The thoughts of a woman trying to live simply yet abundantly, contentedly yet expectantly, wisely yet adventurously... all for His glory.

5.30.2009

why I can't stop smiling

So I had said that I would write about my trip into Cotonou with my roommate, who was looking for shoes...but really, all I might write you already know or can guess. It was dusty. Dirty. Crowded. Chaotic. No, I did not get run over by a crazy driver or a zemidjan (the crew calls them "jimmy johns"), thank you Jesus for that! No, I did not buy anything--this time. Yes, I ignored about a million hisses and the Beninoise version of catcalls. Yes, it was hot--blazing hot. This is the one place where I could really use the words of the wicked witch of the west: "I'm melting, I'm melting!!" Because that's what happens when you go outside in Benin.

So since you already knew (or guessed) all of the above information, let me move on to more important things. Like, for instance, why I can't stop smiling.



I love it here.



I just finished 12 hours on the ward with my VVF ladies, and I love what do. The integration of faith and life and work here is wonderful. We pray before the shift starts; disciplers come in to preach and pray and sing with the patients; we watch the Gospel of Luke dubbed in Fon and the patients hang on every word. Sometimes we pause in the middle of a shift and gather--nurses and translators--and pray for particularly complicated surgeries that are in progress. Every time I walk a patient down to the OR for surgery, the OR nurse, a translator, and myself gather around the patient and pray... and each time I nearly cry. One of these times I won't be able to hold it in!

And we laugh--a lot. Honestly, who wouldn't laugh at my crazy pantomimes for questions like "have you pooped today?" and "does it hurt down there?"

This is what nursing is supposed to be like. Cups of water. A little pain medicine. A lot of laughter. Singing. Holding hands. Bringing hope and healing to women who have spent large portions of their lives ashamed, abandoned by their husbands, and outcast from their families and communities.

I know it will not always be easy or fun or successful. Nor will I always feel like I am making a difference here.

But today... I love it. And I can't wait to go back in the morning.

5.29.2009

float nursing

As Eva pointed out, I am truly a float nurse now: nursing, on a ship... get it?!? :) So here's the obligatory nursing update.

After two shifts of orientation--one day, and one evening--I worked my first shift alone yesterday. I've been working in B ward, which is adult general surgieries and the VVF ladies (see my previous post for a little more about VVF). Most of the adult surgeries so far have been hernia repairs. It's been nice to have some relatively "familiar" patients--ie, adults and fairly routine diagnoses (well, excepting the VVF).

Warning: the following is probably only going to be interesting to my fellow nurses.

Nursing aboard the ship is different as night and day from home. Typical day: care for 6-7 patients, some pre-op and some post-op. Often I will discharge several patients, which involves a lot of teaching (through an interpreter of course)--how to make clean water (boil it, add salt, let it cool); how to care for the incision; no lifting the kids or "mama-papa business" for 6 weeks. Between the nurses and the translators, there's a lot of staff working--there's a translator for every 1-2 patients! Couldn't do a thing without them. For example, when patients are first admitted, the intpreters explain things like how to use the toilet, shower, and sink in the bathroom. Some of the patients who come have never seen stairs before, much less the ocean or a ship. About half the patients speak French, but even with those patients I often use an interpreter because most questions I need to ask are too complicated for my French.

I mostly give vitamins, iron, acetaminophen (called paracetamol here), and ibuprofen, with the occasional codeine thrown in for good measure. I have yet to give an antibiotic, IV medication, or morphine, although those not uncommon here. I think I will be able to get away without learning how to draw blood or "cannulate," which I know as "putting in an IV" or "sticking" someone. My other new favorite phrase used by some of the staff from New Zealand and Australia is "bung your tubing," which of course sounds slightly off-color to us Americans! It just means to cap your tubing.

Our supplies are largely donated, which means there's quite a variety of things, especially in the bandage department. Lots of our IV pain meds come in ampoules. Antibiotics have to be drawn up from a multi-dose vial or reconstituted. If I ever have a patient who needs a mixed IVF, for example D5NS, I will have to mix it myself.

The wards go something like this: A Ward is orthopedics (straightening bowed legs, burn contracture release, etc.); B ward is general surgery and VVF; C ward is currently not in use due to lack of staff; D ward is maxillo-facial surgeries (the thyroidectomies, cleft palate/lip surgeries, and tumor removals). There is an ICU but I think it is only occasionally used. I can be assigned to any of the wards (except the ICU) at any time.

Day shift goes from 0700-1500; evenings from 1400-2200; nights from 2130-0730. Weekends are the familiar 0700-1930 or 1900-0730 shifts. Today has been my only day off for a while, as I work days this weekend then nights Monday through Wednesday (yes, that totals 54 hours in 5 days). I have 4 days off afterwards, but am not sure what I will do. Probably take one day to just sleep in and recuperate (which is what I did today), then hopefully a trip somewhere on one or more of the other days. There are binders where you can sign up for all sorts of things: going to church off the ship, trips to local hotels/beaches, or trips to other cities. This weekend, several friends are going to Abomey, several hours' drive away, to visit the palace and some sort of historical museum. I would like to do that at some point, as well as visiting a village a few hours north of here that is built entirely on stilts over a lake.

My next post--which will happen tonight or soon-- will be about my first excursion into town with a roommate who wanted new shoes for the dinner with the President. Incidentally, the dinner was postponed for unknown reasons... hopefully it will be rescheduled while I am still here!

5.25.2009

church in three languages

So I attended an Assembly of God church yesterday in Seme Podji, a town/village about 25 minutes away from the ship. About 8 total crew went, and as we bounced along in the back of a Land Rover I met some of my coworkers in the wards--two nurses from Sweden and one from New Zealand. All were really wonderful women, and I look forward to getting to know them more.

Church was a lovely affair--women on the right, men in the middle, and then children and visitors (us!) on the left. Clothing was a mix of western clothes and more "traditional" wear--big beautiful, colorful prints for both men and women. I will definitely have a two-piece outfit made of some beautiful fabric... maybe even one of the elaborate hats if I am really feeling brave. The kids sitting in front of us were definitely distracted by us! A couple of their mothers kept coming over and reminding them to behave.

The service was led by the youth/young adults, and they did several songs (plus dancing of course), two dramas, and there were about 4 offerings taken (you have to dance up the aisle, drop your money in the box, then make your way back to your seat). As I have no CFA (local currency) yet, I didn't participate in the offerings. Because it was a youth service, it was longer than usual--it went a total of 3.5 hours! I was glad I brought water with me as I might have melted otherwise. The windows let in the occasional breeze, but it is always blazing hot and humid here.

After church was finally(!) over the pastor had us over to his house and his wife made spaghetti for us--a very good, spicy spaghetti with some sort of fish in lieu of meatballs. We also had peanuts (seem to be the main appetizer at least in my experience so far), sodas, and at the pastor's insistence, an apertif made of some mint pastille liqueur which looked and tasted rather like mint mouthwash. Some of my fellow crew members put up a bit of a fuss about it (mostly on the way home) which was both unecessary and embarassing. When people go out of their way to be gracious and hospitable, the least you can do is eat and drink--at least try-- what is put in front of you unless there are really good reasons not to. If nothing else, no need to comment at great length about the taste (which, being nearly identical to mouthwash, was obviously not terrible!). Anyway, probably only the first of many times that I will be embarassed for the tactlessness of fellow travelers when in a foreign country.

Anyway, on the whole church was very good, but after we got back at 4pm I was so exhausted that I kept wanting to fall asleep and finally allowed myself to go to bed at 9pm. Sleep and hydration are my friends at this stage of the game!

5.23.2009

settling in

Je suis arrive aux Cotonou!

No need to go into details, but suffice it to say that all my flights went well, although I only slept about two hours en route to Paris from Chicago. From Paris to Cotonou I was seated next to a man with whom I conversed in French for about two hours. Despite my rusty French, we got on quite well and I was pleased to remember as much French and follow the conversation as well as I did. I hear that many of the surgical patients come from the northern part of Benin, though, and there are 52 languages (not just dialects, but languages) in that part of the country. So the communication often happens through more than one translator--English to French to one or two other languages. Sounds like quite the process!

After a brief orientation to the ship this morning (much, much more to come later), my group ended up running into the director of the MS hospital, who invited us to go visit the Hospitality Center with him. The Hospitality Center is a new thing this year for the vesico-vaginal fistula (VVF) patients. When women have extremely prolonged/difficult labors, one side effects can be to develop VVF, where the bladder and uterus develop holes or connections between the two. The end result is that the woman is unable to control her bladder, thus is constantly wet, and therefore is ostracized from her family and community. Mercy Ships will do about 120 or so VVF repair surgeries while here in Benin. But back to the Hospitality Center-- it's a ward of sorts off the ship where the women stay pre and post op--no medical procedures are done there--to ease up on the number of "hotel" patients in the wards. After touring the center, we were treated to a tour of Cotonou by land rover, then went out to lunch at a nice place along the coastline. Anyway, all in all a great day and definitely way above what other orientees receive.

Tomorrow I've signed up to go to a local church with some other crew. Monday launches more orientations, safety drills, and goodness knows what else. I think I start in the ward on either Monday or Tuesday. And, get this-- I heard from the hospital director that the President of Benin is going to have us all come to dinner this Friday as a way of saying thanks for the work we do. I have to say, that would be pretty amazing!

Anyway, I think that's all for now. I promise not to give blow-by-blow updates all the time...but at the start, that's really all I have to write about for now. I'll update more later, of course!

5.21.2009

surreal

"Surreal" is, of course, the only word that seems to fit right now.

I'm packed, I checked the list twice, and all that remains is to throw in my toiletries in the morning, zip it shut, and go.

Quick update about my grandpa: I had a really, really good conversation with him about a week ago. As far as I can tell, he still doesn't think it's a good idea for me to go gallivanting off to Benin...but he did say that he would be thinking of me, and that he hoped it went well. I am very much encouraged by the fact that we had a good dialogue.

Just fyi: my phone will not be coming with me to Benin. In fact, it will be turned off and my service temporarily suspended.

Also fyi: I will be about 7 hours ahead of CST. I think.

In case you want to send me anything--and I would love, love, LOVE to receive mail while I am in Benin--here's the info about both email and snail mail from the Mercy Ships website.

Please note, internet connection is very slow so please discourage friends and family from sending large attachments. Large downloads, Skype & Web Cams and streaming video are not allowed.

Letters, packages, etc will be forwarded regularly to the ship. Please advise your family and friends that it could take several weeks for mail to reach you in West Africa. If you are sent packages (or anything over 1 ounce), you will be charged $5.60/ pound ($0.35 per ounce or 28.4g)

Mail can be sent to:

Lindsay Nelson
Mercy Ships
M/V Africa Mercy – Nursing Department
PO Box 2020, Lindale, TX, 75771-2020


I also think there's a rule or two about declaring the contents of packages...but I don't know the details. Will update as I know more. And even though I will have to pay a little to receive anything remotely heavy (ie, over an ounce), I will be more than happy to do so... as long as you don't mail me bricks or rocks or textbooks or other similar items. (Besides, what would I do with a brick/rock/textbook, anyway?)

I'll arrive in Benin late in the evening of the 22nd, after traveling for about 24 hours total.

Ok, enough details. Off to sleep one last night in my own bed!