It feels like we have been gone longer than what it actually has been. This past week was filled with information and everything new. I started working in the outpatient tent on Tuesday and for the first couple days I was on orientation which consisted of mostly learning by staying with someone. On Wednesday I had one patient by myself and I felt really proud about it haha (in a day we see about 30). Everyone has been very helpful and ready to answer questions and teach me what we will see on a daily basis.
In the outpatient clinic we see patients for checkups and wound dressing changes. It has been very different then what I am used to. When in Roanoke on the progressive care unit I did dressing changes but the orders were very specific as to what the doctors wanted. Here it is a lot of personal judgment. We see many of the same things so I think that judgment will come with some time. For now the two nurses I work with are helpful and I can seek their input.
There is a lot of freedom when it comes to the dressing changes and certain medications, but we also have a doctor around (usually running around since they are the hospital doctor) for questions.
I was thinking the other day that although this work is different than what I’m used to I’m so grateful I get to be part and learn. So far I have had the opportunity to remove stitches, draw blood, change a wound dressing, and discharge people who have completed their treatments. I may be a bit ridiculous but as I was removing stitches I was like “I love this!”
As for language we have day crew, who are from here that help with the translation. One guy, Mohamed, speaks about four dialects from the area and then French and English on top of that!!! I told him all I knew was English and Spanish and he jumped right on that asking if I'd teach him some. The translation has been good so far but I have felt that at times there is a loss in translation. I will get blank stares and will have to figure out another way to say what I want and then same goes for them.
I have been learning about “Noma” which is considered the face of poverty. It is a gangrenous affection of the mouth especially attaching children. It is considered the face of poverty because it's linked to malnutrition, poor oral hygiene, poor sanitation, and exposure to viral and bacterial infections. It begins as an ulcer in the mucus membrane and quickly “eats away” at the soft tissue and bone.
A surgeon on the Africa mercy has been designing surgical methods to correct the physical issue. He has been working with mercy ships for about 30 years. Basically, depending on the case, they take different flaps of skin (could be excess lip, parts of the chin, or other areas of the face). One common way of handling it will be to cut skin below or above the lips and bring it up towards the top of the mouth, folding it around the mouth. The skin that they brought up will begin to form back into a lip, and once it is more formed they will cut the skin again to separate the it into a common mouth shape. The issue with outpatients is we have to be cautious, some people will have to come back daily. The patient is more likely to have infections because of the original Noma so you have to keep a close eye on it and make sure it isn't swelling or getting infected again.
It's really amazing to see some of these patients who are far along in their treatment and see the difference that it can make! Just the other day I got to discharge somebody and let them go home. They were very excited. Our practice is to pray with them before we send them away. At first I was nervous about doing it, but this last time I worked up the courage and prayed for them before they finally got to go home and was happy I was able to do that for them.
This past Sunday we were invited by one of the Day Crew, Cynthia, to attend their church off-ship in Conakry. It was a really interesting experience. The church was a pretty good size, we estimated maybe 400-500 people the first service and 200 or so the second. We had to stay for both services because the person who invited us was serving at both of them. To paint a quick picture, it was hot. Very hot and we had forgotten our water as well. It was difficult at times to focus on the service because of this and also because the pastor was very hard to hear and understand. His type of teaching would start out quiet and then exponentially get louder and louder until he was screaming into the microphone, and then the cycle would repeat. His translator would follow his every word and action, repeating it. Here’s a video to get a better idea of what it was like!
It wasn’t until the second service that I was able to focus a little more and understand more what he was teaching on. The worship was awesome! Always very upbeat and people dancing all over.
After church was over we drove back to our host’s home and they presented a very nice meal for us. The hosts are so generous, even bringing out a bar of soap and a basin and holding it for us to wash our hands before lunch. The meal consisted of rice, fish, something similar to sweet potatoes, oranges, and some sort of peanut flavored stew for the rice.
She took us around her area of town and introduced us to some of her neighbors. Everyone was always very receptive and friendly. Cynthia told us that she was very proud to be able to bring friends from MercyShips because it gave her an opportunity to show her congregation the kind of people that she works with and give them a taste as to what it's like for her there. What stuck out the most to us was the generosity they have, knowing that they have so little and yet willing to give so much, and so joyfully. It's really inspiring to see their hospitality and I am excited to get to know them better!