God is faithful

Just to update 1 out of the 3 patients I asked for prayer for earlier in the week went back to theatre and has healed since Monday! The other 2 were able to be transferred to the local hospital under the care of 2 maxillo facial surgeons who worked alongside our own Dr Parker here on board. Please continue to pray for them and their healing and thank God for working out all of the logistics and pratical arrangements through our hard working staff here.

Abra

Abra’s Joy

Abra sits quietly as she remembers the journey of her life. For 24 years, she has known suffering and great emotional pain. One day and one event changed the course of her life for over two decades.
On that day, many years ago, Abra went into labor. It was her fifth child, and she had managed all of her previous labors by herself at home. But this time was different. After struggling with the pain and pressure, she was taken to the hospital for a caesarian section. “There was no hope,” Abra remembers sadly. “Even the doctor lost hope.” The struggle was devastating. The baby died, and Abra remained in a coma for five days.
When she awoke, she learned that her husband had decided to leave her. Then, a few days later, she realized she was incontinent. The condition that Abra suffered from is known as VVF (vesicovaginal fistula). It is an injury caused by obstructed labor, and it results in a continual leakage of urine, feces, or both. Unfortunately, it is a condition that is much too common in developing countries, where women have little access to medical care.
The condition exacts a terrible emotional toll, as well. Abra was ostracized by her family, friends, and community. “Everybody in our area knows about my sickness,” Abra says quietly with downcast eyes. “All of them know.”
Over the years, people often mistreated Abra. They made signs and yelled insults at her. When she stood up, they often checked her clothes to see if they were wet. For a few years, she was able to stay with some relatives. However, when they died, she was on her own in the bush, secluded from the world. She was isolated from every kind of help and support – physical, mental, and emotional.
Abra says she only got through this time with God’s help. “In those times of challenges and pain, I did weep most of the time. I didn’t have anybody to come to my rescue. I spent most of my time in my hidden place, where I wept.” She struggled with depression that made it difficult for her to eat, and she longed for the day her suffering would come to an end. “So the only option is to wait for God’s time when I will join him after death, and it will be the end of everything. This was all I could tell myself before the ship came,” she says sadly.
Then, in 2010, Mercy Ships sailed into the port of Lomé, Togo. The arrival of the hospital ship brought hope for Abra – something she had not felt for a long time. Soon she was received a free successful surgery. After spending a few weeks in the ship’s hospital, Abra was able to go home.
She felt like a new woman, but her joy was short-lived. Tragically, a few weeks later, Abra was the victim of a brutal rape that ruined the surgical repair. She was back in the same nightmare she had experienced for two decades. “When my sickness came back, I was confused and lost,” Abra explains. Sadly, the ship had already left, and she had nowhere to turn.
Abra took refuge with her brother, who required her to be the housekeeper for the entire family. The work was very difficult for her. When she was unable to complete all the tasks, she was driven out of the home. She was only allowed to re-enter the house at certain hours to sleep. She had to awake every morning at 4:00 to leave the house and had to wait until late in the evening to return. She was not allowed to use the kitchen or even take a cup to drink from. She could not share in any of the food. Her brother’s family wanted to make sure she suffered because they were uncomfortable with her sickness.
Abra struggles to hold back tears as she recalls those days. “My brother did not agree with me. According to him, I’m telling a lie – I am not sick because I didn’t lose weight.” She quietly says a prayer and pauses before continuing, “My brother mistreated me. He mistreated me to the point that I got seriously sick.” The pain of her brother’s rebukes and abuse almost destroyed Abra’s spirit.
Finally, she found reprieve with her aunt. “She told me I smelled like a dead corpse before joining her. But the hands of God are upon me. Today I am here. I am still alive today,” she says.
Less than a year later, Abra’s daughter contacted her, telling her the wonderful news that Mercy Ships had returned! “For me, Mercy Ships has been sent from God to me, and I know that the ship is here to heal, I was hopeful. I didn’t know other people, too, have this sickness, I thought I was alone. But now, I know that I’m not the only one. I’m confident, and God is with me.”
Now, Abra has healed from her second surgery with Mercy Ships. She is living with her daughter and has been accepted back into the family. “I feel better now. No, rather, great! And I thank the Lord for the life of the medical team. May the Lord bless them, strengthen them, and give them long life. They will be blessed. God will reward them for ever and ever.”
Abra’s face radiates with happiness as she adds simply, “I have joy in me!”

Abra and her daughter

Story and photos from Mercy Ships' Marketing Team

Prayer needed please!

With 2 official days until the hospital closes I need to ask for prayer for 3 of our patients who have had massive operations and eventful, slow and complicated post operative recoveries.

Each morning this week on the ward rounds we have seen small improvements but humanly speaking I know we are all still worried about plans for their follow up care and healing after we are no longer able to care for them. It has become apparent that the logistical plans are difficult with trying to find an appropriate place for them to stay in Lome so a German physician, who moved here a number of years ago with her husband to run the 'Seamans Mission' opposite the port and who has been involved with serving on board over the past 4 months, has offered to run a free outpatient service for those who still need it from her home.

We are also experiencing problems in trying to provide the needed nursing and medical care for them as the services we have been providing on ship are simply not available, or are at too high a price when we leave.We have got some contacts in maxillo facial surgeons who are Togolese nationals and with whom we have been working so please pray for them as they seek to take control of these patients when we have left.

We also found out this morning that some of the patients from the northern parts do not know how to get home as they were driven here and had never previously left their villages or communities; this is posing a different kind of conundrum as we attempt to find links to navigate rural Togo!

The patients in need of particular prayer are little Maurice (below)

 Esther (in the middle of the picture)

Chara

Please pray for their healing and that God would have his hand over them as they leave here and that their fears and worries would be stilled. Thank God that he is sovereign and praise to Him who is able to do abundantly more than we could ever hope or imagine (Ephesians 3 v 20-22)

Thank you all, really appreciate your prayers

Afi

The story of one of our patients who had surgery to release burn contractures during the time when we were doing plastics. She is an amazing woman and spent a couple of months on the ward. She was always very joyful, praising God despite the hardships she had faced and encouraging other patients alongside her. She also attempted to teach me some of the local Ewe language; I think we got as far as 'oh foin' ('how are you')...I'm just a bad pupil!

Afi’s Release from Her Shackles

“Every moment of my life is difficult to survive. I struggle greatly, and I struggle alone,” Afi says with tear-filled eyes that testify to the pain she has suffered for the last four years. As she speaks of the suffering she has endured, she takes a rag to wipe the tears streaming down her scarred face and recounts her story with courage and grace.
Afi suffers from a disorder called epilepsy. She can suddenly have seizures that force her body into debilitating tremors. One day in 2008, Afi was cooking over a fire with her one-month-old son strapped to her back. Suddenly, she felt ill and thought she needed to sit down. Before she had time to react, her body went into a seizure, forcing her to fall face-first into the fire. She lay there in the fire, seizing helplessly. Luckily, her infant son was not harmed, but the damage to Afi was brutal. She suffered severe burns on her face, neck, hands, and legs.
Afi tried to go to a hospital to get medical help, but the hospital turned her away because she had no one to take care of her son. As her wounds began to heal, her skin started to contract, pulling her face down and her shoulder upwards. The injuries became her shackles over the next four years. Afi’s husband left her because he could not stand to look at her. Riddled with guilt, he ended up committing suicide, leaving Afi to be the sole parent to their three children.
People believed that Afi’s deformity was the result of a curse. She was no longer able to sell fruit in the market because people were too afraid of her. She was forced into a life of isolation, with only her children to help her. The village would no longer allow Afi to walk through the center, touch anything, or be near anybody. When children caught a glimpse of Afi's face, they ran away in fear. She had to hide in her home. If she wanted to go anywhere, she had to sneak around the outskirts of town.
Recently, she went to the hospital again, desperately seeking help. Catching a glimpse of a TV, she heard that Mercy Ships was coming to Togo, West Africa. Afi wrote down the dates. Leaving her children with her father-in-law, Afi tried to get to the port. Relentlessly, she made three trips to the port gates, each time being turned away by the local security. Finally, she was allowed through and examined by Mercy Ships crew.
It was a wonderful day when she was given her appointment card. “I know now that things are going to be better. I can tell my life will move in that direction,” Afi says as she spends her days on her hospital bed onboard the Africa Mercy. Afi’s surgery will release the contracted skin, allowing her neck and shoulder to move again. Her eyelids and lips will be released and repaired. She will receive function and movement again – release from the shackles, the injuries that have held her captive.
She has already had a taste of how much better her life will be. Mercy Ships crew are not afraid of her, and they look her in the eyes. This is the start of a new life, with new hope and a new future. She smiles through her tears saying, “Thank you for everything, and thank you to everybody. I now see a new life coming my way. I pray God will help me each step of the way.”

Afi, prior to her sugery

Afi, after giving her testimony at one of the ward services

Story and photos by the Mercy Ships Marketing Team

Just some pictures to sum up more of life both on and off ship..

My workplace for part of the day..the admissions tent where we see the patients who are being medically screened for the next day's operations.

Little Sammy, one of the patient's brothers who was full of energy all the time on the ward.

Papakey and Toyi with their new noses, smiles and friendship

 Alex, post op playing with the other children on the ward when the maxillo facial ward turned into paediatric land!

Chara, a beautiful little girl who was operated on when we had the cranio facial surgery team here from Germany. She had been born with Crouzon syndrome. This meant that her skull bones had fused too early not allowing normal development of her skull or her brain. Without intervention she would have developed seizures and her life expectancy would have been shortened. She underwent the first of a number of operations where her skull was reshaped and moved forwards to allow her brain room to develop normally. She had an eventful post operative recovery so please pray for her continued improvement especially as we are facing the last week of the wards being open.

Chara with her Mum and the staff on D ward. She is always willing to give anyone a wave and smile; such a joyful little girl!

D ward with all the cleft lip patients post op including whisker style bandages!

Esther pre op, a teenage girl who has suffered with this massive facial tumour for many years. At the time of surgery it was close to causing her problems with her airway.

Esther post op with her nurses

My workplace and home for the past 5 months

Once every 6 weeks there was a community gathering on the dock after work with all of the crew and day workers to share a meal together and then to have a time of worship

Playing on the wards!

The beds on the wards; the caregivers sleep under the beds, can make for some interesting ward rounds especially as we can end up treating both!

Alex and his Mum

One of our cleft lip babies post op playing on Deck 7

Maurice following his operation to remove an encephalocele.

Lulu post face painting!

Fabrics at the market



Local sweet grapefruit drink



Grande Marche

Batik at the Artisan Market

The significance of a dress

Another type of surgery, which began in April, through our 5 month service here was that of gynaecological repairs, following obstructed labour. Vesico-vaginal fistulas are holes or tears, which occur following prolonged labour, which in the Western world would normally progress to an intervention before the baby or mother is put at risk. However, without proper obstetric care the pressure of the baby's head onto the surrounding tissues causes them to become necrotic and die, causing holes to develop between the bladder, vagina, rectum and other tissues. This leaves them leaking stool or urine constantly and outcast from communities and families. Many husbands will leave them and they are left to suffer alone. One woman on the ward this year told the nurses that she was made to live in a hut by herself and if she tried to go to the village well to get water people would throw rocks and sticks at her as they were afraid that she would pass the condition to them.

They would come to be admitted with their heads hanging in shame and would become very upset when they leaked but also came with an air of resignation as this had been something that they had been putting up with for so many years. You would see the transformation take place on the wards where often for the first time they were shown love, care and the fact that they mattered despite what they had been defined by for so long.

Many of the women in the photos below have been on waiting lists for fistula repair since the ship was last here in 2010 and the difference the operation makes to their lives is just impossible to explain. For some of them the incontinence has been there for over 10 years and has wrecked the normal life they knew before. Following their operations they are given a new dress and a service to praise and thank God for all his work in their lives. Some of the women are just so inspiring in their faith in God despite their past sufferings and even when the operations fail to have the so wanted impact they praise and trust in Him who holds all and who is faithful even when we may not understand.

There was one lady, Fati, who touched me the most as she had had recurrent and complicated operations to repair fistulae years after the initial delivery. Unfortunately she had a very eventful post op recovery and even with repeated attempts we failed to make her dry. Despite this, one day when I was examining her wound which had become infected, she lifted her hands and was full of joy praising and thanking God for bringing her here and looking after her. As the field service draws to a close she is still here as is not quite fit for discharge and we hope to be able to pass her care onto a nearby mission hospital. Pray that though we haven't been able to help her physically God would continue to strengthen and keep her, giving her perseverance and joy in Him who never leaves or forsakes us.


Some links to articles explaining more about the impact of VVFs on women in developing countries and the work of the Hamlins in Adis Ababa, Ethiopia.

http://www.christianitytoday.com/ct/2010/january/17.48.html

http://blog.christianitytoday.com/women/2011/03/mother_teresa_of_our_age_talks.html

http://www.christianitytoday.com/ct/2010/january/18.53.html



A good book to read is Hospital by the river, describing the work of the Hamlins in Ethiopia.

A film which details more of these women and their suffering is A Walk to Beautiful, which also shows the Fistula Hospital and follows a number of women from their struggles from their home villages to their operations.

The work amongst these women reminded me of the story of Jesus healing the woman who had been bleeding for 12 years (Luke 8 v43 - 48). Praise to God who sees the suffering of these women over all the years and has compassion upon them. Many of those who came to us were from the North of Togo, where the majority are Muslim, so pray for our women to go back home having seen and heard, maybe for the first time, more of Jesus. May they declare of his power and compassion to those villages and communities they live amongst.

Dress ceremonies with the patient life team

Fati and Molly

Grace

I just wanted to share about a little baby with a cleft lip and palate who had been seen by those in the infant feeding programme (this serves to bring those babies who are underweight and malnourished up to weight in order for them to be able to have their operations).

Her name is Grace. She was born to parents who are missionaries in Benin and is 10 weeks old. She weighs 3kg and has not put on weight since her birth despite her parents feeding her as much as her tiny body will allow; a few drops every half and hour. I was called to see her by the dietician who was concerned that she was looking much worse. Most of the tiny volume of formula that they have been able to get down her seems to be going into her lungs. Add to this her cleft lip, palate and the congenital malformation of her jaw and the work of her breathing is maximised and laboured. When I saw her she looked very distressed and sick and I knew I was faced with the difficult decision of what we could do.

Ultimately we are not a medical facility; we are a surgical ship, which is able to do a limited number of specialised operations. This may seem like a hard and callous boundary to draw but I have learnt over the time being here it is an important distinction to make. Ultimately our patients generally tend to be medically healthy and the bed a medical patient takes up is one which could potentially block another of the countless patients we have turning up to the dock every day. Also, as we have a limited period of time being in a country, this is something which has to seriously be taken into account. These are questions which are almost impossible to ask and even more difficult to answer. Who are we to be choosing? Struggling with these kind of quesitons over the weeks I have learnt the only thing we can do is to bring this all under the will of God and attempt to discern the answers in some way, trusting in his sovereignty and direction.

After many discussions with the chief medical officer, anaesthetists, hospital managers and other people we came to the decision that we had to do something to help to get her over her acute illness, if possible. A feeding tube was placed and she was started on antibiotics to help with her chest infection. We also saw God's amazing hand of provision and grace as the staff working both on the day shift and night were intensive care paediatric nurses, completely at ease and very excited about a familiar kind of patient for them!

Unfortunately after a seemingly promising first day she took a turn for the worse. Her breathing became more laboured and she began to no longer tolerate the feeds. We did a chest X-ray, which showed that her heart was massively enlarged. We do not have the technology here to further diagnose or clarify but this showed us that she would not be able to tolerate an operation, even if we could get her to the weight needed. Add to this the likelihood that her heart will continue to fail without a massive surgical intervention and it was down to us to tell the parents that her condition was incurable and without a miracle would cause her life to be shortened.

Her parents are missionaries in Benin and have been working there for the past 8 years, ministering to the voodoo villages and strongholds in the south of the country. They have another 3 girls; 10, 8 and 5 years old; Testimony, Favour and Miracle. The mother had been through so much over the months prior to Grace being admitted with us; she had just lost her mother, had been admitted herself to an ITU being critically ill with complications from diabetes and had been struggling with Grace's birth and coping with the subsequent 10 weeks.

We were waiting for the father to arrive from Benin, where he was with his other children, before telling them the news. We had called them to come as soon as they could as we didn't know whether or not she would survive the night with her oxygen saturations being so low.

I was paged later on that evening to say he had arrived. He had been found at the port gate, exhausted and hungry. They had spent the last of their money searching desperately for a cure for Grace. They had been promised that through various investigations something could be done, but they had just given all of their money away. He had set off from Contonou, Benin that morning but as he had run out of money had had to run between the taxis he could afford.

Speaking to him that evening was so difficult; he kept on clutching at any hope we would give him. This involved questions about taking Grace to the West and when I said that a baby as broken as Grace may not survive in a western hospital he suggested the option of taking her to a pastor in Nigeria to have her prayed over. Trying to put it as directly as I could that she may not survive the journey to either of us these places, let alone even last the night. He said simply that we would have to trust God for the miracle and that whatever his will was was the right plan.

This simple, child like faith that God could and may fulfill his promises challenged me. Am I being too worldly and medically focused? If it was possible is this not a miracle? Am I limiting God to my own thoughts?

Please be praying for them all as a family, as they go through these deep waters. That they would know God's presence and comfort and would be able to say as with Job 'The Lord gives and takes away, may the name of the Lord be praised'.