More From Deb . . .

Dear Sweet Jesus,  Thank you for putting Deb Louden on the good ship Mercy.  Thank you for being her love and her life.  Be her strength and her hope as she continues to be one amazing nurse down on the wards.  Amen.

Deb's heart in Africa

Monday, 9 September 2013

Dear baby girl,

Today I held you while your mama ate her breakfast. I took you for a walk in the hallway. Two nurse friends of mine swooned over you while you sat in my arms, taking gasps of air. Your eyes were barely open, as you had hardly slept for the last two nights because you were sick.

It was only last week that I met you. You came to the hospital when it opened because the American doctor from the mission hospital brought you and your mama on the plane, hoping we could help. You had a tumour growing in your mouth.

I watched you sitting on your bed with your mama. She said it hurt you when you were eating. You knowingly putting your hand on your cheek, where the tumour hurt you the most. We gave you pain medicine and later you asked for more chicken so I knew you were feeling better.

You didn’t reach for cuddles when we walked by your bed, but you also didn’t cry. Your mama greeted me with a smile every day.

When the doctors saw you during the week, they thought the tumour in your mouth wasn’t one we could operate on and remove. It was growing bigger and you were getting sicker.

A few days ago we gave you a blood transfusion, IV fluids, antibiotics and malaria treatment because you got so sick. We also told your mama that we couldn’t operate on you and we’d try to find you flights back to the mission hospital. Did you see the look on your mama’s face? It broke our hearts. Did you feel her warm tears drop onto your soft skin? We prayed for a miracle.

We wanted to fight for you baby, but this tumour we couldn’t remove. We knew you were dying but we didn’t know when and we wanted to get you home to your family, to your twin sister.

On the weekend you got sicker. You couldn’t lie down anymore because that made it too hard to breathe. You didn’t want to eat or drink much and even though you were so tired you couldn’t sleep because your body had to stay awake to breathe.

This morning when I walked with you in the hallway I had no way of knowing, but as I walked back into the ward, you stopped breathing. Your face changed colour and the tumour that you’ve been trying so hard to breathe around filled the whole space in your mouth. Your limbs straightened out and stiffened for a moment. I hurried to your bed where your mama was sitting and told her through a translator, that you, her baby had stopped breathing. Her face filled with grief and a wail escaped her mouth. She bent over, face to the ground and began to moan, a noise penetrating every surrounding heart with deep sorrow. She hurried out of the room.

I sat on your bed with you in my arms. You’d taken two small breaths but that was it. You now lay limp in my adrenaline shaking arms. I called to the nurse to page the doctors and another to bring a stethoscope. She listened for your heartbeat and shook her head. She put the stethoscope ear pieces in my ears, I put the diaphragm over your heart and it was silent.

Your mother had stepped out of the ward because her heart had broken into pieces, so I had the privilege of holding you in my arms. The nurse put curtains up around us and I sat there alone with you, staring at your face, tears dripping off my eyelashes, soaking into the pretty, white, flowergirl dress you were wearing.

People came in and out of those curtains, checking all was well with me and you, asking if I was ok and did I need anything? Yes, I was ok, because you were in my arms and you were at peace. You weren’t fighting for air anymore. Finally you could rest. Now you are in a place where there is no pain and no sickness. Will you remember me when I join you there? Will we see each other from afar and you will know that it was me who held you as you took your last breath? It was me who held you for the next two hours, in place of your mama who could not bare it. I could hear her wailing down the hallway. She loved you more than words can express and as I sat there holding you and hearing her cries, I thought how raw her heart must feel. I didn’t even want to think how deeply my heart would hurt if you were my child and I had lost you. But I still cried for you. I cried for your mama’s loss, for the hundreds and thousands of mamas and papas all over the world who loose their babies from diseases. I cried for the babies lost in Africa from preventable illnesses. I held you tight.

I stayed with you while the officials came and while your cousin came to see you. She could not bare to see you lying on the bed so still and lifeless, so she didn’t stay long.

When the time was ready I wrapped you up in a patchwork quilt, made with love from someone who knows that the children who need these blankets need something special. I carried you out of the ship and down the gangway and put you on a stretcher to go to the morgue. I saw your mama coming down the gangway in our hospital chaplain’s arms. She was bent over in pain. Agony was written across her face. I thought my heart might split open. The doors shut on the vehicles and they drove away, you in one and your mama in another. I turned my back and walked up the gangway, afraid that the tears would spill over and I would loose composure and fall apart right there on the steps. I will never see your mama again, but I will carry you and her in my heart forever.

So little one, as you rest with your heavenly Papa, I will pray for your mama and your family.

I will never forget you.

It's Not Just Scapels and Suction . . .

Photo courtesy of Michelle Murrey, Mercy Ships

In his blog "Water from the Eyes is Free", one of the surgeons currently on board the ship, Mark, shares his heart . . .

 

Those of us who talk about global surgery a lot (which I promise I do, even though I haven't updated this blog in a few months) often talk about how surgery differs from other global health interventions in a really fundamental way.

Improving surgery, we claim, actually improves entire health systems.  Unlike delivering a vaccine, you can't do good surgery without the physical plant, nursing, sterilizing, infection control, anaesthesiology, electricity, water, and suction required to do it--to say nothing of the surgeons themselves. So, we figure, for a ministry of health that is interested in improving its country's healthcare, writ large, surgery is an appropriate place to focus.  Positive externalities, and all.

It's a dry argument, as anything which requires you to write the phrase "positive externalities" will be, but this week, in a small, 28-pound child, it became incarnate.

On Monday, in Pointe Noire, Congo, where I've been for the last two weeks with Mercy Ships, I met a two-year-old boy who was first diagnosed with malaria a year ago.  After antimalarials did nothing, his parents took him to Kinshasa, where they were told that, malaria or not, he had a tumor in his mouth.  Nothing could be done, and he would gradually suffocate.  Over the last four months, his breathing slowly worsened, until he began to lose consciousness three times a day.  His mother initially brought him to the hospital every time; eventually, she stopped.

His dad, though, works in the port here in Pointe Noire and saw the Africa Mercy sail in.  The rumor was, this clunky, white, metal box actually contained a hospital.  He and his wife bought a calendar, ticking off the days until our patient selection day last Wednesday.  When they got to the front of the line of over 7,300 people, their son couldn't breathe.

Two days ago, he went to surgery, where we took out a mass the size of my fist--ridiculously large for a two-year-old.

The reason I tell this story, though, is not to talk about the operation.

See, as he was wheeled into the operating room, a small, multinational army welcomed this child and his compromised airway:  two anaesthesiologists, one intensive care physician, one anaesthetic assistant, two nurse anaesthetists, three surgeons, and three OR nurses.  We were from the US, the UK, the Netherlands, Switzerland, and Congo, and we were flanked by an entire difficult airway setup, with video laryngoscopy, flexible fiberoptic laryngoscopes, and an open tracheotomy tray.

Taking care of this small boy was not just a matter of a couple of hours of struggling against an obstructing tumor and reconstituting a destroyed palate.  It was management of the patient from the time he was carried onto our ship, through his intubation, his surgery, his middle-of-the-night re-intubation for pulmonary edema, his round-the-clock, one-on-one ICU care by dedicated pediatric ICU nurses, his eventual extubation, and his quiet return to his mother, a toddler finally able to sleep.

This is surgery.  It's not just scalpels and suction; it's an infrastructure.  And while it's hard to build, it can be built, and platforms like this might play a role in building it.  And help a few patients along the way.

FIND JERRY . . .

On August 18th, I was approached after church by an elderly man who I recognized, but did not know - and am sad to say - still do not know his name.  He told me that his (nephew?) Jerry  had been missing In Africa since April 7th.  

Jerry worked for SAS Aviation Service out of Bamako, Mali.  He had been in Johannesburg, South Africa bringing a company plane back.  He was the lone pilot on the plane.  He never arrived back to Bamako.  

Jerry had been a missionary pilot with Missionary Aviation Fellowship for twenty-three years.  When MAF left Bamako, they sold the aviation service and the new owner hired Jerry.  He and his family stayed on in Bamako until Jerry's disappearance.  His wife, Gina, and their three children have all since come back to the states.  I don't even know where.

But this I know - that gentleman from church asked me if Mercy Ships could put out information on Jerry.  Ah, the hazards of wearing a "Mercy Ships" t-shirt to church!  So I prayed quick and gave him my friend Keith's e-mail address.  

I just heard from Keith this morning for the second time regarding Jerry.  The Africa Mercy has scrolling announcement screens throughout the ship that will soon have Jerry's information on it.  

What makes this HUGE is that EVERY person on board will see the screens - from crew to day workers to visiting dignitaries to crew visitors to patients to patient visitors.  Because you see, as you draw a line from Jo'burg to Mali that line goes directly over the Congo where the ship is currently docked!  To God be the glory! 

Pray that we would "find Jerry".

 

You ARE Beautiful . . ..

It's been on my heart all day to speak/sing/pray the truth over every patient that will join the Africa Mercy in Pointe Noire, Congo.  May they hear the truth!

"Beautiful" by Mercy Me

Days will come when you don't have the strength

And all you hear is you're not worth anything

Wondering if you ever could be loved

And if they truly saw your heart

They'd see too much

Chorus

You're beautiful, You're beautiful

You are made for so much more than all of this

You're beautiful, You're beautiful

You are treasured, you are sacred, you are His

You're beautiful

Praying that you have the heart to fight

'Cause you are more than what is hurting you tonight

For all the lies you've held inside for so long

But they are nothing in the shadow of the cross

You're beautiful, You're beautiful

You are made for so much more than all of this

You're beautiful, You're beautiful

You are treasured, you are sacred, you are His

You're beautiful

Before you ever took a breath

Long before the world began 

Of all the wonders He possessed

There was one more precious 

Of all the earth and skies above

You're the one He madly loves

Enough to die!

You're beautiful, You're beautiful in His eyes.

You're beautiful!

You are made for so much more than all of this

You're beautiful!

You are treasured, you are sacred, you are His

You're beautiful!  You're beautiful!

You are made for so much more than all of this 

You're beautiful!  You're beautiful!

You are treasured

You are sacred

You are His

More From Deb . . .

Earlier this year, nurse Deb Louden and I had an e-mail conversation.  She was wondering if anyone ever read her blog and if it was even worth her time to write it.  Read this story and know without a doubt the answer I gave her!  Taken from Deb's blog, "Deb's Heart in Africa":

I walked into the ward last night with my mind prepared for hearing the breathing struggles of a small boy my screening friends had told me about days earlier.

 

On Patient Selection Day there had been an EMT call to the pre-screeners at the very front of the line, for a small boy who had an airway obstruction. He had by-passed registration and histories, where I was stationed, but I heard about it through the radio conversations. I also heard later that he’d been scheduled for surgery in the first week of the hospital being opened.

Yesterday when I walked into the ward, he was sitting in bed 1. When my ears heard the struggle of air passing through his airway, my eyes saw the retractions of his muscles, the tension in his neck, the waving of his hands as he struggled to gasp in the air that his body so desperately needed, my heart lurched and I swallowed back the lump in my throat and blinked back the tears that threatened to roll down my face. At that moment, although he was acutely distressed, he’d been in this position for four months, there was nothing I could immediately do to relieve his stress.

 

When he was awake it was only for small periods of time because his body was so exhausted from the struggle to get oxygen. When he fell asleep it was only for seconds because he would stop breathing and his body would wake him up to breathe. Over and over and over again, he’d wake up, fling his arms around in frustration and flop back into a restless, teasing sleep.

Today he got his surgery. As I was preparing to head to work I could hardly wait to hear how it had gone. I bumped into his surgeon in the hallway, who quickly filled me in. The tumour was out, he didn’t need a tracheostomy and he’d been extubated about 20 minutes ago.

 

He stayed in the recovery room for some hours as they woke him up slowly preparing for worst case scenario. He recovered well and so they brought him around to the ward, to the nurse in my team. Once he was settled in his bed, we monitored everything very closely, rejoicing in the sound of his much quieter breathing.

 

The doctors popped in and out, backing us up by being close by if we were concerned about anything. As time passed by, his oxygen saturation dropped lower and repositioning him didn’t help. His heart rate and respiratory rate increased and so we called the team back for help.

 

After discussion between doctors and with the mama, they took him back to the OR to intubate him and sedate him for a couple of days to let his body rest.

 

An hour later he arrived back from the OR. We settled him into the new intensive care bed, on the ventilator, letting his body catch up on the last four months of missed sleep. His little body lay there, the machine doing the work of breathing for him, his chest moving up and down, muscles completely relaxed, so peaceful and comfortable.

In the following days he will come off the ventilator and we will see him breathe on his own, healthy and strong. I can’t wait to see him walk and play and smile.

This is our little boy, days before his surgery. Strangely enough when you look at him here, you could never known how desperately he was trying to breathe before and after this photo was taken.

 

THE REAL REASON . . .

This morning I joyfully sent three family members off to school - one a bit apprehensive, one excited and one wanting to stay home.  I think those feelings may be similar to what patients entering the ship may feel.  But as I was definitely joyful, read about my Australian nurse friend Deb's joy:

I had the privilege of being able to work the first shift of the hospital opening for this Congo field service. It was so exciting to see patients lining up while walking up the gangway, 4 short days after they queued up for hours on patient selection day. Did any of them realise that day how soon they would get their impossible dream fulfilled? How were their hearts feeling at that moment of walking up the gangway?

 

As they filed into our new admissions ward for pre-operative patients, we led them to their beds. The other nurse and I stood with our day crew to translate and we expressed our excitement that they were here. They responded with thanks and one translator told me later how the patients had expressed that they felt very well cared for and welcomed. Perfect!

 

The following morning I also worked, helping to organise the nurses and new day crew to orient to their jobs, while we got ready and sent the first patients to surgery.

 

During the morning the hospital chaplaincy team came in. They prayed first with the room full of patients, translators and nurses and then began to sing. The room was filled with joyful harmonised voices and the beat of clapping hands, singing praises to God. It hit my heart so hard with joy that I wanted to burst into tears. I swallowed the lump in my throat, with a wobbly smile and let the music sink into my soul. This is the reason that I love this place. We bring the patients here to give them a free surgery but the real reason is because we want them to know the free love that God has for them and pours out upon them. I am just a vessel for the pouring.

A Few Pictures . . .

Here are a few pictures from "Selection Day" on Wednesday.  See the lovely girl in the purple dress (Jay Swanson's blog)?

(Photos: Michelle Murrey)

It was the largest Selection Day in Mercy Ships' history - 7,354 were in a line that stretched so far they had to close off two city streets just to hold it all.  Of those 7,354 people, 4,236 came through the gates to be further screened for potential surgeries..

(Photos: Deb Bell)
 

Here the waiting was measured in hours and days and endless years before there was anyone at all who could help, and even so, there were many the crew had to turn away.

(Photos: (Top) Michelle Murrey (Bottom) Deb Bell)

One by one they came to selection day, old and young and everyone in between.

(Photos: Michelle Murrey)

The hospital opened today as the first patients were admitted. Surgery starts tomorrow (Monday).  Please continue to lift the good ship Mercy up in your prayers as they begin this outreach in Pointe Noire, Congo.