Teenage Isabelle’s consenting adult on the hospital ship was
her older sister. The ship’s medical team works hard to ensure all our
patients give informed consent for all treatment, however Isabelle and her sister never really grasped how close she came in ‘dodging a bullet’.
Isabelle lives in a small village in the mountainous centre of
Madagascar’s far north. The surrounding harsh terrain makes the area
almost inaccessible, especially during the wet season when the dirt
roads become mires of red mud.
The 13-year-old loves her village life, and her favourite thing to do
is to go on walks with her little sister and her best friend.
In their village there is no doctor and no clinic. So when Isabelle’s
face began to hurt and swell a year ago, there was no one to turn to
for advice. “I had a toothache, and I thought it was my tooth swelling.
But it kept getting bigger and bigger, and it didn’t stop!” she
declares.
As the side of her face become more and more distended, life began to
change for Isabelle. She was banned from school when her teacher told
her, “You cannot come here because of your face.” Isabelle suffered hurt
from every side. “Some people in my village were rejecting me, telling
me ‘Don’t come near! I don’t want your disease! I was afraid and was
praying to God asking, what is this problem? Why is it growing?” It
seemed like there were no answers for Isabelle, only painful questions.
Each evening in their small mud-and-thatch hut, Isabelle’s family
they roll their sleeping mats out on the hard-packed earth floor. They
huddle together and listen to radio broadcasts- a life-line for the
isolated community.
One night Isabelle heard something on that radio that completely
altered her future. She recounts, “It said, ‘Those who have diseases
Mercy Ships is doing free surgery. Don’t hesitate to come.” As her
father was away and her mother had just delivered a little sister,
Isabelle and her older brother set off for the Mercy Ships patient
screening day they had heard about on the broadcast. The siblings
walked for two days on the muddy road, stopping at villages for food,
water and shelter along the way. When they got close to the city, they
were able to catch a bus for the remaining half-day’s travel. The
arduous journey proved worth their effort. The rapidly growing tumor on
Isabelle face was examined at the patient screening location and they
were given a date to arrive at the Mercy Ship for free surgery to remove
the tumor. This time, her big sister accompanied her as she traveled
from the middle of the island down to the coast. Isabelle caught her
first glimpse of the ocean – and of the hospital ship that would change
her life.
A month after she was first examined, Isabelle received her free
surgery. Dr Gary explained the challenging decision-making process he
and another surgeon went through. Because Isabelle was at the cusp of
puberty, they were able to do a radical operation that would ensure the
expanding yet benign tumor was completely removed from her face.
The visible swelling that caused so much ridicule for Isabelle in her
village was only a third of the size of the growth. The developing
tumor relentlessly pushed up behind her eye, back into her cranial
cavity, and was embedded in the right side of her upper jaw. Isabelle
and her family were unaware that without specialised surgery, her
expanding facial deformity could cause at least the loss of vision in
her right eye.
The volunteer surgeons conducted a series of complex operations for
Isabelle that removed the tumor, and every piece of bone that it had
begun to devour. With bone and muscle grafts from her skull they
carefully reconstructed her face. They rebuilt the right half of her
upper jaw, they restructured her cheek bone and eye socket, remodeled
the side of her nose. They transferred muscle to restore her cheek and
complete her nose, and skin from her abdomen to her head. When she awoke
from surgery, Isabelle looked remarkable.
Just two weeks after surgery Isabelle was ready to head for home. Her
sister said their parents would be delighted to know ‘the swelling’ is
gone for ever. The girls never really understood the nature and
potential implications of Isabelle’s hungry tumour, even after the team
worked hard to explain. But that’s OK. I think they were mercifully
oblivious.
Isabelle was full of stories about the ocean and having her finger
nails painted. She had a handful of photos after having her picture
taken for the very first time. The source of her ridicule was removed,
and in typical child-likeness she was obvious that her vision (and more)
had been saved. Isabelle was focused on seeing her Mama, and getting
back to the serious childhood business of taking long countryside walks
with her friends.
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