Bless the Lord, O my soul,
and all that is within me,
bless his holy name!
2 Bless the Lord, O my soul,
and forget not all his benefits,
3 who forgives all your iniquity,
who heals all your diseases,
4 who redeems your life from the pit,
who crowns you with steadfast love and mercy,
5 who satisfies you with good
so that your youth is renewed like the eagle’s.
Steve and I commented to each other recently that the “honeymoon is over,” meaning we’ve really settled in to life on the Mercy Ship, and the newness has worn off. As with anything in life, there are hard days, and disappointments, and treatments/approaches to care that are so different from what we’re used to…. but we continue to love being here and being a small part of helping to change lives.
Homesickness is always a struggle for me – and yes, I can get homesick even when my “main squeeze” is right here with me :). I cannot imagine doing this for 2 months without him being here. Actually, Mercy Ships has a policy of limiting time you can serve to 2 months if you have left a spouse or family at home – they fully realize the importance of marriage, family, and togetherness. Anyway, I am so blessed with friends that reach out to me “out of the blue” (ha!) when I need it most, and pray for me when I am struggling – thank you – (you know who you are!)
Last weekend we enjoyed a day off of the ship – went into downtown Douala to the flower market (incredible tropical flowers and arrangements!), a local souvenir market, and to the “Super U” (a supermarket). I ate swarma, which was yummy, and we were able to purchase a few trinkets to take home to friends.
For those of you who have not had the opportunity to visit a developing country, it quickly becomes obvious that you are not at home, and we are incredibly blessed to live where we do. The poverty can be rampant, and the lack of infrastructure evidenced in the roads, buildings, and housing. Safety often seems to not be on anyone’s agenda. And it is a good and humbling twist to be in the minority for a change. BTW, the security folks on the ship stay on top of things and make it very clear what areas off the ship are off-limits for safety reasons; we have to sign out to let them know our planned whereabouts. There are shuttles from the ship to the approved areas that travel on the hour or half hour. And we have Gurkhas providing our security, screening everyone coming and going!!!! We are very safe on the ship! But as with any travel in any city, robbery is a risk you take when you go out and about.
A Different Kind of Nursing
I think I’ve mentioned before that the patient wards on board the Africa Mercy are quite small, and each have 20 beds, spaced only about 2 feet apart. Each bed is slightly elevated, so that a mattress, on which the caregiver sleeps, can be placed beneath it (Yes, they sleep beneath the bed – have about 4 inches from their nose to the bottom of the patient’s bed 😦 ). Most of you have been in a hospital back home, where it is a rare thing anymore to have even 2 beds in the same room. That is largely because we do not want a “clean” patient rooming with anyone who is potentially infectious. It also has benefits in providing each patient with more privacy. And if a patient is diagnosed with an infection that is easily spread to others and/or difficult to treat, we can keep them in the same room and institute “contact” or “droplet” isolation precautions (for which we wear gowns and gloves, and masks if needed, to provide any care). Only if they have something which is highly contagious and spread easily through the air for long distances, like tuberculosis or chicken pox, are they put into special isolation rooms. Infection control, as you can imagine, has the potential of being a huge issue here. Since we’ve been here, we’ve had 4 wound care patients diagnosed with methicillin-resistant staphylococcus aureas (MRSA). At home, we have a great number of MRSA-positive patients – on any given day, half if not most of our wound patients will potentially have MRSA. Here, it seems a miracle that we’ve had so few. But because these folks have not been exposed to constant use/overuse of antibiotics, they have not developed the problems with antibiotic resistance that we have in the States. All patients are screened for MRSA here before they are accepted for surgery, and antibiotics are used sparingly and only after a culture has determined what the infecting organism is, and what antibiotic will be successful in treating it – they never blindly give a patient a Z-pack or Keflex. When we bring a patient to the treatment room for a dressing change, and we note that there is more drainage, or redness, or swelling, or odor associated with the wound, we quickly culture it. If, when we receive the report 2 days later, the patient is shown to have an infection, the appropriate antibiotic is prescribed. If, however, they have MRSA, we also quickly place them in an isolation room. Now imagine: You’ve been in a 20 bed ward for 2 weeks with 20 patients, 20 caregivers, 5 nurses, 5 “day crew” (translators, aides), and doctors, PTs, wound care, chaplains, dieticians, and visitors floating in and about all the time. (The wards are always hoppin,’ especially during the daily praise and worship time with music, drums, dancing, and a message!) Now you are told that you have a contagious infection, and you are whisked off to an isolation room, where you hardly see anyone – maybe the nurse a few times a shift. This is really tough for the patients, especially the kids. And there they must stay in that isolated room until they have no further evidence of MRSA, or they are discharged to the Hope Center. Below are 2 of our patients that we treated for quite a while, all gowned up. It was actually the older gentleman’s birthday, and one of the nurses made him cupcakes and they were “let out” of their rooms for the event. He later told one of the day crew that he had never celebrated his birthday before 🙂 . Crazy white people!
So in the States we would probably struggle a bit with being on a ward, having our medical issues laid out for all the ward to see, not to mention our state of undress, toileting, etc. There are curtains between the beds, and we often have to remind the doctors to pull them before they start to examine patients. And there is no segregation based on age or sex.
One of the biggest jobs the nurses have is to distract patients – from their pain, discomfort from splints, therapy, etc. In the States we went a bit overboard with the idea that no one should suffer pain, and unfortunately, we’ve created a bit of a prescription drug mess because of it. In my most recent job in the States, we did not think of changing a post-op patient’s dressing, in most cases, before they got an IV dose of morphine or Dilaudid. It’s quite different here – most often when we pre-medicate a patient for a dressing change, they are getting acetaminophen (Tylenol) or ibuprofen (Motrin) by mouth. For the first dressing change, which is usually quite painful, they might get a codeine pill or a tad of liquid morphine orally. These patients, especially the kids, are so tough and brave. The physical therapy alone can be grueling. As such, there is a lot of “play therapy” (My SLP friend Melinda Kuehn would be right at home 🙂 ).
So as the nurses work and play with their patients, relationships are built, and not only with the children, but also with the parents and caregivers. And strong relationships develop between patients and caregivers, as well.
When a child (or any patient) comes to the Mercy Ship for surgery, a caregiver has to accompany them. That often means that the family back home is making huge sacrifices. These parents leave their livelihoods, their spouses, and remaining children at home, all for a chance at having their child in need helped by Mercy Ships. One young girl who came to the ship last August, from a couple of days distance, did not have a parent willing or able to come with her. Instead, a neighbor who recognized the girl’s dire need and the great opportunity brought her to the ship and stayed 2 months. When it was time for the girl to have her 2nd surgery, the neighbor had to return home, where his family had almost starved in his absence. Another neighbor then took his place, and stayed with the girl until she was well enough to return to her village.
And we think we make sacrifices to come here to help.