Friday, April 22, 2011

Margaret eight years old sat quietly on the wooden bench beside her dad waiting her turn to be seen at first glance of Margaret one would not be able to divert their eyes from her protruding left eye.
From spending time in Africa and seeing the many patients that come and go the immediate thought on seeing the protruding eye is a Retinoblastoma or Burkette's Lymphoma. A retinoblastoma is a life stealing childhood cancer; Burkette's Lymphoma is a very treatable child hood cancer. When Margaret's turn approached a closer examination was given; due to there being no primary tumour in my mind I ruled out Burkette's lymphoma, my heart was troubled to think "Retinoblastoma." With a little prompting Margaret flashed me a smile and won my heart. I brought her on the ship after speaking with the surgeons Margaret received a comb beam exray for further diagnosis. From the comb beam the surgeons decided it was most likely not a Retinoblastoma, Praise God! She was a surgical candidate. So after a long day of waiting, talking and playing Margaret went home with a return date for surgery. Throughout the day as I had opportunity to speak with her dad. He stated that Margaret had not yet attended school because the other children teased her unmercifully. He stated he had started to teach her as much as he could at home. Which was evident when we checked her vision in the affected eye and she promptly counted the fingers I had raised. On their return to the ship Margaret received her long maticoulous surgery in order to remove the growth behind her eye to maintain her vision and all her other facial nerves.
After Margaret returned to the Intensive care unit on the ship she looked in the mirror and said "Now the other children will want to play with me they will no longer tease me."
Now the waiting for the histology report to come back to find out what indeed was removed from behind her eye. The histogy report has come back as psammomatoid juvenile ossifying fibroma, good news it is benign.

In your head right now if you were to say the above name out loud how would you say it?
So did I. It was not until the patients started to giggle and than laugh out load did I know the "G" was silent.
Gblah, (silent G) turned up on the dockside with his mother and baby sister. Gblah is a very active four years old with bilateral club feet. His mother a courageous woman from the Northern part of Sierra Leone made her with two small children both unable to walk, Gblah strapped on her back and baby in arms. Gblah was an excellent candidate for the poinsetti program where the orthopedic team does a series of casting to correct the children's feet. As I carried Gblah up the gang way he pointed at things and seemed to be a very sweet, inquisitive child, we experienced a whole new side of Gblah when he needed to lie still to have the casts put on, we did succeed but not without being covered in plaster and a few sore muscles. After we were finished with Gblah I could not help but think how much heavier he would now be for his dear mom to carry. Gblah has now been back to the ship for his third set of casts each time with knees of the fiber glass almost worn out.

This year on the ship my title is "Out patient Nurse" a nurse who provides routine post-operative wound care and follow-up for outpatients following discharge from the surgical ward. Follow up includes: wound checks, sutures, nasal bolsters , whiteheads pack removal, dressing changes as well as a variety of other interesting treatments such as colloid treatment injections, crawford tubes and evacuation of hematomas.
The Out patient department has a gradual start up as more and more patients are discharged after their surgeries. So when the assistant screening co-coordinator went home I was able to fill the position for the weeks I have been in Sierra Leone thus far. I have enjoyed this role. The screening co-coordinator is often the first contact a patient has with the ship. It requires some decision making and about 4365 trips up and down the gang way each day, for a variety of treatments for the patients before and after they have seen the surgeons to decide if they are indeed a good surgical candidate. Often patients with tumours or any kind of growth need to have a small section of the tumour or growth removed. The patients are than instructed to go home and return in approximately three weeks when the histology reports come back and it is determined if they are surgical candidates. Often the news is good and they are booked for surgery however there have been several that have also been referred to palliative care due to a variety of reasons the most common being cancer. Today a young girl, age 13 with Hodgkin’s Lymphoma, a twenty eight year old with cancer as well. Dr.Parker our chief surgereon does not have an explanation as to why there seems to be a higher incidence of cancer here in West Africa. His comment as we reviewed many of the histology reports was,
"Lord Jesus comes quickly."

Saturday, April 02, 2011

"In the early morning hours this past Saturday, crew onboard the Africa Mercy here in Freetown, Sierra Leone, woke up before sunrise and prepared for an extremely important day serving those in need.

"We had an incredibly successful day of medical screening! Approximately 3,000 individuals waited calmly and patiently for many hours—some arriving the day before—with hope that today would be the day they would hear, “Yes, we can help you.”

As Chief Medical Officer I have attended a lot of screenings, and this one went very smoothly. God was gracious even in providing cloud cover to bring respite from the harsh West African heat!"

From the above pictures one can see that the second screening day was much different than the first."
Dr. Gary Parker, Chief Medical Officer

Perhaps the thing that makes the waiting ones most anxious is to hear the "yes" that they will recieve surgery and to watch some depart with a yellow card in hand praising God for an opportunity to come on the ship.

There is anxiety...hope... everywhere. Hope to get through the gates to see the doctors.

The focal point of this long lined up crowd is to first pass by the pre-screeners in hope of enter the building to be assessed by the doctor.
Careful instructions are given to the pre-screeners as to who is an ideal surgical canidiate for the surgeons and who is not.
Each pre-screener dressed in black and white lined up outside the gate to begin the exciting process of filling the surgical list.

In the early morning, the street is lined with people waiting for their second chance to bring their sick to be seen my Mercy Ship personal. Some of the infirm are blind, some crippled, many with tumours of different degrees. Mothers cradle their children in their arms hoping for surgical care for their dear little one who without their "conditon" fixed will continue to endure the ridcule of their society and never attend school.

It is now the early morning of March 26, 2011 the second carefully planned screening day of the Mercy Ships 2011 outreach to Sierra Leone.
Throughout the streets of Sierra Leone there are sick people everywhere; steets, lanes, and alleys are filled with people wanting to be healed. The country is overrun with suffering souls.
Privatised healthcare system in Sierra Leone is beyond most people's means.
The healthcare system was largely destroyed in the war. Now the Sierra Leone government is struggling to improve facilities - many of which were burnt down or destroyed.