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.

City of Monrovia

The ship I live on, the Africa Mercy, is currently in port in Monrovia, Liberia until November 30. Monrovia is the capital city of Liberia and has a population of about 1.5 million. Monrovia is actually named after James Monroe, the fifth president of the U.S. Prior to that it was named Christopolis named after Jesus Christ. What were they thinking??? Notice the Liberian flag next to the map - it is very similar to the U.S. since Liberia was founded by freed U.S. slaves.

The country spent 14 years in three different civil wars from 1989 - 2003. A democratically elected president, Madame Ellen Johnson-Sirleaf, was elected in November 2005 and since then Liberia has experienced a fragile peace due to 15,000 UN peacekeeping troops. The troops are very visible, especially to Mercy Ships as we have to enter their checkpoint to get to the ship and their barracks are right next door to us. In fact, we (meaning Mercy Shippers minus me:) play the UN teams in frisbee and volleyball. The troops that live next to us are from Bangladesh.

President Johnson-Sirleaf was educated in the U.S. at the University of Colorado and Harvard. She was imprisoned for a time during the war and spent time in the Monrovia prison. We have a ministry that goes to the prison every week to minister to inmates and two weeks ago, the President happened to be there at the same time. I wasn't there but many of our Mercy Shippers got the chance to meet her and saw the cell where she was imprisoned.

The judicial system here is slowly being rebuilt. However, in the meantime, many of the prisoners have been in the prison for months or years and have never been charged or had a trial. Many of them are in prison for debts - if a family member would come and pay their debt, they would be freed. Every week our team returns home with a list of phone numbers of relatives to call to see if they can come and free their relatives. My roommate Dorothy has made some of those calls and finds that the relatives didn't know they were in prison. Unfortunately, most of them do not have money to pay to get them out of prison.

The city of Monrovia used to be a tourist place prior to the war. When you ask Liberians about their country prior to the war, you will hear that it was a beautiful city. They have many beaches since it is located on the Atlantic Ocean and they even had a five-star hotel called the Ducor Palace. Monrovia had paved streets, electricity, sewers/plumbing, hospitals, banks, a university - it was a thriving metropolis that was the place to see in West Africa.

Today, there isn't a single stoplight in Monrovia, there is very little electricity, the roads are horrible, there is no sewage system or trash pickup, the hospitals have almost nothing to offer, unemployment is 85%; it is a burned out, bullet-ridden city trying to make its way back.

My roommate Megan visited the Ducor Palace which sits burned-out on the top of a hill overlooking all of Monrovia and took some wonderful photos of Monrovia which I am posting here.

A few updates

Peace Ward

I spent four nights this last week working in Peace Ward. Peace Ward is really not very peaceful! Since I got here, I have been only working in Faith Ward or Hope Ward where we have the ladies who have had VVF surgeries and the occasional eye patient.

But for some reason, they put me in Peace Ward - I'm ready to go back to Faith/Hope. Peace Ward holds patients who have had orthopedic surgeries (club feet repairs, bone fracture repairs, burn releases) and they are all in casts. It is also a mixture of kids and adults and that is why it's not peaceful.

Kids and pain and our white faces make for a lot of screaming and crying. Kids also means there are a lot of extra people around since they all have a caregiver (mom, dad, aunt, etc.) that stay with them at all times. (A funny side note: the caregivers sleep on mattresses under the beds of their kids...not something you see much of in the States). And then you mix those kids with adults who have also had surgery all in one big room and you have chaos. Not to mention, Pippolo, the clown comes down every evening to entertain the kids by making balloon animals.

Fortunately my patients were all adults except for Esther, a 16 year old. I've been caring for Ella who is 84 years old - that is a miracle in this country. She is well-off and has traveled all over the world. Her children and grandchildren live in the U.S. She had her hip repaired and has been here about 12 days and she has had enough. Her bed is right next to Roosevelt - the 7 year old who is in a cast from his waist to his knees and apparently she doesn't like his manners.

One night, she was complaining to me about him and just kept saying 'That boy is too frisky.' I had a good internal laugh about her terminology. But an hour later, she was offering him a piece of her apple.

Then there is 16 year old Esther. When she was three, the rebels put her arm in a fire. She came here because her arm had contracted and needed to have the scar tissue released (it's called a burn contracture release). She has her arm in a cast and wires sticking out from the tips of her fingers. I can barely stand to look at it. She endures painful dressing changes every three days. Unbelievably, she is always smiling...and she's pretty pampered by the nurses...the word 'princess' comes to mind (notice the tiara:).

Here's a picture of Esther (on the right) with my roommate Megan. She taught Megan how to carry things on top of her head like a real African woman. It took several nights of practice but Megan's pretty good at it now.

And speaking of a princess, the names of the kids on the ward make me smile. Here are the names of some of the kids currently in the hospital: Princess, Remember, Roosevelt, Baby, Angel, Mustapha (isn't that from The Lion King?) The adults' names seem to be names we are used to or African names but there seems to be some odd naming trend going on with the younger generation.

Waterside Market

On a totally unrelated topic, I went with three friends to Waterside market yesterday. We went in a cab with 7 people in it that was built for five - and amazingly, the cabbie didn't rip us off when we paid the fare. Waterside market is several long streets filled with hundreds and hundreds of people walking around, seemingly doing nothing. There are street vendors selling anything you can imagine, some with their product in wheelbarrows (like chicken) and some on their heads. Others just sit on the sidewalk with their stuff all laid out neatly on blankets. For some reason, there are lots of vendors selling dishes.

Then there are vendors that have a little booth and some even have actual stores you go into (these all seem to be owned by Lebanese people rather than Africans - at least the ones we went in). We spent an hour or so 'shopping' which isn't really the same kind we do in the States.

When we walk down the streets, we stand out and everyone is always watching us. And not only do they watch us, they constantly yell things at us (more specifically, only men do this). This is what we hear as we are walking: hey, whi woma marra me (meaning hey, white woman marry me); musy ship (meaning mercy ships); be ma fren (be my friend); or just plain hey, hey! And they make lots of sucking noises at us which is horribly offensive. Anyways, it's why I don't go shopping often!

I wish I had a picture to show you but it's a little dangerous to take out a camera in a crowd. The amount I paid for my camera is a year's wages for a Liberian and so we try not to do anything else that draws attention to us.

We caught a taxi back home and met a wonderful cabbie named Musu. He was married with three children and a granddaughter. Wow, he was passionate about Liberia and America (as they call the U.S.) and the younger Liberian generation and how they wanted handouts and didn't want to work and what the last three wars have been like. Prior to the war, he had a good job in a bank. Now he drives a taxi seven days a week but he owns the taxi and all he makes is his. We got a flat tire on the way back which will cost him $21.00 US to fix which is a few days wages for him.

I find that getting out and experiencing the Liberian culture in a mass of people is tiring and bizarre. But when I meet individual Liberians (like Musu) and have a chance to talk to them and learn more about their lives, it is an amazing experience and it makes me glad I am here. After a few hours out in Monrovia, it also makes me thankful for the air conditioning and my little cubbie home on the ship.

Tribute to Collin

It has been just under a month since our crew member, Collin, died here. It still makes me sad as I pass the door to his cabin which was right next to mine. On the Mercy Ships website, http://www.mercyships.org/, there is a video tribute to Collin on the first page. It was played during his memorial service here on the ship. It is his family's wish that Collin's work here not be forgotten and I ask that you view the video and let his message penetrate your heart. Continue to pray for his parents, sisters and other family as we continue to do here.

Peace,
Michele

Community life

I've been living on the ship now for two months and have pretty much adapted to living in community. I never lived in the dorms in college so this is a unique experience for me. One thing I've learned is that you have to be flexible and give people a lot of grace - it helps to be laid back like I am. This is not a place for people who need to be in control and have everything their way because it is the opposite here - you have almost no control over anything and you can't insist on your way since you have between 5-9 other people living in your cabin (yes, we have ten-berth cabins).

I've been so lucky to have the roommates I have. Our ages are 24, 26, 32, 33, 42 and 57 and we come from 5 different countries (5 nurses and 1 doctor). The opportunity for conflict and misunderstandings is huge but we all actually get along really well and everyone is considerate. I know many other cabins where people just can't seem to make it work...so much for the Christianly attitude of grace.

The hardest part about living in community is that you are never alone, not even when you are in your bed sleeping because you have a bunkmate sleeping as well. You eat meals together, you do laundry together, you watch tv or movies together, you check your email together, you worship together, you work together. You can't go anywhere off the ship without at least one other person and preferably in a group. You are sick together (we've had lots of this lately - it just gets passed from person to person).

And it doesn't matter what time of the day because this is a hospital and a ship that operates 24 hours a day. I did laundry at 3:30 a.m. the other night and there was someone else in there doing laundry at the same time! I tried to go into the International Lounge (where we have all our community meetings and church) at 1:00 a.m. a few days ago to pray and there was a group of musicians in there practicing.

For the most part, I like the community living but as I've been thinking about whether I can do this long-term (two years or longer), I'm not so sure. Long-termers have better cabins - some have single-berth cabins but many are in four-berth cabins. I've heard the family cabins are great, just like apartments with multiple rooms and a kitchen...maybe I can get a family to adopt me while I'm on the ship:)

Some great things about community living: always someone to talk to or play games with or pray with or eat with...someone else prepares all your meals and cleans up after you...there is always a birthday to celebrate (meaning chocolate cake)...I have many, many friends from all over the world...no one cares about what you do for a living or how big your house is or how much stuff you have because you don't have anything here - just your small little cubbie. Most people are just here to serve God.

We have youth pastors who work in the kitchen, retired couples who work in housekeeping, doctors who are on call 24 hours a day and don't care if you call them in the middle of the night, nurses who spend their off-hours down on the ward just hanging out with the patients even though they just spent the day working on the ward, mothers who bring their young children down to the ward to play with the kids who have had surgery, teenagers who live on the ship that hang out with teenage patients after school, nursing supervisors who stop by the ward at midnight just to make sure we're doing ok.

I'm not saying everyone is perfect and we're living in paradise! We're living in a country that is so poor that it doesn't even rank on the list that ranks how poor countries are. And we take care of people everyday who have tragic stories to tell and many, many people who come looking for help and we can't help them. And we're living in community with 400+ other people and we are working a lot of hours and shifts and people get cranky.

So, for now, I'm fine with community living...it's just a different way to live. We'll see what my attitude is 10 months from now!

One last note: I'm coming home for Christmas, thanks to frequent flyer miles! I'll be in Des Moines from Dec. 14 - Jan. 5th. See you then.

I'm going to leave you with some photos of community living:

Ans and Melanie just hanging out.

Music night. Every two weeks or so, we have some kind of musical event in one of the lounge areas. Last week, we had a gospel singer, Tina Greene, visiting the ship so she sang for us. One week there was a talent (or lack-of talent) show. This photo is a night where some of our crew put on a concert. At times, someone will just sit down at the piano to play and others will come up and start singing and, the next thing you know, there is an impromptu worship service going on.

Jo and Jo out on the town. Jo (on the left) went home to England today. Jo (on the right) is my roommate and my friend - she will be going home to Wales in two weeks.

Celebrating a birthday in the dining hall.

Out on the town - Melissa, Rachel, Jo and Megan. Melissa and Rachel are nurses here for two years. Megan is a nurse here for one year.

Dessert after the Thursday night worship service. Every Thursday evening, groups of crew members make a special dessert for the rest of the crew and we basically hang out and socialize after church.

Peace,

Michele

My new job

September 3rd, I will be starting a new position as a palliative care (hospice) nurse. I met today with Jean Brown, currently our one and only hospice nurse, to get more details about the job. I'm in for a challenging few months.

There are two parts to the job. First, is caring for patients who are terminally ill. I will be traveling to the patients' homes with Jean to provide nursing care along with spiritual and emotional care. Most of her patients are kids with cancer - I wasn't prepared for the kids part...I'm not sure how I will handle this. Lots of prayers, please. Liberia has no healthcare system so cancer is a terminal condition always, even the kinds that are curable or treatable in the U.S.

The second part is developing a sustainable hospice program that will remain in place after Mercy Ships leaves Liberia. Working through churches, we want to create a program where terminal patients can seek care. While we have many of these programs developed in the U.S., the West African culture is far different from ours and we don't know what will work. For example, West Africans do not talk about death - they live only for today. So if the topic is taboo, creating a program for such a topic will be difficult at best.

It feels good to be way out of your league, as I am. It's much easier to rely on God and His direction when you don't have a clue what you are doing. I'm glad to be back in such a position. West African medicine frequently involves the occult as many people seek treatment from witch doctors, especially people who live in rural villages.

So for any of my counseling, chaplain and nursing friends, I would be interested in hearing about any resources that may help me (books, websites, magazines, support groups, etc.). You can email me at mzeller27@yahoo.com.

Jean will be leaving Mercy Ships in December after 10 years. I don't know what my long-term plans are yet but this may evolve in to something permanent. We'll see what God has planned!

Peace,
Michele

More about George

My 9 year old friend George is still here, delayed by mechanical problems with the Red Cross airplane that was supposed to take him home last Friday. See the photos in the previous post of George. He has become quite popular onboard the ship and he loves the attention. Last night, he came and ate dinner with me in the dining room (rather than eating the African food we serve on the hospital ward).

It was his first experience eating at a table, he said. He doesn't have a table in his house. Dinner was ribs, french fries and peas. He liked the ribs but absolutely loved the french fries (hated the peas). I guess fries are universally loved by all children. As we walked through the dining room, many people stopped us to say hi because everyone knows George.

After dinner, I took him to the internet cafe. He hadn't seen a computer before and didn't know what it was. I showed him how to play a computer pinball game. He quickly caught on to how to use the mouse and the keyboard. He played for an hour and a half and I had to peel him from the keyboard! When he got the high score, he typed his father's name as the winner. His father was killed by the rebels when he was very young.

I took him to the Academy and the library onboard. He was amazed. He goes to school but his school is outside (no building) and they have no books. Our school has thousands of books and about 12 computers, taking up many large rooms on the ship.

He saw the laundry room where we have 10 washers and 10 dryers. He wanted to know how they worked. He washes his clothes on a washboard.

I took him to the snack shop where I bought him some M&Ms which, of course, he loved. I asked him where his family got their food. He didn't know where it came from but he said there wasn't a market close by. Makes me wonder how far his mother has to walk to buy food.

I wonder how these simple exposures might change him. He has been exposed to many new things and ideas over the last week and a half and I wonder if it will make him less satisfied with the simple life he has now. I hope not - I don't think we should impose our Western lifestyles on African culture. But I hope his viewpoint is expanded so that he knows he doesn't have to settle for an impoverished, unemployed life. Maybe he'll be one to make the difference in his country.

Saturday, I went back to God's Childrens' home, an orphanage I previously wrote about. We sang and played with the 50 or so kids. They are energetic, happy kids who are loved by the people who care for them. This isn't so in all the orphanages. The Liberian government had to put laws in place that prevent NGOs (non-governmental organizations - Mercy Ships is one) from supporting orphanages that do not meet the laws as there are apparently hundreds of orphanages that are exploiting children rather than caring for them.

At the orphanage, I met Joshua. He's 14 and he says he's named after Joshua from the Old Testament. He brought out this huge children's Bible and he told me the story behind every single picture in the Bible. He knew all the famous Bible stories (Adam and Eve, Noah's Ark) but he also knew many, many other stories that aren't usually a point of teaching to children. Some I will have to go back and reread to remember. He said he is going to be a pastor - I believe him.

After he told me all the Bible stories, he and two other boys platted (braided) my hair. I didn't know boys could do that but they all knew how. Almost all African women where their hair platted - mine didn't exactly look like theirs. Sorry, I didn't take a picture - it wasn't my best look!

Peace,
Michele

More about patients

It looks like I'm going to have a change in my job duties sometime in September. They were looking for another nurse to work in palliative (hospice) care and I volunteered. It was great how this came about (God, of course:). I had been praying last weekend about how I could get more involved in the community because we kind of live in this westernized bubble of a ship and the Liberians come to us rather than us out with them.

So Tuesday, I listened to a presentation about all of the community projects Mercy Ships is involved in and one was about palliative care. I talked to some friends about how I had been thinking about doing hospice nursing when I got home and said I'd really like to get involved in this ministry. So about three hours later, the nursing staff got an email from our supervisor saying there was a position in palliative care and did anyone want it. So I volunteered.

I don't have any details yet but I know the current palliative care nurse goes out to her patients' homes 3 days a week to care for them. It just occurred to me that I may have to drive here - that is a horrible thought. Hopefully, I'll have more details in the coming week. I am really, really excited about this (except about the driving).

I've had a lot of fun with my patients lately - really getting to know them rather than only caring for them. I have a few photos to share.

This is Jo (my roommate from Wales), me and George. George is a 9 year old who has been with us for a week. He was badly mutilated by rebels when he was two (they killed his dad) and his mom came hoping we could help him. We couldn't help him physically but he has been a huge joy for all the nurses. He never, ever stops smiling. He has been well-loved by all of us, helping us with our nursing duties, playing with us. George and I like to play soccer on the ward (with a balloon). He loves soccer. He has had lots of moms over the last week!


Here's another one of George. Even though we couldn't help him, he and his mom spent a week on the ward waiting on a way to get back home. The Red Cross picked them up today (Friday) to take them home.



This is Peter. Peter is 33 years old with three kids - he was born blind. We removed the cataract in his right eye and he will be fitted with a prosthetic eye in the left side. He left before I found out if his eyesite was restored. We had a long walk up and the down the hallway so I got to learn more about Peter. He liked to say 'Praise God' after every sentence.


Every afternoon, we take some of the patients up to Deck 7 so that they can get outside. The hospital is located on Deck 3 and has no windows so this is their opportunity to get some fresh air. Usually one of the translators leads us in singing for an hour which absolutely helps in the healing process (spiritually, emotionally and physically).

This is 6 month-old Junior. He came with his mom who had surgery. He has been with us about three weeks and the nurses like to 'fight' over who gets him. He is about the size of a two-month old due to malnourishment so we have him on a feeding program. His mom was in obstructed labor with him for four days and his brain was damaged - he can't hold his head up and his eyes don't track. Junior and his mom, Amelia, left today. She was physically healed - I don't know what the future will be like for him.

Here is Jo with Kou (left) and Mary. Kou has been here about 6 weeks due to a burn contracture wound that won't heal. She has a 10-month old baby waiting for her at home named Maurice. He has been able to come and stay with his mom for a few days but he doesn't like the nurses much! Mary left a couple days ago physically healed. She has been such a mentor and mother-figure to the ladies on the ward. She has tremendous faith. She's the one who called me 'her daughter.'

That's all the photos for now. As I sit here in the internet cafe looking out the portside window, I'm laughing as I watch my nursing supervisor, Judith, learn how to change the tire on one of our Land Rovers. They require that anyone who drives a car here must know how to change a tire so she is learning. I wish I had my camera! That will be me soon if I have to drive here.

Peace,

Michele