radio

Here on the ship, silly videos are regularly made for general announcements.  We have a video reminding us to take just two-minute showers and a video reminding us to keep the reception area quiet, and so forth.  Last year in Sierra Leone, I was in a video about knowing how to use the Land Rover radios.  So, without further ado:

o pos

A few days back, I had the opportunity to be a blood donor (again!) here on the ship.  You can read about my first time donating by reading (and watching the video!) on this post entitled "blood."    Last time, my blood was for a patient in our Intensive Care Unit, but this time it was needed in the OR for a patient that was undergoing surgery right then and there!  As I've mentioned before, we have a living, breathing "blood bank" on the ship since we don't have storage space for blood.  If a unit is needed, the donor is called, the blood is drawn, and then it goes almost immediately into the recipient. 

 One of our lab techs/vampires Polly drawing my blood.

Moments later in the OR with Dr. Iain (an anaesthestist).  Yep, that's my blood being hooked up.

A gift from some of the OR nurses.  My number was supposed to be 15 (my hemaglobin/iron level), but the 5 was accidentally made into a 2. 

thumbs up

hope

Wednesday morning.  I wake up at 5am.  I don't even remember the last time my alarm went off that early.  Brush teeth.  Put on blue scrubs.  Fill water bottles.  Breakfast service started at 3:30 this morning--the first vehicle left around 4.  It's going to be a good, albeit long, day.

Around 6:00am, my caravan leaves for Kégué Stadium.  Security teams have been there since yesterday afternoon, to help the line stay in order.  3,500 people show up. 

 

The hazy morning soon gives way to ray of sunlight.  Underneath the brightly colored, patterned fabric typical of West Africa are moms, dads, children, elderly...all with ailments, maladies, deformities, disfigurements...seeking relief.

Pre-screeners work through the line, identifying potential patients.  As the heat picks up, volunteers distribute water, peanut butter sandwiches, and laughter.

Inside the stadium are several stations.  Registration, history, physicals.  Exam rooms for max fax, plastics, and general surgeries.  X-ray, lab, pharmacy, data entry, scheduling, communications, infant feeding program, children's ministry.  Final check.  Prayer.

 

1,600 people enter the gates and proceed through the screening process. Tumors, cleft lips, goiters, hernias, burns.  People are weighed, masses are biopsied, x-rays are scheduled.

I'm working at Data Entry.  Over 1600 patients, about 550 make it to this station, after their exams.  We enter their information into a database and print ID cards.  The patients are then directed to either scheduling, lab, x-ray, or pharmacy.  Over the course of the day, I enter information for about 180 people.

Just shy of a 12-hour day, I head back to the ship in another caravan, tired and sweaty.  This is just the beginning of the outreach.  The beginning of new stories of lives transformed.  

open house

This past Monday was the annual Hospital Open House.  Before the hospital opens at the beginning of an outreach, the hospital opens up for all the crew to visit and play games.  Each ward and OR, as well as the lab and x-ray, has a different activity.  In our department, we had practice suturing, intubation on dummies, and my station: dress-up and play surgeon.  Despite all of our gowns and gloves being way too big, our room was definitely popular with the kids on board!

Kylie gets ready to begin surgery.

Xavier receives assistance with his too-big gloves before operating on Theo's "broken" arm.

Practicing my scrub nurse skills with Laura and Malachi as they operate on Tracy's arm lipoma.

revisiting eyes

Monday morning I woke up thinking it would be a normal day down in the OR office, getting some things ready for the start of surgery (which is this coming Monday!).  As I was about to leave my cabin, the phone rang (around 0745).  On the other end was Innocent, our Assistant Eye Team Coordinator, explaining that two of the current four eye team members were sick, and they were about to head out to screening.  Knowing that I had previously been on the eye team, he asked if I could help them out.  "We'll be back by two," he reassured me.  I said I'd check with Missy (the OR supervisor) and get back to him.  After getting the okay, I hopped in a Land Rover...right after our big all-hospital photo shoot.

All of the Hospital staff (as of 30 January 2012).  I'm sitting on the hood of the center Land Rover, with sunglasses on.

The OR Staff!  

We are a little short right now because we are getting 12 new staff this coming weekend.

As I was saying, we headed off for our eye screening site of the day, the International Chapel at the West African Advanced School of Theology.  If you're like me, you probably think of a small house of worship when you hear the word "chapel."  Emphasis on the word small.  But, just when you think you have West Africa figured out, it turns around and calls this a "chapel":

Yes, this behemoth of a building is the International Chapel.  As we unloaded our equipment, I couldn't help but compare this site to our places in Sierra Leone.  Usually when we went to a church in Sierra Leone for screening, we would end up clearing out all the pews and still being a little on the cramped side.  But here, oh my.  The whole eye screening operation was set up right inside those front doors with ample space left over...we didn't have to move a single one of the 100+ pews.

A quick look at our set-up.

An unfortunately dark photo taken from the pulpit area.  The huge balcony was about half of the main floor. 

I was put in charge of pre-screening and was told to expect about 200 patients.  No big deal.  Pre-screening involves looking in each person's eyes with a flashlight to determine quickly if they have cataracts, a pterygium, or another something else we can help.  "Yes" people then proceed into the church to be seen by our optometrist.  When I took my place to begin pre-screening, Innocent explained (in French) what would be happening and the crowd immediately began clapping!  It was really overwhelming--I mean, I'm not a doctor, but I think that these people were just so happy that someone was there to care for them, regardless of what the "care" would look like.  My cursory exams proceeded well and I got to polish my slightly rusty French skills ("Pas de cataractes!  C'est bon!")  Hours later, I find that I'm still working on this group of what I thought was 200 people.  Eventually, a day volunteer comes out and tells me that Nancy, our sole ophthalmic tech, says we need to stop--there are too many patients!  I look at the click-counter my translator is holding and we are at 368 patients!  I quickly pre-screen the remaining few, telling the "yes" patients to return in two weeks and that puts us up to 408 total patients.  I guess when you're on a roll, then you are on a roll.  Eventually, we manage to get everything packed up by 3:45pm and back to the ship at 4:15pm.  The day was longer than expected but definitely well worth it, as we scheduled 57 patients for a secondary screening at the ship (a yield of about 14%, which is great!).  I did get a little sunburned, but my great conversations with the day volunteers made up for it (topics included churches and how one votes in the U.S.).  All of them were crucial in making the day run smoothly and what was really a pleasure to work with them.  

On Tuesday morning, the ship held a Hospital Evacuation Drill.  It starts at as a regular fire drill, with most people mustering on the dock and the hospital folks staying in there respective areas.  Then the captain announced that the "fire" was out of control and the hospital would need to be evacuated.  Despite not having any actual patients on board, the ward was filled up with crew volunteers, acting as blind, injured, recovering, and unconscious patients.  We also had two intubated dummies in the OR and three "recovering" patients in the PACU.  The whole thing was pretty exciting.  You never really think about "Okay, what do we do if we have to evacuate the ship while we are cutting apart this person's jaw?"  After getting our OR patients outside, we proceeded to one of our four dockside tents, which operated as our makeshift OR.  The whole drill went very smoothly and it was great to see how everyone worked together to clear the ship safely. 

Tuesday afternoon, the OR nurses began bleaching the department.  As the completed individual rooms, my job was to go around and swab pre-determined surfaces (unknown to the nurses).  I then sent the swabs to the lab to be cultured, in order to see if our bleaching was effective.  I just got the results back and let's just say that we will be doing some rebleaching tomorrow :(

c'est bon

It is good. 

The past two weeks, for the most part, have been really good.  I say "for the most part" because I did sustain an untimely, yet minor, injury last Monday, but I'll get to that in a bit. 

A lot has been going on, so I'll try to touch on a little but of everything.

My travel to the ship was much less eventful than my first time traveling to Africa (no cancelled flights, etc.).  I met up with some ship friends at the Brussels airport, which was easily the highlight of that airport.  I've said it before, but just for the record: The Brussels airport is the worst airport ever.  If you are stuck in the terminal, your food choices are abysmal and the entire building is basically one huge window, so the sun is pretty much always in your eyes.  Also, those food choices are also super expensive, even by airport standards.  A regular-sized bottle of water and a small can of Pringles cost over $10 USD.  There also seems to be a lot more misbehaving, hyperactive children running around there.  Anyway, our flight into Togo made a scheduled stop in Abidjan, Cote D'Ivoire before getting to Lome.  After the very long series of flights, we had made it.  Through passport control, baggage claim, and a joke of a stop at "customs."  Our bags went through an x-ray machine, and then an "officer" suggested that we give him a gift.  I said absolutely not, grabbed all the Mercy Ships luggage I could and struggled through the final door under all the weight.  On the other side, our team of friends was waiting to pick us up.  We hugged in the stifling heat and headed to the vehicles.  My friend Jay offered me a ride on his motorcycle, which having never been on one before, I skeptically accepted.  It was much better than expected!  As we headed out of the parking lot and down a long, wide boulevard, it was very apparent that Lome was much different from Freetown.  Electricity at night (!), almost no traffic (!), sidewalks (!), long, wide boulevards (!).  As we pulled into the ship's section of the port, more friends were outside waiting to greet us and assist with carrying luggage.  More hugs and laughs were exchanged.  After wearily receiving my new badge and some paperwork, I headed straight for a shower and bed. 

My first week back on board was spent getting settled in: unpacking, getting necessary signatures, organizing stuff in my office, and just generally getting my bearings. That Friday, the OR staff and some other crew were invited to the "grand opening" of the Hope Center.  You will recall that the Hope Center is our off-ship facility were out-of-town patients can stay after their initial recovery time on the ward.  This year, the Hope Center is located in a building that also houses a maternity hospital.  When we arrived at the compound, about 150 mothers and their babies were outside, waiting to be weighed-in for the check-up appointments.  I'm happy to report that all the babies looked very healthy--we even heard that there was a one-week old baby that weighed 5 kg (~11 pounds)!  Anyway, the ceremony for the opening was also attended by several ceremonial chieftains and included short speeches by our Managing Director, Donovan, and the Togolese Minister of Health.  Afterwards, we toured the facility.

One of the (male) ceremonial chieftains in traditional (?) garb.  Comparisons were drawn between his "hat" and something you may find in your grandma's bathroom to cover up a roll of toilet paper. 

The interior of the Hope Center.  Each of the wings has an open courtyard with a sand garden.  A truly beautiful design. Off of this area there are sleeping quarters and bathrooms

Inside one of the bedrooms.  Beds are ready and waiting to be filled with patients!

That night, we went out to eat a nice restaurant off of the main road.  We ate outside in the walled courtyard while a live band played jazz-esque covers of the Beatles and Cat Stevens.  It was a little bizarre, but my beef kebabs were delicious and the fries were perfectly crisp.  The currency hear in Togo is the West African Franc (CFA), colloquially pronounced like "see-fa."  It is used in several French-speaking, West African countries and the exchange rate is about 500 CFA to one dollar, making it very easy to figure things out in your head.  Cheeseburgers range from 1000-1500 CFA, fries are 1000, and a meal with salad and side can be 3500-6500 CFA.  There are several reputable restaurants in the city, many of which offer very affordable choices.  There is even a true ice cream parlor (Festival de Glace)! 

While the first week was mostly relaxing, this past week was much more work.  The hospital opening/first surgeries will be on Monday, February 6, so there has been a lot of preparations to take care of.  While the ward nurses were busy setting up the wards and training a whole new group of nurses (40 arrived in one night!), us OR folks have been unpacking, cleaning, and setting up the ORs.  Since I'm not much help with technical aspect of the OR, I volunteered to head up our laundry project, which shall henceforth be referred to as Laundry.  I knew I was ready to take on Laundry because I had received ample training from the great Jana Matheny of Rockbridge housekeeping fame.  I know a) how to fold a fitted sheet, b) that the metal laundry carts are only for clean laundry, and c) that the washers and dryers have an exact number of sheets, towels, etc. that they can efficiently wash at one time.  Equipped with this knowledge, I tackled Laundry head first starting Monday, January 23.  With two working washers (one was broken), and three dryers, Laundry was proving to be quite the beast.  The main goal was to wash every and all of the OR linens (sheets, towels, rags, etc.) in preparation for the outreach.  I also had to process some ward items that were mixed in, along with scrubs, mop heads, and blankets.  The OR itself had over a dozen overstuffed bags of stuff!   At only two hours into Laundry, disaster struck.  The hospital laundry room gets very hot when the dryers are running, so I went and found a large black fan to help with ventilation.  Little did know that the very heavy "fan" part was separate from the "base" part.  After lugging it from one end of the ship to the other, I set it upright.  Unfortunately for me, the "fan" had slid apart from the "base," so standing it up straight sent the "fan" straight down on my left thumb.  I quickly grabbed my hand and grunted in pain, but the damage was done.  The fan had claimed a nice slice of my fingerprint and replaced it with some greasy gunk and a blood blister.  Squeezing it with a towel to stop the bleeding, I made a beeline for the Crew Clinic where Lynne, the crew nurse, cleaned and bandaged me up.  Laundry was turning out to be more than I bargained for.

Thankfully, two of our OR nurses, Christina and Zoe, were huge helps when it came to folding the hundreds of sheets and thousands of towels.  I couldn't have done it without them!  Four days, dozens of bleach tabs, and buckets of sweat later, Laundry was complete.

A mountain of laundry to fold.

 

Just a portion of the OR linens...

Christina and Zoe modelling some random fenestrated drapes we found. You can see that evil culprit, the fan, lurking in the background.

Another highlight of this past week was the return of 7@7, our Wednesday night worship time.  This year, we decided to shoot for 7@8 (meeting on Deck 7 at 8 o'clock), in hopes of drawing a bigger crowd.  Well, it worked--we had roughly 40 people show up as we sang worship songs, read scripture, and shared encouragement under the night sky.  It was so great to see that turn-out!  Needless to say, I'm looking very much forward to what our 7@8 sessions bring us this year.  

This week will be a busy one.  As I type this, I realize it's after midnight, so...today (!) we have our Hospital Photo will be taken with all the hospital staff, followed by an OR pow-wow to plan for the Hospital Open House...followed by the Hospital Open House this evening (yes, we are a little last minute on this one).  I will be sure to write about the Open House in a future post.  Wednesday will be a long day, as it will be our major screening day.  We are anticipating it to go much smoother than last year's screening day (which you can read about here).  This is when we identify the majority of our patients for the outreach, so success is imperative.  Finally, we will be bleaching the ORs on Thursday and potentially Friday, in order to "go sterile."  After bleaching, we will culture swabs of different surfaces to make sure we have killed all the germs.  If stuff grows, we have to rebleach until it's truly clean.  And then Monday we welcome our first patients!  

So, in closing, my request is this: pick something and pray for it!  Energy, teamwork, good attitudes, that the right people come to screening, that the wrong people don't come to screening, safety for the crew, the health of our soon-to-be patients...you name it, you can pray for it!