ali's african adventures

We met in Esther's office early on Wednesday morning to work out the plan for the next two days. Twenty patients would be coming to the ship who needed to be evaluated for surgery. Tumors and jaws fused shut and gaping holes in the roofs of mouths and finally D Ward was going to have people in it again, if only for the day.

We sat at the table, she handed us a stack of pink sheets, and suddenly it was a year and a half ago and I was sitting in front of this computer again, sending e-mails around the world deep into the night.

These were twenty of the same pink sheets left over at the end of the outreach last time we were in Togo, twenty of the people that you prayed for so faithfully. Every single one of them had the telltale black dot in the top righthand corner. Someone is praying. You can set this one aside. You don't have to carry them in your heart any longer; someone is praying.

It was so overwhelming to watch them file into the ward, to match each one with a black-dotted pink sheet. To know that in the time we've been apart, someone has been lifting them up to the Father.

Only ten out of the twenty showed up between yesterday and today, and of those ten we couldn't schedule all of them for surgery. One little boy, Koffi (he was three when I sent out his name, just in case you recognize it) has a tumor on the back of his head that might be a break in his skull. He will need to wait for his CT scan to be reviewed by a radiologist somewhere in the first world before we can make a decision, but we're not even sure if the surgery will help much, since he's already so developmentally delayed. One woman tested positive for HIV and we had to send her home because her body would have rejected the surgery we wanted so desperately to perform.

These are hard things to hear at the very start of an outreach, hard things to say to aunties and women with hope-filled eyes. But all day long those black dots in the corner of their papers sat as a silent testimony. This is not your load to carry. It has been given to Him, and He holds it in His hands.

As we welcome new staff and train new nurses and get ready for the mass screening day on the first of February, this is the reminder I so desperately need. None of us are in this alone. None of us has to shoulder the entire burden. We rely on each other and we rely on you, scattered around the world, praying for names on little pink sheets of paper.

We're in this together.

I was giving a tour of the hospital to some new doctors yesterday and they asked me how long I'd been on board. Four years in February, I answered, and then stopped short. Somehow, it's hard to believe that I have been a bona-fide, full-time, long-term missionary for almost four years. I know it's nothing to the warriors of the faith who spend entire lifetimes in their adopted countries, but it's quite a significant chunk of my life thus far.

As the calendar marches on and we prepare for yet another Field Service, I've been thinking a lot about short-term mission teams and how much we need them. Here on Mercy Ships, the years follow a predictable cycle. (As predictable as anything in West Africa can really be.) We sail to a new port in January, untie everything that's been secured for the sail and scrub down the hospital before setting everything up so that we can function. We train the crop of new nurses, hold screening and admit the first patients for surgery. For the next ten months, we operate and care for the patients on the wards and in the outpatient clinic and eventually it's time to close up shop and move on. We double-bleach every surface, pack everything away in carts and on pallets and we tie everything back down to the bolts in the floor. Somewhere in December we sail away to a first world port so the crew can have a break and maintenance can be done on the ship. Christmas, New Years, and it's January again. Lather, rinse, repeat.

It can get old.

Not the surgeries and the patients and the lives changing in front of my eyes. That will never be commonplace. But all the in-between. The cleaning and packing and unpacking and setting up. It's an endless set of jobs that we have to do every single year, and I'll be completely honest when I say that I'm not a fan.

This is where the Mercy Teams come in. They don't live this cycle year in and year out,so they don't remember how much their knees hurt from scrubbing the floors just a few months ago or how tired they were after securing yet another strap. They don't remember because they weren't here.

They're a breath of fresh air for those of us who are used to doing all this on our own. We have a team here from Texas (and one random guy from Rhode Island, but we won't hold that against him), and the amount of work they're gotten done in the last week is incredible. They emptied a room that was packed literally floor to ceiling, wall to wall, in a single day. They've set up beds and put together tents on the dock and made medication packs for pharmacy and I just saw them getting roped into helping unload a container with the sales team.

I've heard a lot from people who say that short-term trips aren't really beneficial, that the money should just be given to the organization rather than paying for plane tickets when the people on the team aren't really going to have that much of an impact in two weeks.

And you know what? It wouldn't matter if these guys and girls never even talk to a single Togolese person while they're here. They've blessed and encouraged and strengthened those of us who will be here for the long haul. We'll go into this Field Service energized by their energy, more ready than ever to pour out our lives for the people here in West Africa.

They say that silence is golden, but my mother would beg to differ. She told me a little while ago that people are going to think we're still in Ghana, and since we've actually been back in Togo since Thursday, I guess I do owe you all an update.

Thursday was what will probably my favourite sailing experience of my life, which was one hundred percent due to the fact that it lasted less than twelve hours. I've driven the road between Tema and Lome before, and it only takes a couple of hours. Sailing in a ferry is another matter, and we were told to expect around ten to twelve hours on the water. I had a perfect plan, fully approved by my boss, which involved not setting an alarm, sleeping through the first four hours (except for a few unruly minutes as we first left port) and staying in bed for most of the rest of them. I'm a big fan of a sail that ends before you really have time to realize it's begun.

This is the first time that we've sailed into a port we've been in before, and the feeling of coming home was strong among those of us who were here in 2010. As night fell and we realized that immigrations wasn't going to clear us to leave until morning, we spent the time talking about all the places we're excited to revisit. Unsurprisingly, our favourite restaurants got top billing as the various merits of Akif Burger versus Al Donald's were quietly contested.

Unfortunately, either the HoJ or I has been on call ever since we dropped anchor, so we haven't had much of a chance to head out and enjoy ourselves yet. This week the real work will start up in earnest again as we set about untying and setting up the hospital to get ready for the field service that will begin with screening on the first of February.

Six months are ahead of us, and I'm ready to get started.

We have arrived safely in Ghana, and I for one am happy to have solid ground under my feet. Which is a little odd, maybe, because I'm still iving on the sea and there's nothing but water under the ship. But that water is still now and the mooring lines are out, so I can finally sleep at night again.

We'll be here for three weeks while the crew gets a break after a long outreach in Sierra Leone. We've already started enjoying what the West African crew (and any of us yovos who've been here before) call the Promised Land. It's wonderful to be in a place where the roads are clear enough that we can drive miles in minutes instead of hours, but it doesn't quite feel like Christmas yet if I'm being honest. I associate Christmas on the ship with Tenerife, with weather chilly enough for a scarf and fruit like pears and strawberries. But this Christmas is going to be an African one, complete with ninety degree weather and mangoes in big plastic buckets in the dining room. It's going to be different.

So much is the same, though. The Christmas season on the ship is steeped in tradition; anyone that knows my family knows our love of traditions. Because the crew comes from so many countries, there are little pieces pulled from all around the world to make up December on the Africa Mercy. We have cookie baking and a European-style Christmas market, complete with gingerbread and homemade snow cones, of course. (It's the closest we're going to get to the real thing!) We have a storytelling night and the Academy students put on a big Christmas musical. (It was last night, and it was amazing. A definite highlight was all the high school girls dressed up like angels and dancing hip hop. Who says that wasn't how they appeared to the shepherds?!) On Christmas Eve we all put an empty shoe outside our doors, and sometime in the night we sneak out to fill the shoes of our friends with little presents. (One of the prerequisites for this activity is feigning blindness if you happen to cross paths with one of the other elves in the middle of the night.) We all roll down to the dining room in our pajamas for Christmas brunch, and it's like being with your entire extended family and then some.

I'm going to enjoy these next few weeks. We have friends to visit here in Ghana and lots of exploring to do in Accra. Posting will probably be light, since the only real work I'm doing is in the office, and I'm pretty sure you don't need to know how the scabies policy is coming along, now do you?

Once again, we have set out to sea in a ferry.

This never quite seems like a good idea to me, despite the fact that we're sailing on the smoothest seas I've ever seen. Honestly, there are lots of times in the past two months alone that we've been moving more in port than we are right now. The thing is, there's no way for me to know how it's going to go for me over the next five days or so. This is my fourth sail, and on the first one I was so sick that the HoJ (who was, at the time, just the Boyfriend of Joy, but showed real promise with what I'm about to tell you) would make me Ramen noodles just so I had something soft to throw up. I think they could totally use that in an ad campaign. Ramen: Something Soft to Spew When You Sail. The second time was like a dream. Smooth seas, perfect weather, and wildlife every day. Seriously, at one point the officer on the bridge came over the intercom to announce, Dolphins, basically ... everywhere. The third sail was a mixed bag. I threw up for the first half and felt mildy human for the second, so statistically speaking, this could go either way.

I'm not quite steady enough to call myself a good sailor, especially when just the thought of pulling away from the dock makes me breathe deep and eat one last big meal rather than jump for joy. But if I make it through this one in style, I might start to feel a little more confident about my sea legs.

There's one thing that I know will work for me no matter what, and as soon as they made the announcement that the bow was open I grabbed a chair and headed outside. Out there, with the whole ocean spread out in front of me and the breeze cool in my face, I never feel sick. One by one people make their way down to Deck Three, all the way forward, and then back up to the salty air and together we watch the sun set and the moon rise. If we're lucky (like tonight) we see dolphins and flying fish and nearly-transparent jellyfish billowing alongside us. Someone brings a guitar and we worship together and there's this sense of community that's somehow different from the rest of the year.

For some reason, we are closer when we sail. This morning before we departed Jenn put words to the feeling. It's like we're one big family getting ready to go on a trip together. For as long as we're on the water, this feeling of family is so much stronger than other times, somehow. We greet each other with sincere questions about our friends' health and we make pilgrimages around the ship to deliver food and ginger biscuits to those who can't get out of bed. We sit together out on the bow, and for the only time in the year it's just us. Just crew, no visitors or day volunteers or tour groups or food delivery men. The ship is ours, and we revel in it for these few, sacred days.

I'm sitting cozy in my bed right now. The moon is high outside my window (although porthole, I suppose, would be the more nautical term), and the water rushing past is shot through with silver. At least for tonight, I love sailing.

I always find it much harder to blog once the wards have emptied for the year. It's as if their lives and stories are so much more important than my own. Or, at the very least, a lot more interesting; I can't deny the truth of that. But once they go the place is quiet and dark. Except for the emergency lights of course; you can't turn those off, and they stand constant guard over the empty rooms.

I've been thinking about light a lot in recent days, in large part because of the Advent services that started last week. You know, the ones with real candles. Candles are a big deal around here; open flame is prohibited on board except for these five small candles once a year (and sometimes the ones in Santa Lucia's crown, but that's a whole different tradition for a different day). The International Lounge, where we have Sunday services, is darkened and each week another candle is lit. Last week was the candle of Hope, and as I sat there watching the tiny flicker of the flame, it hit me again what a tremendous thing hope is.

We use the word all the time. I hope it doesn't rain. I hope dinner will be good tonight. I hope this brownie doesn't make me fat. We use it so often that, like so many other weighty words, it's lost much of its impact. I looked it up just now because I love words and all their shades of meaning. The first was unsurprising.

A feeling of expectation and desire for a certain thing to happen.

It makes sense that the first little candle throwing its light into the darkness of a new year is the one christened hope. Hope is that longing for something new, that breathless anticipation of something you can hardly bear to speak aloud.

The second definition was the one that set my heart spinning in my chest.

A person or thing that may help or save someone : Their only hope is surgery.

Hope is so much more than just a feeling, more than an idle wish or a passing desire. For so many, hope is all that's left when the rest of the world has turned away. Hope is what gives a mama strength to hide her baby in a back room rather than bury him in the forest when he's born with a cleft lip. Hope is what keeps a seventy year-old woman walking, all the way from one country to another, seeking help for the tumor growing on her hand. Hope is what whispers in the ear of a man as he lies awake at night, desperately wishing that someone would look past the scars on his face.

Hope is the light in the deepest night, the single flame in the face of crippling despair. It's the unwavering promise that, yes, salvation is possible, that there is a way out, no matter how dark the path might be.

Matthew wrote that nations would put their hope in the name of Jesus.

Is it any wonder that He called Himself the Light of the World?

Happy December! Living on a ship off the coast of West Africa, there's not much that really screams "Christmas," but hopefully these wallpapers will help a little.







The Advent season on the ship is special, and not just because it's the one time of the year where real candles are allowed (only for the Sunday night services in the Advent wreath). It's the end of an outreach, and as we look forward to the coming of the Saviour, we look back at the Light that He's already brought to this country through us over the past year.

(Click any of the photos to be taken to the larger size that you can download and use as a wallpaper.)

Yesterday I had the incredible privilege of photographing the wedding of two dear friends from the ship. Becca and Greg met when she first came to the ship in 2009, and yesterday I got to be there as they pledged their lives to each other. The day went off in fairly typical West African style; there were Land Rovers, closed roads, rain showers and lots and lots of love.

Here are a few snaps from a beautiful day. (For those of you on the ship, I'll have a full set on the Transfer Drive once Becca and Greg get back from their honeymoon and have had a chance to see them first.)









What would a Mercy Ships wedding be without a bride on a Land Rover?



There were a few snags along the way, of course. After a long drive through town, complete with crazy market-day traffic, we ended up walking the last part of the way to the house where Becca was going to finish getting ready. She led the parade with a smile, a smile that wasn't even dimmed when rain started pouring down as the outdoor reception was set to start.



The ceremony took place in the church Greg and Becca have been attending here in Sierra Leone. It was packed, and when the Liberian worship started, they almost blew the tin roof right off the place.





The rain cleared up enough to let us get some beautiful shots of the bridal party and the happy couple.





From there it was off to the reception, which took place in the garden of the house where the Mercy Ships off-ship teams lived here in Sierra Leone.







Thanks to the new Mr. and Mrs. Kulah for letting me be a part of this amazing day!

And just like that it's over for another year. There were three lonely beds in D Ward this morning, Hassan, Grandma Groundnut, and the last patient from A Ward who I hadn't met before. I walked in and Grandma Groundnut stopped in her tracks, ran over to me and buried her head in my chest. She held me tight, sobbing out her fear and her sadness into my scrub top.

I busied myself with the last tasks. I buttered bread and made tea and handed out lotion, and after a surprise fire drill, we gathered in a circle to pray. Hassan sat on Sarah's (our administrative assistant) lap, and to every sentence I spoke, he added an emphatic amen.

We headed out into the cool morning air, huge bundles of dressing supplies balanced precariously on heads as Hassan's mama and Grandma Groundnut swayed down the gangway. We held hands as we walked out to the gate, and after one last hug they turned and headed up the road towards home.

There are times when other people's words work so much better than my own, when someone else can speak my own heart better than I can. This is one of those times. I love her thoughts on the end of the outreach, on the way it feels to get here so close to the end. So I'll just let her speak for me.

Coming in for the last leg of the race has been a blessing to me. We care when something ends because of the significance it had throughout its course. And, as it turns out, experiencing the end of something significant can be just as moving as being part of its beginning.

To quote our friend Hassan, Amen.

(Quick update on Sia: I spoke with her uncle this morning who had just been in touch with the hospital in Guinea. Sia, her mama and her baby sister have arrived safely after a journey of several days. Keep praying for the continuing treatment to be successful.)

Oh, today. Today was perfect in such a typically African way. From start to finish, it was everything that I miss when the place is packed up and tied down to bolts in the floor. I could tell you so many stories, but I'll stick with two, both awesome for different reasons.

First the funny. The patient in Bed Fifteen has her sister staying with her to help care for her and her little baby. Sister is slightly demanding, albeit in a rather endearing way; she's definitely the bossier of the two. Yesterday in the evening Sister came to me and asked if she could leave for a little while this morning to buy shoes for the pikin. Despite the fact that said pikin is no more than three months old and nowhere near walking, I told her she could definitely be released for a while.

This morning she came to me when she was ready to leave, and asked for one of the many little pieces of scrap paper that live in the top desk drawer. I handed her one, not sure what she might need it for, and sent her up to the gangway with one of the translators.

I thought no more of it for another couple hours until I got a call from the gurkha guarding the entrance. Atypically, he was laughing pretty hard, and it took me a minute to realize he wanted me to send someone up for Sister. She arrived down to the ward a minute or so later, a bundle the size of a wadded-up king-size duvet wrapped in plastic balanced on her head, (definitely more than one pikin-sized pair of shoes in there, I'm pretty sure) and immediately started waving the scrap of paper at me and yelling in her tribal language.

If you've never been yelled at by a tiny little African lady with a huge bundle wobbling on her head with every shake of her little fist, you've never really lived.

She eventually surrendered the paper, which I unfolded to find just as blank as when I gave it to her. Dis papah no good! No good! It turned out, after a good bit of translation, that she thought she was asking me for a signed permission slip to leave and come back. She had presented the blank scrap to the gurkha, intently demanding to be let in as a result, which caused the normally serious guy to laugh nearly as hard as I was right at that moment. Regardless of the fact that she can neither read nor write, I would have expected the utter blankness of the paper to clue her in to the fact that it wasn't going to give her permission for much.

I think I expect too much.

Or, as it turns out, maybe I don't expect enough.

We stood together at handover, and Natalie (the current Team Leader who's been training me to step into her shoes next year) brought us a challenge. What if these wounds haven't healed because we haven't asked? What if God is waiting for us to speak out our requests, to rest in expectation on His power?

And so we did a different kind of rounds today at two o'clock. Instead of discussing drainage and fevers and what the inside of mouths looked like, we gathered at each bedside and prayed our way around D Ward.

I've been present for a lot of handovers here on the ship; I don't know if I've never been at one this powerful.

I don't know what it was, but taking that time to lay hands on these precious people and pray in faith for their healing, one at a time, leaving no one out, filled me with a sense of awe I don't normally have amidst the busyness of my shifts here.

One by one the patients bowed their heads. Some held out their hands to receive blessing, some snuggled further into the arms of the nurse holding them, some wrapped their arms around our waists as we stood at their bedsides and we prayed. We prayed for our sisters and brothers and grandmas and the pikins whose presence in our lives has become the standard by which we mark our days.

Tomorrow most of them will go in the wee hours of the morning. Just a few will stay one more night and then we'll close down for the year and somehow we'll go back to sleeping at night without lying awake wondering how they're doing downstairs.

These ones will go buoyed by prayer, surrounded by the angels we called down for them, filled with the comfort of the Spirit.

We should round like this more often.

Mondays are generally busy around here, at least for me. Since I don't work on the weekends, it always feels like I'm playing catch-up. Rounds are spent rifling through the charts to answer the questions I don't know the answers to offhand, and it takes most of the morning at least until I feel like I've got a good handle on the place again.

Today wasn't just any old Monday. Today was The Last Monday, the first in a long series of lasts until this place will be packed up and tied down to bolts screwed into the floor and we'll sail away from Freetown some muggy day in December. The wards close for good on Friday morning, and so this week is going to be spent sending the remaining patients home.

It's always a bittersweet time. There are a few patients on B and D Ward right now who I don't know very well, simply because they just had surgery last week, but the vast majority of them are long-term residents of Deck Three. They're the ones with wounds that won't heal, the ones who have been back for second, third, and fourth surgeries. And because they've been here the longest, they're the ones I love the best.

I know; I'm not supposed to have favourites, and I'm certainly not supposed to admit it out loud to the whole internet. But if you could see that place right now you'd understand why my heart aches to think that their beds will be empty soon.

However, regardless of how much I've come to love my pikins and my Grandma Groundnut, go they must. The going is complicated, more so than almost anything else; this is not an easy place to live with a health problem.

If there are any nurses who read this blog, I'm sure you can sympathize. It's hard enough, sometimes, to get a patient discharged home with everything in place so that they can continue to be cared for. Add in hundreds of miles of dirt roads, mud huts, malaria-carrying mosquitoes, heat and humidity, and a complete lack of resources and it's a recipe for disaster.

This is the time of the year when we start to pray for miracles. We know that some of the wounds that still remain aren't going to heal by any other means, and so Doctor Gary isn't really kidding on morning rounds when he orders prayer, every two hours and more as necessary. This is the time of year when we see those miracles. We've already taken Abu's name off the list of patients who will need follow-up care when his neck healed overnight, but there are many more, and the situations are complicated.

Pinky needs to get back to Liberia. I haven't written about her yet, but she sleeps next to Sia and the two of them are good friends by now. The surgery to remove a tumor from her jaw and replace the bone with a rib went well, but the money for their return journey was stolen from her mama on the way here. Please pray that the money we raised to send them back will be safely guarded and that they will find their way to their uncle in Duala Market. (I smile as I type that, because I can picture that dusty road in Monrovia so clearly in my mind.)



Sia is going to leave early tomorrow morning to make the long trip to Guinea with her mama and baby sister. They'll have all the money and all the medications needed for the rest of her treatment for Burkitt's with them. Her blood tests were good this morning, everything is in place for her at the hospital in Guinea, and all that remains is for her to get there safely. Please pray for protection to go with them as they travel.

Litte Kadiatu, whose face we've started to rebuild, finally had her feeding tube removed today. She flies at me the minute I step through the door, hands up until I lift her into my arms. She chatters away, just like a little bird, and I chatter back, wondering what on earth I might be saying. The skin graft inside her mouth didn't heal fully, so she's on the list for more surgery when the ship comes to Guinea next year. The place on her leg where we took that skin is taking far too long to heal, though, and we're working on teaching her dad how to care for it before they head back up north early on Thursday morning. She's another one who needs a miracle.

It's more than just these three girlies. Pray for Baindu, too, whose mouth is healing slowly. She'll need more surgery in the future, too. Pray for Isatu (Grandma Groundnut), whose future is uncertain and whose wound is also slow to heal. For Aminata, whose tumor is already starting to grow back and who will need to go home on medications that her mama might not be able to afford for a whole year until she comes to see us again. Pray for Bockarie. We built a nose to replace the one he lost when his house burned down around him when he was six days old, but the place on his leg where we took the skin to cover the place on his forehead where we took the nose (I know, it's confusing) is also stubbornly refusing to heal, and he'll be heading home on Thursday morning, too.

There are more, but I don't know their names, patients who have been here for months since plastic and general surgery rotations finished, each battling stubborn wounds as the clock moves inexorably forward.

We are almost out of time. Please pray with us.

Today was the last day of surgery; it happens every year, but it still comes as a shock every time. It's different this time because I've only been here for the last six weeks, but there's still the sense of having come to the end of something monumental.

To mark the occasion, we had a full-out party on the empty side of A Ward this afternoon. We crammed almost the entire hospital in there along with caregivers, nurses, day volunteers and anyone else who wanted to come. It was like the Sunday morning church services on steroids, and I am not kidding you when I tell you that they heard us sing two decks up clear on the other side of the ship.

Clementine, one of the Patient Life workers, started us off with a reminder that this place is not about preaching religion; it's about a relationship, about the love of God that pulled us from our homes to come to West Africa and serve here. It's about the love He has for us and the love He wants us to have for one another. And when it was translated into Krio, I couldn't help but smile. He no wan church. He wan dis padi padi business.

Looking around the room as we clapped and sang and danced to the rhythm of the drums, I saw so many people I've built relationships with over the past weeks. There was more padi padi business crammed into that low-ceilinged room than I could possibly have imagined in such a short time.

Isatu sat behind me and then danced her way around to the front of me, pulling me up to shake my tumba along with her. I call her my Grandma Groundnut because of her age and affinity for a peanut-flavoured high-protein supplement she takes to help her wound heal. G. G. had surgery to remove a cancerous tumour from her jaw; no one knows whether or not the operation will cure her, but it's given her these extra months to live and love. And, apparently, to become a zebra-printed hair dresser. (Thanks again to Deb Louden for the photos in this entry.)



When the praise slowed to worship (two entirely different tempos and decibel levels here in Salone), Grandma Groundnut slipped her arms around my waist and laid her head on my chest, just like one of my little pikins. We swayed together as we sang, and I realized that I love this little old woman.

When I sat down to hear testimonies, Abu crawled into my lap. He had surgery a couple weeks ago to take out most of a tumour on his neck. We couldn't get all of it, which means he'll need more operations in the future, and we've been worried by the length of time it's taken for him to recover from this one. We've had his name on a list of people who will need follow-up care when we sail away, but just this morning when his nurse took of his bandage, we realized that it was clean and dry underneath.



Abu has been healed, and as much as I'm ecstatic for him to go home soon, I'll miss our daily chats. I sit in B Ward every morning writing in charts, and we sing back and forth to each other. This is another one that I love.

There are so many more, and today we all sat together and heard testimonies of what God has done in our lives. My hair was (and still is) plaited in six ragged rows courtesy of Sia's deft fingers, my scrub top damp with sweat, my heart full enough to burst.

This padi padi business means that a part of me stays here in Salone when we go, just like the pieces I left in Liberia and Benin and Togo and so many other countries around the world. And I wouldn't have it any other way.

I've waited a little to blog again, because I wanted to tell you about Sia but I wanted to have photos to share with you. Today our ward photographer came down to take some 'snaps' while we were working, and I think it will be fairly evident that my little Sia is feeling much better these days.

She had her second chemo treatment on Monday, and has bounced back much more quickly this time around. It's obvious why; when we gave her the first treatment, her tumors were huge and she was a very sick girlie. Today, though, she's a completely different person, and boy is her personality amazing.

She's still scared to death of having her blood drawn, though, something that unfortunately happens fairly often when you're being treated for cancer, and this morning I was the lucky one who got to hold her down for the proceedings. We use a cream that numbs the area so she's not feeling as much pain as you'd expect, but just the sight of us coming with the tourniquet is enough to start her crying. By the time we finished this morning (despite a fabulous nurse getting the blood easily on the first try), she was limp in my lap, a puddle of tears staining my scrub pants.

I wanted to be more than just the one who holds her down while we hurt her, so I did what comes naturally to me: I made a face at her. And then I made another one, and another until she was finally making them back. We kept going until she was laughing and reaching up to kiss my cheeks.



And now, it seems, I have broken dear Sia. She doesn't appear to be able to make a normal face in photos any more. I love it.



This kid is spunky like you wouldn't believe, and it's what's going to get her through the next few months. Everything is in place for her to go to the Hope Clinic in Guinea, and we're just waiting for her uncle to arrive so we can send her on her way with all the supplies she needs for the rest of her chemo treatments.

There's one every outreach. (Jenn wrote about hers here, and I love how she explains it, how there can be so many who mean so much but just one who really gets into your soul.) Sia is definitely my one, and as short as this time here in Sierra Leone has been, she's got just as much of a hold on my heart as any of the others have.

(Have I mentioned how much I love this place?)

Yesterday was busy, much like every day around these parts. We still have more than our share of max-fax patients on the wards, and Natalie's been letting me hang out with the patients while she does the mundane office work.

I had finally started writing notes in charts when the Patient life team came onto D Ward to start morning worship. Content to sit and finish my tasks, I was listening to the singing and not paying much attention to what was going on around me.

Sometimes, though, there are things more important than note writing.

It wasn't long before I felt a little hand on my knee and looked up to see Kadiatu, her head cocked to one side, eyes asking me to come with her.

Kadiatu lost the middle of her face to noma, and we've started the process of rebuilding it. She's still small, so it's too soon for a new nose, but Dr. Gary has cut and pulled and moved and sewn until he's covered the hole next to what's left of hers. It's been a battle so far, and we're not out of the woods yet, but Kadiatu is a far cry from her former self.

No longer angry and frightened, she skips around the ward, feeding tube dangling off her cheek, chirping out goodness knows what in her tribal language. Yesterday, she wanted me to worship with her.

I was busy. It was late and a meeting was just around the corner, and I wasn't finished my work, so I tried to resist. She gave me a stern look, the likes of which only the very stubborn can really master, and pulled harder at my hand.

It's hard to resist a pikin with a feeding tube and a new face and a lifetime of struggle in front of her if we don't build her that nose one day. So I got up and I worshiped with little Kadi. I clapped and sang and shuffled my feet, and the words surrounded me like a prayer.

You are the pillar that holds my life.
You are the pillar that holds my life.
Daddy Jesus, You are the pillar that holds my life.

Whatever we do for these patients, whatever help we can offer, it's not us who holds their lives. There is one much stronger, much more capable of making sure each little chirping bird is sheltered.

There are some days that I would kill for a hidden camera on the wards, because there's just no way to properly describe this place in plain words. Today was another one for the books; half hilarious, half heart-wrenching.

The hilarity started when we got the doctor to come see the sister of a patient. The patient, eighteen years old, has a little baby, and the sister is here, too, to help take care of the pikin. The sister was complaining of pain, and we needed to send labs off to make sure she was okay. In order to send samples to the lab, we need to have an ID number so that the results can be entered in the hospital database, and in order to give out an ID number, we need to know the name and age of the patient. Simple enough.

I asked the sister her name, and she answered without hesitation. The trouble came when I asked her, how many years you get? Eyes narrowed, she sized me up before answering. Fifty. Since she's maybe twenty-two at the absolute max, I laughed and told her I needed another answer. It came quickly: Okay, fifty-four. At this point a crowd had gathered (as per usual here in Africa), and I told her that we, in fact, that number was still far too high. A question in her voice, she gave me her final answer. Twenty?

Sold to the lowest bidder.

A little later, I was writing a note in a patient's chart when I felt an inquisitive finger prodding the underside of my bum. (For those of you not blessed with curves, yes, a bum can have an underside.) It's a measure of the comfort I have with this place that I didn't even flinch. When I turned around I found the mama of the little one in Bed Eleven holding her hands a good three feet apart, an approving look on her face. Fine, she assured me, You have the African shape! From behind me came another mama's voice. Ali Tumba! 'Tumba' (TOOM-bah) is the word for rear end around here, and mine has garnered a good amount of attention in recent days. This morning, it ended up as the deciding factor in a debate.

The pikin in Bed Eleven is a little three-month-old baby who had his cleft lip fixed yesterday. His mama calls him Duck, and yesterday she promised Jenn that she could marry him. That was, however, before she caught sight of my tumba. There were hoots and hollers and a fair amount of elbowing, and I'm not sure, but I think I'm now engaged to Duck. Please don't tell the HoJ.

The last story is the heart-wrenching one, but for once it's not in a bad way. For once I have nothing but good to share with you, and it's good for Sia. Her story developed in the most amazing way today.

First, I want you to head over to Reka's blog and read the story of how Sia was found on the street. That's how Sia's story started, and you've heard a lot about what's been going on since she arrived on board. I want to tell you about what's going to happen when we leave.

We've found a hospital in Guinea where she can receive further treatment, and we've been working out the details as far as how she'll get to and from her home in the north of Sierra Leone and what sort of financial help they'll need to make this all happen. I worked on the wards today while Natalie, the current Team Leader, spent the day doing office work. She felt like she wanted to see the sun, so she took her work up to Deck Six to sit in the internet cafe. While there, one of the women who works with Patient Life came to talk over the whole thing and see where we were at.

Natalie and Yvonne moved to the comfortable chairs near the cafe and started working out the total cost for Sia to receive the four more months of treatment she'll need. Factoring in all the costs, it came to around $130. There's a woman who attend's my mum's Bible study back home who shares my blog with a friend of hers. That friend already donated thirty dollars towards that sum, and Natalie figured that the remaining hundred would be easily raised since we all love Sia.

Which is when God stepped in.

A woman sitting a few chairs over leaned towards Natalie and apologized for eavesdropping. It's just that, before I left, my neighbours gave me a hundred dollars, she explained. They wanted it to be used specifically for the care of a child, and I had no idea how to find a child or how to best use the money. Are you talking about a child?

Of course they were talking about a child. It's not a joke when it says that He does more than we can ask or imagine; before we could even come up with a plan to raise this money, God had already provided. He moved in Marie's heart to donate thirty dollars, and he moved in the hearts of an unknown couple to give the rest of the money, specifically to be used for a child. He arranged for Natalie to take her office day upstairs, for Yvonne to meet her there, for the woman to be sitting near enough to hear their conversation.

This God of ours, He does nothing by halves.