ali's african adventures

I feel like it's been forever since I have written. Right now I'm in the middle of my third night in a row, and I've got three more after this one. I was called in unexpectedly last night and the one before, so I worked both on less than two hours of sleep; this week has been spent in the resulting stupor.

Since the wards opened, it's been one emergency after another. When really sick patients go to be seen at hospitals in Monrovia, they'll sometimes refer them to the ship. Which means that, on any given day, we have no idea who is going to get carried up our gangway.

A few nights ago, it was Sadie. He's four, with little pink sandals waiting hopefully at the end of his bed. Sadie is about as sick as you can be. He has Burkitt’s Lymphoma, a condition which Dr. Mark (a cancer surgeon on board at the moment) calls 'eminently curable.'

If he were an American four-year-old, he would have seen a doctor when his face started swelling a month ago. He would have been diagnosed, he would have gotten chemo and he almost certainly would have been cured. But instead he's lying so still (far too still for four years old), bound to his bed by the bouquet of tubes and wires sprouting from his small body. I think I'm echoing the hearts of everyone involved in caring for Sadie when I just want to scream: your birthplace shouldn't be a death sentence.

I look at little Sadie and I am undone. It's the same heavy, aching feeling that I used to get back home when little ones came in so sick. Except this could have been prevented. If only Sadie could have seen a doctor. A doctor who had the right diagnostic equipment and the right knowledge and the right medicines. But Sadie lives in Liberia, where there is something like one doctor for every hundred thousand people. Liberia, where the lights in the capital city have yet to be turned back on after the brutal civil war. Liberia, where the government spends less than five dollars a year per person on healthcare.

How can we hope to make a difference?

Scenes from screening at SKD Stadium. Click any photo to see it bigger. (Photography by Esther Biney or Megan Petock)



































(Can you see why I may never come home?)

Today started out like any other. I got report, checked on my kids, helped put in an IV. Since all the beds on the ward are right next to each other, it made sense for me to help our charge nurse, Red, when she went to draw labs from a patient next to one of mine. We got the blood and I went to fill the lab tubes. It's something I've done hundreds of times before.

I could blame it on second-day jitters. I could say the boat rocked, or that another patient jostled the bed I was sitting on. Unfortunately, the truth is that I watched as the world slowed and, completely unprovoked, I stuck the bloody needle directly into my finger. I've never done that before. To have it happen for the first time on a boat in Liberia while drawing blood to test for HIV was possibly the worst case scenario.

Sitting in the crew physician's office, I felt like a small child. One look from the nurse, and I burst into tears, regaining composure only long enough to lose it again when Dr. Wolfgang asked me if I was scared. Was he crazy? Of course I was scared. I was facing the possibility (however minute it may have been) that I had just contracted an incurable disease. I was shattered.

"I think the first thing we should do is pray," the doctor said. Now, I can be a bit of a skeptic when it comes to the emotional manifestations of faith (ask me sometime about the moonwalking pastor from church last weekend), so I was a little surprised at what happened. As Dr. Wolfgang prayed, I felt God's very real presence. Peace surrounded me as the Healer spoke comfort to my ragged little soul. There's no other way to describe it. I stopped that awkward hiccuping that comes after a hard cry (you know what I'm talking about), and the paralyzing weight was lifted from my chest. I went back to the ward, laughed at my naked two-and-a-half year old patient, and wasn't the least bit shocked when the man's test results came back negative.

I've said it before- I'm a forgetful child. All too often it's far too easy for me to forget how truly dependent I am. I start to rely on my own skill and knowledge; God fades into the background when I'm sure I can handle things. Today rocked that confidence to its core. But as I came to the end of myself, it was pure joy to find that God had only just begun.

Yesterday was my first day of work on the ward. Things were a little hectic. With every nurse working with a preceptor and only one ward being open, we had a good twelve people jostling for position around the supply carts and med cabinets. The shift started off with singing and prayer (such a difference from shift change at home!) followed by report. One of my patients was Adolpho. He was six, with wide eyes and a wider smile, complete with a dimple big enouch to lose yourself in. He spent the shift running around the ward, coloring and trying on his blue surgical bouffant cap that a kind-hearted recovery nurse had left with him. We spent a good 45 minutes on the floor together building lego bridges. This is my kind of work.

We also had a bit of excitement. Last week, the head and neck surgeons had held a teaching session where we learned what to do in case a thyroid patient started to bleed once she was back on the ward. We all joked around and laughed about how it would never happen. I said the same thing to my mum when I talked to her before my shift. Imagine my chagrin when I had to call her afterwards and tell that, in fact, we had had to call in the surgeon, open her incision and rush her back to the operating room. I was able to help grab supplies and get her ready to go, and when I got back to my own side of the ward, my preceptor just grinned, shook her head and said, "You really are an ICU nurse, aren't you?" I guess I am. Thanks PICU!

That situation was actually what made me feel the most at ease on the ward. When things were quiet, I was having small small moments of panic when I realized that I had to do things like calculate IV rates based on report of "medium slow." But all this will come with time.



In the meantime, I have a confession to make. I feel like I've been fooling myself (and maybe you) into thinking that all is well with me when, for the past few days, I'd be flat-out lying if I told you I was content and happy. In fact, I spent the entire morning on Thursday sitting on the dock, listening to music and crying to God. I felt like He tricked me. I've been totally overwhelmed by the feeling that this is not what I came to Africa for; this luxury and apart-ness is sickening to me. I've felt almost bitter at moments. Choking on the fact that God got me totally excited to be in the place where my heart is, and then told me I'd be living in a ship at the end of a secured dock, totally caged away from Liberia proper. I hadn't realized how different my expectations were from what the reality of this would be. And of course, like the petulant child I am, I blamed God for it. If He was going to bring me here, He should jolly well have let me know what it would be like, right?

Nope. He promises a lamp for my feet, not floodlights to illuminate the entire road. And He asks me to be content in every situation. Hungry or well-fed. In plenty or in want. Abased or abounding.

So I am going to learn how to have much. I am going to discover what it means to the people of Liberia that I'm able to offer all this. After caring for Adolpho and his dimple yesterday, that all seems, if not easy, at least much more possible.

Check out Murray's blog for a great explanation of what screening day entailed. I'm going to let him talk about the technical side of the day, since he did such a great job of it.

As far as the emotional side goes, here is a photo of Abraham. It's not the easiest picture to look at, so if you're unsure, you might not want to click on the link.

Look closely, past the scars, and you can see Eric's sticker on his nose.

I promised to wait until I had photos to share about screening with you, but I just finished looking through a friend's blog entry, and I have to write.

I had been nervous about yesterday, afraid that I would see things that would be too much for me to bear. Instead, I spent ten hours amidst a delicious cacophony of crayons and balloon animals. Children are children; some are just more broken than others.

... Cynthia, dressed to the nines in a miniature African dress, her twisted face bent low over her paper long after the others had begun to look up and share their wide, perfect smiles.

... The weight of Obadiah's twisted body, pressed against my heart like a prayer, his sweaty head tucked firmly under my chin as he struggled to hold his crayon.

... Abraham. Sweet, small Abraham. Too afraid to leave the line and play with the other kids. His features locked in a hardened mask with eyes that wept constant tears because he could no longer even blink. His scars extended over his head, down his arms and back. His left hand was a ball of scar tissue, his right twisted and small.

Kimberly wrote in her blog:

He didn't cry or complain. He was quite content playing with his blue balloon that one of the staff had given him ... In addition to the balloon, a blue shiny star was firmly attached to the tip of his nose. This was really the only point on his face that still looked somewhat normal.

When I saw those words this morning, I lost it for the first time. Because I know where that star came from. I had gone over to him, armed with a balloon and some stickers, absolutely no idea how I could connect with a child who couldn't move his mouth to smile. As I sat on the ground next to him, offering my own smile in place of his, I felt a small body lean against my back. I turned to look into the perfect eyes of Eric, a little guy I'd been playing with before seeing Abraham. Eric wasn't a patient; he was waiting for his mother to go through the line, and his face was, by this time, covered in stickers. It was obvious that Eric was somewhat disconcerted by the distorted face in front of him. He stared unashamedly at Abraham before turning back to me. He touched his nose, adorned with a purple heart. Then mine, where I had a gold star, placed there by some other eager child. He pointed to Abraham and then chose a blue star for Abraham's nose. So we could all be the same.


Abraham doesn't have an appointment yet, but he will be seen by the plastic surgeons once they arrive. As I sit by the window and the ship buzzes with anticipation while we wait for Her Excellency President Sirleaf to arrive for her visit this afternoon, I'm acutely aware of where my own heart is. Not in politics or glamour or high-profile positions. My heart is in the dirt and in the streets and in the maimed hands of a boy named Abraham.

I can't wait to take care of him when he comes to the ship.

I'll write about screening properly when I get photos from the communications department to share with you. But for now, suffice it to say that I have revised my image of heaven. I don't think there are going to be staid angels floating around with white robes and sweet-sounding harps.

In heaven, our feet will pound, our hands will be raised high and we will dance to the beat of African drums.

This entry promises to be something of a mixed bag, much like my own thoughts these past few days.

Coming into this experience, I knew there was something I'd struggle with enormously. I was talking with Nicole earlier (not only taller than me, she is also a wicked ultimate player ... I sense a bond here) and she phrased it so perfectly. "We don't live in Africa. We live beside it." My brother wrote me an e-mail recently where he wondered what he was doing with his "ipods and fancy car" when there are people living in poverty. I'm wondering the same thing about myself. Here I am, living in complete luxury (because you can't convince me otherwise when I can take a hot shower, check my e-mail and then wander down to the Town Square and buy an authentic Starbucks chai tea latte for 75 cents), when just outside the gate there are kids dying from hunger. How can I come to terms with that?

Maybe it makes more sense when I think about the hospital here. We have electricity 24 hours a day. We have IV pumps and oxygen and a ventilator. We have supplies. We have staff. We're not going to see babies die because there was no fuel for the generator that day. We're not going to watch women suffer in pain because there aren't sufficient resources to manage it. So maybe it's okay that we have so much. I don't know. I'm still working through this one, and I'm not sure when I'll have it all sorted out.



At any rate, screening is in two days. We are waiting eagerly for the wards to be full (except for Megan, who I'm pretty sure is deliberately picking her nose in this photo). We had a briefing yesterday where we got to meet the teams we'll be working with on Monday. I was part of the "handing out water/children's ministry" team. Somehow my enthusiasm for small humans must have been evident, (perhaps my mention of finger puppets and an over-abundance of sharpies?) because I'm now one of the leaders of said children's team. Which means that I'll leave the ship at six in the morning on Monday and spend the entire day colouring, playing, painting faces and putting stickers all over Liberian kids. I don't think anyone could have dreamed up a better job for me.

I was talking with yet another new friend last night (one of those talks where you end up just blown away by how faithful God is) and we were wondering together about screening. I've honestly not given it a huge amount of thought because I'm afraid I won't get into my Land Rover on Monday morning if I do. We don't know how many people are going to show up. What we do know is that the Samuel K Doe Stadium is going to be filled to overflowing with that strange mix of hope and despair. Some will be scheduled for surgery and will get with that little card the chance to reclaim a place in society that may have been lost to them since birth. So many more will be turned away empty-hearted.

Pray for us that we will be able to see them all through God's own eyes. Loved and lovely, precious beyond belief.

Late afternoon is my favourite time of day here. The world opens up when the heat from the day starts to dissipate. Tonight I packed my dinner and headed outside to eat on the dock. I sat there, my feet hanging off the end, idly watching a crane unload a container ship across the harbour. A slight movement at the top of its mast caught my eye, and I saw the red, white and blue of the flag flying there. For possibly the first time in my life, I felt the needle of homesickness (not so much sharp as it was a dull ache, low in my throat).

There is no America here on the Africa Mercy. There is no Canada and no Germany and no Nigeria. We are an amalgam of humanity wrenched from homes and families around the world by God's unnerving call. We must find a way to live and work together in the face of thirty cultures and almost as many languages. We misunderstand each other on a daily basis, and the real work has yet to begin. Gulfs to span as wide as the ocean in front of me.

When I looked back at the flag, I realized that there was only one star against the blue. Liberia, not America. My old home and this new one, blurred together by sudden tears.


So I did what any self-respecting ex-pat would have done. I finished watching the sunset and then went for a run. My sister would be proud.

This is the Africa I am learning all over again. She is tired and broken, riddled with bullet holes and shot through with despair. Her men sit by the side of the road because they have nowhere else to go. Her women pick through piles of garbage as they seek to find their way again. It is too much.




Even so, amidst the darkness, a light is shining. We screen on Monday. The wards open on Wednesday. Hope and healing are coming back to Liberia. And we will remind her children of God's unwavering love.

So now you can trust that I'm really here...

Photos from my arrival and a tour of the ship!

It's killing me not to have photos to share with you all, but as I haven't yet gotten my own password, I can't get my computer onto the internet. And I don't have time for the thousands of words it would take to describe what a few pictures would be more than able to. How about thumbnail sketches instead?

The ship is enormous. We easily dwarf all the other ships in port here, especially the four or five wrecks, bits of their unfortunate hulls just visible scattered throughout the harbour. My cabin is shared with four other girls (a fifth will make us an even six on Friday). We hail from England, New Zealand, Sweden, the Netherlands and Jersey. Everything I own seems to be stuck to the wall with magnets now. The only way I know where I live is that the floor on my deck is green. When all else fails, I find a set of stairs and go up and down, up and down until I'm greeted by that familiar green. Strange to think that my cabin is just a few steps away from an ICU, because deck three is also the hospital.

Yesterday, I walked to the market with one of my roommates and a few other girls. I am eternally grateful that my first experience in Africa was in the bush, because I know that not everywhere is this dirty. Joseph was right though- I may not be in Sierra Leone, but this is war poverty, too, and it's so different from the bush. People lined the sides of the road, life for sale spread out on benches or cloths in front of them. A heavily pregnant woman paused her work as we passed, only to bend down again and continue pouring gasoline into large glass jars. Small children with impossibly large loads on their head wove their way through the crowd and piles of garbage, one hand clutching a stack of liberian dollars (LD), the other alternately waving to the white girls and gently steadying their wares. Battered yellow Nissan taxis bucked and honked, picking up passengers until their back bumpers (if they still had one) rested on the ground. Mothers wrapped in brightly coloured lappas carried small babies on their backs. The babies were bundled, presumably against the cold, although my own shirt clung damply to my back and the sweat ran down the back of my legs to form mud from the dirt on my feet. Everywhere, men called out. "White girl, you fine! I want to marry you! I will come to America!"

Today I napped because I still wasn't feeling like a real person. Hours of travel and too many new faces had combined to leave me feeling like I was in an extended dream. When I woke up, the most natural thing in the world was to join some new friends for a half hour drive in the back of a land cruiser to the beach. (Interesting side note: God must really want me here, because I'm the one who gets sick in the back of a minivan on an American highway. Today I sat sideways, looking backwards in ninety degree heat on roads so rutted that we looked drunk as we drove to avoid the potholes and felt not a touch of nausea. There's hope for me yet!) Next to the road on the way to the beach stands the shell of an old building. Before the war, it was the bustling five-star Hotel Africa. Now it's nothing but concrete, roof gone, open to the sun and rain. Heartbreaking to think that Liberia was once the gold standard, the country that all other African countries wanted to emulate.


In the midst of all this, God is so good to me. Last night we had a time of worship in the ship lounge (I'm headed there in a few mintues for a church service). We sat in a circle, again, a motley crew collected from the ends of the world. We sang and prayed together. At the end, the girl leading took out her Bible and opened to Isaiah. Chapter 58. "If you pour out your heart," she read, and I dissolved into tears. I know God wants me here. I was confident of His leading when I got on the plane on Thursday. While I'm often overwhelmed by the idea that I won't be home for a year, I am sure that this is where He has led me. So why did He give me yet another proof? Why, on my first night in Liberia, did someone read the very verse that He used to call me here? Because He loves me. Wholly and unreservedly. And I'm starting to realize that He will never tire of showing me that.

The rest of my life is going to be amazing.

I'm sitting in the internet cafe on board the M/V Africa Mercy. The floor is moving ever so slightly beneath my chair. No pictures yet, but I promise I'll give you a visual as soon as possible. I'm oddly at ease right now. No one in the goup I came with yesterday is staying as long as I plan to. I can't find my way around. I'm sleep-deprived. Nothing feels normal, nothing feels familiar.

But when I got off the plane last night, it smelled like home.

I woke up today with the feeling that it was something really momentous. A day I never honestly thought would come. It seemed to lend itself to overstatement: My Last Day Before Africa (or something equally self-indulgent and capitalized). And yet I spent it doing the most commonplace things. I went to the bank and signed some papers. I visited Marco and Jonah and got to marvel at the fact that they are not, in fact, babies anymore. I went to Target with my cousin, had dinner with my family and watched American Idol while drinking tea and eating Dunkers with my sister.

I said goodbye. To everyone and anyone I came across. Yes, lady at the bank, I'm leaving tomorrow. Yup. I'll see you in a year. Cousins? It's been real. Until next year. Sister? Couldn't quite manage that, so I'll get up tomorrow before she leaves for work.

I just got off the phone with a friend after saying yet another farewell and collapsed into tears. Call me a girl, call it hormones, call it normal, but I can't shake the feeling that it's weird for me to be this upset. I've always known that I'm supposed to be a nurse in Africa. This is, in effect, the culmination of all my schooling and all my life up until this point. I feel like I should be ecstatic, excited out of my mind. And yet I'm fighting the urge to quietly unpack my bag and stay curled up tight in my bed until long after the plane has flown tomorrow.


And then, of course, I just happened to look over at the corner where my things are stowed, and my eye was caught by a flash of purple and yellow. You can just barely see the rattle in the picture here, to the right of the baby. It was the favourite toy of my favourite baby at work. He was a little African monkey of a boy, left alone most of the time by parents who didn't know how to face having two babies- one perfect and the other so broken. I loved him with all my heart, and when he went to be with Jesus, the rattle was buried with him (placed there by an unknowing funeral director who had the good sense to think it was the most natural thing in the world that he had picked out that very one from a vast pile of toys). When I first met Jennifer, the mother of the twins I visited today, we bonded easily over shared stories of ICUs and love of babies. It wasn't until she pulled out that same stupid fish rattle, explaining that it was a hands-down favourite of her own boys, that I knew we were kindred spirits. She said she had no idea where it had come from. It had just appeared in Jonah's pod one day and the nurses said they could keep it.

Today, as I was leaving her house, she disappeared for a moment, reappearing with eyes that glistened suspiciously (through my own tears, though, it was hard to be sure). She held out the rattle to me, a little worn and wobbly now, adorned with a few bite marks. "Jonah and I had a talk and we think you should take this to Africa with you. Share it with lots of babies or give it to one. Whatever needs to be done."

And, once again, just like that, things make sense. I've been scared because all of this is so much bigger than me, when it should be just the opposite. Despite the fact that I see this as all so huge and momentous and flat-out scary, I should be jumping at the chance, because God has been showing me all along how He has been preparing me for just this task. I want to save the world and I'm awed by the size of that challenge. I forget that God's not calling me to the whole world. He's calling me to Liberia, to one ship in one port. He's asking me to take my fishy rattle and trust that He will show me the one baby in the whole world who needs it. Strange thought, perhaps. But on this eve of departure, I'm finding it oddly comforting.

This weekend was a whirlwind. I feel cliched saying that, but I can't think of another way to describe the sea of faces and emotions. (And no, I don't fail to see the irony of an oceanic metaphor.)

Friday was a classic pizza night coupled with a grand sendoff. The girls, true to form, had created a banner which will hopefully be gracing my cabin in a few days. (Not sure what my roommates will think of me calling myself a queen, but hopefully the art will make up for that.) Paul donned Hawaiian shirt and sang along to a slightly altered Beach Boys song. Feet shuffling nervously, he broke ridiculously far out of his comfort zone to get us all belting out "Help me, Ali. Help, help me Ali." Friday night pizza is amazing on a regular day, but this week was something extra.

Saturday found us cooking up huge cauldrons of chili and recruiting the youth group boys to create corn bread muffins galore. (Hint to novice bakers: blowing into the cup of flour is not the way to level it off.) We joined up with another youth group and packed forty-plus kids into three different houses for a progressive dinner all over the area. We ended it with sweet worship, intense drumming, and a challenge to not stay stagnant in our faith.

Sunday was church. I've never been hugged so many times in one day. The kids made me a card and slipped me notes and baby Judah finally gave me a kiss. Uncle Jim entered me onto his prayer list. The elders surrounded me, the church stood together, and they lifted me up to the throne of the God who's guiding all of this. Paul's words were so simple. "In a sea town there are people." The Sunday School kids stood in the front, making faces and trying (without much success) to wink at me. When we were released, we ran downstairs to act out one last story. At least five times.

Sunday was also the Super Bowl. I've only missed one Super Bowl party at the Haggans' in my entire life. Thankfully, this was not that one. The usual sausage and meatball sandwiches were there, along with the chocolate fountain and a mountain of fruit. The living room was packed with rabid fans wearing all imaginable forms of Giants gear. We lost our voices on the first first down. And when Eli and Plaxico and the boys pulled it off? Well, go ahead and check my facebook for video proof of that mayhem.

I love these people. I want so badly to stay, but I can't wait to leave. Bring on the year of paradoxes.