The Finale

As many of you know by know, I have returned home to the States indefinitely in order to take care of my mom. She spent three weeks in the hospital and a skilled nursing facility and finally went home on Friday. We moved her into a new place as she is not able to live independently in her condo.

Having left so quickly, I didn't get to say goodbye to everyone including most of my patients. Two have died since I returned home. I did get to see Michael off to Ghana as he left the Monday before I left. He has not started his chemo treatment yet (I don't know why they are delaying) but hopefully it will start in early May.

I did get a job the day I returned home...see, all that planning and polling about my future apparently didn't help - God had other plans. I'll be self-employed (yea, a real income) working from home as a software designer for the next 6 months (that's what I did before becoming a nurse). After that, who knows. I'll have to see how my mom is doing - I hope to return to Africa at some point.

I don't plan on blogging anymore since this was about my experiences in Africa. Good-bye!

Weekly update

My wonderful patient, Monica, died this week. She was in her 30s and had breast cancer. We only met her about three weeks ago and when I saw her last Friday, she was doing seemingly well. No complaints, just a small cough. We had a fun visit, just sitting outside by the river she lives next to and talking. In another place and time, she is someone that I could have been good friends with.

When I showed up for a visit on Friday, I knew something was wrong as I was walking to the house. There were lots of people just sitting around on benches outside and inside the house - that's always an indication of a death. As soon as I walked up, Monica's sister Rose came up to me, grabbed me in a hug and started to cry. 'She fini-o, she fini-o' Rose kept repeating, meaning 'she died.' Rose told me that Monica started having trouble breathing on Sunday but decided not to go to the hospital for any help and she died Tuesday morning.

The family will be meeting on Saturday to decide on funeral arrangements and what to do with Monica's four children. The children will most likely be given to Rose to raise (that's what Rose thinks anyways). Their biological father is dead and the stepfather will probably not take any responsibility for them.

We also got three new patients this week, all children. Nelly (5), Princess (10) and Alexander (5). All three will be getting chemo for Burkitts lymphoma (cancer) starting Friday. On Friday, five of our patients will be at St. Joseph's hospital receiving chemo at the same time. Makes for easy visits when they are located in the same place!

Here are some random photos from the week:
The U.S. Navy was in Liberia for PR/humanitarian reasons. Many Mercy Shippers were able to tour their High Speed Vessel (HSV) and their big ship anchored outside the port. Here is a group heading out to the Navy ship. Notice the sunken ship behind them.

Father and daughter.

















Surrounded by kids.











My friend, Liz and my translator/friend, Jerry next to our LandRover.
Random pig walking around in front of my friend Rose's church.





Only God Make Me Big Boy #2 (there is a #1 taxi as well, I've seen it:)

Photos

More photos to share! This is Nemle (aka Old Man Wallace although I can't bring myself to call him that). He's in his 70s which is really, really old for this country. You can see his cancerous tumor on his neck. He's a retired teacher.


































Here's Nemle's aunt. She looks like she's close to 100 years old.

This is Alfred, one of my newest patients. He's a mechanic but has had to quit working because of the cancer in his right arm. He moved to his fiancee's house so that he has someone to care for him. On our first visit, his soon-to-be mother-in-law gave us a whole sack full of avocados as a thank you...it's so humbling to receive such a gift from people who have almost nothing - but they don't think twice about offering you what they have.

Just some cute kids at Alfred's house.










This is Armstrong, one of my patients from last outreach, and our translator Jerry. He is mentally and physically handicapped but doesn't have a terminal illness. I hadn't seen him since November - he has grown in inches but his body seems to be shrinking and he's now very stiff.


















Armstrong's mother just had a baby two weeks ago named Favor. Here I am holding the new baby!

Ship life continues

A lot of people back home ask me how I like ship life and I can't say really that I dislike it or like it. It's just different...so I was trying to think up a way to explain it. So I want you to think about all of these people and picture them in your head:

You
Your boss
Your boss's boss
Your boss's boss's boss
Every single one of your coworkers
Your doctor
Your doctor's nurse
Your hair stylist
Your librarian
Your local grocery clerk
Your local Starbuck's clerk
Your car mechanic
The person who washes your car
Your teachers
Your principal
Your pastor
Your church worship teams
All the people in your church
Your dentist
Your dental hygienist
All of your neighbors within a one block radius
The person who fixes your computer or helps you with your internet access
The person from whom you rent DVDs
Your local post office clerk
Your local bank teller
200 random people you crossed paths with today that you don't know but look vaguely familiar

And now imagine that you see these people all the time because you all live together. You see them at breakfast, lunch and dinner; you see them in the library and while doing your laundry; you see them at meetings and at church; you see them when you go out to a restaurant and when you are looking for a quiet, private place to read; you see them when you are working out or when you go to the movies; you see them when you hang out at Starbucks or when you go grocery shopping or when you are on your break at work or you go to the bank; you see them in their work clothes, in their casual clothes and in their workout clothes; you see them with their spouses and children and with their friends.

You basically see every person who has a connection to either your home life, work life or church life everywhere you go. Even in the middle of the night when doing laundry - one of these people is bound to be there!

Some days I miss my nice, quiet condo back home but, for the most part, I'm acclimated to ship life and it is just normal now. I'm not sure what I'll do when I get home and I actually have to make an effort to see any of these people!

An odd day

Today started off normally with a quick visit to Levi to make sure he was doing ok after his chemo treatment last week (which he was) and also to give him a soccer ball we promised. Here he is with his new soccer ball.


















So after this visit and a couple of other stops, we headed back to the ship for lunch. As I was pulling into the port, my translator saw a little girl who was just sitting at the entrance. She looked familiar so we stopped and found out it was one of our patients from last year named Grace. She's 13 but looks maybe 10. She got in the car and we asked what was she doing here. She told us she had walked from her house (a two hour walk, I'm guessing and through heavily congested streets) because she wanted to come on the ship. She'd been to the ship before a couple times last year to watch movies and have lunch. She didn't tell anyone at her house she was leaving.

We turned the car around and drove her home. Her granny and step-mom were furious. She had left early that morning to go buy some peanuts and just never came home. I can't imagine how worried they were - it's not like there is a process here to find missing children as far as I know. She was obviously in big trouble. I'm just thankful we went to the ship for lunch and saw her - we don't always do that. She would have had to walk back home.

Then we headed back to the ship for lunch (again) and while I was there, I got a message from my boss saying we were getting another patient. It was a little 1 1/2 year old girl with retinoblastoma (cancer of the eye) that was referred to us by another organization working here called The Next Right Thing. This organization connects sick kids in developing countries with medical care in countries like the U.S. The patient hadn't actually been seen on the ship but this organization was trying to find someone who would help care for her because there was nothing they could do since the cancer was too far advanced. So we called the phone number we had and talked to Habib. He said he would meet us and take us to the patient. He told us the location which happened to be right near where we have another little patient who is a 1 1/2 year old boy named Archie with retinoblastoma.

So we drove an hour to meet this man Habib. We picked him up at the junction and started to ask questions about this little girl and, after a few minutes of discussion, we discovered it wasn't a little girl at all but it was our little patient Archie. For whatever reason, the family had not told this other organization that Archie was under our care so they referred us a patient who was already a patient. This is a city of 1.5 million people and we only have 7 patients so I find the odds incredibly small that this would happen. Anyways, I'm glad there isn't another little patient out there!

We went to Archie's house and just made our visit a day earlier than planned. He is not doing well. He has a large tumor where his left eye would normally be. A week and a half ago, he could see out of his right eye and was out playing with other kids. He cried at our white skin and wouldn't let me hold him. Sometime last week, he lost his vision in his good eye and is no longer up playing. He let me get close to him and touch him because now he can't see my white skin. He is restless so we upped his pain meds and will revisit tomorrow to see how well that worked. His family is really sad so they could definitely use your prayers while they go through this horrible time.

One final update: we had planned on sending our patient Michael to Ghana this week to start his chemo treatments. But it may actually work out that he can receive the treatment here in Monrovia and about 1/10 the cost of sending him to Ghana. He would get to stay in his home and hopefully continue his college studies while in treatment. Please pray this would all work out for him!

Updates

The days here sometimes seem like the longest days of my life but the weeks seem like they are flying by. Almost every day is really hard. There are so many people with medical needs that aren't being met in this country due to lack of accessible healthcare, lack of money and lack of education (I recently talked to someone who lives in Monrovia who didn't know there is a free pediatric hospital here - seems like something you should know when you have 12 children). Every day I have to tell at least 5 people that we can't help them. It makes for really long days (not to mention it is scorching hot here - much worse than last year).

We're on track to send my patient Michael (22 years old with Hodgkins lymphoma) to Ghana for chemo, hopefully this week. His brother will go with him to take care of him while he is in the hospital and if he's home sick from the chemo. Neither had a birth certificate so it took awhile for them to be able to get passports. Michael is currently attending college thanks to sponsors in the U.S. but he will have to give up his studies for at least six months while he is away. He is the hope of his extremely large family. Here's a picture of Michael with his father Rudolph.

My patient Levi (10 years old with Burkitts lymphoma) is still receiving chemo and is almost done with his treatments. So far no one has survived this cancer even with chemo so I continue to pray that Levi will be healed completely. Even though the chemo kills the cancer pretty quickly and the tumors can go away in as little as two days, their little bodies are almost always undernourished and immunocompromised so the chemo is hard on them. Here's a picture of Levi (with my sunglasses) and his little brother Ivan.

We have been visiting the family of Survivor quite a bit since he passed away on March 1. They are devastated - I can't think of much worse than losing a 5 year old to cancer, especially when he finished his chemo and everything seemed to be going well for him. His family left this week to go upcountry for what they call the feast. It is what they do when someone in the family dies - everyone comes from all over the country to pay their respects and have a big meal. They already had this feast planned because James, Survivor's father passed away in October. So they decided to combine the feast for both James and Survivor.

For cultural reasons, Rebecca (Survivor's mother) is no longer part of her husband's family even though they were together for 12 years and have 6 children. Her children remain part of the family. One of the things that will go on while they are at the feast is decisions about Rebecca and her children. They will take up a collection of money that will be used to support her and her children. Her children, however, will probably not remain with her - they will probably be given to the oldest brother of James (named Steven) and his wife Doris to raise. On my last visit, Rebecca said to me 'Oh sis Michele, you need to just forget about me.' As far as she's concerned, she's out of the family. It made me cry...I told her I would never, ever forget about her.

Here is a photo of their large extended family. Rebecca is third from the left in the back row and Doris is first from the left in the back row.

My patient Mark (26 years with squamous cell carcinoma) is really having a hard time. While we were in the Canary Islands, he went to the local hospital and they debulked his facial tumor. However, the skin grafts didn't take and now he has a large hole in his face that is infected. And, since they couldn't get all the cancer, it has returned and is growing very quickly. He's having a hard time coping with the pain and the daily sterile dressing changes. We are working to get his pain under control but it's not an easy task here since we don't necessarily have access to the meds that we would use back home. Here's a photo of Mark with his 2 year old daughter Angelina.

Here's Angelina 'driving' our car! She's a beautiful little girl with a big smile.

My patient Sarah is a wonderful, vivacious 75 year old with lots of energy even with the cancer. She loves for us to visit and likes to tell us about her family and her growing up years. She wants her whole family to meet us ('her people' as she calls us) so next Tuesday I'm expecting a big group of people at her house. She is well cared for by her family. Here's a photo of Sarah.

We made a visit to the family of Rose who passed away last summer to see how her four children were doing. Here they are with the neighborhood kids goofing off.

Baby George eating his rice.

My partner June and I had a large box of metal and plastic bowls that we donated to an orphanage called SOS Village. My translator Jerry's sister Dorothy is a house mother there who lives with and cares for 8 children. She called my translator and told us she wanted us to come by so she could thank us. So when we stopped by on Friday, she had a whole African meal cooked for us.

I have been here over 8 months and so far have avoided, on purpose, eating at an African's house. But there was no way I was going to avoid this. It was such a humbling gesture considering these bowls weren't anything special but to her, they were a big gift. She said this was her way of inviting us into the family - her own mother, she said, was really hospitable and they always had strangers over to their house for a meal.

So we had rice, chicken with pumpkin, fried plantains, french fries and hot dogs (I didn't eat one - that seemed like a sure way to food poisoning). It was all really, really good and it was a fun lunch. She told us about her family and told tales on her brother (our translator). She talked about living during the war and about the kids she cares for. We met all eight of her kids at the house (plus she has four of her own children who live at another house).

This house she and the kids live in was the biggest, most furnished home I have seen here. It has at least 8 rooms - two kids per bedroom. It had a living room, a dining room, kitchen and even a TV (haven't seen a TV here before since it takes electricity). All the rooms were furnished and each child had their own bed. The floors were concrete instead of dirt. I think these orphaned children were living well above the normal standard of living.

Here's June and Jerry before the meal.

Here's a picture of Dorothy and her 8 children (plus a neighbor boy).

A little one getting a bath!

My friends Marilyn and Lesley and I went out for dinner tonight at a Lebanese restaurant called Sajj. The tables are under huts out on a patio. As usual, no matter what restaurant you go to, there were other Mercy Shippers there! Now that I can drive, it's a lot easier to get out and there are plenty of restaurants that cater to the western/NGO crowd. The difficulty is getting home at night since there are no street lights and so many people walking the streets. They are dark-skinned people usually wearing dark clothing and they dash across the street in front of you. I'm not sure they understand that you can't see people at night when there are no street lights and it's a scary experience to drive here at night. Here we are at the restaurant.

Updates

I have some sad news about my little 5 year old patient Survivor. He passed away on Saturday morning in a local hospital here. I did get to spend about an hour and a half with him at the hospital on Friday afternoon so I'm very grateful that I got to see him.

Survivor had Burkitts lymphoma and had been receiving chemotherapy. He had his final chemo treatment a week ago Friday. When we saw him last Tuesday, he was up and about but not feeling very well. Then on Friday morning, his family called and said he still didn't feel well and so I told them to take him to the local children's hospital (run by Doctors Without Borders and it's free). When I arrived Friday afternoon to check on him, he was awake but very weak and jaundiced. They were giving him IV fluids as well as blood. We prayed over him for quite awhile and just talked and sang to him.

His family will bury him today (Sunday) and we will visit them Monday afternoon. He was a beautiful, shy little boy. He'd sit on my lap but I could never get him to talk. His mom says he talked all the time but he wouldn't ever talk around us. Survivor's father just passed away in October so his mother, siblings and extended family are really hurting so please pray for them.

Here are a couple of photos of Survivor.
Survivor (r) and his older brother Promise (l)
Having fun on the ship.

















I also have some photos from our screening courtesy of our communications team. I never heard a final count as to how many people came to the stadium but there were easily over a thousand people.

The line of people waiting and hopeful that we could help them.
Nurses (in blue) taking health histories and vital signs.
The United Nations and the local Liberian police were on hand to keep order. Thankfully, it was very orderly chaos at the stadium.

Entertaining the kids. Some of these children waited with their families for up to 15 hours.

More kids entertainment (jumproping). We had singing, face painting, coloring and balloons.

A little one getting her vital signs taken.
Since we do orthopedic surgeries, there were many kids with bowlegs.
Getting a physical examination by nurse anesthestist John (a fellow Iowan from Carroll)




Making friends and showing the love of Christ.



Father and daughter.
Results of inadequate healthcare. Her foot is fused to her leg due to burns she suffered.

The prayer team (I'm in the far background in blue). I was on the team who prayed for those we weren't able to help medically.

The golden ticket. He is holding a green surgery card.