Saturday, August 31, 2013

Africa Mercy - Selection Day: One Nurse's Journey

More from Marilyn on the Africa Mercy. It's hard to imagine, but 7000 came for the screening in Pointe Noire, more than 4000 of which received doctor's appointments! 


I am thankful for people who give of their lives and time to help those in need in such a far away place. It is humbling to say the very least. Not that all of us have opportunities to help in this way, but it does give perspective. I guess it comes down to this: we can all do something to help others where ever we are......a neighbor, a friend, a family member or even a stranger. One person at a time. It all adds up, no matter how small our contribution may seem. Anyway......this and the last post sure got me to thinking. Sharon


(This is a running post about a nurse's journey on the Africa Mercy, a hospital ship that travels up and down the coast of Africa)



8/31/ 13
Selection Day

Last Wednesday was the day of our big screening, the day we selected patients for the various types of surgeries in the coming months.  By government request, our advertising poster depicting the types of surgeries available did not have a date or place for the main screening event, so I wondered if the people would know to come.  They came--more than 7000 of them.  I've attached a picture which suggests the size of the crowd, but one picture doesn't really capture it.  The line of people wound all around the wall of the selection site, doubled back, down a second street and back.  It made the longest Disneyland lines look short!  




I've heard that we had about 350 crew members plus 100+ day crew translators working on site that day.  We needed every one of them, both to manage the crowd and to do the actual screening procedures. We screened for more than twelve hours, from dawn until after dark, to see as many people as possible. More than 4000 people got appointments, either for further medical testing or for the surgery itself. 

Altogether, it was a very successful screening day.

The hardest part of screening is having to turn people away.  They come so full of hope.  They wait patiently in line for many, many hours to be seen.  Then, some of them have to be told that we cannot help their particular problem.  More than half of the people in line for eye problems didn't have cataracts, or their cataracts were not sufficiently ripened so that our procedure would help, and they had to be turned away.  Some had corneal scars--a corneal transplant would restore their sight, but that is not possible to do here.  Some were blinded from untreated glaucoma--irreversible damage was already done. Some were blind from injury that couldn't be fixed.  So many reasons to say no...and every "no" hurts.

 We saw a fair number of children with evidence of Vitamin A deficiency. The poorest people eat mostly white starchy food because it is  cheapest, so even though they get the calories, they lack the vitamins  they need.  Vitamin A deficiency in children can lead to blindness, but  it is preventable.  One thing we try to do is to educate parents about  Vitamin A and where to get it.

 Because cataract surgery is quick and patients are released the same day, we can do a lot of eye surgeries.  So, we will continue to hold field screening to gather more patients throughout the months that we are here.  Our next eye screening is scheduled for next Tuesday.  There will be hundreds of people there, but not the thousands that gathered for the main screening, because only one type of surgery is being offered.  Still, it is likely to be another emotional day.

Let me end with a couple of stories from previous years.  Many of our cataract patients are old, of course.  One year a man a wife both received cataract surgery the same day.  When the eye patches came off the next day, the grandpa turned to his wife and said, "you are as beautiful as I remembered you to be."  They were very much in love.
 

Next year, another old couple had surgery the same day.  When the eye patches came off, the old fellow turned to one of our day crew people and asked her to marry him!  Needless to say, grandma was having second thoughts about having his sight restored!  People are people, the world over, aren't they?  Well, we screened an old couple this year and scheduled both of them for surgery...

More another day...

Oops..."They" won't let me send such a big file, with the picture attached.  So here's the email, and I'll work on how to send the picture separately.

Marilyn




Click here to learn more about the nurses and doctors on board the Africa Mercy.


Wednesday, August 28, 2013

Africa Mercy - The Big Day: One Nurse's Journey

Another email post from the Africa Mercy in the Congo. What do you do when you can only admit so many patients? The 'big day' is here and maybe over (but unlikely; it's 7pm in the Congo). The excitement prior as the crew prepares for a 'massive screening' of potential patients is described in this post. Marilyn gives a detailed account of what to expect during the screening, when thousands of potential patients line-up and Mercy personnel are given the daunting task of deciding who can be admitted. She has asked for prayers. They can only help so many . . . Sharon 
 
(This is a running post about a nurse's journey on the Africa Mercy)
 
Our heroes, the Africa Mercy crew. Doesn't it just make you want to
shout "Hurray!?"
The Big Day
 
8/27/13
Tomorrow is a big event for us, the biggest event of the year.  For weeks or months, we have been advertising about Mercy Ships and the types of surgeries that we can do, inviting people to come for screening to see if they can be helped.  Tomorrow is the day of that massive screening.  Thousands of people will come.  Some will camp in line overnight to be sure of their place.  If it is like other years, they will wait patiently for hours to spend a few minutes with our doctors, hoping fervently that we can transform their lives.  Some, we can help.

Many, we can not.  It can be a heartbreaking day, having to turn away people who have nowhere else to go for help. But it is also a joyous day, seeing so many people for whom we can make a difference--a huge difference.

Why must we turn people away?  We try to advertise the types of surgeries we do, but many people come with other health problems, hoping that we can help anyway, or they have a problem that looks like the posters but is not the same, or they have additional health problems that make surgery not an option...or...sometimes we just don't have enough time and surgeons to handle all that could be done if we had those resources.  You've heard the story of the boy on the beach tossing stranded starfish back into the ocean...we can't save them all, but we do what we can.

Screening day is a massive logistical operation.  Think of a football stadium, and thousands of people all trying to get in through the gate in time for the game.  Consider--all they need is a ticket, and their place is assured.  All they have to do to qualify for that ticket is to pay money, which they have.  And if per chance the game is sold out, they can go home, none the worse for wear--probably even to watch that same game on TV!  The stakes are pretty low, really.  But you've been there, felt the crush of people pushing to get in the gate, heard the noise and felt the energy of so many people in one place.

Now think of those thousands of people vying for a once-in-a-lifetime chance to get a desperately needed surgery.  So many hopes and fears, so much at stake for each of them.  Try as I might, I cannot really put myself in their shoes to understand the depth of this experience for them.  For those of you who pray, please pray for our prospective patients tomorrow--especially those whose hopes are dashed as we sadly send them away.

On the ship, we have six operating rooms.  They will be in constant use, beginning next Monday. There will be a whole parade of surgeons coming and going throughout the 10 months of field service.  Most can only break away from their practices for 2-4 weeks at a time.  We have a stream of eye surgeons doing cataracts, plastic surgeons doing burn contracture repairs, orthopedic surgeons fixing dysfunctional limbs, general surgeons doing thyroids, tumors and hernias, surgeons who do vaginal fistula repairs, maxiofacial surgeons working on cleft palates and facial problems of all sorts, and so on.  So, in screening, we need to look for patients whose needs match the specialties of our surgeons, and we need to schedule them for surgery at the right time for the right surgeon!

A little bit about the flow of screening day:  We have the use of a large school compound with walls and gates.  That's important for crowd control.  Security people establish the lines and keep people in order.

Pre-pre-screeners walk up and down the line, eliminating those who are obviously not candidates for the surgeries we offer.  Eventually, the people get through the gate to the pre-screeners.  Those folks gather enough information to send the person to the correct station for further assessment, or out a different gate, if we can't help.  Eventually, after a medical history and basic nursing evaluaton, surgical candidates are seen by a doctor.  If he approves for surgery, the patient gets an appointment card to come to the ship at the proper time.  There's a prayer tent for those who would like prayer.  There are translators working with each medical person, of course.  There are people passing out water and bread for these people who have been waiting for hours.

There are escorts to lead people from one station to the next throughout the whole process.  We have hundreds of crew members on the ship, and we all have a specific job to do tomorrow.  Hopefully, it will be like a well-oiled machine!  We expect to process thousands of people in one day--it had better run smoothly!

Many, many of these hopeful people have eye problems.  Those are sent into a separate line to come to the eye team for evaluation.  We expect to process thousands of people just in our area, and hope to select about 500 of them to come to the clinic on other days for a more complete eye examination, with the hope of cataract surgery for many of them.  I filled out 520 appointment cards to give out tomorrow, for clinic days from now until mid-October.  It took several hours to fill out the cards--and each card represents several people who will need to be seen tomorrow, since there are probably more rejects than acceptances.  Obviously, our optometrist is going to have to work fast tomorrow!  In fact, we all will have a very long, very busy day.

I've attached a picture that they took today of the Africa Mercy crew. If you are looking for me, I am about half way back in the crowd directly under the "r" of ".org" painted on the ship.  White hair, green shirt... All these people, plus about a hundred more Congolese day crew (translators, etc.) will be working tomorrow.  If I can, I'll send pictures of screening day a little later this week.  Meanwhile, appreciate your prayers that it will go well tomorrow, and that we will select the right people for surgery to do the most good possible while we're in Congo.  Thanks.

Blessings,
Marilyn

Click here to learn more about the nurses and doctors on board the Africa Mercy.
 

Thursday, August 22, 2013

Africa Mercy - In the Land of Congo: One Nurse's Journey

Long awaited news from my dear friend in Africa! She has finally arrived in the land of Congo and has yet another interesting tale to tell. This is a running post about her journey as a nurse on the Africa Mercy, a fully staffed hospital ship that travels up and down the coast of Africa. Learn with her as she discovers and relates  to life in Congo and the people firsthand.


Online image of Pointe Noire market
 8/19/13
In the Land of Congo

We arrived in Pointe Noire, Congo a little over a week ago now, although it seems much longer ago that that.  As expected, we spent last week in a flurry of cleaning and unpacking.  The job is not done yet, but it's beginning to look like a hospital again, and it is certainly much cleaner than it was before.  We'll be ready in time for our first patients on September 2nd.

This week, we are beginning to train our day workers.  We have eleven day workers assigned to the Eye Team.  They are all Congolese who speak English, and usually four to seven other languages.  They are not medical personnel, however, so we begin at the beginning. Today I taught basics like handwashing, use of gloves, body mechanics, and waste disposal.  Tomorrow we'll teach about blood pressures and administering eye drops, and then move into basic eye anatomy and eye diseases. I do wonder how much of this they are understanding--but we do a lot of show and tell and we give them written material so that they can read what they miss.  And I'm sure we'll be re-teaching the material individually in the coming weeks, but at least we've laid some groundwork.

Probably the most interesting exercise we did today was to blindfold half the class and have their partners lead them up the gangway and down two flights of steps into the hospital eye room.  I participated, and it was interesting to see how frightening it was to make that journey blindfolded, and how much difference it made when my partner led me by the hands and gave me verbal cues.  That's what our patients will experience, only more so, since they are not familiar with our ship, have probably never been in a hospital, and don't get to take off the blindfold at the end of the journey.  Most of them have been blind for a long time and depend on family members to guide them.  Now they have to leave that caregiver outside the ship (we don't have room for them inside) and go in alone to face surgery among strangers.  It makes you appreciate their courage and their desperation, to entrust themselves into our care that way.  Well, hopefully today's exercise will make our day workers both sensitive to the patients' situation and skillful in guiding them along.

First impressions of Congo: 

1.  Weather:  Right now is their winter season, very pleasant, usually sunny, but not too hot.  I hear that the rainy season lasts from October to May, and it gets hot and humid then.  So, I'm enjoying this good weather while it lasts!

2.  Plastic:  Congo outlawed plastic bags a couple of years ago.  You can get quite a fine if you put a WalMart bag in the garbage.  We didn't know that when we arrived--a lot of plastic went out with the trash that accumulated during the two weeks of sail  Oops!  Well, someone is figuring out what we need to use to collect our trash in--it'll all get clear sooner or later.  Meanwhile, I can certainly see the wisdom of such a law.  Pointe Noire is not buried in plastic like the places I've been before.

3.  Market:  Pointe Noire has a very large open air market downtown.  It is organized and relatively tidy. Here there is a whole row of little stalls with traders selling shoes.  Next is a whole row of little stalls with bananas.  Fruits and vegetables are in abundance as far as the eye can see.  Some stalls have clothing, or cooking pots, or electronics.

Whatever you want, it is probably there somewhere.  I was struck with the lack of trash piles or garbage underfoot.  I hear that the traders must completely vacate the market two days a week so that the city can clean the area.  It certainly makes the shopping more pleasant.

4.  Traffic:  Unlike Guinea, Congo has traffic laws that are enforced. Policemen in the intersections are not offering suggestions, they are giving orders. There are a few traffic lights in town, and they actually work.  Taxis are abundant and relatively cheap; most people do not own cars.  The roads are crowded, but not like I've seen elsewhere, and traffic goes in the right direction, not every which way.  For the most part, traffic flows without major bottlenecks.

5. Port Security:  Congo takes their port security very seriously. That's good, but it has also been a hassle for us, bumps in the road that haven't been ironed out yet.  It is about a mile from our ship to the port gate.  Our vehicle generally gets stopped about three times in that mile so that they can check our ID badges--very carefully, comparing our pictures to our faces for everyone in the car.  Problems arise when we pick up new crew at the airport and try to get them to the ship, since they don't have a proper ID badge yet.  We've worked out a compromise, giving the port authorities a list of expected arrivals each day.  Then  our new people just need a picture ID of some sort, which is compared to the list.  In theory.  Not every guard seems to know the procedure.  Vehicles get hung up, and Mercy Ships officers have to go out and negotiate again. Soon we'll face the same issues trying to bring patients in to be ship.  Do all of them have a picture ID of some sort?

I doubt it.   We are an odd duck, moored here for ten months, with
patients, caregivers, patient visitors, new crew, and ship guests all coming and going, giving those port guards heartburn, I'm sure.  Well, resolving these issues is above my pay grade...but I'm sure it'll get smoothed out before long.  This is the first time Mercy Ships  has been to Congo, so a lot of little details have to get ironed out as we go.

Blessings on you all.

Marilyn


Click here to learn more about the nurses and doctors on board the Africa Mercy.

Friday, August 16, 2013

Combine Ride: Harvest on the Palouse


I have lived in the Pullman-Moscow region, which borders the states of Washington and Idaho, for over thirty years now. I have watched the dust swirl up around me surrounding these fair towns as the farmers till and harvest the deep black soil of the Palouse, as the land is known. I have stopped behind them in their large farm vehicles, as they traverse our two-lane roads, halting traffic to make a cumbersome turn. I have traveled through the scenery they create in the fields that changes dramatically from green to golden yellow each year without fail. My husband and I have been privileged to meet and know only a few.
BARLEY (about a foot tall; wheat is much taller)

As a child I lived west of the Cascades, but sometimes took trips with a friend's family through Eastern Washington to Coeur d'Alene Lake. En route, we always passed the fields of wheat and other crops. One of our favorite things to do was to stop and sample a stalk of wheat. We would remove the chaff and chew the wheat kernel, as if it were the best snack in the world. And what did it taste like? Bland, salt free flour of course, but oh what a treat. Ever do that?
Barley up close at dusk (my camera lens was dirty from the harvest dust)
Big teeth!
So imagine my excitement yesterday when my husband and I were invited to ride in a combine harvester on the Ensley farm. They were busy harvesting their barley crop. 

"Frank"

I have to admit I thought of Pixar's movie, Cars, when I saw the big teeth of the combines up close. Remember the scene where Mater and Lightening McQueen scare the 'grazing' tractors and they go belly up in the field? Then Mater warns Lightening to watch out for Frank? Ha! Combine harvesters are huge like that, and I mean HUGE.
Cathy, co-owner with Mike Ensley in front of Ensley Farms harvest truck, which follows behind the combine for grain dumps. The Ensleys currently grow wheat, barley and garbanzo beans.
Big tires! Vince climbing into Mike's combine.
 Here they come!

Dumping the barley
Mike at end of day. Time to shower!

Today farmers sit in air-conditioned and filtered cabs, although there is plenty of dust. Check out Mike's photo on the left! They have talk radios and music to pass the time and use cell phones for communication.
Imagine how it must have been before combines existed (or modern ones with enclosed cabs). I am told that farmers often suffered from emphysema from the heavy dust exposure.




                                       Combines were horse drawn in the "old days."


Jeremy (Mike's son) and my driver. This is a multi-generation farm.
View from inside the cab with Jeremy. It was surprisingly quiet inside.
We could talk easily, but oh was it ever dusty!!

Combines get around 7 miles to the gallon, I am told. The farm uses around 100 gallons a day during harvest. That's me on the bottom step. Thanks for the ride, Jeremy! 


Take a look at my shoes. I was told I would get dirty . . . and I thought I was being careful. My face was gritty with dust, too, as was my camera lens. But what a marvelous once-in-a-life time experience.

Thank you Ensley Farms!!


Wednesday, August 7, 2013

Lake Entiat: Sailing and More

Well, we did it. Vince and I took "Duet" out of storage after nearly four years of neglect and sailed for two days in a row. I must admit though we had a comical Laurel and Hardy start, rigging the boat and trying to remember which line went where. Vince was beginning to question the work-to-fun ratio. What had once been a thirty-minute process to rig this fifteen-foot wonder (a Montgomery 15) quickly turned into a two-hour fiasco, with a lot of head-scratching and staring at instructions. But our efforts did eventually pay off. 



Duet was a beautiful sight when the sails were finally hoisted. She was the only sailboat on Lake Entiat last weekend. Sailing is all about the moment, not the destination. One glides along at the mercy of the wind on a zig-zag course. In a world spinning faster the older I get, I find this pace relaxing at times, but the work getting the boat ready was hard in the hot sun. (Note to V&S: do not rig in 90-plus heat!!)

Vince at the tiller, his favorite position.
At the tiller or on the bow. Either spot, I like both!

Lake Entiat is a large reservoir located near Rock Island Dam, one of Washington's many hydroelectric dams on the Columbia River.




Near Orondo, Washington next to the Wenatchee Mountain range, Lake Entiat is a nice recreational destination for campers and boaters. It is about four hours away for us. Vince and I camped three nights on its shore at Daroga State Park along with my brother and wife's family.

Site 24. Where we camped.





Lots of food and good company!

 

 
 Delicious campground beef stew with home grown vegetables, made by my sister-in-law. I was surprised to learn that this is the same Coleman stove my parents used when I was a girl. My brother had discovered it recently in storage. Still works great!

Besides sailing, I also tried water skiing behind my brother's boat, but alas . . . after a hiatus of probably thirty years, my legs just were not strong enough. ~Sigh~ I so much wanted to be up on those skis. I still remember skiing under the Narrows Bridge in Tacoma, Washington behind my father's boat as a teen. The water was quite choppy that day in Puget Sound under the Narrows and there had been whale sightings nearby. I held fast to the rope and avoided jumping over the wake, as was my usual form, on the lookout for anything black and unusually large.

 (Brrr . . . Don't worry, I can do this! I think I can, I think I can . . .)
 


 My brother remembers a similar experience skiing over a swarm of yellow jelly fish when he was younger, also worried he would fall. By the way, he bounced right up on those skis when it was his turn. Way to go, Bob!!

Vince and I brought bicycles, too, and enjoyed the bike trails that run through the park and beyond alongside the lake. Five hours of sailing and and an hour or two of biking gave us a good workout, and yes, I was a bit sore when I came home. Not bad for a couple getting ready to retire in a year or so, huh?





Copyright 2013 © Sharon Himsl