Liberia '07

Hello Everyone
It's still raining over there then?
I don't feel quite so miffed about the weather here then; the rainy season continues to live up to it's name!
Yesterday we did a clinic in the rain, the same one as last week. I took a picture of the 'pre-visual acuity' patients waiting in their shallow 'barn' with corrugated tin roof. the rain was pouring off the front in rivers. That was another fun clinic, we saw 200 patients. We certainly can't help them all; we prayed with a Mum with her blind baby and a totally blind 46-year old man. Fortunately, his brother-in-law cares for him. Prayer is needed that somehow MS will be able to extend the ophthalmic operating time; the ship is due to leave here in Nov, and the schedules are nearly full.
The other eye nurse was telling me how MS now manage to reach the REAL poor where they are, as opposed to the people that could afford to pay for their operations. In the past there used to be a well-advertised mass screening, which often the more middle-class people got to first, probably because they had transport. Now, they start clinics in the already-established hospitals, most of which are in very poor areas. It's quite common to see patients who've been managing with visions of count fingers and light perception for 5 years.

The working day here is long, no part time! We either start work at 7.30, or there is devotions a couple of times a week at 7.30, then work. We often don't finish till 4.30 or 5. Thankfully, we don't need to cook; when we arrive there are meetings we need to attend, also meetings if we haven't just arrived! They're all good tho'. I've been going to aerobics x2 weekly (1 hour), then I see my adopted patient every day.
Last w/e I was very tired and chilled out by sitting up on deck 7 (outside) reading. Managed 2 books, but I felt better after that! 'Pacing' myself will be very necessary when I come long term. Relationships are very important, probably more so than at home; I think you rely on your friends here quite heavily. I've seen how hard it is when long-termers leave. There are quite a few women 'of a certain age' here, thankfully, who you can talk to!

Over the past 2 days the dental team have been doing extractions in Monrovia's prison;they saw 91 patients. They're limited to doing extractions only, by torchlight, because there's no electricity. Still, if I'd had prolonged toothache I'd be glad of an extraction!
There's a bit more reason to be thankful in the prison too; the men here explained how they met with the men in the one large room there, which unfortunately had no windows. They take torches, but mostly it's a case of communicating by speech and touch. Anyway, one enterprisisng man called Tom asked the prison authorities if he could take away a bit of wall, presumably thro' to a lit area, and they agreed! So down he went to the prison with hammer, chisel and ladder AND LET IN THE LIGHT. Now they don't need torches!
Today I'd booked to visit the orphanage. From notebooks I'd ripped pages, stapled about 8 together x60, stuck a sticker on and bought 60 pencils. This was for the orphanage; this morning at breakfast Patsi told me the trip was off, because of flooding. Unfortunately, 2 different trips had just left, there was 1 to go (to the prison, where I didn't want to go!) and they had 1 car space left. So I said 'ok God, I'll go to the prison!'
We prayed before going, 18 of us, and people who'd been before filled us in.
When we got there we men and women split off to different buildings; when we got to where the 24 women were we found 3 outside in the rain, they were collecting nuts on the ground from the large tree in the courtyard there. The other women were in the corridor up some steps,so we went in. They can roam free till 4pm, when 4-7 are locked in each room, with 1 mattress.
I made friends with 2 ladies, both there because of debt. I checked their stories and they're thought to be accurate. Blessing (40's) is from Ghana; she's a teacher here. Her brother stole money to take back to Ghana; because the authorities couldn't catch him they imprisoned Blessing. Bintu is in her 30's and has a child of 17 and 1 of 11. She owed her friend $450 and when she couldn't pay her friend contacted the police. Apparently, if someoone here has money and dislikes someone, they can pay the police to lock them up. I'm sure not all the police are corrupt, but prayer about these sort of situations is necessary.
The women seemed to enjoy our time with them, we gathered with them in the corridor and had a time of singing and prayer. It was very joyful, hence the name of the blog! That song will always epitomise my time here, because it was sung at length at a 'new dress' ceremony I went to. Blessing said she prays and fasts if she is desperate, and that God does indeed bless her! It is truly wonderful that we have God's power at our disposal.
I will never forget that prison experience. Now I have extra people to pray for on my daily list. I will keep in touch with people here to find out when Blessing and Bintu are released. I felt sad that I'm leaving in 2 days and won't see them again.
Anyway, I left the paper and pencils with a Christian guard; he said he'll ensure they reach the literacy scheme.
More good news from the prison! A male prisoner, who is now free, became a believer whilst in prison and is now out spreading the Gospel! Also, there's an Alpha course being run in the prison by him for the men.

'K', the lady I've adopted, has asked Christ into her life! Her operation has been successful, and she'll be home once her catheter is out successfully. There's a scheme here to line up adopted patients with someone else when their 'adopter' leaves.

It's extremely dirty, noisy and crowded here. Four of us drove aroound in the week, looking for a market; it's rush hour all the time and traffic jams everywhere, often because one stream of traffic is waiting to get round some of the huge potholes in the dirt roads. Going into Monrovia city is slightly better, but the outskirts is just a heaving mass of humanity struggling to earn a crust, trying to sell you things as you drive etc. The people are lovely, humble, but they have SUCH a hard life. One taxi we were in last week had bullet holes in the windscreen ( I presume from the war, not now). It went very slowly and an ominous grinding sound came from somewhere by the back axle. For fresh air we had the window open; the nearest girl had her brolly up IN the car!
Catherine, I must tell you, there are Portuguese lessons here on the ship!

I'm still being surprised by the depth of knowledge of the translators here. The eye nurse here has trained Joyce; she can tell an untreated glaucoma patient by the open 'staring' appearance of their eyes, somehow their corneas look 'stretched'. I can see what she means; often you find these patients have, at times, had treatment. Of course, as with glaucoma generally, they don't realise the importance of their treatment. They don't bother buying more drops, so we have to be quite frank with them, saying it's more important to buy drops than food sometimes. Alot of Liberians live on about £2.50 per week.

I've tried downloading photos - may have been successful with one, but the otheres wouldn't download. You may find it in 'thanking God for rest'.

Here's a good verse to end with (probably my last blog):

I keep asking that the God of our Lord Jesus Christ, the glorious Father, may give you the Spirit of wisdom and revelation, so that you may know Him better. I pray also that the eyes of your heart may be enlightened, in order that you may know the hope to which He has called you, the riches of His glorious inheritance in the Saints, and His incomparibly great power for us who believe.
Ephesians 1:17

IT'S ALL TRUE!

See you soon

Love
Mum/Margaret

| 07.07.07

Hello everyone.
This is my 1st proper day of rest since arriving here nearly 2 weeks ago and I definitely appreciate it!
Everyone here works so hard, lots of people here have 2 jobs; for instance, the man who drove us from the airport (11/2hours)is a plumber. He has plenty to do sorting out the plumbing on our deck as it seems to want to pump upwards instead of down. I don't know any other plumbers; this one is great, he comes out when you call him!

The eye surgeon flew home this week, but Bob has been doing clinics, every day except Tues, which is when I did teaching. Bob says an eye nurse is a very rare person on Mercy Ships (he's leaving Nov), and the 2 nurses we have aren't eye trained. Therefore I taught them alot of the basics, also a non-eye trained Dr and the 3 translators who do 1st dressings. I'll be assessing the translators on Tues.

The clinic yesterday was very demanding; it was at the back of a small hospital where patients don't pay, so is very over-subscribed. Basically, we use 3 bare rooms, they do have a roof and cement floor, and a table and chair, but that's all. No slit-lamp, so we do the best we can with torches. There was a fair sprinkling of people with old war wounds on their heads, and cataract on that side, because a blow to the head can cause cataract. Between us (Bob, the non-eye trained Dr and myself) we saw 150 patients; and listed a fair number of them. We'll have to stop listing soon as the surgery schedule is nearly full up to Nov, when AFM sails to Sierra Leone. She'll be back again in the next couple of years tho'. Because of the sheer no's at clinics (people wait from the night before) we can't see everyone there, asking them to return next week, and praying for them. We do pressures with a Tonopen; found several glaucoma patients who weren't taking drops because they couldn't afford them. Sometimes you could tell that they probably could afford them (the translators are helpful) so it was best to spell out the risks to them. You can never be sure tho' as generally, people wear their best clothes to come to hospital. There's SUCH alot of need, tho' you can't afford to be despondent, or to stop praying! Another common eye (and systemis) problem is one caused by vitamin Adeficiency because of poor diet. We give out cards with pictures of the food they need to eat, and vitamins.
Before we even started the clinic we had a problem; a local lady who does crowd control and was there before we arrived was suspended and had the key to one of the rooms taken off her. She was told the administrator had said it was because she was 'taking money' from MS ships staff
to open the room, which was untrue. It's more likely that he wanted to give her job to a member of his family. Alison, who's worked with African's for years, says that things are rarely what they seem. Alison and Bob had a meeting with the administrator after the clinic.

The Liberian people generally seem happy and carefree, which is fortunate, because they know no other way. They say they have hope now because they have great faith in their new President, Ellen Sirleaf. She has visisted the ship.

Talking about faith, that's the name of one of the wards here. The others are Joy and Hope. There are 78 beds, including ITU beds. On the door to each ward is a notice saying 'welcome to -----ward', including ITU. It's probably just my sense of humour, but I thought 'who on earth would want to be welcomed to ITU?!'

I said previously that we have the chance to 'adopt' a patient; I've adopted 'K' - she's aged 30, very cheeky, and we have to converse thro' a translator. She's had 5 children but 4 have died.She had her operation yesterday.
There are 9 other women in that small ward, all with
the same condition, it's quite amusing to be there for a while. We've been teaching them to knit and crochet, some of their 'makes' are becoming almost stair-carpet length!Last night I was drawing pictures for K, when I drew a snake she put her hand to her mouth, as if eating - UURGH!

Every week, the ladies who've had the gyneacological operation are given a new dress and matching hat, and there's a ceremony to celebrate their new condition. I wondered why the bongo-bongo drums were on the ward! It was a very lively occasion this week, with LOTS of singing and dancing, and the ladies' talking about what it meant to them. All this is helping me to understand Liberians a bit better. I remember emailing Bob with a question about whether to do a Tropical Diseases course;he replied that it was better to try to understand the African mind!

Alot of patients here have high blood pressure; I noticed on the notes of one where it said he only took his tablet every 3 days - money again. It does make you grateful for the Nhs, even tho' it's not perfect.

Another thing I'm still grateful for is that I don't have to cook! I suppose I'd tire of the food eventually, but not yet. Another thing that's great for me is the fact that filter coffee (caff and decaff) is available 24 hours (can you inmagine that, Catherine!)

Because there are alot of Americans here I get called Marge, which is new, but ok! The next most apparent race is Australians; I've met about 6 from the UK.

Something making me laugh the other day was the way the ophthalmologist was describing how he very nearly used to career across the operating theatre floor on his wheeled chair when he was supposed to be operating. One of the nurses called it a 'geriatric skateboard'!He didn't do it on purpose,
it's just that the Anastasis eye theatre had a dip in the floor, and he had to steady himself before starting surgery! This theatre apparently has a slight slope!

I was wandering along the quay recently and found a tame rabbit in a kind of hutch. On enquiring I found that there's a project going to supply families with a male and a female rabbit. Guess what they'll soon have! Apparently, there's a dearth of animals because they were killed for target practice during the war. There are also similar projects for snails and bees.
The team have also been helping to restore at least 1 local school, and a Psychologist here is setting up a mental health programme that will continue after AFM has left. There's also going to be a palliative care programme set up.

One day we were walking and noticed quite a big creature hurrying along in front of us and then stopping - think it was either a lizard or a scorpion,unsure which.

At the moment the Wimbledon ladies' final is on at the nearby rest-room tv, with lots of audible
accompaniments!

One day next week we're going to visit a local orphanage, there is a visit today, but I was having my lie-in!

God is being so good, helping me in ways I never thought possible, because it is so very different to home, and a big challenge to give eye care. For instance, He's allowed me to be able to use the Tonopen, because it wouldn't calibrate at first. People are so lovely here too, coming up to me and introducing themselves. It's not possible to be lonely!

A good verse for me is 'you will keep in perfect peace him whose mind is fixed on Thee' from Isaiah 26:3, reminding me that if I don't have peace, it's because my mind isn't fixed on Him.

Love to you all, till next time
Margaret/Mum

My Control Panel > My Diary > My Diary Entry - News from Liberia

News from Liberia
Liberia | 29.06.07

Hi everyone
Thought it was about time I started my blog,so here goes.

The flight here was interesting in itself, 5 hours late leaving and an angry crowd on board because the pilot had to keep changing the order between Monrovia and Freetown concerning where we were going 1st. I got to sleep at 3am after a scheduled arrival of 7.30pm!
Our driver drove us skillfully in the rain and dark; at one point there was a faint torchlight swinging in the road - it was an illegal roadblock, designed to get money out of you. The road was blocked by 3 small wooden crates and about 3 men - don't know if the fact that we were Mercy Ships helped - they let us thro', thank You Lord! We didn't stop to see if they had guns, though our driver declared he would have stopped if they had!

It is just so, so differet here to anything at home; I've learned that it's best to throw anything out of the window concerning how we do things at home, particularly that to do with nursing! You just have to keep the principles of what you're doing but be adaptable as to how you do it. For instance, I've been responsible for 1st dressing and eye exam of 1st day cataract and pterygium patients; usually there's no eye nurse here and they get done by a trained translator (they're very good). The surgeon trusts me to spot anything untoward (with a v. small,unsophisticated slitlamp) which so far I have; but he does such a good job that complications seem to be rare. From today he's left me entirely, not checking, but obviously I'll tell him if I'm concerned. The thing is that I'm used to having a sterile pot and swabs to do a 1st dressing; here the only sterile material I've found are eye pads, so I've used those. The pot is a non-sterile plastic beaker (I've asked Theatre to trial a sterilization of these). Into the beaker we put a mix of sterile water and Betadine, rather more Betadine. (Mrs Morton, are you there?!) There we go!
The translators give the family post op instructions satisfactorily, and a bumbag containing all they need to care for the eye, including dark specs and shield for night.
Yesterday I noticed 1 man still at dockside hours after we'd finished, poor man had come back because someone had stolen his bag! Sometimes they do sell them tho'. Now, we tell patients to wear them under their shirts.

Accomodation is good, even if space is a bit tight. I share a room with 5 others. I have a Chinese nurse/anaesthetist sleeping in the bottom bunk, fortunately she doesn't snore! Actually, I wear earplugs because of the constant 'thrum' of the generator. Even my over-active brain has been stilled, I rarely wake at night as I'm definitely ready for bed when sleep beckons!

Food is good; maybe if you're here long term monotony might be a problem, tho' long termers get a kitchen of their own. There is a kitchen we can use; I thought of having a pancake party before I leave!

I have had total strangers come up and introduce themselves, as they've noticed you're a new face. I found that really welcoming. Not that non believers wouldn't do that; it just wouldn't be common. I've found that people are prepared to go the extra mile.

There's a really good scheme going here set up near Starbucks; it involves 2 drip sets, 1 pink for a girl and 1 blue for a boy. Patients due for surgery have a paper with their name pegged onto the giving set. Someone of the same sex (taking account of African culture) completes the slip with their name, thereby volunteering to visit the patient, as they may be far from their family. Isn't it a good idea?! I might volunteer. The other sorts of surgery done here are orthopaedic, maxillo-facial and veso-vaginal fistulas (from prolonged childbirth). Dental work is done in outreach clinics.
The surgeon does about 8 cataracts (ECCE) and 3 pterygiums per day, finishing about 3pm. Pterygium is a benign structure which spreads acrosss the cornea, eventually obliterating vision in alot of people here. He does a fantastic tunnel approach, needing no sutures, and puts a lens in. Trouble is, he's going home next week and there's no eye surgeon till the day I return, 16th July. Never mind, there are outreach clinics next week, where him and Bob (eye nurse) see about 400 patients per day, listing about 250. Bob has no lunch and is fit for nothing when he's finished, he tells me.Am I surprised?! He's of retirement age.

We've just finished a meeting planning surgery for the next few months, taking into account the skill of the surgeon; the fact that 1 eye theatre will close in Oct for noise reduction work (it's near the generator)etc. Also, some surgeons have to cancel a few weeks before they're due, causing big probs when patients are already scheduled. Still, God has the big picture! Why have they not had these probs before? The old ship, Anastasis, had only 1 eye theatre, so rarely were any GA's done. We've had GA patients this week, but can't take any the week 1 theatre is shut.
Bob oversees the planning; his priorities are cataracts in adults (tho' if there's a pterygium sitting atop that obviously gets done 1st). Next priority is a toss up between removing painful, blind eyes, cataracts in children and disfiguring eye problems,particularly in young women/girls, as it affects their marriageability. The need is HUGE.
In reality my effort is only a drop in the ocean, even tho' I'm at work 7.30 every morning, till about 4.30. There are 1st dressings for tomorrow too (Sat) so it's bit like eye ward.
The people here are LOVELY (both staff and patients). I'm really impressed with the way all staff give 200%; alot have 2 jobs! There's so much been going on recently; yesterday we all helped to move final things off Anastasis as today she sailed away to India to be dismantled. I was doing 1st dressings in a field tent on the dockside as she sailed; it was quite emotive to hear her horn and that of Africa Mercy blast to each other as she sailed out of view.Some people have been upset; especially those who have served up to 19 years. Alright for me, I had the marvellous sound of Africans singing while they waited for their eye dressing, and then to see Dr Strauss!
I didn't realise at first the seriousness of 'swimwatch' and 'stowawaywatch', for which volunteers were requested. My manager explained how she and others were up for 2 hours in the night on Anastasis's deck to prevent stowaways entering the ship. Not long ago a man was found aboard with a machete! Yesterday a stowaway was found in a locked office by an organised search by staff, who combed the whole ship. Liberia is so poor that even a sailing to India may offer promise.
Nearly there now!
The other things AFM staff do are, briefly:
1) education re AIDS and training people to educate;
2)sinking wells and training people to maintain them, plus giving them materials to do so
3) mending water supply, electricity supply and sewerage systems in Monrovia
4)training educators to instruct in basic health and hygiene
5)visiting people in orphanages and prisons
6) many others I can't remember at present!

Now I'm going for my tea. It is nice to not have to cook, tho' I'm sure I'll welcome my kitchen when I get back to it!

Oh, I want to come back next year if I can afford it - Helen, are you listening?!
I hope you are all well and that Wimbledon is providing entertainment.

Something to keep me going should I flag - I CAN DO ALL THINGS THRO' CHRIST WHICH STRENGTHENETH ME.
(Philippians 4:13)

Love and God's blessings to you all
Margaret/Mum

Margaret
United Kingdom | 25.06.07

Hello everyone!
Am at the airport with a 3 hour delay but am not bothered, the Lord is speaking to me alot and I'm enjoying the time to keep up with Him.
Have no more news at present, but ask you to pray for the entire crew of Africa Mercy and those travelling to join her, especially those with children. It's going to be difficult keeping them occupied for 3 hours.
Will update on 26th June, hopefully.
God bless
Margaret