Driving through Redlight District

I finally learned how to show videos on my blog. This is a video of what it is like to drive through town. People, animals and cars share the streets here. We are driving through an area called Redlight District (no similarities to the infamous Redlight District in Amsterdam:). The video is a little over five minutes long. This is what I experience for about 3-4 hours everyday since that is how much time we spend driving from place to place.

My internet connection is too slow here so I couldn't actually check to make sure this video works. Someone let me know if it doesn't work!

Stories - Baby Joanna

I want to tell you up front that this one has a happy ending! We received baby Joanna (6 months) as one of our patients about three weeks ago. Joanna was born with a clept lip and palate which means that her lip and the top of the roof of her mouth didn't develop properly and so there is a hole where there should be a lip and palate. These aren't that unusual in the U.S. but we fix them. Here is a photo of baby Joanna.

In Africa, many times the mother and the community will reject the baby because they believe there is a curse. In this case, Joanna's mother Rebecca did reject her (but didn't abandon her). She brought her to the ship a few months ago for help but the baby was too underweight to have surgery. So Joanna was put on a feeding program and the nurses also helped Rebecca to bond with Joanna.

So all was well for a while. Joanna gained weight and Rebecca took on her role as mother. So a month or so ago, Rebecca brought Joanna to the ship to see if she was ready for surgery. Upon her full physical evaluation, it appeared she had a heart murmur and the anesthetists were concerned she had either an ASD or VSD (which are basically holes in the walls of the heart). They were concerned that she would not survive the surgery and so we gave Rebecca the bad news - we wouldn't be doing surgery on baby Joanna.

Obviously, Rebecca was devastated and cried and cried. I can only imagine how much she hurt knowing that her baby was going to grow up in a society that shuns people with deformities. Rebecca was so upset that she was referred to us so that we could provide ongoing emotional support.

So we visited Rebecca and Joanna (and big sister Madeleine) 3 weeks ago. Rebecca told us that she thought God was angry with her and that was why Joanna had this problem. So we told her how much God loved them and he didn't cause this and all the other explanations we come up with that really don't provide answers.

Now for the good part. For the last two weeks we have had a pediatric oncologist, Tom Walwyn, from the UK going out on visits with us so we asked if he would evaluate Joanna so we could get a better idea of what her problem was. At this point, we had no idea what her heart problem was and whether she would live a long or short life. Dr. Tom evaluated her last week and detected NO heart murmur - in fact she was perfectly healthy. So he arranged for Joanna to come to the ship on Wednesday for an ultrasound of her heart.

Fast forward to Wednesday. Baby Joanna and Rebecca come to the ship for the ultrasound. Dr. Wolfgang, our new crew doctor and heart specialist, and Dr. Tom perform the ultrasound and they see only a strong, healthy heart. So we are all now very excited. Dr. Tom gets a hold of the person in charge of the surgery schedule and she says we can fit Joanna in the next day for her surgery. So now Rebecca is crying and I'm crying. And we all have huge smiles.

It turns out, though, that Joanna had a respiratory infection so to be safe, we are postponing her surgery a few days after a few days on antibiotics. Joanna's surgery will be next Monday, Oct 1, so Rebecca and Joanna will come to the ship on Sunday to be admitted.

Tom says sometimes VSDs/ASDs repair themselves on their own. I'm skeptical because it has only been a month or so since we heard the murmur but it's possible. I prefer to believe God healed her. We have been praying so much that God would make a way for Joanna and I believe He has. If Dr. Tom hadn't come and if Dr. Wolfgang hadn't come or if they had come earlier or later than they did, baby Joanna wouldn't be having surgery. And we won't be back to Liberia until 2010 at the earliest. Joanna would have grown up with her deformity and her mother would have lived all these years believing Joanna had a heart problem.

Here's a photo of Rebecca, Joanna and Madeleine. I can hardly wait to post an after-surgery photo!!

Peace,

Michele

Photos

We visited Joseph's family again today to give them some photos and I took some pictures of our adventure of getting to the house. Fortunately, it hasn't rained much in the last two days so it was mostly just muddy - previously it was flooded and we had to walk through the water.

These are the houses we walked through over paths to get to Joseph's house. They are baking these clay log things which they sell - that's why there is so much smoke.

Here are some of the clay logs. People actually eat clay - they consider it a food item!

A little girl in her home as we walked by.

This is Joseph's house in the forefront. Today it was just really muddy getting to the house - last week we walked through water.

We are walking away from the house now. In front of me is Joseph's oma (grandma) who raised him. You can see more of the clay logs.

These houses make me think about how little we actually need to live (of course, they don't have winter). Not that they should live like this but they do and they survive. It puts my own possessions into perspective.
This is the view from our car as we are backing up to leave. As I've said before, we are like monkeys in the zoo and whereever we go, people gather around us and stare. You can see the small crowd that gathered to look at us. Rather than just let them stare at us, I usually get out of the car and walk through the crowd and shake their hands (they do that here with everyone, even tiny children) and ask their names and take photos. It's my 15 minutes of fame!

This last photo is just for fun - some schoolboys who wanted me to take their picture. Liberian children are some of the cutest kids ever!

Peace,

Michele

TGIF

I'm thankful this week is over. It's been a good week but stressful as we've had to support two families who have lost loved ones recently. Families are starting to gather from all over the country and the grieving is occurring en masse.

Today started off great...it was a beautiful, sunny day which is unusual since it is the rainy season. We started off by visting the family of Rose, who passed away a couple of weeks ago (I wrote about her on Sept. 11). We were just making a short visit to drop off a 100 lb bag of rice because we knew Rose's funeral was on Saturday. When we first got there, we found out Rose (a different one than the one who passed away) had had her baby the day before. So we got to see the new baby and take photos. The baby won't have a name for at least another week.

While we were waiting for the family patriarch, George, to get there, I played with lots of kids -the best part of the job. They kept trying to take my bag because I always have candy in there for them. Here's Jean holding baby George (that's not the new baby) and Rose who just had the baby.

So finally George showed up and we gave him the rice and prayed for them. Then he said that they would be bringing home the body of Rose later that day and asked if we would come back and take family photos. Yikes...not something I was looking forward to but, of course, we agreed that we would come back later that day.

So next, we went to Korto's granny (her name is Mama). I wrote about Korto earlier, the 3 year old girl who passed away about a month ago. Hanging out on Mama's porch is really fun. There are lots of kids and Mama's English is good so she is easy to understand and we can actually have full conversations.

Jean and I had already decided we wanted to help Mama restart her selling business. She used to sell dried fish and other meat products but when Korto got sick, she had to quit selling to take care of the little one. That was seven months ago and she has no money left.

Before we told Mama we wanted to help, we asked her to tell us about her previous business. For someone who has never been to school, she is one smart businesswomen so we are very encouraged that she will be able to make a good living if we provided the startup costs.

So it was the most amazing experience when Jean told her Mercy Ships was going to give her $100.00 to restart her business. That's about 5 months of income here. She just kept raising her hands and thanking us and shaking our hands and praising Jesus (she's the one who just became a Christian about a month ago, the week Korto died). She was so overjoyed. It is really an amazing feeling to impact someone's life so directly and then to see their reaction. Just watching her face as she counted out the money Jean handed her was priceless. Wow, I wish I could explain it better in words so I can remember the feeling.

As we were leaving I took a photo with all the kids there and had them hold my Eddie doll (the Principal Financial Group mascot). My friends from Principal sent him to me so I could take photos of him in Liberia. Principal has a contest to see all the places Eddie goes so they will submit a photo and maybe we'll win (what do we win, Jamie?).

We did two more visits and then it was time to return to Grace's home to take the photos. When we got there, George and the casket had not yet arrived so once again, we hung out and played with kids. Here's a few of the photos.

This is 4 year old Mawi (holding Eddie). She looks like this because instead of saying 'smile' when taking their photo, we say 'show your teeth.' So she showed her teeth! Mawi talks non-stop and likes to beat up on her older brother Emmanual. Mawi and Emmanual are two of the children of the Rose who died. She also has a sister named Handful. I told Mawi she got the wrong name - she should have been named Handful. She didn't understand a word I said:)

This is a little neighbor girl. You find many times, girls this age are expected to look after younger siblings.

Another group photo. You will see that Mawi is missing because she was very mad that I wouldn't let her keep my Eddie doll. She refused to be in the picture. Handful is the little girl in the middle with the blue dress and the patch under her eye. She just had surgery this week on the ship to remove a benign tumor.

This last photo is the neighbor doing laundry. Their babies go whereever they go and they often sleep through situations like this.

So finally the van appeared at the house and the men carried the casket into the house. The next 15 or so minutes after this was one of the most distressing experiences in my life. The mourning began almost as if on cue. The women started screaming and wailing and falling on the ground inside the house.

We were waiting outside with most of the kids, not really sure what we were supposed to do. Finally, someone led us into the house so we could take photos of the family around the casket. It was extremely stressful and people were inconsolable.

The worst part is that the children were completely ignored. While people were trying to console the adults, Mawi and Handful were just standing against the wall staring at the casket. I picked up Mawi and put my arm around Handful and just held them and prayed over them. Adults just kept walking past us (including their father) and no one even looked at the kids. Eventually I took Mawi out of the house but a lady outside took her from me and took her back in. So I went back into the house and Mawi again was standing against the wall alone. Handful was sitting next to her aunt, patting her back. Handful is only 8 years old. Someone should have been patting her back.

While we chalk up many experiences we can't explain to cultural differences, this is one I will never understand. I can't imagine the trauma these children have gone through today (and I'm told this kind of wailing/screaming will go on all today and tomorrow). And I guess one day, they will mourn like this in front of their children.

So I probably sound pretty judgmental in this post. But just because a culture has always acted in a certain manner doesn't make it right. Today is one of those days where you realize you can't change the world but hopefully I made a small difference for Mawi and Handful.

Stories - Joseph

I could only hear one side of the phone conversation this morning but I knew it wasn't good. Jean was speaking to Thomas, the father of our 12-year old patient Joseph. She hung up the phone and just left the office. I knew Joseph had died...and I hadn't even got to meet him yet.

Joseph died yesterday (Monday) and was buried the same day. I find this very difficult to comprehend. In the U.S., when someone dies, we usually have a funeral where everyone can view the body and can say their good-byes. That is actually a luxury that requires money. I never thought of it as a luxury before.

In Liberia, people who have money only have money for real essentials, like food. They don't have money to keep a loved one who has passed away in a mortuary while funeral preparations are being made. People must be buried here very quickly (for obvious reasons). And so Joseph was buried the same day he died, before any of his family members could travel to Monrovia to say their good-byes.

Another luxury we have back home is a casket. Here the cost of a casket is far beyond what any ordinary person could ever expect to pay. They do have cemetaries here - the difference is that the body is buried in the hole in the ground without a casket and without a headstone. Sometimes they will place flowers. I felt sad wondering if anyone would visit Joseph's grave and how would they know where to find him.

We went to visit the family after Thomas called. It's been raining buckets here so we had to park the car a ways from the house and navigate our way through mud and water to get there. Because there is always so much flooding, many people have already put out concrete blocks, tires, etc. to make pathways to walk on and fortunately, this awkward path existed. We worked our way through a housing area that I can only describe as looking like the homeless camps we see back home. These houses were made of four tall sticks and then some raggedy tarps thrown over the tops. Everyone lives in poverty here but this seemed especially harsh.

But we finally reached Thomas' house and were welcomed in, as we always are. And as always, all the neighbors came to see what we were doing. There's really very little you can say during this kind of heartbreak except I'm sorry...and that's what we did. As my friend Gary told me, we usually say things to make ourselves feel better or less uncomfortable. I wished I could take away their heartache but I knew there were no words that could do this. We prayed for them and they were so grateful for our interest in them and their son...as if we were someone special. I was so humbled.

And then we left with a promise to return. We also left them with a 60 pound bag of rice. In this country, when someone dies, family and friends come to visit from all over the country. The family is then expected to feed all these people who come which is a very difficult burden. So Mercy Ships provides the rice. There will be some sort of a memorial for Joseph once all the family has a chance to travel to Monrovia.

Here is a photo of Joseph and Thomas about one month ago. I can see that Thomas was already sad. He did say today that he is happy that Joseph is no longer suffering. And that's what we hold on to.

He will wipe every tear from their eyes, and there will be no more death or sorrow or crying or pain. All these things are gone forever. Rev. 21:4

Ceilidh

If you're thinking 'huh' about my title, that's what I thought when I first saw the word. It's pronounced kaylee and it is the Scottish Gaelic word for visit. A ceilidh is a social event with music and dancing and we had one here Friday evening. It was the most fun I've had in a long time.

All we knew was that this event was for all ages, we would be dancing and you didn't need to have any dancing abilities (thankfully, since I have none). We all met outside on the dock at 7pm and then spent the next 2 1/2 hours dancing. There were at least 100 people there.

We learned maybe 10 or so dances with names like Stripping the Willow and the Gay Gardens. Our event leader would teach us the dance first and then once the music started, she would call out the steps over the PA system.

We were dripping sweat and laughing so hard for those 2 1/2 hours. My roommate, Megan, took photos when she wasn't dancing. These are some of the ones she took.








We're actually doing The Wave here (that's not Scottish:)

Signs

There are lots of funny signs and slogans to see when we're out in town so we always have our cameras ready to take a picture. Here are a few that we've seen.

Stories from the week

It's only Tuesday and I have so many things I want to talk about! But I'll try to condense...my roommate, Jo, went home to Wales on Monday. I will really miss her:( Here she is at her going away party (in the middle, Hannah - L, Prisca - R).

Monday started off badly (starting with Jo leaving) but ended on a happy note. Monday morning, we went to see our patient Yatta who has cervical cancer. She was in some serious pain and generally not doing well. Her family was taking her to her home village later that afternoon so her sister could start caring for her. Unfortunately, she will be leaving her 7 children behind in Monrovia. Four of her sons and one of her daughters were there and you can tell they really love their mom. So it was sad to see that she was going to leave them. However, she was going to her home village where her father lives. Her father disowned her when she became a Christian so we're praying for reconciliation between them. So this was the last time we would see Yatta.

After saying good-bye to Yatta, we went to visit our next patient Rose. When we got to her sister's house, everyone was looking really sad. Then they told us Rose had died last Thursday. It took us by surprise and it was a really sad situation. She left behind four children under the age of 7 - one is a baby. Here is a picture of Rose and her children. I am posting the photo so you can see that the people dying in Africa are real - not just statistics we read about in the newspapers in the U.S. about X number of people dying in Africa. Every person has a story and a family they are leaving behind. If Rose had been born in the U.S., she would not have died from this disease.

One of the gifts Jean gives to families is that she always tries to take family photos and then gives them multiple laminated copies so that the family has a remembrance. People here don't have cameras or photos - so in Rose's case, without a photo, her small children would never remember what she looks like. I think it is a precious gift.

After that sad visit, we picked up Candy and Kaka who I've already written about. Candy was actually smiling and laughing when we picked her up and she was smiling and laughing when we dropped her off. That was a good ending to the day - just seeing her laugh like a regular little girl was good for our hearts.

One of the fun parts of the job is interacting with all the children we come across. They are everywhere and I get to hand out a lot of suckers! The funny part is that many of them have never seen white people before and they are usually either curious or scared. Today, we were walking to a house and I saw this little boy about 3 years old walking down the street, happy and smiling. He then turned and saw us and he literally turned around and ran screaming down the street with both of his hands in the air. It was just hysterical! I think that's going to be one of the best memories of this whole experience.

Earlier, we were making a visit and we were sitting on the front porch with the family and all these kids would stick their heads around the corner or up over the porch to look at us. But if I went over to talk to them they would run. The woman we were visiting said they had never seen white people before. They were laughing but shy. The kids always warm up to you once you pull out your camera - they love to see themselves in the small camera window. Here are two sisters who were very fascinated by us. And next is a group picture of some of the neighborhood kids plus Jerry, our translator. He likes to be in the photos as much as the kids.

More kids - this is Lucky Girl on the left (yes, that's really her name) and Jessica on the right. Lucky Girl just laughed and laughed when she saw herself on the little camera screen.

Speaking of Lucky Girl's name, another funny name we ran across is Chinese Girl (the daughter of one of our patients). It feels really strange to call a little kid 'Chinese Girl.'

That's all for now. I hope the photos are giving you a feel for Liberia and the work God is doing here.

Peace,
Michele

Stories - Candy

Candy is an 11 year old girl who I got to see four times my first week on the job. She is very shy, especially around her dad and other adults. Candy has retinoblastoma (the same cancer I described in the previous post) and it requires that we clean the wound three times a week.

Candy and her father, Kaka, are from Cote D'Ivoire (that's Ivory Coast for us Americans) which is the country directly east of Liberia. They came to Monrovia in March of 2006 seeking treatment for her cancer. Her mom and siblings remain back in the Code D'Ivoire and Candy hasn't seen them since. Here's a picture of Kaka and Candy.

Unfortunately there is no treatment but Candy won't go home and Kaka is respecting her wishes. Candy believes if she goes home, she will die. Even though she isn't getting any treatment here, she doesn't understand and it's heartbreaking. It's heartbreaking to know she is away from her mom and family during her final months here. It's heartbreaking to know there is no treatment in Liberia for this cancer while almost no one dies from it in the U.S.

This is the hard part of the job. Kaka understands what is going on but he's trying to balance the hope Candy has with the harsh reality of the cancer. We could spend more time getting Candy to understand there is no treatment but what's the point - who's to say that we should take away every last bit of hope she has. If she lived in Monrovia, it would be easier but she doesn't. It's like she has to make a choice between the hope she has and spending her last months with her family. Ugh, it's horrible to think about.

She and Kaka are living in a rented room and we go to pick them up every Monday, Wednesday and Friday afternoon. We take them to a local medical clinic where we can do her wound care. We play games (like Uno) or with play-doh while we wait for her pain medicine to kick in. Here's a picture of Candy with some play-doh jewelry I made for her. And you can see in this other photo that whereever we are (white people) there are children watching us!

We try to really make her feel special and love her and encourage her. On her last birthday, Jean had a birthday party for her on the ship with cake and presents and decorations. About 8 little girls from the crew came to celebrate with her.

Last Thursday, we brought her to the ship along with another 11 year old girl patient of ours, Grace, and Grace's twin sister Gloria plus the two dads, Kaka and William. Just so they could have some fun. We painted our nails and colored, ate peanut M&Ms and drank pop. Then we had lunch in the crew dining room. When the three girls were together, they talked and played and laughed. It was so great to see them smiling because they don't do a lot of that. Here are some photos from the day.

From left to right: Gloria, me, Candy, Jean, Grace.

Grace, Candy and Gloria up on Deck 7.

William (Grace/Gloria's dad), Jerry (our translator) and Kaka (Candy's dad). The men sat around and talked while we played elsewhere with the girls. Parents are generally pretty harsh with their children here (in my opinion) which is why we decided to separate the groups - the girls could play and talk without having to worry about getting in trouble. There is a huge difference between how they act around just Jean and me than when their dad's are around.

More stories to come!

Peace,

Michele

Stories - Korto

I've finished my first week in palliative care and I'm really tired. This job is far more tiring than working in the ward, physically, emotionally and spiritually. And it's awesome! There are so many things I could talk about, it's hard to know where to begin.

One of the best parts of the job is being out with people in their own environments, in their homes and neighborhoods. When we visit a patient/family, we go to their house and we usually sit out on their front porch or lawn or whatever they have in front of their house and we talk. There are always so many people around especially children. We visited a family today and there were 17 children sitting with us on the porch and almost all of them lived in the house. Here is a picture of them with our translator Jerry.

We currently have ten patients and four families of patients who have passed away that we visit, usually at least once a week. Some we visit multiple times a week if they need nursing care or if a patient is in the final stages of dying. Fortunately, none of the patients I have seen are in that final stage.

I am going to write about my patients but will leave out many details because I want to make sure I tell their stories without compromising their dignity. But my prayer is that as I write you get a sense of who they are and what their life is like and that you would pray for them and their families as you read.

Today, we started with a visit to the family of Korto. Korto was a three year old little girl who passed away just last week so I never got to meet her. She had retinoblastoma which is a childhood cancer of the eye(s). In the U.S., there are about 350 new cases of this cancer each year and the death rate is 5%. No one knows how many cases there are in Liberia but 4 of our original 22 patients have this. The death rate in Liberia for this cancer is 100%. There is no cancer treatment in Liberia.

Here is a picture of Korto's house. We hung out on this front porch with a million kids and lots of chickens.

We didn't get to talk to Korto's mother today as she was at the market selling her goods. There's no time off from work here to mourn the death of your child. Korto's grandma was home with all those children in the first picture as well as a few of her daughters and sons and sisters (there are so many people you can't keep track). Granny is an amazing woman. She was the primary caretaker for Korto as well as most of these children.

Here's a picture of some of the family. Left to right: Pastor, Korto's mom, Korto on her lap, Oumaru and Granny.

When asked how the family was doing, they say 'we are trying.' I interpret that to mean 'we are sad but moving forward.' I hope that's what it means - they won't talk about death or grief so that is all they will say - 'we are trying.' Nothing more. So we talk about other things.

Last week, during the final stages of Korto's death, Granny became a Christian. Her entire family is Christian (her brother is even a pastor which is why the one little boy is named Pastor) but she was a Muslim until last week. Today, she was joy-filled over this. She was excited to tell us about her new church and how they welcomed her. She was adamant that we know how much her heart has changed in the last week, even in the wake of grief. She said she has so much peace and love in her heart. And she was forgiven - over and over she kept saying this. Her family, obviously, is ecstatic.

Granny is unable to read or write but starting this week, she has been accepted into a literacy program so she is going to learn. I'm guessing she is in her 50s and she is thrilled with this opportunity. Fortunately, she understands the importance of education and all of the children in her household are going to school. Mercy Ships has helped by paying the registration fee for all of Korto's siblings. School in Liberia isn't free - that's why most of the children are not in school.

Since Jean and Granny were doing most of the talking, I was free to sit and watch and pray. I wish I could put into words what it felt like to be on that porch but I'm not sure I can. It felt like pure peace and true relationships. I was envisioning Jesus interacting with all of us and I could see his love for this family. I am absolutely confident that Korto is living in the embrace of Jesus right now.

Tomorrow, I will tell you about Candy, an 11year old girl from Cote D'Ivoire, also with retinoblastoma.

Peace,
Michele

New job

I started my new job in palliative care on Monday and it has been awesome, everything I hoped it would be so far! I can't say much right now as I'm so tired - I'm switching back to a day work schedule from a night schedule (I went to bed at 6 pm last night). But I wanted to post some photos I took as we were driving out in the city and countryside to travel to our patients homes. We've really been using the four-wheel drive option on the Land Rover!

Traffic jam on Jamaica Road thanks to the cows.

You don't see this much in West Des Moines!

Trying to decide if we can make it through this. The photo doesn't do the treacherous nature justice. We backed up and went another way. Jerry, our translator, is on the right and a local man on the left.

The walking bridge over a flooded road. The flood didn't stop the cyclist but he tipped over in the water about 3 feet later.

Two new friends. One is the daughter (L) and the other is the sister of one of our patients, Leah, who died last month. We went to visit the family to see how they were doing.

Clearing amongst a group of homes we walked through to get to Leah's house.

Jean with some friendly neighbors. You can see the tire in front of the girl on the right - that is the rim to their well and they were getting water.