S is for Salone

I have arrived in Freetown, Sierra Leone to serve as Plastic Surgery Team Leader on the ward aboard the Africa Mercy for 3 months. In this role I will be responsible for training a team of 15 nurses who have been designated to care for the plastic surgery patients. My job will be mainly a mentoring and teaching role, educating the nurses about different plastic surgery procedures and the care of patients with regard to wound care using sterile technique. Many of the plastics surgery performed aboard the Africa Mercy is to release old burn contractures with skin grafting. Sierra Leone or "Salone" as the country is affectionately referred to by its citizens was first discovered by the Portuguese in 1462 and given its name which means "Lion Mountain" for the beautiful lush green mountains rising up from the ocean behind Freetown. Sierra Leone underwent a devastating civil war from 1991 to 2002, resulting in over 50,000 deaths, thousands of orphans and victims of brutal war crimes. The Revolutionary United Front (RUF) rebels engaged in forced recruitment of child soliders, burning of villages, rape, amputation and disfigurement of civilians. The events of the Sierra Leone Civil War are depicted in the film, "Blood Diamond" as well as in the autobiography of child soldier Ismael Beah, "A Long Way Gone." The documentary film "Sierra Leone's Refugee Allstars" tells the story of so many Sierra Leonean refugees who lived in refugee camps for over a decade in neighboring Guinea.Sierra Leone just celebrated its 50th Independence Day from England on April 27th. Banners, penants and flags are waving all over Freetown as the citizens look to the future for a brighter Salone.

Jean

Jean Loko began developing a lipoma on his back in 1992 after he was caught in a battle between government and opposition forces in Benin and was beaten on the back with a rifle. The tissue damage resulted in a swelling which continued to grow over the course of 18 years into a 7 kg lipoma which limited his range of movement and ability to work as a tailor and he abandoned his business.Jean also had to battle the cultural aversion to deformities, which are often viewed as a curse. The father of seven, Jean was rejected by his two oldest sons because of the growth. He had sought treatment at the local hospital where doctors told him they were unable to help him with his problem. He heard about the Mercy Ships surgical screening on the radio. Although he was a bit fearful that he would meet disappointment again, he went to the screening anyway.
“But I was chosen!” he said with a combination of surprise, disbelief and elation. After removal of the lipoma on the Africa Mercy Jean stayed at the Hope Center and returned daily for several months to the post-operative department for wound care. On one such visit, nurses thanked Jean for his patience with the wound healing process to which he replied through a translator “I have new life.”The volunteer surgeon aboard the Africa Mercy successfully removed the lipoma that had caused him so much misery. When asked about his experience, his usual serious expression turns to a brilliant smile. “I just thank Mercy Ships for what they have done for me. They gave me my life back.”

Abel is Able!

Abel is a joyful eleven-year-old, who loves to make new friends. His attitude is surprising when one considers the physical problem he has been living with for most of his life and the reaction of most people to that problem. His parents first noticed that he was having difficulty learning to crawl. His muscles had stopped growing, but his bones had not. His leg bones could not grow correctly because there was so little musculature to direct and support them. His legs began to bend backward at the knee, forcing his upper thighs out behind him. His parents took him to three different doctors, but none of them knew what to do for him. Despite this condition, the resolute Abel learned to lean forward, correcting his balance enough to walk, climb and do just about anything any other active boy can do. He even became the goalkeeper on his soccer team. The only thing he couldn't do was ride a bicycle, since it requires sitting straight on the seat and pushing down on the pedals. Abel's physical deformity made him the target of ridicule from other children. But he remained optimistic thanks to his joyful spirit and his wonderfully supportive parents. One day, there was an announcement on the radio that a Mercy Ship was coming to Togo, offering free surgeries. Abel's hopeful father took his son to an orthopedic screening in Lomè. A few days later, a wonderful surprise awaited Abel when he awoke after his first surgery onboard the Africa Mercy. His left leg was straight out in front of him, in a cast. As he admired his newly straightened leg, he asked his dad if his right leg would also be straight after the next surgery. His father assured him that it would. And a second surgery did straighten his right leg. He also had a third plastic surgery procedure for skin grafting to his upper thighs. Through the surgeries and post-operative care, Abel’s sparkling personality and brilliant smile earned him many new friends among the crew and among the other children recovering at the Hospitality Center. Finally, after more than three months of surgery and recovery, it was time to return home to his northern village of Homa. Abel and his father, accompanied by a Mercy Ships team, climbed into the Mercy Ships Land Rover to begin the six-hour journey. As villagers recognized the Mercy Ships logo on the vehicle, they ran to spread the word. Soon the Land Rover was surrounded by curious villagers who wanted to see what the volunteer doctors had done for the boy with the backward legs. The suspense ended when the star of the show, a very happy Abel, climbed out of the vehicle with two straight legs!

There were gasps of surprise, disbelieving stares, and cheers. Abel, dressed in his cheerful blue and yellow outfit, was the center of attention. The other boys in the village stood quietly nearby. Abel kicked a small soccer ball with his straightened legs. Abel smiled graciously at them, the uncontested victor on every level. The Dalome family squeezed together for a photo commemorating this fantastic and unforgettable moment. When it came time for the team to leave, the villagers vigorously shook the hands of each crew member and expressed their thanks, saying, “God bless Mercy Ships.”

Wound Care Ninjas

Since the beginning of the Togo Outreach, I have been serving as a ward nurse and charge nurse in the orthopedic and maxillary facial surgical areas. Plastic surgery is soon to begin and I was approached about serving in a new role as Reconstructive Care Coordinator.
In this new role, along with my friend Jane who has been managing the Outpatients Department, we will be responsible for overseeing the care of the Plastic Surgery patients on the ward, for rounding with the surgeon in the morning and performing sterile dressing changes on the plastics patients, many of whom will receive surgery to release old burn scar contractures and skin grafts. Let the wound care by Sensei Jane and Grasshopper begin!

A is for Abla

Here in Togo in meeting translators and patients on the wards, I began to notice many reoccuring names such as Yaovi, Kossi and Komlan. One day I asked one of the translators about the meaning of his name and he told me that many people in Togo are given the day of the week in which they were born as one of their names, either as a first or middle name. He asked me what day of the week I was born on to which I replied, "I don't know." "You don't know?!?" he said, quite surprised. After I little internet calendar research, I learned that I was born on Tuesday. My Togolese name in the Ewe language would be Abla. I soon discovered that my good friend Marianne is also born on Tuesday as is our friend Geraldo. We began a tradition of Happy Tuesday dinners together up on Deck 7 every week featuring locally grown coconut or pineapple.

Lawson

Lawson was a joy to care for on the patient ward. He sought treatment for a large, benign tumor affecting his upper jaw. His tumor was ameloblastoma which develops in the jaw, often at the site of the third molar, and may involve tissue from the eye sockets or sinuses. Ameloblastoma is formed from remnants of cells that, under normal circumstances, develop into tooth enamel. Lawson's tumor continued to grow over the course of 4 years. He arrived on the ship with a piece of cloth tied around the back of his head to hide the tumor. Individuals with disfiguring conditions such as ameloblastoma are often cast away from their villages, viewed as being cursed or punished by ancestral spirits or gods for something they or a family member has done. They often live isolated lives in hiding, apart from their family and village which is especially difficult in a culture which so greatly values community and interdependence. Ameloblastoma tragically kills its victims who are unable to receive surgery slowly and painfully through starvation and suffocation, by eventually occluding the mouth and throat. Lawson received surgery to remove his maxilla. His new smile says it all. Here Lawson departs the ship in his traditional dress, ready to reunite with his daughters. I feel so blessed to be able to participate in all that God is doing to show His love to West Africa. Thank you for your prayers and support to make this work possible.

The Snapshake

One of the cultural joys of Togo are the daily pleasantries and greetings, "Bonjour, ca va?" "Ca va bien, et vous?" "And how did you sleep last night?" "How is your family?" But the greatest part of the greeting is with what I call, the "snapshake":

Grasp the hand of your counterpart

Slide into a thumb-to-thumb grip

Pull back to clutch the finger tips of your counterpart

Release with a loud snap of the middle fingers

Bobo, our beloved patient with the bow legs found it very funny when this Yovo greeted him first thing in the morning with a snapshake.