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
This Adventure Ends 
