother

 

A few days after their surgery, various members of their family began to visit, including their father. The girls were in the hospital for six weeks, and then they went home to a family that now accepted them.

They returned to the ship with bright smiles and new shoes on their feet. Shoes. On feet that looked like feet, even with open toed dress shoes.

 

Wearing Shoes!

Prince and Eli

Prince

Eli

Prince and Eli are twelve year old boys who both suffered from severe burns which resulted in burn contractures. Eli's hand was burned when he was only three years old, and what was left of his hand had fused closed into a fist. Prince had also suffered burns which had caused burn contractures to his wrist, leaving him unable to use his hand properly. The boys both received surgery to free their fingers and  were both so excited to see their hands, with the individual fingers separated and free. Eli's hand had been so severely burned that he had lost the top half of his fingers, but the surgeon separated out each individual finger to give him a better ability to grasp objects. Both boys were full of fun and laughter, and life was always an adventure with the two of them together on the ward.

Prince and Eli having fun on the ward

Prince and I

Eli goofing off in the ward

Neither boy liked the physical therapy exercises that they had to do to strengthen and stretch their fingers or the dressing changes which were painful, but they were so happy to have the use of their fingers once again. After spending a little more than a month on the ship, they both went home. They returned to see us one last time with hands healed and bright smiles, a reflection of a brighter hope for their lives.

Prince showing off his hand

Eli giving a thumbs up

Faces like these are why I wake up every day with a smile, knowing that I get to go to work, and serve these beautiful people.  Faces like these make everything worthwhile.

Goodbyes and Picnics

One of the hardest things about life on the ship, especially for those of us who are on the ship long-term, is saying goodbye. Goodbye to patients, goodbye to friends, goodbye to fellow nurses.
This week two of the nurses on my ward are going home. We decided to have a goodbye picnic down at the beach. Those of us who were not on shift walked together through the port down to the beach (about a 30 minute walk) and shared chicken sandwiches, played in the surf, and watched a beautiful sunset together. It was a wonderful evening, full of friends and smiles.
People come, people go, but the love remains, the memories remain, and the mission remains. We will continue to bring hope and healing, we will continue to follow the model of Jesus. We will. Together.