ali's african adventures

I think I may have led a few people astray by leading them to believe that we are strictly a volunteer organization. The truth is, everyone who signs on articles on the ship is, in effect, signing a contract that states we will be paid a salary of two dollars. Per year. Payable if and only if you happen to be on board on your birthday and in the form of a gift certificate to the Ship Shop.

Today marked the third year in a row that I've been paid this enormously large salary, and I promptly spent half of my year's earnings on a extra large mug of chai tea.

Wandering onto the ward at seven, I was greeted by a sign on the door and a not-so-hushed chorus of Happy Birthday in seven separate languages. A few minutes later, one of the translators stuck his head around the door, obviously fake panic in his eyes. Afi! We need you! There is an emergency! When I made it into the hall, there was a whole pile of them, laughing at their clever deception while Mark/Eric (he goes by either name, depending on his mood) held up his camera. The emergency is that we need a birthday picture, and so we all piled together to capture the moment.

Being in this community on your birthday is lovely. You spend the day receiving hugs and greetings from all around the world. When you show your face in the dining room, someone rings the big ship's bell and the whole place sings to you. There are cookies outside your door, left for you along with your yearly wages by the Hospitality department. And, in an unspoken tradition, one of your friends has inevitably stayed up until they were sure you were asleep and then decorated the wall outside your cabin so you're greeted by balloons and other pretty things in the morning. (It doesn't matter that you go to sleep knowing full well that this will be the case in the morning; it still makes you feel like a rock star.)

This year in particular, I just feel happy. That may have something to do with the scrub top my friend Jen gave me, the one she loved so much she was planning on taking home, and the one I've secretly been coveting since I first saw her wear it. I probably won't take it off until after she leaves on Saturday, just in case she changes her mind.

But more than anything, I'm just in a good place. I'm twenty-seven, and I couldn't be more content with my life, a life that is, by all accounts, something of a failure. I don't own a car, and I don't even have a license to drive here. I've never rented my own apartment or owned my own home. Everything I own fits into one narrow closet and a couple of drawers underneath my bed. I make two dollars a year.

I am by no measure a wise woman, but I feel like I'm beginning to understand a deeper truth.

A truth that tells me that life marked by the rhythm of drums and sunsets behind palm trees is a good life. That having is not as important as giving. That beauty is our inheritance, no matter how we look. That if we can learn to love, deeply and without reservation, everything else will fall into place.

This is why I'm so excited to be looking forward to many more birthdays on this ship. Because I am, more than ever, convinced that I love best here.

I mentioned a patient yesterday, a man who was willing to live his life with a tumor on his face if only he could have his hernia repaired and how we didn't think it was going to happen with time so short.

Today, I got to be the one to dance to his bedside, pen in hand, to add to his consent form. Next to excision of submandibular tumor, I printed in my neatest writing, repair of bilateral inguinal hernia.

I thought my eyes alone would betray the good news, but, like so much else here, there was a breakdown in communication. It's happened innumerable times now over the past two-and-a-half years, so often that I barely flinch anymore. It's always the same; I speak my piece, the translator relays what I think is my piece, the patient responds, and the translator comes back at me with an answer as unrelated to the question as chalk is to cheese.

Today, when I told the man that a place had opened up in the schedule, that he would be having both surgeries instead of just one, his face actually fell, his eyes downcast as he shook his head. Puzzled, I asked the translator to ask him if he was happy. The answer came swift, a word even I can understand in Mina. Ah-oh, he said. No.

Still rather confused, I asked the translator to ask him why he was so upset. The answer made perfect sense. If I hadn't just finished explaining about the second surgery. He is feeling sad because we wishes you would leave the thing on his face and take the other trouble instead. He will not be happy when he still has that one.

At this point in the conversation (and remember, this is something that happens to me literally every single day at work here), one's options are limited. You either get mad or you just laugh and repeat, using slightly different words, as many times at it takes until you get an answer to the right question.

So I explained again. A couple more times actually, until I realized that words just weren't cutting it. Thankfully, sign language is fairly universal, and one sharp motion directed towards his jaw and another at his more sensitive bits seemed to do the trick. I actually heard the English words chop it in the translation that time as both words and actions were relayed, and the patient's face broke out into a wide grin.

We shook hands on the deal and I signed my name as a witness to the new consent form.

It may have taken longer than it should have, but the message was finally clear; you will get your life back. Not only will you be able to go into public without people staring, but we will take away your hidden trouble, too. You are twenty-two years old and you will finally be able to work as fast as the other men on your farm.

Fixing a hernia might not seem like the biggest deal when we're normally dealing with things like tumors threatening airways, but for this one man, it's everything.

Sometimes, we can give everything, and it feels good.

Balkissa is back. When Sally, our speech therapist, saw her at a session recently, she found that Balkissa's tongue had split open again, making her look more like a snake than ever, since now the two halves were neatly delineated by what should have been a line of sutures. We spoke to the new surgeon, the one who's only got three more days of surgery for the outreach, and found her a place in his schedule.

She went to the OR today, but not before spending all morning hanging off my body and attempting to run loose down the hall. It appears that she has not lost her spirit, and her little voice rang out loud, if somewhat garbled, after we prayed at handover. Hallelujah! Amen, and her little hands swished underneath her headscarf as she twirled in a circle and came to rest against my chest.

Amen, she said again, quieter this time, and I echoed her.

Yes, God, let it be so. Let this child come to know You in all your Love and all your Beauty. Let her see herself as a reflection of You, no matter what happens in this second surgery, the last we'll be able to provide, successful or not.

And as we sat in our leadership meeting at ten in the morning, I flipped over my schedule to see that the back was empty. We had just assigned the last beds to the last patients we'll treat during this outreach, and my heart caught in my throat as I saw their faces in my mind. The man with a keloid scar hanging down below his shoulder. The woman recovering from yet another VVF surgery, her baby climbing all over her, a testament to her hope. The man with a tumor on his jaw that we're planning to remove and the hernia we might not be able to fix. Please, he begged. Leave the thing on my jaw. It does not look good, but it is okay. Please fix my hernia, because I work on a farm. I work slower than the others. Please.

And little Balkissa, recovering in her corner of B Ward tonight, wrapped in her blankets and the love of the nurses watching over her.

There are only three days left. I pray that we would use them wisely, that we would be faithful, that we would not grow weary.

Amen.

I forget that this is usually just after the halfway point in an outreach, that there are normally still four months still to work. We've gotten ourselves so fully immersed into the beginning of pack-up that I'm losing sight of the fact that there are still patients in the wards and lots more coming and going from our outpatient clinic.

Today, I was sitting in the nearly-empty C Ward making a spreadsheet for everyone in the hospital to input the weight of every single thing that isn't bolted to the ceilings before we head off around the Cape. I'm not actually kidding about this; every monitor, mattress and mirror has to be weighed and charted. (Don't even get me started on the bed frames. It's awfully tricky to stand on a bathroom scale while holding one of those and still be able to see the numbers.) I heard a little chirp outside my door and looked over to see the jug-handle ears and huge smile of one of my favourite little boys from this outreach, Godwing.

He's six, and when he came to us, scar tissue on the back of his leg held his knee at a right angle. He would hop around the wards on miniature crutches like a little bird until the day we were finally able to do his surgery. Afterwards, his healing took a long time. He required a skin graft to cover the area where the scar was released, and he's been coming back to the outpatient clinic every few days to have his bandages changed, his leg now sticking straight out in his custom-made splint.

Today, when I looked up, Godwing wiggled his eyebrows and beckoned me over. Va, mi jo, he told me. Come on, let's go. I got up and peeked around the door to see his leg covered with just a little bandage instead of the big, bulky splint he was used to wearing. I threw him a questioning look, and he started to giggle as he showed me how he can bend and straighten his leg now.

I thought that was it; I thought he just wanted to show me that the leg that used to be frozen by scar tissue could now bend like a normal little boy's leg, but it turned out Godwing had saved the best surprise for last. With one last look and a kiss on my cheek, he took off down the hall. No crutches. No support. Walking proud and tall (as tall as you get at six years old) down the middle of the corridor, slowly but surely making his way towards the stairs that would take him home.

I forget that this is the time in the outreach that the patients are learning to walk. We've seen them come and go from the wards, but the outpatient nurses and physiotherapists have continued on, bandanging wounds and stretching muscles, and this is what it all means.

And Godwing wasn't the only one. Over the last two days I've seen so many of them. Little Ali, who was burned with boiling porridge when he was a baby, has finally taken the first steps on his own, on an foot that can now rest flat on the floor. Tossedi is using little sticks to help him, but his crooked legs are straight, free from their casts, and supporting his weight.

All around the hospital, little boys are learning to walk. With my head full of packing up, my heart is full of this.

When there's ABBA blaring from the iPod, beds full of supplies and mattresses stacked up high, it can mean only one thing: the end of the outreach is upon us. This year's tie-down is going to be, in a word, a nightmare. I say that in all seriousness. Since the ship is heading to South Africa for the generators to be replaced, this isn't just the usual business of collecting all the supplies and equipment and making sure they don't move when the ship hits a twenty-five degree roll in the middle of the Atlantic. (Repeat after me: I will not set out to sea in a train ferry.) Once the ship reaches South Africa, we're planning on spending anywhere up to six months in dry dock, and that's where the stress comes in.

For those of you who don't actually live on ship, dry dock is where the ship goes into a shipyard and is lifted completely out of the water for repairs and maintenance. It means limited electricity and no air conditioning. For six months. In one of the hottest and most humid cities in South Africa. Do you see where I'm going with this?

We are a hospital, and as such, we have a lot of very sensitive bits of machinery. Things like anesthesia machines, heart monitors, IV pumps, and the list goes on far longer than I care to think about. Not only that, but a huge amount of our supplies can't really survive in the hot and humid. (Fun fact of the day: sutures are on that list. Not-so-fun fact of the day: the OR has more sutures than you've probably ever cared to think about.) One of the wards is going to have some sort of cooling system in place, so we've got to get everything that might go bad in the heat into that ward. All the machinery, all the linens, all the paperwork, all the everything, practically. Into one ward.

All of this creates a jigsaw puzzle far more complicated than my little brain's power, which means that while the patients are still in their beds in A and B Wards and the ORs are still running, we're starting to think about packing up at the other end of the hospital. This is where my office day got exponentially more fun today. As we wandered through the wards looking at what might need to go in "the cool room" (a name I have only just now come up with and hope to sell the rest of the hospital on tomorrow at our seven AM meeting when we sit down to talk all this over yet again), we realized that there were x-ray viewing boxes on the walls of every ward that were going to be taking up a lot of space.

Thankfully, at this point we also realized that our entire x-ray system is digital, and we really only need to leave one or two of them on board for emergencies; the rest could be taken down and donated to local hospitals. Naturally, just doing that simple job wasn't really an option; we needed to pose with them and take ludicrous photos, too.

Hopefully, after tomorrow, the twelve viewing boxes we managed to collect from all over our hospital will be headed off to hospitals and clinics all over Togo, and the scrubbing and emptying and arranging of the wards will continue without a hitch.

Let's not get our hopes too high, shall we? This is, after all, Africa.

(But I heart Africa, so I think everything's going to be okay.)

Every single day, broken babies are born into this world. Here in Togo, no one knows how many. Often, no one marks their coming but their mamas and the village chief, the one who hands down the proclamation that this baby is cursed, that he cannot stay in the village or the sickness will spread. And so many babies are abandoned, left to die because they were born with a cleft lip or clubbed feet or crossed eyes. In the West, we can't comprehend this. We've gotten to the point where people with special needs are being referred to as "differently abled," and this is a good thing. It reminds us that they are human, that their lives are worth just as much as ours.

Here in West Africa, things are often so different.

Which is why, I think, I'm so giddy when we take care of the littlest ones. When their mamas love them enough to scrape together the money for transport to Lomé, to wait in long lines at screenings in the blistering sun, to endure days and weeks on board the ship while their babies get better. I love knowing that they will never have to know that other life, the one filled with ridicule and shame. The one where they can't make friends, can't go to school, can't find love and get married.

And most of all, I love knowing that they'll know any life at all. Because for Kossi, life wasn't a guarantee.

He was born five days before we met him, in a hospital way up north. Doctor Russ works there, a man well known to Mercy Ships, and when he saw the growth on Kossi's tongue, how the brand new baby couldn't suck and couldn't get milk, he e-mailed us right away. The surgeon's schedule was already full, but everyone involved knew that we had to at least see Kossi; saying no meant that he would starve to death, sharing a fate with so many other of these cast-aside babies.

When he arrived, our littlest man couldn't close his mouth over his tongue. It's a good thing newborns have to breathe through their noses, because there wasn't enough room in his mouth for much other than that growth. We didn't know exactly what we were dealing with, so we decided to do a CT scan of his head and neck to make sure it wasn't a tumor that extended any further. Since he was so small, making sure he stayed still was easy; I swaddled him tightly in a receiving blanket (the only one I could find in the entire hospital) and started a pump that delivered milk through the tube we'd placed in his nose, right to his stomach.

It worked like a charm and Kossi slept through the entire thing, his whole body fitting into the part of the CT bed meant just for the patient's head. The next day, Kossi had surgery and returned to the wards where his mama and papa were waiting. Instead of the mass on his tongue, there were just a few sutures. Instead of a death sentence, life spread out in front of him.

Kossi's still struggling to learn how to breastfeed, and since his family lives so far out of town in a village where formula isn't really available, (even if they had the money to buy it) we need to make sure he's a champ at it before we can send him home. Which means that we get to keep him for a few more days, bundled up in his blankets in his little corner of B Ward where his mama watches over him.

And every time I catch her eye, she looks up at me, the scars on her cheeks lifting with her smiles, and she moves aside the blanket so I can see his little face.

Because she knows I love him, almost as much as she does.

Here's a sneak peak at the smallest patient we've treated this outreach.

I'll tell you Baby Kossi's story soon.

I've been blogging for a while now, and I've gotten used to the sound of a keyboard rather than the scratch of pen on paper. It's just as easy for me to upload a photo as it would be to doodle one in a margin (provided the ship's bandwidth is feeling up to the task), and reading entries starting at the bottom of a page and working my way up doesn't seem terribly backwards. I think I like this whole internet thing.

Be that as it may, there's something incredibly satisfying and, well, just plain right about reading the old-fashioned way. The get out a flashlight and burrow under the covers kind of way. No illuminated screen, just real paper in your hands, pages turned instead of loaded.

Yesterday, I got to hold my writing in my hands for the first time, and I'm not going to lie; it felt pretty good. Flipping through the pages of my blog from my first year with Mercy Ships felt really organic, if that makes any sense. I could see so clearly how I moved through that year because I didn't have to stop reading every few minutes to load a new screen on my browser.

And the cool thing about the website I used to make the book is that it serves as an independent bookstore. Which means that you, if you're crazy enough, could go here, preview the book and buy a copy for yourself. (There's a button in the sidebar now that will take you there, too.) Heck, I'm planning on making one for each outreach, so by the time HoJ and I leave the ship for good, you might have enough of these things to fill a whole shelf!

Blurb lets you pick your own price for selling your book, with the understanding that you earn the profits above the manufacturing costs. Which is why, if you're actually considering buying this thing, the price seems high. I was talking with another of the nurses about this today, and she gave me a great idea. One of our Togolese day volunteers, a housekeeper named Amelie, was just diagnosed with leukemia, and we've been taking up a collection to help pay for her treatment, since she's going to be losing her job in a month when we sail away.

Wouldn't it be cool to set aside the money from the book for crew and day volunteers who have needs like Amelie, she asked me, and I knew it was the right thing to do.

My cousin Dave calls it love money, this secret stash of cash that it's always good to have on hand for needs like this. For the patient's caregiver whose roof blows off in a storm. For the mama who suddenly needs to pay for her baby's funeral instead of his formula. For a co-worker who gets sick and lives in a country where money for treatment is so hard to come by.

I'm not saying we're going to solve the world's problems with the couple of dollars this might raise, and I don't want you to feel like I'm guilting you into buying it. Money isn't just hard to come by in Togo; I know that.

Just know that if you want to hold a copy of these wild ramblings in your hands, a few of the dollars you spend will go towards love, half a world away.

Some days I hate Africa.

I hate that I live in a place where twenty-five year-old guys can be perfectly healthy in May only to show up in July at a clinic with sunglasses hiding an angry, red tumor where there was once an eye. A place where the best diagnostic tool in reach sometimes is the fact that, if I can't walk more than ten minutes without getting dizzy, there must be something wrong. I hate that money and the lack of it determines that some people can't be seen by a physician when symptoms first start, before the side of their faces swell until the skin breaks.

And, in some ways, being on the ship makes it worse. Because that twenty-five year-old man might barely make it up the gangway before needing to sit down, and we might have access to the lab tests that explain this by counting his hemoglobin at a shockingly low 5.3. Access to monitoring equipment that traces his heart racing far faster than it should. Access to a CT scan that shows the tumor snaking its way through his jaw and nose and the place where his eye should still be, if only he lived in a country where he could have seen a doctor when the swelling in his mouth first started. Sometimes I hate knowing the truth.

Two months ago, Koudjo was healthy. He was twenty-five with his whole life in front of him. Yes, the tumor grew fast; he knew that, but he still thought we'd have the answers, that we'd be able to do a simple surgery or give him some antibiotics and he'd go home healed. He had no idea that coming to our dental clinic today was going to change all that. He thought it was a problem from where someone had pulled his tooth a few months ago somewhere in Benin. He thought we'd help. He thought it would be okay.

He was wrong.
I hate that he was wrong.

And the thing that's probably going to keep me awake into the dark hours of the night tonight is that I don't know whether he would have even had a chance in the first world. I'll never know, because we have no way of finding out just what it is that's probably going to kill him. Soon. And what little help we have to offer by way of palliative care is going to be taken away in a month when the ship sails away from this port.

And it's just not enough.

I stood in front of all the nurses at handover, and I said that I love seeing the pain and the joy balanced, and I hoped all the time that they wouldn't see in my eyes that I was about to cry, that I couldn't really see the joy today.

I feel so small, so useless when faced with a world that is broken like this. I tell myself that God is working to redeem it in His own time, but my heart wants it to happen now. While Kuodjo is still alive, while he still has a chance. I want him to get married and have kids and be an old grampa with white, fuzzy hair and a wooden cane, sitting on a bench outside his house.

It was hard to imagine a world being redeemed when I looked at Kuodjo today.

I looked at a calendar this morning and absent-mindedly noted that it's the twelfth of July. Huh. Already, I thought to myself, and went back to what I was doing.

About three seconds later, I did a massive double-take.

The twelfth. Which means that in exactly one month, I leave the ship to set off on a crazy four-month adventure around the world with the HoJ by my side. One month. Suddenly everything narrows, and I'm thinking in terms of lasts. One last cleft lip. The last hemimandibulectomy. The last tie-down at the end of an outreach. Even the incredibly mundane. This will be the last bottle of shampoo I'll buy; by the time it runs out, we'll be travelling.

The map above our couch is marked, each magnet holding a slip of paper reminding me what dates we'll be in each country, and I find myself staring at it at odd moments, hardly able to believe that I'm going to do this.

I'm going to see the Taj Mahal at sunrise. I'm going to canoe down the Zambezi River and sleep under the stars on its banks at night. I'm going to dance on the Great Wall at the express request of my sister; if not for her I might just be planning to walk sedately along its length. I'm finally going to visit friends in countries where the water swirls the wrong way around.

I'm going to do all that and a thousand more things, and I cant wait to start.

But starting all that means ending this, and I'm just not ready to do that.

If you look closely at that map, you'll see one magnet without a little piece of paper under it. It's sitting in South America, over the northern part of Peru, and we're not going there on the world tour. And I slipped a little hint into an entry a few days back. (Did you notice? I'm firmly convinced that Togo in raining season has the absolute most perfect weather in all of West Africa, or at least in the four countries I've visited so far. [I'll get back to you in ten years or so once I've been to the rest.])

While I'm well aware that West Africa and Peru clearly have little to do with each other, I'm so excited to finally explain how they're both in our future.

It all started a few months ago when the HoJ and I turned our sights to home, trying to figure out where we'd be heading come August and the end of the outreach. Our options were as wide as Canada, but every time we sat down to seriously discuss just where in the real world we were going to settle down, I would dissolve into tears. I just couldn't picture us in any of the cities we were considering, and that scared me. It also made me cry. A lot.

Time went by, and we found ourselves at an impasse until one day the HoJ turned to me in the midst of me tears and said the wisest thing he's ever said. What if we change the question? What if, instead of a city in Canada, we try to decide between staying on the ship, working on land or doing a DTS and then coming back?

It was like flying, like sunrise, the way I felt then. I can't even begin to explain how excited I got every time we discussed the future, no matter which option we were considering. And the more we considered it, the more we realized that this season is not over. That our time with Mercy Ships is going to be much longer than just this next month.

So here, tentatively (as is everything in this crazy world) is the plan.

Once the world tour finishes, we'll have a month or so at home to spend time with family (and hopefully meet some new friends). In February of 2011, we're hoping to head to Peru together for the next six months to do a Discipleship Training School with YWAM. We're going to spend three months in the largest city in the world not accessible by road and three more in the Amazon jungle of Peru and maybe Columbia and Ecuador, too, learning Spanish and getting to know God so much better.

And when all that is over, we're coming home. Home to the ship, to our life here in West Africa. While we couldn't picture life in North America having anything to do with us, life here makes all the sense in any world. It fits us, this place and these people.

This is our real world, and it looks like we're going to live in it for a long, long time.

There is nothing better than belly laughs from a chubby nine-month old baby, his whole face crinkling with the force of his smiles despite the IV in his head and boards keeping both his elbows stiff so he can't pull out that IV, his mouth wide open in a toothless, gummy grin every time you come near.

Nothing better than a little toddler, the stumps of his burned fingers covered in a bandage turning brown from too much play, who shrieks with excitement when he sees you across the room, pushing adults out of his way as he runs over, turns around and drops into your lap as you sit in the floor to welcome him.

Nothing better than a seven-year old girl, a paper crown on her head declaring her allegiance to the Netherlands in the World Cup final, who leans into your side and looks up into your eyes to show you that the swelling in her tongue is almost small enough that she can close her mouth for the first time in years. That's she's not scared anymore, her arms wound tight around your neck to prove it.

And when all three of those things happen within three minutes of each other?

I hope you'll forgive me for missing the first half of the game. I didn't want to cry in front of everyone, even if they are tears of pure joy.

Balkissa is seven. She came to us swathed in a dark headscarf, tears running down her cheeks every time one of us so much as looked at her. I have rarely met a child so scared, and I can only imagine the kind of life she's experienced that's made her this way.

I might have stared, too, if I had met her before my time here. Before long familiarity with extremes in pathology bred this comfort I feel around the ones cast aside.

We don't really know what caused her problem, her history vague like so many others in West Africa, but she came to us with a tongue too big for her mouth, split down the middle like a snake's. Her lower lip protruded under its weight and she was unable to close her mouth.

On the morning of surgery, her doctor, Dr. Leo, said something so poignant. In the Western world, little children use their tongues to lick ice cream. I hope, when this is all finished, that Balkissa will be able to experience that part of life, too.

But it seemed that enjoying ice cream wasn't in Balkissa's future, at least not any time soon. She returned to us from the OR much as she left; shy and fearful, sleeping in her corner bed with her blankets pulled over her head to shield her from the world.

It's been days since her surgery, days in which we counted ourselves lucky if an interaction with Balkissa didn't result in those huge, silent tears. Days where the closest we'd get to playing was a little seven year-old girl, sitting on a chair, holding a rag in front of her mouth to catch the drool the still flowed freely. Honestly, it's been a little discouraging.

But in one moment this morning, everything changed.

Balkissa's mama was sitting on a stool next to another patient's bed, little Ali. Apart from sharing the best name ever, Ali is one of the cutest kids around. He's also a boy, a fact that has the translators hooting with laughter when I try to claim the same, very Muslim, very masculine name. Balkissa and Ali's mamas have bonded, and we often find them in one corner or another, chattering away in the fluid tones of their language.

As the mamas talked, I looked over to catch Ali's eye and make him laugh with a silly face (not hard to do, now that he's over his initial yovophobia). When he started shrieking, Balkissa's mama turned to look at me, and that small movement was enough to upend her stool. She crumpled to the ground in an undignified heap, and without thinking, Balkissa broke out laughing.

I hadn't ever seen her smile, and here she was, cracking up at the sight of her mama in a pile on the floor. When she saw us laughing along with her, breathless in our own joy, something seemed to click in Balkissa's little head. Somehow, we stopped being the enemy, the people who were going to make fun of her, the people who were going to hurt her. With one swift fall from a chair, we became conspirators, sharing a secret that finally made having fun okay.

We stood in our customary circle to pray at the end of day shift, raising our thanks to God for sparing the life of a woman whose nearly-forty pound tumour had just been successfully removed, and Balkissa ran over to join us, no trace of her former fear anywhere to be found in her racing steps. Absolutely confident in her place among us, she leaned up against a nurse's legs, squeezing her eyes shut tight and then peering between cracked lids to see whether I was watching, her face breaking into a perfect smile when she realized that I was, every single time.

This is my favourite thing about this place. Watching them finally realize that we're in this together, that there's nothing about them that will make us love them less. That they can have massive tumours or snake-like tongues and no one will stare. No one will mock.

Because we're in this together. You, me, Balkissa, all of them, each one who finds shelter with us. We are all image-bearers of a beautiful God, a God I saw so clearly today in Balkissa's bright eyes and ready smile.

When I first met Josee, the first thing I noticed were the flip flops sticking out from underneath her bed. She had shoved them as far back as possible, but I could still see them. One was an ordinary, black leather sandal. The other, obviously custom-made, was more than twice the size of the first, fashioned to provide a place for the two massively oversized toes on her right foot that had brought her to us.

She was quiet in the evening before her surgery, more than a month and a half ago, now. We had no idea that day just how long she'd end up staying with us, no idea that the silent little teenager in Bed Eleven would become a fixture on the wards.

Unfortunately, that's just what's happened. Josee had her surgery, and her right foot was reshaped to match the left. Everything looked good at first, and she was discharged home only to be readmitted about a week later, the wound beginning to break open, threatening the entire success of the procedure.

And so Josee has stayed with us, confined to her bed, only allowed outside for a short time every day, and only if she promises to keep her foot up, since any swelling might make us lose the tenuous grasp we've got on her healing.

She's another of the incredibly bright ones; Beth (one of our nurses whose mishaps and adventures this outreach could fill an entire blog post all on their own; suffice it to say that she's the only person I know to burn her leg on a zemidjahn and be hit by a falling coconut all in one week) taught her to do her own wound care, and so twice a day Josee sits in her bed, brow furrowed in concentration as she performs a complicated dressing on her own foot using impeccable sterile technique.

But a dressing, even if it needs to be done twice a day, can only take up so much time. And with the World Cup drawing to a close, there's not much for Josee to do during the rest of the day.

This is where Claire comes in.

Claire is one of my favourite people these days. She's a writer with the Communications department, but she doesn't just write. She hangs out with us, making it a point to spend time with each patient before ever pulling out a pen or asking a personal question. The patients love her, because they can tell she loves them.

The other day, Claire stopped me in the hall and told me about an idea that she had. She wanted to write a story from the patient's perspective, in their own words, and she was wondering if I had any suggestions. It was all I could do to keep from hugging her; here was the solution for Josee. Here was something to keep her occupied during the long hours between dressing changes and football matches.

And so now Josee has a little notebook and a pen and she's writing her own story. Every time she passes me in the hall, on her way outside for some fresh air, she grabs my arm. Alice, I am writing. I am writing.

When she's finished, I'll share it with you. I'll let you know how it feels to be a teenager with a deformed foot, trying to blend in in a cruel world. But this time, I'm not going to use my own words. I'll let Josee tell you herself.

The wards are slowly filling back up, with more and more beds occupied with patients waiting for their turn in the operating rooms. Even so, D Ward is still dark and quiet, a testament to just how slow the last few weeks have been. As a result, we don't need all our charge nurses every morning, and I've drawn the short straw: admin days.

Don't get me wrong; having an office day isn't all bad. I get to sleep in, for one. My alarm doesn't go off at six, and whenever I do end up rolling out of bed I don't have to make my way to the dining room; the dear, dear, HoJ will have brought me breakfast and a glass of orange juice, and they'll be waiting for me on the counter. (Yes, I know I'm lucky. Even luckier is the fact that, not only do I get breakfast delivered, I never, ever have to cook dinner. Who else is ready to sign up for Mercy Ships?!)

However, being in the office means just that: I'm in the office. Sitting at a desk, staring at a computer. All. Day. Long. After a good eight hours spent working on the end of outreach report today, I was feeling more than a little stir crazy and more than a little lazy. So after dinner, I laced up my sneakers and headed outside to exercise.

I'll give you a moment here to get over your shock.

It was a beautiful evening. I'm firmly convinced that Togo in raining season has the absolute most perfect weather in all of West Africa, or at least in the four countries I've visited so far. (I'll get back to you in ten years or so once I've been to the rest.) There was a cool breeze blowing in off the ocean and the sky was awash in pink and orange, the fiery remnant of an early sunset. It was the perfect night for a brisk walk.

I hadn't reckoned with the guard to our gate. He sat on his customary wooden bench next to his little shack, holding onto the rope stretched across the open road. Whenever a car passed, he dropped the rope to let them pass and more of then than not left it on the ground for ten or so minutes afterwards until he remembered to pick it up again.

He thought I was insane.

Every time I passed his way, he was staring at me, wondering why on earth this crazy yovo would be walking back and forth, not carrying anything on her head, clearly getting nowhere.

After about six laps, it seemed that he was catching on and would wave happily as I made my turn. On laps ten through fourteen, he got really excited and clapped, cheering me on. However, somewhere around lap sixteen he had had enough and started frowning at me, his forehead all wrinkled with concern, making the characteristic patting motion with his hands that means stop around here. Through the music in my earphones I could hear him telling me, Doucement! Slow down!

I decided twenty laps was probably all he could take, since his concern for my health (more mental then physical, I assume) was growing rapidly, so as I passed him on the final turn I made sure to let him know that I was finished.

Evo, I told him, finished, and he smiled in relief and made sure of what I'd said, adding the one little sound that turns everything to a question here. Evo a?

Under the pink and orange sky, I headed back to the ship as a rat and three rather large cockroaches ran across my path. Which, even if I hadn't almost given that poor guard a heart attack, might be enough to convince me that this whole exercise notion is a bad one.

And now if you'll excuse me, I've got a World Cup match to watch. I'll let the professionals do the exercise from here on in.

It felt so comfortable this morning, coming in to work in B Ward, greeting Samson in familiar Fon, a language that still seems to slip from my tongue more easily than Ewe, despite my almost-five months here in Togo. My curious, A fon gangi a, was met by a smiling een, (Have you woken up well? Yes!) and the day was off to a good start.

The morning was filled with waiting for Samson. He snuggled under his covers, just his characteristically scarred cheeks visible above the blanket, finding it no doubt freezing on the ward compared to the tropical weather outside. In the hall, hopeful patients shuffled from one room to the next as they waited their turn to be seen by the surgeon here to screen them.

Today was one of answered prayer. We had scheduled more than seventy patients to come and be screened, but the surgeon who was supposed to be here became very ill at the last minute and was unable to travel. When it seemed that we would have to cancel this block of surgery and crush the hopes of almost a hundred people, Dr. Frank, a visiting surgeon who's been here learning how to do VVF surgery, reminded us that he's a general surgeon and would like to stay for the four weeks that were planned. All morning he examined one patient after another, and the blank pages of the schedule book were slowly filled.

I met them in the stairs as I went to my room to get my mug for some tea. They marched down, all in a line, and then, much later, planting both feet firmly on each stair, a little old Grandma in a navy blue dress printed with wild, orange flowers. When she finally reached the bottom she turned to me with a smile like a sunrise and performed a little dance for me, right there on the landing, before shuffling off to join the rest of her parade in the waiting room.

When I passed back their way, I opened the door to see them all sitting on chairs, shoulder to shoulder, eyes turned down. Waiting. Hoping. Praying.

How are you all, I called out in Ewe (a language I can't even begin to spell out in English characters), and as one, faces were turned towards me, smiles blooming all around the room as they answered together. Yes! We are fine! And then they went back to their waiting, the smiles erased before I even had time to close the door.

Oh, but there were prayers answered all over that hospital today. Each name, each diagnosis neatly printed in that book was a ticket back from the darkness, a glimmer of light in a world that had seemed so dark.

Akossiwa. Thyroidectomy
Christophe. Right inguinal hernia repair.
Salome. Excision of lipoma, left shoulder.

And in his bed in B Ward, Samson is resting quietly. The little pieces of bone placed over the metal plate in his jaw will knit together over the coming months, and he will grow strong again. His prayers, too, have been answered in the clean, white bandages covering his cheek and hip.

He is one of the hopeful ones.