Monday, March 5, 2018

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. 

"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

"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

     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.


"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

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


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You could call me an eternal optimist, but I'm really just a dreamer. l believe in dream fulfillment, because 'sometimes' dreams come true. This is a blog about my journey as a writer and things that inspire and motivate me.