Noma

Noma is a disease of poverty. You will not find it in a developed country. It is a bacterial infection run rampant. Many times it occurs when a malnourished child has one of the common childhood diseases such as measles. With the additional insult to their immune system, the normal oral flora overwhelms the body's natural defenses and eats away at the flesh. It has a predilection for facial tissue. It will kill most of it's victims, those that survive will be scarred for life. I just goggled it and the world health organization fears that it is on the rise. While it could not be eradicated, a 10 cent vaccine for measles would greatly diminish the number of children afflicted by it. Unfortunately, the poor cannot even afford that much. The local people call it the melting disease. On Monday, you have a beautiful child, on Wednesday, his face has been destroyed, he no longer has lips, sometimes the nose is gone as well...that is, if he is still alive. A nurse with antibiotics could cure it if caught within the first 24 to 48 hours. Goggle it if you want to see the devastation it can cause. Most children die, those that survive live on the outskirts of society. They hide as much as they can. They are ashamed of their appearance.

Christine is the only Noma patient I have taken care of, and I had her the day she went to surgery. Please don't think I am heartless, but I want you to get a feeling for what these people live with every day. She truly defined the word "hideous". She had a hole in her cheek the size of a lemon. Saliva seeped out from it and from between her lips which she could not close because of her swollen gums. Her facial skin was drawn so that it caused her to not be able to shut her eye which was red and weeping. Without the push back of her lips and cheeks, her teeth were pointing randomly, some through the hole in her cheek, some out the front of her mouth. She would not look you in the eye. I first saw her as she lay in bed, facing the wall, covering her face with a sheet, a dirty rag clutched in her hand. As I would work with her, she would uncover herself (I learned that she used the rag to wipe at the drool), and whenever I was done, back went the sheet as she tried to hide herself. Over 20 years of rejection, pain, and suffering where reflected in her eyes. I saw no hope in them even as I prepared her for surgery. I think I wrote earlier how the surgeons took the temporalis muscle and made her a cheek and then grafted skin on top, many teeth had to be removed. I just spoke with the nurse caring for her tonight and she said that she was just looking at herself in the mirror. I wonder, how does it feels to her to want to look in the mirror? Slowly she is emotionally recovering. Dr Gary says that she is getting a little sparkle in her eyes, the eyes that had been so hopeless.

Mercy Ships saw a lot of Noma in Liberia, a country that has had most of it's infrastructure destroyed by many years of civil war. Thanks goodness, Dr Gary says that he has not seen nearly the number of Noma patients here in Benin. He says this is a reflection of improving health care. Let's pray that it continues to improve... that no more children will suffer as Christine has.

I am at work again tonight. It is my second night of 4. We always start out our handover with a prayer but tonight we had a special treat. Two of the translators had brought guitars and they, with several others, sang. Although, we may not have understood all the words, it was obvious that they where praising God. It was an awesome way to start the shift.

God is good all the time, all the time, God is good.

Social life on the Africa Mercy

Disclaimer, long post, more chatty than mission...may want to skip...



Now I know that many of you think I'm a saint and that I am working all the time....hey I heard that!!! Actually there is an active social life on the ship and since I have partaken of it heavily last weekend, I thought I would share.

Meals come at regular times on the AFM. Breakfast 6:30 to 7:30 (pancakes on Wednesdays), lunch 11:30 to 1:00 and supper at 5 to 6:30. The only variation is the weekend when breakfast is 30 minutes later and you fix lunch at breakfast as the cafeteria doesn't open at lunchtime. In the cool of the evening after supper, the families with small children tend to gather on deck 8 which is open to the air. The kids have several choices of what to do. There is a round above ground pool (just put up last week) and a jungle gym that was erected last year, as well as many riding toys (which I have seen some not so young crew ride). I think that it is wonderful for the 50 or so kids to have this area as they do not have a backyard or traditional playground anywhere in Cotonou.

The rest of the crew who are not working tend to gather in the midships lounge where the Starbucks and Internet cafe is located. Starbucks is open for about an hour and a half most evenings and I must admit, many of us are just devastated on the few nights that it is not: ) We have to have a trained barista to operate the coffee machine and it is a volunteer job, so occasionally it won't be staffed and there we will stand with our coffee cups (we have to bring our own cups to cut down on waste). It would be amusing to watch if I weren't one of the devastated. After coffee, one can usually join a card game or find someone to walk the dock with. We had a British dentist here for a few weeks who was quite the game master. One night he had a group of about 30 or 40 of us hooting and hollering as we played a game where you ended up sitting in each others laps (the record was 8 people in one poor soul's lap) as you tried to make your way around a circle of chairs, yours truly won...whoo hooo. Myself and a few friends usually end the night up on deck 8 aft enjoying the breeze coming off of the ocean before retiring to bunk at about 10:00.

Last weekend I ended up with a very busy schedule! Friday night after work, the ward nurses went out to eat at Livingston's which is an English Pub. It had many of the traditional food items (I got a thin crust pizza which I thoroughly enjoyed) but the surroundings where definantly African. Saturday morning, a group of us went to a large craft market (about a 45 minute walk from the ship) and spent a few CFA. Then, at 3:00, I went on an organized crew activity to Obama Beach. We are not allowed to swim as the currents tend to be pretty strong....but we did some high wading, watched people, drank coconut milk from fresh coconuts and then had the fellow who brought them chop them open for us so we could eat the nut part. That was a little scary as he whacked into the middle of the coconut with a machete while holding it in his hand...I just knew that us nurses where going to be called into action but he never misjudged the force required to cut half way rather that all the way through to his hand. We then partook of a fairly traditional African meal before adjourning to a bonfire and then limping home to gratefully take showers at about 10:00 at night. I enjoyed all of the meal except that I have to say, I am partial to chicken with a little more meat on it. The chickens around here are called "bicycle chickens" as they are always running about. They tend to be....shall I say a little scrawny. Of course, then I felt guilty for not fully appreciating the meal as there are so many who would have considered it a feast. Just so the night wouldn't end on a boring note, one of the Land Rovers broke down and we had to find a rope and tow it back to the ship in the dark hoping that no scooters would try and cut between the cars.

So Sunday, I had planned to go to the local church I had gone to previously, but couldn't get a ride....so....I went to Bab's dock. what a lovely piece of the world! We took a boat ride through a mangrove swamp and ended up in a large, shallow brackish lagoon. A Belgium couple have built a dock with a restaurant which was just lovely. It was so wonderful to hear birds again. I don't know where the birds are in Cotonou, but I had only heard one since I have been here until then. There where loungers, hammocks, kayaks, and even a sailboat to enjoy. The younger set played water volleyball while the rest of us napped, turned over, and napped some more. The peacefulness was only occasionally broken with a shriek when one of the numerous lizards decided to scamper over a sunbather. I got to where I didn't mind them so much unless they decided to stop and bask. We had hamburgers and french fries for lunch which where perfect (even if there where no buns....did you know that much of the world doesn't have bread with their hamburgers?) They also made a nonalcoholic drink from hibiscus flowers and lemongrass which was really good and refreshing. We just had the most relaxing, wonderful day away from the ship and got back at 6PM just in time to have supper and go to church at 7:00.

Then it was work on Monday and Tuesday. I worked evenings this week, so Tuesday morning I got to visit the dental clinic, the eye clinic and the hospitality center. I will post more about those later. Wednesday morning, I went back to the orphanage. It is so impressive (and very cute) to see how scheduled the nuns have the children. We arrived at about 9:30 and played with the young ones (about 2 to 4 years of age) for a few hours before lunch. They where given large bowls of a reddish gruel (can't think of a better word) which they ate every bite of. After presenting their empty bowls they where given a glass of water. They then pulled off their underpants (some of them needed help) and walked to the next room where there was a line of pottys. As we left to go back to the ship they where each sitting patiently on their potty until it was time to go and take their naps.....where where the nuns when my kids where young???? I saw Ibrahim, the young boy I posted about earlier. He is such a pleasant chap and I'm sure he will have many visitors when he comes in April for his surgery.

So that was my week. Life in a small community such as the ship has proved to be wonderful in so many ways. You can almost always find a playmate or prayer mate (depending on the need) and there are a variety of stimulating activities....but I do have to admit....sometimes.... occasionally...... truly only once in awhile...... it feels like you can't fart that someone is going to smell it.

On a more sober note. Please pray for Wessegui. She is one of the VVF ladies. She is an older women but just such a delight. I think her VVF surgery was successful, but she has an infection somewhere in her body and is having a difficult time. As always, thanks for any and all prayers.

1.5 kg tumor

I almost got called to give blood yesterday. When our patients need blood, guess where it comes from? The different, neat, Africa thing is that we (the crew) give it, and the patient receives it while it is still warm. You know, at home, you are far removed from ever seeing who will receive you life giving gift. Here, there is no delay! Yesterday, this lady had a 1.5 kilogram (about 3.4 pound) tumor removed from her face. She was in the OR for quite a while and ended up having to have 5 units of blood. If she had needed 6, I would have been her girl. They thought for awhile that she would need to go to ICU, but she recovered nicely and ended up going to the ward with one to one nursing. Last week, there was a patient who had a large tumor removed and when she went to recovery my roommate (Linda from the UK) was her nurse. She got out a mirror for the patient to look into and was very moved by the pleasure that she saw in the patient's face as she felt the bandages that covered the part of her face where her tumor had previously been. I don't know, how do you put a price on being a part of such a ministry? I can't. It has and continues to be a wonderful blessing.

So, I'm on call for blood tomorrow. Now I don't wish anyone to do poorly, but if they need blood....I think that it would be very cool to provide it!

Sorry I'm not replying to any comments. I have tried several times, but I think the Internet here is slow and it keeps bumping me off. I do read each one and very much appreciate the kind words and that we are remembered here.....although I think some of you may be just a touch blind: )