Africa Mercy - Douala Health, Simple Solutions, Thanksgiving: One Nurse's Story

More from Marilyn in Africa....  Sorry these postings are so late! My friend, as you know, is in Africa serving as a nurse on the Africa Mercy. She emails me and I share her words with you. For those of you who know nothing of  Marilyn's story, the Africa Mercy is a hospital ship that travels the African coast with a crew of nurses and doctors. They come from all over to give of their time as volunteers. 

(November)

2017-11-02,

"Douala health, Frank, Solange"

     My time here in Cameroon is 25% done already.  How can that be?  I

     feel like we are still on the on-ramp, gearing up, trying to get up

     to speed.  For whatever reason, we aren’t finding the patients we

     expected to find, at least for cataracts.  Most of the other types

     of surgeries—ortho, plastics, tumors, etc.—are already fully booked

     for the remainder of the field service.  The eye team is never

     booked that far ahead—we screen for new patients all year long

     because we can do so many surgeries each day.  But, we are not

     finding as many patients as we could be handling, and the people we

     do see are not as blind as the folks we usually schedule.  We’ve

     done a lot of unilateral cataracts for folks whose other eye sees

     pretty well.  It’s pretty strange to see a whole line of eye

     patients walking up the gangway without assistance because they can

     already see.

     Why are we not finding the profoundly blind people with bilateral

     cataracts?  Perhaps we are screening in the wrong neighborhoods.

     We’re screening where the government told us to screen…but judging

     by the number of medications our patients are taking and the number

     of prior surgeries they’ve had, the overall health care around here

     seems quite a bit better than other places we’ve been.  Perhaps

     Douala itself has good health care but the rest of the country does

     not.  Initially, the government planned to screen for cataracts in

     the regions of Cameroon where we can’t readily go, then pay to

     transport and house those patients in Douala so that we could do

     surgery for them.  So far, anyway, that has not happened.  I don’t

     know if it will eventually, or not.  Whatever the reason, we are

     not effectively reaching the poor who need cataract surgery, and

     that makes me sad.

     Turn this on its head:  The people of Douala seem to have pretty

     good access to health care!  People take vitamins, supplements,

     medicines for aches and pains, as well as medications for specific

     problems like diabetes and hypertension.  People with HIV all seem

     to take their medications consistently.  Quite a few people have

     had prior cataract surgery on one eye, done somewhere, and are now

     coming for the second eye.  I rejoice that so many of the people

     here are doing so well.

     Not everyone in Douala is that fortunate, of course.  Frank, the

     boy I wrote about before, comes from a poor family.  By the way, we

     saw him again this week, and his vision had improved a little more.

      It’s still not good, but he’s no longer “legally blind.”  He

     crossed the street in front of his house for the first time in many

     years…with assistance, but still…  He and his family expressed

     gratitude that we did what we could for him, wondering aloud why on

     earth we cared.  They could have been angry or bitter at having

     their hopes raised and then dashed, but no, only gratitude.

    Next I want to tell you about Solange.  She’s a young woman who was

    put out on the streets when her mother died, and so has a huge heart

    for orphans.  She is currently caring for 48 orphans by herself.

    Her house is in terrible shape, she has no income, and she feeds her

    children by faith, not knowing where the next meal is coming from.

    They eat mostly rice, of course; they almost never have meat or

    vegetables or fruit.  Mercy Ships is getting involved.  We took up a

    collection to buy food for them for the next few months.  Someone

    paid the rent that she has been unable to pay for the last five

    months, and Mercy Ships is looking into alternate facilities for the

    future.  Meanwhile, our electricians and plumbers have been working

    on her house to get it functional again.  The dentist team took care

    of all the kid‘s teeth.  Solange brought one child to our eye clinic

    today, so I got to talk with her.  Her cheerful faith in God is

    wonderful to behold.  It reminds me of the stories of Hudson Taylor

    in China many years ago.  Would that I had such faith!

     Can anyone wonder why I love to be here?

 --

  Marilyn Neville

2017-11-16,

"Simple solutions, broken legs"

     Sometimes the simplest things bring delight.  This week, a fellow

     came to the clinic because he’d had cataract surgery sometime in

     the past, but his vision had gone cloudy again.  He was a

     journalist, but he couldn’t work because he couldn’t see to read.

     This condition, dubbed “secondary cataract”, happens gradually in

     about 20% of all cataract surgeries; the posterior wall of the

     capsule that normally holds the lens gets a film on it.  The

     solution is simple…if you have a laser and know how to use it,

     which we do.  You poke a few holes in the membrane with the laser,

     and voila!  Problem solved.  That was one happy dude that day.

     FYI, we routinely do this laser procedure on all our cataract

     patients at six weeks post-op, just to prevent this from happening

     to our patients, since we can’t predict who will be in the unlucky

     20%.

     We really haven’t had enough work to keep two scheduling nurses

     busy, so Amber decided to move to a different position.  She is now

     a facilitator at the Hope Center; I think that she will like it.

     I’ve been doing all the scheduling for a couple of days now, and it

     seems to go along just fine.  In fact, we usually get done seeing

     and scheduling the patients by lunchtime.  Most of the team returns

     to the clinic in the afternoon for other tasks, but I usually stay

     on the ship and help with data entry and other stuff to help the

     team leader.

     One woman came for cataract surgery today walking on a broken leg.

     She apparently broke it nine days ago by stepping into a

     pothole—that’s not hard to do around here, especially if you can’t

     see—and she just wrapped it up and hoped it would heal.  Instead of

     doing her cataract surgery, we sent her to X-ray, then to the local

     hospital to get the displaced fracture attended to.  We’ll do her

     eyes when that gets sorted out.  But imagine the pain she endured,

     walking on a displaced fracture without even a splint, in order to

     get here for her cataract surgery!

     Our reputation is beginning to build.  One fellow remarked that

     he’d planned to go abroad for cataract surgery, but his friend got

     such good results that he decided to come to us instead.  Well…if

     he’s rich enough to go abroad for surgery, he’s not really among

     the forgotten poor that we came to serve…but it was nice to hear

     the good report, anyway.

     We are starting to draw patients from places further away.  We have

     been developing a questionnaire for untrained screeners to use to

     identify potential cataract patients as they are screening for

     other things.  We got our first batch of these potential patients

     on Monday, and three of the four actually were suitable for

     surgery.  It seems promising.  Perhaps this will be a way to find

     patients among the poor who live outside the city, in the villages.

      I sense a wave of the future here…

     You folks will be celebrating Thanksgiving next week.  It will be a

     crazy-busy work day for us, but that won’t stop us from giving

     thanks!  What a blessing it is just to be here, doing what we do.

     I wouldn’t trade this time for anything.  So, eat an extra bite of

     turkey or pumpkin pie for me, and rejoice with me in my good

     fortune to be here.

Marilyn

2017-11-23, 

"Thanksgiving, YAG day"

Well, it feels like Thanksgiving after all.  Yes, we worked hard all

day, but when we got back to the ship, they had prepared a delicious

turkey dinner, and many people had made desserts to share, so it really

is quite festive.  There are a lot of Americans on board…but we invited

everyone to the party, not just Americans.

I wish you could see YAG day at the clinic.  It looks chaotic, with

people everywhere, but it is actually a fairly well-controlled chaos.

The clinic is a room about the size of a normal school classroom.  On

YAG day, the surgeon is doing the YAG procedure on about a hundred

people—our patients who had cataract surgery about six weeks prior, plus

random people who have had cataract surgery in the past but never had

the YAG done.  All of them get their eye pressure checked (for

glaucoma), then their visual acuity done.  They move to the next bench

to begin the drops to dilate their eyes, then have an auto-refractor

reading done.  Moving to the next bench, they get more dilating drops

and wait their turn for YAG.  Meanwhile, based on the auto-refractor

readings, we give them readers if they need them.  After the YAG, we

take them back outside to wait for the Celebration of Sight.  That’s a

lot of procedures happening simultaneously, and the room is packed with

people moving from bench to bench, and workers swarming all around.  It

reminds me of lines at Disneyland.

Once all the YAGs are done, we bring all the patients and all their

caregivers back into the clinic for the Celebration of Sight.  Now there

are 200-250 people packed into the space.  The singing is beautiful,

unlike anything I’ve experienced at home.  The testimonies are

heart-felt gratitude to Mercy Ships and to God for their restored sight.

 Looking at that whole room full of people we’ve impacted with just one

week of surgery—it blows my mind.  And we plan to do it for about 28

weeks.

This week, I had a relatively young man, profoundly blind, brought to us

from a city many hours away by his friend, a very old man, because he

had no family to help him.  They rode the bus all day and then spent the

night on the streets because they had no money for a hotel.  Normally,

when they come to the clinic for secondary screening, we do the

measurements and book their surgery for the next available slot, about a

month later.  But, for this fellow, we put him in as an extra surgery

that same afternoon, and found beds for them at the local hospital,

since of course he needed to stay for the one-day post-op exam the

following morning.  You should have seen that young man beaming as he

greeted me that morning!  What a difference that act of friendship made.

We are starting to get more and more patients from further away, so we

are scrambling to figure out how to handle them.  For most of them,

multiple trips to Douala are a hardship, and yet, stuffing them into an

already full surgery schedule isn’t always possible.  So far, we’ve been

able to find a bed at the local hospital for those who really need it,

and usually we can squeeze them into the surgery schedule, although it

is disruptive to do last-minute add-ons.  If the number of long-

distance patients increases too much, it may not work…but for now, we’re

scraping by.  If we could predict the numbers, we could adapt…but, dream

on.

 Marilyn