End of the outreach

I survived my first outreach here in Monrovia. The hospital is shut down and all the patients have returned home. We've said good-bye to all of our palliative care patients and their families. The dock is looking more and more bare as all of the containers are being loaded onto the ship. The dockside medical tents have been packed up and loaded. The entire ship's crew is in the process of cleaning and securing equipment so that it doesn't end up on the floor damaged during the sail.

We will leave sometime this week but I can't give the official date because we have to be careful of stowaways. If people know the date we leave, they will try to board the ship for a free ride to the Canary Islands so we're not allowed to give the date. I guess all of the crew will go through a pretty extensive search of the ship looking for stowaways.

We've already had our first abandon ship drill and we'll have at least two more before we leave, I think. I'm responsible for handing out lifejackets so at least I'll be one of the first to get one!! But I'll be one of the last to actually get on a lifeboat if we really had to abandon ship. Obviously I don't expect to have any problems but you never know, considering that ship in Antarctica just sank and all the passengers had to abandon ship. Anyways, the leadership on the ship takes this very seriously and we will be prepared in case of emergency.

The sail to Las Palmas, Canary Islands will take about 6 days and I'm not sure if I'll have internet access or not so I may be out of touch during the sail. Once we're in Las Palmas, we'll be in dry dock for approximately four days. That means the ship will actually be lifted out of the water so that it can be inspected and any repairs made. During this time, we're told it will be like camping. We won't have running water so no toilets or showers. There will be portable toilets/showers available somewhere (out on the dock possibly). Once any repairs to the lower half of the ship are made, the ship will go back into the water and other inspections/repairs will occur. We then will sail to Tenerife, Canary Islands around December 23 where we will stay until the end of January. We'll then sail to Sierra Leone and stay for just a few days, then back to Monrovia.

On another high note, I'm cabinsitting for someone who is on vacation for two months so I am in a three-berth cabin with my own space and a porthole! I actually got to wake up this morning to natural light. In my usual cabin, there are no windows so every morning when I wake up, it's pitch black and feels like three in the morning. I've discovered I really don't need much space but it's nice to have your own little area that is only yours (even if it is only about a 7x8 space).

I looked up the weather in the Canary Islands and it is in the 70s year round. I can hardly wait for the cooler temps. Plus I'm looking forward to the snow when I get home for Christmas!

Peace,
Michele

Goodbyes

We've been saying goodbye all week to our patients so it's been a long week - just one more day to go. Here are the people I've said goodbye to over the last two weeks:

Sah: he's 54 with cancer. We brought a local pastor with us on our final visit in the hopes that he will continue to visit with Sah. Sah said this week he is tired of suffering and wants to die. There were lots of tears. I expect by the time we return in February that he will have passed away.

Martha: she's 50ish with cancer. We also brought a local pastor with us on our final visit so that someone will visit while we are gone. It may have been a mistake but nothing we can do now. The pastor (a woman) and a couple friends prayed for Martha fervently at the very top of their lungs. I hate to be skeptical of someone else's faith but I don't think God is deaf and I don't think He listens more when you are literally screaming. Again, there were lots of tears.

Mark: 26 years with cancer. He's a sweet guy and my heart really hurts for him. In our final visit as we talked about preparing for death (including the need for forgiveness), he told us how his mother and siblings rejected him because of his skin color (he is albino). His mother knows he is sick but she won't see him even though they live close. Some of his siblings don't even know he has a terminal illness. Heartbreaking. I don't have any photos of Mark but here is his adorable little girl Angelina.



















Candy: 11 years old with cancer. This is the worst goodbye. We see her everyday to do her wound care and all week she has just sobbed. Today was really hard for us and for her. She and her dad will return to Cote D'Ivoire next week for the first time in almost two years. She said she is happy that she will get to see her mom. We've taught her dad how to clean her wound and we've found a medication that works for the pain during the wound care.

Survivor: 5 years old with cancer. His dad died just two weeks ago. His mom is having a hard time as you would expect - she's left with six kids and no income. She just started to learn how to basket weave so I bought her first two baskets for $20.00 which should provide food for them for several months. Survivor is getting chemo and has one more treatment. In the photo, Survivor is in the gray/yellow tshirt in between his mom and dad.

Levi: 10 years old with cancer. He was supposed to start his second chemo treatment on Tuesday but it got delayed because he has chicken pox. We don't have an official diagnosis yet so the chemo may not work.

Winifred: 40ish with breast cancer. She's very weak and has had a respiratory infection that won't heal. This could be very dangerous for her. I don't have any photos of her.

Armstrong: 2 year old mentally and physically disabled. There were lots of tears since we were his mom's only support system. I am worried for their future. Here's Dr. Tom and Armstrong's mom adjusting his wheelchair.

Joanna: 7 months old with cardiac/brain abnormalities. Baby Joanna is doing well and her mom is happy. Joanna is sitting up which is a positive sign since we don't know how well her motor skills will work. She can't roll over yet.

Grace: 13 years with TB. Her growths continue to shrink and I expect her to fully recover. There were lots of tears but I think mainly because they can't come to the ship anymore to eat lunch and watch movies.

Nelson: 29 years old with a benign fibroma. He will have surgery to remove the remaining tumor when we return in February. His father passed away two weeks ago.

We also said goodbye to lots of families of patients who have already died:
Family of Nush (8 years old)
Family of Josephs (12 years old)
Family of Korto (3 years old)
Family of Liaa (20-something)
Family of Rose (26 years old)
Family of Yatta (50s)

It's been a very emotional two weeks and I'm looking forward to our break. The crew is in the process of cleaning the hospital wards, the OR and also starting to load things onto the ship. I think they will start loading cars this weekend. Next week, I'll be working on paperwork - we have to write an end of outreach report and then we'll sail sometime next week or so.

Peace,
Michele

More random photos

Just some random photos for your viewing pleasure...mainly because I'm too tired to express any real thoughts.

Little Prince asleep in our car after a fun day on the ship (we watched Finding Nemo)

Baby George by our car. A prime example of one way disease is spread here. Their children crawl on the ground where the chickens and other animals have been...the children touch and eat things that cause disease and then they get sick and many times die.

Baby Joanna...remember her? She is the baby where we fixed her cleft lip and then she ended up in cardiac arrest and on a ventilator. She is doing fine. She wouldn't stop crying so the photo isn't the best but you can see her 'normal' face.

Emmanual, Mawi and Handful in their new school uniforms. Their mom passed away a couple months ago and they are now being raised by their Aunt Grace (along with Baby George).

Beautiful Mawi...I adore her. She has this little pipsqueak voice and talks 100 miles an hour and I never understand a word she says.

Sharing the road with sheep, as usual. BTW, they are sheep, not goats. You can tell because their tails are down. If they looked just like this but their tails are up, then they are goats.
Movies in Liberia. They are little huts with a tv and a satellite dish. These boys are watching the movie without paying.

The little girl on the right is practicing for mother hood. She is carrying her stuffed raccoon on her back the same way mothers carry their babies.

Peace,

Michele

Mark

We visited our 26 year old patient named Mark today and I was nervous to go because it seems like there is always something wrong going on in his life. Mark has either basal cell or squamous cell carcinoma (a skin cancer) and, because he is albino, we can see that his entire body is covered in the cancer plus he has a large, protruding tumor covering half his face.

Mark is married with two little girls who are 4 (Olivia) and 2 (Angelina). Whenever we visit, he is home with Angelina while his wife works doing domestic work for a wealthy couple. His wife is gone from 6 am to 8 pm working 6 days a week and she is paid $20.00 a month. Of that $20.00, she pays $16.00 in taxis just to get to and from her job which leaves a net income of $4.00 per month. That is what this family is currently trying to live on.

Before Mark got sick, he was a mechanic working on big trucks and made a good living. I can tell because of the things he has acquired in his house. His family lives in one room of a house that is maybe about 12 x 12 but he has electricity, a bed, a tv, vcr, dvd player and a stereo. I have not seen any other family with these kinds of things. Most live in one room and only have a couple of plastic chairs and some mats to sleep on.

We planned on visiting Mark at the end of the day because we didn't want to have to rush to another patient in case he needed some support. Last week, when we visited, he told us his wife was leaving him that evening because she was afraid she would catch his sickness and she didn't want to deal with it anymore. If she left, he had absolutely nobody else to help him. He only has distant family left and they live far away. He had a few friends but they only visit every once in awhile.

So Mark was really distressed about this (as were we). He can't work because he is very weak and the large wound on his face bleeds a lot if he exerts any physical effort so he has no means of supporting himself. He also cannot do the wound care for his face because he only has one eye remaining and, because of his albinism, that eye sees very poorly. Not to mention he wouldn't get to see his little girl every day (the 2 year old lives with him, the 4 year old lives elsewhere with her mother).

When we left last week, we were very sad for him and his situation. So we started to pray...that God would change his wife's heart and that she would stay and want to take care of him. We tried (unsuccessfully) to find clinics where he could go to get his wound care done. We brainstormed with others to see how we could help him but we weren't coming up with any answers since we are leaving very soon.

So when we pulled up to his house today, we saw him sitting outside but little Angelina wasn't around as she always is. My heart just fell. We went into his small room and started to talk. He was really depressed and teary-eyed. I could see his dressing change on his wound had been done today and it was well done so I know he didn't do it. He told us his wife had had a change of heart and was very concerned for him and decided not to leave. Little Angelina was at a neighbor's house playing with her children.

He told us they had finally run out of money yesterday and he and Angelina hadn't eaten yet today (it was 3 in the afternoon). He didn't have the 30 cents it would take to buy a meal for the two of them. Of course, we gave him money for food but that was only a very short term solution. We couldn't buy food for them everyday and they only earned $4.00 a month which wasn't enough to pay their $10.00 a month rent let alone buy food.

So we started to brainstorm with him about how they would survive. He was very concerned about how they would live after he was gone. He told us his wife was very unhappy in her job (obviously) and she had told him earlier today that she really wanted to quit because it just wasn't worth $4.00. She had run a successful business in the past selling various products in the local markets and she wanted to do that again. So the more questions we asked, the more we could see that he understood how to run a business. And this type of job would allow them to work together as a couple just a few blocks from where they live. And Angelina would get to see her mom all the time.

Jean just looked at me and said "Are you thinking what I'm thinking?" and I said "Absolutely!" So we (meaning Mercy Ships) gave him the money to get his business off the ground right there on the spot. We didn't even have to pray about it as we usually do. Mark was just so grateful and relieved and excited. He would tell his wife when she got home that she didn't have to go to her job ever again and they were going to the wholesale market tomorrow to get started.

It's such a great experience to see God answering a prayer so clearly. We were praying that his wife would have a change of heart and Mark was praying that God would make a way to earn more money.

Just getting to be a part of helping Mark and his family makes every hard part of this job worth it. I experienced true joy and peace in my heart today. I don't feel that often but when I do, it reenergizes me and makes me want to do this work forever.

I'm signing off with a picture of Angelina.

Peace,

Michele

Liberia in 2008

We received official word yesterday that the Africa Mercy will be returning to Liberia for 10 months in 2008 instead of going to Sierra Leone as planned. So we will be leaving here sometime towards the end of this month, sail to the Canary Islands and stay until end of January then come back to Liberia.

There have been many reactions to this announcement - some people are upset, some don't really care one way or the other and some people are happy. Personally, I'm glad to be coming back because I still have patients who are alive and need continued care. Now, when we leave, we can leave our patients a couple months worth of pain meds and then we can start revisiting them when we come back (assuming they are still alive). Plus I know Monrovia well and can easily find my way around.

In other news, I've been driving for a week now and really like it. It makes me feel like I'm living in a more normal situation than I actually am. Currently I can only drive for business purposes but next year when we return I'll be able to check out a car for personal reasons (like going out to eat or going to the beach) so it will give me a little more freedom.

I'll be home in 31 days! I'm planning on spending 4-5 days in St. Louis after Christmas but other than that, I'll be in Des Moines the rest of the time.

Peace,
Michele

Armstrong

I know a lot of my blogs are somewhat depressing because of the nature of my job...and this one probably will be the same by the time I'm done. I really don't want you to get the impression that nothing good ever happens here because we have so many success stories from the patients on the wards. It's just that now that I'm not working on the ward, I'm not experiencing these successes first hand. But I assure you, everyday Mercy Ship volunteers are restoring sight to blind people, removing huge facial tumors and showing the love of Jesus by accepting people who are considered outcasts.

But today, I want to tell you about my 2 year old patient Armstrong. He's a cute little boy that is physically disabled and, as far as I can tell, mentally disabled. Here he is with his mom Filemina. We don't know what happened to cause his disabilities but I personally think the injuries occurred during a prolonged and difficult birth. His mother says he was treated for tetanus two days after his birth. You can never really get the whole story from people here - I'm not sure if it's a communication problem or if they really just don't know. Back home, we'd have all kinds of lawsuits filed but here, people just chalk it up to a curse or the African sign (that's what they call any sickness they can't explain which is almost all sicknesses) and move on.

I'm not exactly sure how Armstrong came to be a palliative care patient because he doesn't have any type of illness and hopefully will live a relatively long life. But we have become friends with Filemina and stop frequently just to visit.

I cannot imagine the difficulties of raising a completely disabled child, let alone raising one in a country like Liberia where there isn't a single social service program to assist you. Armstrong requires round-the-clock care and his mother will be the sole person providing this for the remainder of his life.

We have seen Filemina's struggles firsthand and have nothing to offer except our compassion.
Filemina is dependent upon a boyfriend for food and shelter. If he doesn't provide this (which he threatens to do at times), she has no means of supporting herself and Armstrong. She can't leave him in someone else's care so she can work (even if there were any jobs here). Her family will not help her even though they live only a few minutes away and there are zero government programs to assist in this situation. It's not like back home where people can get social security or food stamps or go to a homeless shelter or a food pantry or a church. There are literally no resources for her.

She is incredibly sad because we are leaving. I think we are the only people who talk to her about her struggles. We will only get to see her one more time this week - it will be really hard to say good-bye.

On a completely different subject, we celebrated Thanksgiving last week. It was a very different experience than Thanksgiving at home. I did no planning, shopping for food, cooking, watching football, taking a nap, hanging out with family. The planners of our Thanksgiving did make it special, though.

For dinner, we had turkey, ham, stuffing, mashed potatoes, sweet potatoes, glazed carrots, corn, cranberries and different salads, apple, pumpkin and blackberry pie with ice cream. The food was amazing and I didn't have to do any dishes afterwards. Then we had a celebration church service with a message and worship music. At one point, a crew member from every country (36 countries) got up and said a quick prayer in their own language. It was really moving. Overall, it was a really nice day and the great food really boosted the morale of the crew.

On a food note, I never realized how much food impacts morale. For the first two and 1/2 months here, I ate almost exclusively peanut butter sandwiches twice a day. But ever since we got a chef volunteering the food has been wonderful. After a long, hot and depressing day, it is so nice to come back to the ship and look forward to dinner. Everyone talks about how great the food is and how it has really impacted their attitude. I now only eat peanut butter sandwiches when we have lamb:)

Peace,

Michele

Saying goodbye and driving

We've started the process of saying goodbye to our patients and families because we will be leaving Liberia soon. Today we said goodbye to our first family because it will be unlikely that we will be able to visit them again.

In this family, I never got to meet the patient, Liaa, because she passed away before I started working in palliative care. Liaa left behind three small children and now her mother Theresa is caring for them (the husband left her when she got sick). Mercy Ships helped Theresa to start a small market business since she now had three more children to feed. She makes 'small small' profit but it isn't really worth all the effort. We've offered her ideas on how to improve her business but she has resisted them. For example, she will buy 10 of something for 100LD and then she will sell the 10 items for 100LD. Obviously that doesn't make sense to spend your time on a market business like that.

Anyways, she is doing what she can and the oldest child at least is in school this semester. Here's a photo of the baby, who will never know her mother. Her name is Chinese Girl (yes, that's her real name) and she cries everytime she sees me. She has TB and she also just spent a week and a half in the hospital for respiratory distress. She is absolutely adorable!
Here's a photo of the entire family. Jerry (our translator), Josephine, Dorcas, Theresa, Chinese Girl, Rebecca and Jean (my partner).

It was a really good visit and it was nice to kind of bless them and then release them back to their normal life. I think as long as we visit them, we keep them from their post-mourning life. It would be different if we were friends. We like to think of our families as friends but I don't know that they see us that way. We're in this awkward position of having things they need and want and they are in the position of always asking us for things. It makes for an unbalanced friendship.

The other exciting thing that happened today is that I took the driving test and passed so I am now officially a Liberian driver. I didn't actually have to get a license here or pass a Liberian test. My drivers license from home is valid here and I had to pass the test by taking out the Mercy Ships head of transportation so that he could evaluate if he wanted to entrust a valuable Land Rover to me:)

So I hopped in the Land Rover and he said we were going to the police station. I'm thinking 'uh oh' that's downtown and there's a really steep hill where I have to stop for traffic (the car is a stick shift). But it went fine...I didn't kill any pedestrians or hit any taxis or stall the car. So I will officially be driving starting Tuesday. (BTW, the reason we were going to the police station is a long story but let me just say it wasn't pleasant and I kept thinking about the guns they were carrying and that we were making them mad!)

You may be thinking that driving isn't a big deal but you've never been here to see how bad the streets are and how crazy the pedestrians are and the fact that you share the streets with taxis, people, cows, goats, wheelbarrows, street vendors, humongous overloaded trucks and tons of broken down vehicles. You don't go fast enough to hurt anyone if you hit a taxi but people (kids and adults) run out into the street all the time without looking.

The other scary part is that we are frequently on roads that are so bad that we have to be in four-wheel drive. Just today, the road to get to Theresa's house was bad and I'm really surprised we didn't get stuck. Here are some photos of the road so you can see what I mean.

So I hope I survive the next couple of weeks driving.

More goodbye stories to come!

Peace,
Michele