Published: May 28th 2010May 28th 2010
Hi everyone, well I’ve been in Lome, Togo for nearly a month now and I’m feeling pretty settled and have learnt a lot already. My week consists of working 40 hours on the ward (although I’ve just finished working 44 hours of night shifts straight after each other) and trying to get off the ship and spend some time relaxing or seeing new things on my days off.
Work on the ward is quite different to anywhere I’ve worked, not surprising though, the main reasons are the major language barrier and 10 patients (often plus their parent & sometimes a sibling) in a 10 metre by 10 metre room, with another 10 bedded room joined as well. The parent either sleeps on a mattress under the bed, or shares with the baby/child. Every so often you hear a bang, and pick up the child who has fallen out of bed and screaming and the parent is fast asleep.
Pretty interesting at times when there are 8 kids aged under 6 running around, women wandering around topless and feeding their kids who are way too old to still be feeding, babies (and even 6 year olds) strapped to their backs
Nice spacious top bunk
(and sometimes us nurses!) and up to 5 african translators (men & women) and 5 nurses all in this ‘ward’, the fact that you feel a sense of ‘community’ is a bit of an understatement. But it’s fun. Here in Africa the people are ‘hot climate’ people compared to us ‘cold climate’ kiwis, so living close to other people, everyone looking after each other’s kids & sharing food is part of life. You can especially see this when you are talking to a mum about feeding her baby through a male interpreter and also the male patient in the bed next door (some people speak a language that possibly only one other person speaks so we improvise), it gets pretty funny and I think…wow that would not happen in NZ. Oh well. Dignity & privacy mean different things here. Dignity means wearing clothes covering your knees, I don’t even think I’ve seen an African woman’s knees! They all wear skirts, wraps & dresses made out of colourful fabric even in the 40 degree heat and almost 100% humidity.
It’s been really amazing to see the transformation of patients (adults, kids and babies) who have had major & minor deformities
Beautiful beach near the port, too dangerous to go on unfortunately!
and injuries surgically healed or improved. The majority of people I have looked after are kids who have had cleft lip/palate repairs, and kids and adults who have skin grafts taken from their thigh and are used to release burn contractures on their feet or fingers. Burn contractures seem to be too common in Africa unfortunately, from falling onto fires used for cooking, and then the limb or fingers develop scar tissue and make the limb heal in a bent/wrong direction. The surgeons put wires in to the joint once they have cut and released the scar tissue and leave the wires in for between 5 days to 6 weeks. These operations are really good because now the person can walk normally, or fit shoes properly, look normal and hopefully use their hand and fingers again.
I got to watch some surgeries last week which was great. The operation rooms here are fun and nowhere near as tense as the ones in NZ that I have seen. I watched 2 cleft lip repairs and a fatty tumour be removed from a woman’s shoulder which was the size of maybe 2 fists. I think I could have removed that tumour,
Me observing a shoulder surgery
it looked pretty simple, flag the training to be a surgeon though. Last week I also went to the hospitality centre which is where the patients who are waiting for surgery and are from out of town or are recovering after surgery stay. They had a Celebration of Sight for the people who had had ops on their eyes (cataracts mostly) where they sang & danced (they do a chicken dance where they stick out their bottoms & do the chicken wings, its pretty funny to watch, even the 90 year old women) to celebrate seeing again.
This week they are starting VVF surgery which is for women who have had injuries sustained during prolonged childbirth which cause them to leak urine & sometimes faeces from then on. If the baby cannot be pushed out, only a C-section would help. However, here the baby eventually dies & the head of the baby pushing often damages & creates a hole which they then leak out of constantly. These injuries only occur because of their lack of access to healthcare & limited number of doctors & trained health professionals in Africa. In a developed country this would not happen. These operations
At Coco Beach, was so nice to feel sand and swim in ocean again.
are tricky and may require a few surgeries until they are ‘dry’. These women are also outcasts in their family & community. Because they leak urine, they smell constantly & also sometimes their nerves in their legs are affected so they cannot walk. Often they are rejected into a hut in the dark, most times divorced, & many would die due to infection & probably malnutrition. It will be nice to see them transformed into more happy and hopeful people if the surgery is successful.
In Africa, there is a lot of black magic, voodoo and belief in curses. Children who have any deformity (especially tumours, cleft lips/palates and eye problems like cataracts or cross-eyed) are believed to be cursed and often are killed, encouraged to be killed or outcasts. Parents believe that it is their fault that their baby is like this & that they are being punished for their sins. You hear stories of their return to their village and their acceptance back into the family and that’s really amazing.
Even though we are helping with their appearance, this makes a big difference to their quality of life. In our country we are pretty accepting of
Back to reality after the beach
differences, but with the belief in curses people are scared and treat the person or family different. We also hope the patients and their families see that we are doing this because Jesus loved his children also and accepted everyone equally. On Mercyships we try and demonstrate our Christian faith to the patients through our actions and love rather than through trying to convert them through religious acts, rules or speaking AT them. Its pretty cool on the ship, most of us are Christians (not everyone) and we pray at the beginning of the shift for the patients and the day, and also when we take the patient to theatre, the patients are quite appreciative of that which is cool. We look after patients of any religion and its nice that even though some muslim patients might be apprehensive about coming onboard, they still want the surgery for them/their child.
On a more lighter note, I’ve had lots of fun getting off the ship. There is a reduction in my freedom here unfortunately, but that is just to ensure we are safe when off the ship. There have been several people mugged with a machete on the nearby beach,
Another cute little boy whose cleft palate and lip were repaired.
and also at night about 100 metres out of the port so we are very cautious. But I’m figuring out my limits and the places which are safe. So far I have been to the local hotel for a few swims & even aquarobics, to another hotel to swim in the ocean, to a local bar & restaurant, to 2 markets. I also had the best icecream IN THE WORLD at one of the hotels.
We also went to church with one of the African day volunteers/translators last Sunday which was about 1 hour away from the port. It was an interesting day that’s for sure. Quite different culture and church to anything I have seen. The pastor was shouting the sermon with a microphone in Ewe (a common language here), I thought the speakers were definitely going to blow! And then our friend had to translate all of this, the sermon was at least 1 hour. Lots of singing, clapping & dancing which was fun and really warming. This was all in the 40 degree heat, luckily there was a roof, no walls though. After this we went back to the guy’s house & he spend 1 hour
preparing our lunch! He pounded away at cooked yams to make fufu which looks like and tastes bread dough & made us a delicious chicken soup, was waiting for the salmonella to hit later on but it never did thank goodness. They don’t have fridges so was a bit worried, but I think they boiled the life out of it so that was fine. Then we sat and talked to some old African pastors/missionaries for about 3 hours. These guys were really interesting. They were telling us about voodoo culture here, and marriages in Africa where the man pays a doury for the women to the parents to pay them for “bringing up the daughter”. They were shocked when I said that we don’t do that in NZ. They said “what is the benefit for the parents?” when they give their daughter away…maybe we need to introduce that into NZ!
Next weekend I am going to Kpalime (pronounced Palamay) with about 5 other people & 2 translators which will be loads of fun. It’s about a 2 hour drive and we will go for a long bush walk through little villages to a large waterfall. Im really looking forward
A cute little boy called Amza that I looked after who had contractures on his hand, wires were put in to straighten them. There are no after photos yet as he still has the wires in.
to that. One of the translators is from there so it will be nice to meet his family and the fact that he knows the area will be so helpful.
I’m pretty much used to ship life now, but wouldn’t want to live on a ship long term. There are about 480 people on board, and the size of the cabins is a challenge. I’m in a 6 berth cabin, there are 3 pods and 2 people per pod. Each pod is about 2 metres by 2 metres but the good thing is that it is air conditioned & there are no windows so it is nice and dark. I’m in the top bunk which is not ideal in this old age (yes im 26 (over the hill haha) ) but I’m pretty good at jumping up like a monkey so that’s one skill I’m improving at. There are some good things about living on this ship though, I can go up to deck 8 and lie in the sun (well, I have to cover my knees) and look out at the ocean (and dirty port), and they are putting a pool in so lets cross our fingers that
it will be open before I go home. I think those are the only benefits actually, ooh maybe the gentle rocking every so often.
Anyway, talk later, I love hearing from you guys back home, keep it coming please.
There are more photos below