My work schedule has not been the most conducive recently to getting off the ship, and the rainy season has not helped either. Many things become significantly more complicated or even impossible once the unpaved roads can no longer absorb the rainfall.
Despite that, though, I have been able to get off the ship some recently. I do have pictures, but can't upload them at the moment so will try to add them later.
Earlier this week I took a tour of some of the off-ship ministries. We stopped first at the Hospitality Center which is a warehouse converted by Mercy Ships to sleeping space for patients either before or after their surgeries, as well as the evaluation and follow-up site for some of the eye patients and for the orthopedic patients who have a lot of rehab.
Next we visited one of the sites of the eye team, which rotates around 5 different locations depending on the day of the week (this helps with the logistics: imagine trying to queue, evaluate, and treat 400 blind or visually impaired people... and that's just at one site, on one day!). Some people just need eyedrops or steroids; others are referred to the ship for cataract surgery. Some are given "prescription" glasses--I say "prescription" because what happens is that patient tries on a pair or two, and if their sight is improved then it's a match. Obviously we don't have the facilities or equipment to create custom lenses for everyone, nor is that high on our priority list (helping the blind see by removing their cataracts definitely trumps eyeglasses). Even a moderate improvement with eyeglasses is still an improvement.
Last on our itinerary for the day was visiting the dental site in Akpakpa, which is a little way outside of Cotonou. Some NGO built the Benin government a really nice facility that was intended for a labor and delivery ward/maternity clinic, but the government doesn't have the money to pay staff to work there, so this really nice compound has been sitting empty... until Mercy Ships. The Beninoise government offered MS the use of the building and it has worked really well apparently. The team is able to run generators for their electricity, sterilization equipment, etc. A lot of teaching happens here (dental hygiene, how to prevent cavities, etc.) as well as extractions and cleanings. Interestingly, some people have really nice teeth here, and others have severe cavities and infections of all sorts. Many of my patients use a stick to clean their teeth--it looks like a really thick toothpick, but with a blunt end which is chewed until soft and then rubbed on the teeth.
The biggest adventure on this tour was the drive to and from the sites--since we are in the rainy season, things get unpassable really quickly. Dirt roads quickly turn into lakes and rivers, and I was thankful we were in a utility vehicle, as the water was probably waist high in some areas! Below: a truck headed towards us as it begins to head down into one of the "puddles."
Today I visited an orphanage called Jardin d'Eden with a group of Mercy Shippers. I'm not sure who runs the orphanage, but the kids ranged in age from probably 4 or 5 to about 15. Everything today was tied to the story of Joseph as he went from being the favored son with the robe of many colors to being sold into slavery to interpreting dreams for pharoah and being reunited with his family eventually. I was really impressed with the way the lessons were all related to the story--everything from singing, doing a skit, coloring, and games all served to help the kids remember the story.
As often happens when anyone from Mercy Ships is out around town, a mother who lived nearby brought her little boy to us. A little spitfire about two years old, he burned part of his arm 6 days ago, probably in a cooking accident. It's unfortunately all too easy for kids here to accidentally pull a pot of steaming food from the cooking fire down on themselves. (Incidentally, I have not seen too many burn patients, but the surgeon who does those cases will be returning soon so I might.)
What do I know about burns? Next to nothing. But I was there along with one other nurse, so we were called upon to give recommendations to the mother. Through a translator, we talked about how to keep the wound clean with clean water (boil water, add a spoonful of salt, and let it cool), how to keep it moist (she was already applying a cream meant for sunburn which was not probably ideal, but it was probably helping), and how to cover it to keep the cream in place and to keep the dirt out. I don't know anything more than that, but hopefully that should be enough to keep the open areas clean, moist, and free of infection so it will heal. Fortunatelythe burn was not very deep, so I think he will end up with scars but not lose use of his hand or arm.
I could definitely use a primer on first aid with an emphasis on bush medicine. Although I am not in the bush, even in Cotonou people with very basic health problems and accidents and cannot necessarily go to the doctor. They can't afford it. So a whole range of problems--from the "little" things like ear infections and cuts, to bigger things like burns, days-long labor, cleft palate, tumors, and flesh-eating bacterial infections--are essentially untreated apart from whatever can be found over the counter or through the local herbalist or the equivalent.
This afternoon about 85 of the Americans onboard went to the US Ambassador's house for a Fourth of July celebration. We had originally been told we would go to the US Embassy, but no such luck! All the US citizens of Cotonou were invited, so there were maybe 100 people total for a potluck meal and socializing. It was very low key, but it was nice to be off the ship and in a lovely backyard with food and music and plumeria trees (I had a flower in my hair but I lost it before coming back to the ship). I met some MS folks I hadn't met before as well as some people who work for the US Embassy in various capacities. Overall a nice dinner, and it was fun to have some classic foods like corn on the cob. In order to have corn on the cob, they had to buy a plot of land and plant the seeds themselves--you just can't buy sweet corn around here. I think there is feed corn, but not sweet corn! A little hilarious, the lengths that people will go sometimes for particular foods. :) But I enjoyed the corn anyway.
Nothing much else to add at this point. I continue to enjoy work, and the way things are scheduled means I might work 6 days (64 hours) one week and 3 days (24 hours) the next. But going off ship is limited by transportation or, more accurately, the lack thereof. You are limited either by the heat, the rain, or by how far you can walk... or, by how complicated it is to get someone to drive somewhere. But I have a long list still of things I want to see and places I want to go! And of course life in the wards is always an adventure.
Tout a l'heure! (See you later/until later!)