Yes, after six weeks (or there abouts) of plastics I am back into the world of maxillo-facial surgeries and NG feeds! The first night back was fairly busy as I reacquainted myself to this genre of care but the last two nights have been fairly quiet. ...Hence, this update at 2am my time! We have only 8 plastics in-patients left on the ward and have discharged several general surgeries (hernia repairs, cyst removals, etc) and max-fac patients over the last two days but tomorrow starts another day of admissions in preparation for Monday's surgeries.
In another week we will be starting two weeks of surgery for VVF (vesico-vaginal fistula) ladies. These surgeries are to repair holes between the birth canal and urinary and/or fecal tracks. There are many causes of VVF (or the other varieties of fistulas we'll see) but one of the main ones is the disproportion between the pelvis size and the size of the baby being born. The children here start working very young and often carry loads on their heads that would be heavy for you or I to carry. This, combined with poor nutrition, means that most of the energy they get from their food is put into their work and not into growth. So, often, they remain smaller framed. Also, sometimes these girls are married quite young (more so in the northern rural tribal areas) and have not yet finished growing themselves when they become pregnant. (A young woman doesn't stop growing until at least 18-21 yr of age.) Because of their smaller frames, the baby's head is too large to fit through the pelvis and becomes stuck. These women are often in labor for several days (one I've heard of was in labor for a week!) without medical clinics available or too far away to get to. With no one around to help, the baby dies and sometimes, so does the mother. If the mother survives, she soon realizes that her urine and/or feces leak constantly and she may also have some weakness or paralysis of her legs. Because of the leaking, no one wants her around and she is often rejected by her entire community, even her husband and family. The social shame, embarrassment, disgrace and rejection that go with these conditions cause untold emotional pain for these women. Some of these women come to us young (16-20yr). Others have had to deal with this for more than 20+ yrs! Along with the surgery, they have exercises to do and their bladders and muscles must be retrained to function properly. They also need lots and lots of complete support (emotional, social, spiritual, physical, etc.). Not all holes are able to be fixed and some may take more than one surgery but each woman comes here with the hope of being "fixed." There are many fears and expectations as well as emotional scars that each one must deal with. At the end of these two weeks, each woman receives a new dress to symbolize the new life that she's been given and we celebrate with them at the New Dress Ceremony. Though many of these women are unable to have any more children some do. They will never be able to have a natural birth again as that may cause the repairs to tear. So each woman is given a card stating that arrangements have been made with a local doctor to provide free c-sections should they have more children.
I have heard several of these ladies' stories--some ending with joy and happy reunions with husbands and families while others are unable to return home or bear children and must find other means to live--and yet God shows Himself faithful to each one. Along with providing them a new life through their repairs, we have the opportunity to tell them of another new life they can have through Jesus Christ. The joy you see in their smiles, knowing the pain they have already experienced, can't help but encourage you! Everyone here is looking forward to those two weeks!
Wow! I can't believe it! I have only three weeks left! One more week of max-fac and general surgeries then two weeks of VVF and my time here will be over! Though I am looking forward to being home, I have tried to enjoy every day for what it holds. My worst fear is that I'll get home and have regrets about opportunities I didn't take and what I didn't do. I already know that there will be several African friends that I will miss! Thank the Lord for heaven! I'll have all of eternity to see them again!
Saturday, October 10, 2009
Thursday, October 8, 2009
Playing tourist....
I've never been very good at playing tourist. I'd much prefer to be helping someone somewhere. However, rest is just important as the work and often makes for a lot of good memories!
Last Saturday, a large group from the ship went to Bab's Dock for the day. Bab's Dock is owned by a German couple who built their resort on a shallow semi-fresh water lake (it is a very short distance inland from the ocean). It's a beautiful little retreat offering sunbathing, relaxing in hammocks or on mats around decks and the sandy beach, swimming, canoeing, kayaking, sailing, water volleyball, a restaurant with wonderful food, and a variety of animals around (they keep a pet monkey, several donkeys, some dogs, and of course, the ever present lizards seen everywhere). It was so much fun! I decided that I really don't know how to kayak, though I have been before (and quite successfully, I might add!)--their small yellow kayak I couldn't even keep from rolling for more than 15 sec! Every time I would swing the paddle to row I would tip myself over!!! Thankfully the water was only about 3 feet deep! You could walk across the lake if you wanted to. Most of the water got no higher than mid-chest on an average person.
My friend, Gry, and I decided to try the two-person kayak and that went much more smoothly! We did a bit of exploring, discussing what might really be in the water we had been swimming in! Hhhmmm....some things are better not to know! I also tried to ride the small one-man sail boat with one of the ship's officers; however, the plastic surface is completely smooth and there is nothing to brace yourself on if you are not sitting in the pilot area! I slid off every time the wind would catch the sail and tip the boat a little!!! My friend, Gry, graciously pointed out after several of my dunkings that the idea behind sailing was to ride IN the boat! Huh! Whoda thunk it?! At one point, I decided that we were going fast enough, I'd try barefoot skiing since I was dragging behind the boat anyway but that created too much drag and slowed the boat right down. I did eventually manage to stay on long enough for a ride by straddling the mast and tucking a foot under the ledge of the boat on either side! Quite a sight, I'm sure, but it worked! That little boat got moving pretty fast once we were going!!!
To get out to Bab's Dock, we had to take a motor boat through a tunnel carved out of the many trees with their highly visible roots, looking much like hundreds of fingers dipping into the water. It was beautiful! I did see a few smaller tunnels/canals off of the wide one we took that I think go to the beach side homes and farms we saw driving to the boat launch. I even saw them moving a zimmy-jea'n(motorcycle) across the lake on a boat!
Sunday was another day off, one to relax. A fellow nurse and I did a tour of the ship for friends and family of one of our translators. Then, after our ship's evening service, I was invited to the gospel concert of one of our other translators. I went with him and one of the other day volunteers who works in engineering. It was really good but a little weird. The concert was held in what looked like a bar and seemed like it was coming at the end of an all-day church service. There were about 20 people there when we got there and the worship team was still leading songs up front. Soon they introduced the group that was to give the concert and even though the group started their music right away, several people got up and left. For the rest of the evening, only a few people remained, some drifting in and out of the building. And one man started picking up chairs and putting the room back to normal weekday order not long after the concert started! And it was to go for over an hour yet! It was peculiar! I've never been to a concert where someone was invited to play and then right after they start, people leave and start cleaning up! But as they say, "that's Africa!" The engineer is from Benin and helped me learn a little of African dancing, which by the way, is excellent exercise!!! Dance for an 1-1/2 hr and you really feel it! I have now mastered a sort of shuffling step in time to the music--just going forward and back or side-to-side--but it is African dancing! He tried to teach me the more traditional, what I call "chicken", dance but that is way beyond my skill level! I think I'm hopeless on that one! Anyway, we had a lot of fun and I could really feel the Holy Spirit there as well. Being a little northern baptist girl, dancing in church is definitely new but it gave me a new appreciation for worshipping the Lord with everything I am. The dancing isn't for people around you. It's for the enjoyment of the music and having fun praising the Lord!
Monday and Tuesday were busy work days. Many of our plastic surgery patients have now been here for more than a month consecutively. I think the winner has been here for 43 days now and still healing! Infection interrupts the healing process and greatly delays their discharge from the hospital. However, we now have a number of them that will be going home soon. Though we cover a lot of teaching right around the time of their surgery (since we normally don't keep them more than a few days generally), we realized that that was a long time ago for most of these patients. So to prepare them for their discharge we did a big group teaching about preventing infections in their wounds, signs and symptoms of infection, what to do if they think it is infected and good hand washing. If we had just gone through the teaching, simply telling them everything, I think they would have just let it go in one ear and out the other. But I had two of my girl friends who are translators here working with me and they did an excellent job of asking questions to make them think, frequently reviewing and reiterating the important points, and thoroughly explaining everything! I also pulled another nurse in last minute to role-play a scene with me and asking the patients what we did that spread infection. Then we role-played a cleaner scenario and then talked about the things we had done to prevent the spread of infection. We also talked a little about purifying their water at home and about how there are many different bacteria and they need to be treated in very different ways. Therefore, it is very important that when they think they have an infection that they go and see a doctor instead of just buying an antibiotic tablet or two or three on the street. (And yes, that's common! It's expensive to buy the whole round of antibiotics and many feel that more than 2-3 tablets is unnecessary.) We also told them that it was not just a "crazy yovo" thing to wash hands all the time. That it served a very important purpose no matter where you were from.
I ended by telling them that now that they knew all about infection they could watch each other and the nurses and tell us when we were messing up. One of my nurse friends came up to me the next day,...apparently, she'd picked up a cup that had been sitting right-side up on the floor next to the patient's bed and proceeded to fill it up for him in order that he might take his meds. The patient stopped her, saying, "WHAT ARE YOU DOING?! Are you trying to KILL me?!" then laughed with the nurse that she'd been "caught." Apparently, they were paying more attention than I thought....to both the lesson and us! She also told me that she overheard one patient reprimanding another for scratching one of her wounds (a BIG cause for infection in these patients!). LOL! At least I know they understood everything!
Then yesterday, I got to play tourist again and went for a very relaxing day with friends at El Dorado Beach Club. We pay a small fee to get onto the beach then we can stay as long as we want. We had two of our translator friends with us and attempted to teach them how to swim using a boogy-board for a floaty! They both did pretty good. One of them picked up the idea of body-boarding pretty quickly and got in several good rides. For me, it was much like the beach I grew up going to so I was excited to get back into body-surfing! It was great! And we had some good-sized waves coming in! Also got to spend some time climbing around on the rocks that formed the small harbor we swam in, laying in the shade of one of the cement shelters reading, had a long and interesting discussion about doctrine and took lots and lots of pictures!
After these two trips, playing in the water and frying myself thoroughly, I've come to the conclusion that my water-proof sunscreen is not nearly as water-proof as it says it is!!! Oh, well! The burns look a lot nastier than they feel so I shall survive and live to tell the tale of other adventures! Talk to you later!
Last Saturday, a large group from the ship went to Bab's Dock for the day. Bab's Dock is owned by a German couple who built their resort on a shallow semi-fresh water lake (it is a very short distance inland from the ocean). It's a beautiful little retreat offering sunbathing, relaxing in hammocks or on mats around decks and the sandy beach, swimming, canoeing, kayaking, sailing, water volleyball, a restaurant with wonderful food, and a variety of animals around (they keep a pet monkey, several donkeys, some dogs, and of course, the ever present lizards seen everywhere). It was so much fun! I decided that I really don't know how to kayak, though I have been before (and quite successfully, I might add!)--their small yellow kayak I couldn't even keep from rolling for more than 15 sec! Every time I would swing the paddle to row I would tip myself over!!! Thankfully the water was only about 3 feet deep! You could walk across the lake if you wanted to. Most of the water got no higher than mid-chest on an average person.
My friend, Gry, and I decided to try the two-person kayak and that went much more smoothly! We did a bit of exploring, discussing what might really be in the water we had been swimming in! Hhhmmm....some things are better not to know! I also tried to ride the small one-man sail boat with one of the ship's officers; however, the plastic surface is completely smooth and there is nothing to brace yourself on if you are not sitting in the pilot area! I slid off every time the wind would catch the sail and tip the boat a little!!! My friend, Gry, graciously pointed out after several of my dunkings that the idea behind sailing was to ride IN the boat! Huh! Whoda thunk it?! At one point, I decided that we were going fast enough, I'd try barefoot skiing since I was dragging behind the boat anyway but that created too much drag and slowed the boat right down. I did eventually manage to stay on long enough for a ride by straddling the mast and tucking a foot under the ledge of the boat on either side! Quite a sight, I'm sure, but it worked! That little boat got moving pretty fast once we were going!!!
To get out to Bab's Dock, we had to take a motor boat through a tunnel carved out of the many trees with their highly visible roots, looking much like hundreds of fingers dipping into the water. It was beautiful! I did see a few smaller tunnels/canals off of the wide one we took that I think go to the beach side homes and farms we saw driving to the boat launch. I even saw them moving a zimmy-jea'n(motorcycle) across the lake on a boat!
Sunday was another day off, one to relax. A fellow nurse and I did a tour of the ship for friends and family of one of our translators. Then, after our ship's evening service, I was invited to the gospel concert of one of our other translators. I went with him and one of the other day volunteers who works in engineering. It was really good but a little weird. The concert was held in what looked like a bar and seemed like it was coming at the end of an all-day church service. There were about 20 people there when we got there and the worship team was still leading songs up front. Soon they introduced the group that was to give the concert and even though the group started their music right away, several people got up and left. For the rest of the evening, only a few people remained, some drifting in and out of the building. And one man started picking up chairs and putting the room back to normal weekday order not long after the concert started! And it was to go for over an hour yet! It was peculiar! I've never been to a concert where someone was invited to play and then right after they start, people leave and start cleaning up! But as they say, "that's Africa!" The engineer is from Benin and helped me learn a little of African dancing, which by the way, is excellent exercise!!! Dance for an 1-1/2 hr and you really feel it! I have now mastered a sort of shuffling step in time to the music--just going forward and back or side-to-side--but it is African dancing! He tried to teach me the more traditional, what I call "chicken", dance but that is way beyond my skill level! I think I'm hopeless on that one! Anyway, we had a lot of fun and I could really feel the Holy Spirit there as well. Being a little northern baptist girl, dancing in church is definitely new but it gave me a new appreciation for worshipping the Lord with everything I am. The dancing isn't for people around you. It's for the enjoyment of the music and having fun praising the Lord!
Monday and Tuesday were busy work days. Many of our plastic surgery patients have now been here for more than a month consecutively. I think the winner has been here for 43 days now and still healing! Infection interrupts the healing process and greatly delays their discharge from the hospital. However, we now have a number of them that will be going home soon. Though we cover a lot of teaching right around the time of their surgery (since we normally don't keep them more than a few days generally), we realized that that was a long time ago for most of these patients. So to prepare them for their discharge we did a big group teaching about preventing infections in their wounds, signs and symptoms of infection, what to do if they think it is infected and good hand washing. If we had just gone through the teaching, simply telling them everything, I think they would have just let it go in one ear and out the other. But I had two of my girl friends who are translators here working with me and they did an excellent job of asking questions to make them think, frequently reviewing and reiterating the important points, and thoroughly explaining everything! I also pulled another nurse in last minute to role-play a scene with me and asking the patients what we did that spread infection. Then we role-played a cleaner scenario and then talked about the things we had done to prevent the spread of infection. We also talked a little about purifying their water at home and about how there are many different bacteria and they need to be treated in very different ways. Therefore, it is very important that when they think they have an infection that they go and see a doctor instead of just buying an antibiotic tablet or two or three on the street. (And yes, that's common! It's expensive to buy the whole round of antibiotics and many feel that more than 2-3 tablets is unnecessary.) We also told them that it was not just a "crazy yovo" thing to wash hands all the time. That it served a very important purpose no matter where you were from.
I ended by telling them that now that they knew all about infection they could watch each other and the nurses and tell us when we were messing up. One of my nurse friends came up to me the next day,...apparently, she'd picked up a cup that had been sitting right-side up on the floor next to the patient's bed and proceeded to fill it up for him in order that he might take his meds. The patient stopped her, saying, "WHAT ARE YOU DOING?! Are you trying to KILL me?!" then laughed with the nurse that she'd been "caught." Apparently, they were paying more attention than I thought....to both the lesson and us! She also told me that she overheard one patient reprimanding another for scratching one of her wounds (a BIG cause for infection in these patients!). LOL! At least I know they understood everything!
Then yesterday, I got to play tourist again and went for a very relaxing day with friends at El Dorado Beach Club. We pay a small fee to get onto the beach then we can stay as long as we want. We had two of our translator friends with us and attempted to teach them how to swim using a boogy-board for a floaty! They both did pretty good. One of them picked up the idea of body-boarding pretty quickly and got in several good rides. For me, it was much like the beach I grew up going to so I was excited to get back into body-surfing! It was great! And we had some good-sized waves coming in! Also got to spend some time climbing around on the rocks that formed the small harbor we swam in, laying in the shade of one of the cement shelters reading, had a long and interesting discussion about doctrine and took lots and lots of pictures!
After these two trips, playing in the water and frying myself thoroughly, I've come to the conclusion that my water-proof sunscreen is not nearly as water-proof as it says it is!!! Oh, well! The burns look a lot nastier than they feel so I shall survive and live to tell the tale of other adventures! Talk to you later!
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