A Day on the Isle de Roume, in Photos

"We should go to the islands!"

This became the consensus last week as the circle of us girls tried to decide what to do with our Saturday off. A few groups had already ventured to the islands just across the waters from Conakry and all had met wild success. Why not us?? 

So we set out yesterday at 10am for the local fishermen's wharf, hoping to snag a good deal on a boat for the day. A young guy met us as we approached the docks, and after some smooth talking by the only French speaker in our midst, he gave us a great deal on a roundtrip reservation (which included lifejackets!). The eight of us hopped into a long, wooden beast with a small engine and said our prayers. Across the waters we went, and our eyes met a most enchanting sight!

Here is our day spent on the beautiful Isle de Roume.

(some photos courtesy of my dear friend Hannah)

Jasmin, Beth, Hannah and Pat, sportin' the life vests!

My seat buddy, Jen :)

Petra and Kathy, sitting up front

A look back at Conakry's coast

Water seeping in? No problem - Jasmin is on it, haha

Passing the Isle de Kassa

Our boat, waiting in the shallows of Roume

Crossing the island, oh how I've missed green!

Five minutes from one side to the other. Perfect.

The local restaurant and hotel, closed for rainy season. 

Our boat driver (life vest) and our " island guides"

The beach - all to ourselves

It was like a paradise forgotten; beautiful in it's unkempt nature.

Our first view of unadulterated shore

I love this sound (can a picture invoke sound?)

Our little plot of happiness for the day :)

Waves

Not too hot, not too cold. Perfect day in perfect waters.

Hannah, Beth and Jen, soaking up some rays in all the best ways

To our right

And to the left

Skies so blue

Trekking back across

I couldn't get enough of the greeeeen

Pat and our favorite type of tree in Guinea

Departing from the other side of the island

Jen and Beth!

Hannah and I, sun-kissed and smiling :)

Finding Community

Community has been a theme onboard the ship recently, and it's a concept near and dear to me. When we first set out for Mercy Ships my biggest fear wasn't living in Africa. (I've done that before and really loved it) Nor did I feel apprehension about the patients, their surgeries or my ability as a nurse. My biggest fear was that I would not find community. 

Sounds silly, right? After all, isn't this ship basically a floating community?? 

While that may be true, becoming part of a community means more than just being in close proximity to others. It's having the "I don't just live by you, I do life with you" mentality.

Community, in my mind, suggests intentionality.

Because it all boils down to cultivating genuine relationships: 

with my husband, my family, my friends, and the Lord.

This has been something that Pat and I have sought ever since we left Spokane. The community we had in Washington was tight-knit, and the making of a new one does NOT happen overnight. As our travels have taken us far from home, to the East Coast and now to Africa, I've realized how vital community is for me. It sounds simple, but I thrive when there is richness of relationship, and I whither when there is none.

In thinking over the past five weeks spent on this ship, I feel so blessed to count all the ways I have experienced community so far:

In the way laughter and fellowship always go hand and hand with a meal.

In impromptu dance parties with my patients, where we joyfully express what words cannot.

In reading God's Word, sharing struggles, and affirming truth with the beautiful ladies in my smallgroup.

In jogging during the wee morning hours with a small band of early risers through the quiet streets of Conakry. 

In weekly worship services, where praise is more about the Lord than about the song that is sung. 

In the still moments spent talking with my husband at the end of the day.

In the surprise and joy I hear in my mom's voice when I call her.

In prayer with my fellow nurses, banded together with heads bowed, lifting up our patients and each other before we start our shift.

I am so thankful for these opportunities to do life together. It's not always comfortable (let's face it, we're human) but I don't think it should be. Only by rubbing against one another's rough spots can we be made smooth. Only by bearing one another's burdens can God teach us how to love one another well. Only in Community can God work out the kinks in you, in me. 

And I invite that wholeheartedly :)

A glimpse of Max-Fax: stories from my hospital ward

     I feel as though I've been a bad blogger. We have now been off the coast of Guinea for one month. Much has happened. Much. And while I've tried to share about ship life and how I'm doing with this transition, so far I have shied away from telling stories from the ward. I'm not entirely sure why that is...part of me is uncertain where to start. Part of me wants to protect their privacy. And part of me is just plain overwhelmed by all that I've seen. I'm a processor, and it can take me awhile to digest what I'm thinking or feeling. And frankly, I shrink from the idea of putting their stories into words, as though that would cheapen it. Because down on the wards, it's not just healthcare: it's personal. It's heart wrenching. And it is altogether beautiful.

     But I need to start telling their stories, if only to remind myself that they happened. That for a moment, my life and their lives crossed paths. And though we are credited for changing them, they changed me too.

     My ward of the hospital is known as Max-Fax. We generally care for maxillo-facial surgery patients, which generally refers to cleft lip and palates, and tumors of the skull or jaw. The first week on the ward, I had a little old man with a large tumor to the right upper side of his head. I will never forget the smile on this man; gaping with missing teeth and beaming with genuine joy. Though he spoke not a word of English, you could read his delight in even the most minute exchanges. Anything I said to him, he would nod eagerly and try to shake my hand. Translation revealed that he was just overjoyed to be here. He had lived with this tumor (the size of a peach) for about 20 years...that's almost two thirds of my life.
     His surgery came and when he returned, his head was bandaged up like you see in those old war movies: big thick gauze wrapped around his head and then under his chin. When he woke up, he gave one of those big toothy grins. It was almost comical. When his dressing was first removed, he held a mirror and watched intently. This was it. The big reveal.
     And with that undeniable smile he confirmed with his heart what I knew in my mind: it was good. He studied his new scalp, learning the shape of his head again, touching it ever so lightly. How that must feel, to see your body changed from carrying an ostracizing deformity to wholeness. In a couple days he was gone, returned to the village from which he came. I may likely never see him again, but I will carry him and his smile with me like a little badge of happiness on my heart.

     Another of my first patients has turned out to be one of the ward regulars. At over two weeks, she's been here almost as long as the hospital has been up and running! She is a four year old spit-fire: stubborn as all get out, dancer extraordinaire, and ready to command you to play. She is also the victim of a massive candle accident, which burned the right half of her face. Her lower eyelid and cheek had contracted and scarred in such a way that she was unable to close her eye. The plan was to do a facial flap. The surgeons would use thin layers of tissue from her neck and lateral cheek to replace the burned skin to her face and reconstruct her eyelid. I've never worked with plastic surgeons before, but they are akin to miracle workers in my mind.
     Her surgery came and went, and tada! She had a new cheek! It was amazing; this beautiful new cheek, all soft and smooth. It remained covered for a few days, as it was extremely delicate. A small drain to the side of her neck allowed any bleeding from the flap site to easily drain to her bandages. After a day of recovery and sleepiness, she was up and running around again. All looked well!
     Then about five days later, we began to notice a darkening at the suture lines near her eye, near her nose. By the next day, her new cheek was a patch of leathery black on her little chocolate brown face: the skin was too dark, too taut. Something was not right. Then came the horrible realization. There was no longer vascularization. The flap had failed.
     My first thoughts: What now?? This was supposed to work...how could it not work. What will she do now with a dead cheek?? Thankfully, the surgeons don't think this way. They made plans for surgery #2! A few days ago, they performed a full thickness skin graft . This means they literally took a wedge of skin from her right lower abdomen and created another cheek. She took this second surgery like a champ, even pointing out her new tummy battle wound from time to time. Four days later, and it's still holding. Her first dressing change is tomorrow, and only time will tell...

     There are so many more but I want to take time. I want to get them right. They deserve to be thought over. And I'm a processor, you know :)

Pieces of Home: Cake, Mysteries and Obama

(Caution: This entry contains only lighthearted thoughts.

Just a little levity this time around, hope that's ok!)

Confession #1: Last night my friend Hannah and I made a layered red velvet cake with cream cheese frosting. 

Yes, we're still in Africa! We had discovered the crew galley, you see; a small kitchen with every kind of bakeware you could possibly require. And the ship shop onboard the Africa Mercy sells cake mixes. Like exactly what you might pick off the shelves of Safeway. So yesterday we grabbed the red velvet as though it were the last box on earth and gleefully made our way to the kitchen! 

There has always been something soothing about baking treats, for me. Maybe it's the smell, or the the predictability of recipes. Regardless, something about it feels familiar and comforting, like a hug from mom. So, discovering I could bake here was like having a direct link to home, as though I could make my way back there. We presented that velvety, cream cheesy goodness to the group of us that arrived here together, in celebration of our three week anniversary of being aboard the Africa Mercy. And it was delicious.

Confession #2: I love Agatha Christie's murder mysteries.

I have no recollection of when I first became acquainted with this woman's works, but ever since I first followed her inquisitive and somewhat cheeky Belgian detective Hercule Poirot on the hunt for "who-dunn-it" on the Orient Express, I was hooked. And then just as quickly, she fell into the periphery and finally the background of my mind's eye. School, work, and other more pressing literature eclipsed her entirely. 

Then, two weeks ago, I was perusing the small yet mighty library on the ship, and what do you know? There it was, all in a row: Agatha Christie's Murder Mystery Classics Collection. Ha! After reading the first book in three days, I've had one at my bedside without fail. It's been just delightful.

Confession #3: I went to the Obama Cafe and I liked it.

This past Friday a big troupe of us left the ship for an evening out in Conakry. We made our way along the coast south of the port and found ourselves at a little seaside restaurant and bar called the Obama Cafe...yep! It's an open air establishment, all wood and stilts and bungalow appeal, perched precariously over the ocean with the slimmest little plank bridge leading out to it. In the daylight, this sight could strike fear into the heart of any would-be patron afraid of water. But not us!

Expat locale, the Obama Cafe

The dozen of us Mercy Shippers clambered into this little place, which was already packed to capacity (Maybe 50? There are no fire marshals here that I know of). We enjoyed drinks and live reggae music, played a round of the hand game and then got up to enjoy the band a bit closer. Near the end of the evening the power went out, and the whole room spontaneously carried on singing "No Woman No Cry" while the band played the drums. Priceless.

Michelle O. keepin' it classy

So while we encounter hard things everyday, I thought it important to put out a lighter note and let everyone know we're having a great time. Truly! It's not home, but the little tastes of home remind me that God thinks of the littlest things. Even red velvet cake :) 

"On Deck 3, it is Africa"

This is what we were told in our first cultural orientation onboard the Africa Mercy. 

One of the Patient Life coordinators was trying her best to explain to us that, while the ship may feel a lot like our respective homes, the hospital level is another story. Down there, it would be more like the country outside the portholes than the ones we hail from. And honestly, I wasn't really sure that was true at the time. I mean, of course the patients would be African, but they will be coming aboard OUR ship, admitting to OUR hospital, learning to do things OUR way ...right? Haha.

After having worked my first stretch of shifts, I now have a taste of what she meant. And she was right.

Here is the first lesson I have learned on Deck 3.

My very first patient was a 7 year old girl; a little doll with big, chocolate brown eyes that just stared at me with the hint of a smile. She would have surgery the next day on her wrist. But today, all we had on the agenda was to admit her. She was accompanied by her mother, who was dressed to the nines. And for the life of me, I wanted to talk to them. I wanted to know what happened to her, if her mother had any questions, what I could do to "ease their way".

But there was one teensy problem:

I don't speak Susu.

My second patient was a 2 year old boy, one that I actually recognized from Screening day! I had taken his history from his mother, an absolutely lovely woman also dressed to the nines. I'm not sure if she remembered me, but I'll never forget her face. Again, all I had to do was admit them; his cleft lip surgery was scheduled first thing in the morning. But I wanted to reach out, tell her how excited I was that they were here, ask if she had any worries, learn about their lives. 

And then the tragic reality check:

I don't speak Fullah.

Overarching feeling? Totally handicapped.

I realized in that moment how much I value my ability to verbally communicate. 

Subjectively, it's one of my best assets. 

As a nurse, It's what I have come to lean on. 

It's how I build rapport, 

how I make my patients feel at ease, 

how I let them know that I am on their side 

and have a handle on their care. 

I love talking with my patients. 

And here, that is being withheld from me. 

Every patient I encounter speaks everything but english.

So I have to learn another way. 

I need to depend on others to verbally communicate for me. 

(Which feels often times like taking three lefts to make a right)

I need to trust that those translating for us are saying what we need them to say. 

(Only one out of 30 have ever been in a hospital before, and they are our conduit for relaying information to people who have also never encountered a healthcare system) 

I need to practice patience. 

(My pace is not everyone's pace, and we are all learning this new way together)

And I need to let Christ's love shine through my actions. 

(They speak louder than words anyway)

The next day, one of my patients was a 63 year old man who had just had a tumor removed from the right side of his skull. Now, with a big bandage wrapped around his head and under his chin, you couldn't wipe the smile off his face! And his favorite pastimes included coloring with me. Or hitting balloons back and forth. Or playing Jenga for hours at a time on his bedside table. I realized in THAT moment that not every important encounter has to be accompanied by words. Maybe just by being with the patients, showing interest, playing with them, I can connect more than with my translated attempts at conversation.

Sometimes I get the feeling I am living in an alternate universe. On the one hand, we live on a converted cruise ship. We can pass the day reading in the cafe, playing games in the mid-ship lounge, sunning on deck 7 overlooking the ocean. Then, when shift comes, I go down to the third deck and find myself somewhere else entirely. Where the patients have never been in a hospital. Where they believe that surgery means taking them to a white room, killing them, and then bringing them back to life. Where the national language doesn't guarantee you communication at all. 

I am still trying to reconcile my expectations of these two vastly different environments. 

This is the Africa Mercy. My hospital. My home.

So THIS is how a floating hospital begins...

     At precisely 1600 (4 o'clock pm) today, the hospital aboard the Africa Mercy accepted its very first pre-op patients in the country of Guinea. As I type this in the mid-ship lounge, there are patients two decks below me. It's real. They are here...

     Now jump back approximately two days and eighteen hours, and you would see Pat and I bleary-eyed, preparing to depart the ship with over 150 crew mates before the sun had risen. We were headed for the People's Palace to participate in the largest healthcare feat I have ever witnessed.

Screening Day

      Those two little words come nowhere near to describing the mass amounts of coordination and organization and controlled chaos behind such an event. When we arrived at the People's Palace to set up at 6am, there was still no light. Imagine a building the size of a large convention center with 10% of the electricity and no working plumbing - this is where the Guinean congress meets, large plays are put on, and the screening of over 3,500 people was about to take place. 

     In no time, everyone went to work setting up countless chairs in various wings. Bays of tables were arranged, large stacks of water bottles and trays of pre made PB&J sandwiches were brought in, and as the sky outside the windows finally began to turn a slightly lighter shade of purple, we looked out at the line. I have now put this picture everywhere possible, but I can't help it. This sight was the most heart stopping thing I have ever seen, because I knew it was all headed our way.

     People had apparently begun lining up overnight hoping to be among the first seen. The line snaked in front of the palace's huge courtyard, through the main gates and out to the street beyond sight. Inside, we still scrambled for our places, preparing each designated zone to be the picture of efficiency. Patients would first be seen in line by Pre-screeners, who ensure that only potential surgery candidates make it inside. [Due to the specific care provided by Mercy Ships, no medical patients can be accepted. That means anyone wanting to be seen for things like high blood pressure, liver disease, malignant cancers, etc] 

     Once inside, they would be processed through Registration. Then, on to my station, Patient Histories.  After this, we would send them to a wing corresponding with their specific need: Ortho, Plastics, General, and Maxillo-Facial. Here, the extremely dedicated Physicians and their teams would do the actual physical assessments and determine a) if they were candidates for surgery and b) how urgent their case was. With this information on their paperwork, down to Scheduling they would go. There, the final team had the dizzying task of fitting everyone into operating slots over the next ten months. Patients would then depart, armed with a card telling them their date to arrive at the ship for their surgery. A literal Golden Ticket :)

     It sounds really simple now that I've just typed it out, but this was the most elaborate, choreographed event I have ever witnessed. Escorts ferried people to and from stations, volunteers passed out nourishment to patients who had been standing in line for hours, security joined with local police to ensure everyone's safety. And the people just kept coming. At times I would look up from my table and current patient to eyeball the waiting area that never seemed to shrink, and just inhale deeply. Fifty chairs were lined up in front of our station alone, and when it was one person's turn to get up, their spot wasn't vacated for long. The closest thing I can compare it to was the inside of a watch: so many moving pieces, so many connecting cogs. And somehow it all worked!

     This means we now have the blueprint. In one day this whole endeavor went from being the plans for a hospital to a suddenly tangible reality. We're no longer talking about "the people of Guinea" from across the ocean. These patients have faces, they have ID numbers, they have surgery dates. 

They're downstairs...

     Pat and I went down to the wards last night to take pictures before patients arrived, just some goofy fun! How does a room lined with beds and equipment turn into a place of hope and healing? Tomorrow we find out :)

Week one: Life onboard begins

Today officially marks one week that we've been onboard the Africa Mercy :)

     Despite how short that is, it seems like we've been here much longer. Maybe that has something to do with the way time has felt - relatively free, and unstructured. Though these past couple days have been spent in a number of orientations and meetings, our time has largely been our own.
     So we've spent it acquainting ourselves with the ship and daily rhythm onboard. When mealtimes are, when/where mandatory weekly gatherings take place, what protocol to follow for coming and going. It's surprising how easily one can learn a new routine - like we're happy to return to a predictable way of doing life.
     We've also begun to build relationships with those we will work alongside. There are so many kind, loving people on this ship, and it's been a joy to spend this uninterrupted time together. There have been loud, hilarious moments playing games in the mid-ship lounge, and quiet, peaceful moments reading and praying together outside on deck. I know the next few months will bring challenges that only life lived in community presents, but right now I am just excited to join lives and purpose with these people.
     It is difficult to sum up the days: Do I blog about events? Or should I talk about the friendships being formed? Do I give you facts about this country, attempting to sum up the richness of these people with a few pictures? Or do I share how I'm feeling about it all? I'm not quite sure...I think the content of this blog will evolve as my days here increase. So bear with me as I figure out how to best process and relay this experience. I want to give it due weight.
     But for now, I will share a few things I am thankful for now that we're here! :)

Everyone filing off the ship and gathering at our muster stations

Andrea, Beth and I during the routine fire drill on Friday

     First things first, I am beyond thankful for Pat. He has been such a reassuring presence during this transition. Always steady, always loving me well. We have each adjusted to this change in our own way, but in the shared experience of upheaval and life shift we have found joy in yet another common ground. He is the biggest blessing I could have asked for, and I'm a lucky girl to share my cabin with him :)

Pat playing in our cabin; getting ready in the morning wouldn't be the same without that sound :)

Inspecting our Guinean money...plastic bag given to us by the bank

    Secondly, I am SO thankful for the group of people we arrived with! The dozen or so nurses that came in on our flight have seemed to knit into this happy little bunch who basically do life together. It's somewhat like freshman year: you all walk around smiling with your new name badges on, going where you're told, eating in the cafeteria every meal, and just trying not to be too overwhelmed. So it's really great that we're not alone in this experience, that we have others to share in it too!

Pat giving Hannah her first chess lesson

Becky and Emily's squared during Dirty Uno

Jen, Juan and Andrea - the competitive corner

     Lastly, I am extremely grateful for the chance to be here. It sometimes feels like we've jumped the tracks of our life and found ourselves here by happy mistake for this brief time. But I know better - this has been a long time coming :) And it's going to go by so quickly, which I think is part of what makes it so precious. If I'm honest, it's been an adjustment reconciling the dream of what Mercy Ships would be like with the reality of what it IS, but I wouldn't change it. How cool is it that we get to do this beautiful thing alongside all of these people who want to be here...?
     Next week the hospital opens, and everything will change around here. This peaceful ship will be bustling with life, patients will come, surgeries will be done and lives will be changed. So I've tried to just soak up this week of rest and learning, because the ship will never be this still again. We're in the calm before the storm, but this is one storm everyone here is actually looking forward to :)