Africa Mercy - Goodbye Congo: One Nurse's Journey

A parting post from Marilyn in the Congo, as she prepares to come home for a break. Those of you following the Ebola outbreak in Guinea will find this
interesting. .....Sharon



(This is a running email post written by a volunteer nurse serving on the Africa Mercy, a hospital ship that travels the African coast).





Goodbye Congo
11 April 2014

Our time in Congo is fast drawing to a 

close. Because of the long follow-up required after cataract surgery, we have to stop surgery several weeks before the ship leaves the country. In fact, our last day of cataract surgery was yesterday. We will do some pterygium surgery next week because the follow-up is not so long for them, but after that, my job is done. The ship leaves Congo around June 1, but I will be leaving Apr 23rd, headed for the good ole USA and visits with family and friends.

As I was thinking about this email, a band of about 30 minstrels marched slowly up and down the hall outside the hospital wards, singing at the top of their voices, some of the dancing a bit, all of them harmonizing and moving from one praise song to the next without missing a beat. 

They were dressed in hospital gowns, and each carried a Foley bag (collects urine from a catheter). Who was this strange choir? The VVF ladies! VVF stands for vesicular vaginal fistula. This is a condition that can happen to a woman as a result of a long, difficult labor without proper medical attention. The baby's head presses so long on surrounding tissues that some of them die, leaving her internal plumbing a mess.


Many women die, of course. I've heard that one in ten women around here do die in childbirth. Many others survive, but with scar tissue and fistulas between the vagina and bladder and/or bowel. The incontinence makes them social outcasts. Husbands move on. Families put them in a shed out in back to sleep and eat and won't let them come into the house. It's not a nice life. 

Then Mercy Ship comes, and they get repair surgery. Recovery takes weeks, and the women are with us at least until the catheter can be removed. So our wards are brimming with very happy, hopeful, thankful women. No wonder they march up and down the hall several times a day, singing their thanksgiving and praise to God. We give each woman a new dress before she leaves to celebrate her recovery. I'll try to attach a photo of some of our decked-out ladies.

 I think I told you about the edict that we will not do eye surgery on anyone whose blood pressure is over 200/110. This is Africa. Probably half the population over the age of 40 has high blood pressure, and most of them don't take medication for it. We tell them to see their doctors and get on medication before surgery. We call them to remind them to take their medication before they come to the ship for surgery. But, pretty much every day, we have several people arrive with pressures over the limit. We tell them to take their medication if they've brought it with them; we tell them to relax, even take a nap. But mostly, we pray.

An amazing number of times, their pressure will eventually dip low enough to allow surgery...and then immediately rise again once we're finished. It feels like God's blessing, parting the "sea" to rescue these people. I can almost hear him chuckling, "I want these people to get help, so I'll make it possible, and never mind your rules."

One such fellow was our very last patient yesterday. He arrived early in the morning, as scheduled, but his blood pressure hovered around 230/125. He is only 50, but he has dense cataracts in both eyes. He could see hand motion, maybe even count fingers held in front of his face, but he is a teacher, and he needs better vision. He'd taken his medication as directed. He took a nap. Still, his pressure remained above the limits. 

He waited on the dock all day, and every time we brought a patient out after surgery, we'd check his pressure again. It dipped slightly, to about 210/115, but time was running out. We checked about 1:30...nope, still too high. Did he want to give up? No, he'd wait some more. More prayer. Finally, about 3:30, it dipped to 198/110. We rushed him onto the ship and did a fast prep for surgery to get him in as last case, just in the nick of time. It was a beautiful finale to our surgical year. Wouldn't it be fun to follow him home to see what a difference the surgery makes in his teaching and in his life?

As you know, we are supposed to go to Guinea for our next field service.

Now there's an Ebola outbreak in Guinea. We don't know if that will affect our ability to work there or not. Can you imagine a crowd of thousands gathering for our main screening, and then an epidemic breaks out? Ebola is spread by body fluid contact, so that's better than respiratory transmission when it comes to crowds...but hospital wards and surgical patients are abundant sources of body fluid contact. We have up to twenty patients, twenty caregivers, and half a dozen nurses and aides in a single room, and they mingle freely, use the same bathroom, etc. Mix in one Ebola patient... Well, Mercy Ships is studying the situation carefully, including our own on-the-ground assessments as well as WHO and other experts' input. They will make a careful decision and let us know.

Meanwhile, please pray for Guinea. It is quite possibly the most needy nation in our service area. They are too poor and too turbulent to attract foreign capital, but without outright war, they don't get international aide and rescue, either. Jobs are extremely scarce, and poverty is everywhere. Medical care is desperately needed. We always have more patients than we can handle every time we go there. It's like tossing the starfish back into the sea--you can't help them all, but you can make a difference to some. I really hope that conditions will allow us to go there next year. So...stay tuned...

Marilyn  











 




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