ali's african adventures

Sometimes being a nurse feels like belonging to a strange, secret club. We have our own language (where things like tracheomalacia or amp and gent or positive pressure ventilation actually mean something), and our own set of weird customs (such as hanging out in hospital wards on our days off). Most days, it feels good. It's incredibly satisfying to scrounge around the cupboards of an ICU, make a call back home to your old unit who, six months down the road, still seem excited to hear from you, and manage to MacGuyver a bubble CPAP setup that actually works. It's the biggest rush ever to realize that your being the one to care for a particular baby during a particular shift has actually made a difference in the baby's condition. And it just makes you happy to have a mother's face light up when you walk through the door, knowing that she trusts you with her child's life for the next however-many hours you'll be on duty.

Unfortunately, while the past couple of days have been something like that, they've also been laced with a very real sense of frustration. Sometimes being on Team Nurse isn't all it's cracked up to be. Sometimes, despite all the paper clip and duct tape creations you rig up and all the moments of getting the baby settled and sleeping for the first time in forever, it just isn't enough. Sometimes they get worse instead of better, and you can't stop questioning your every decision. Sometimes you just can't stop worrying.

Baby Greg isn't doing so well. He's slipping backwards, his jaw starting to swell again as his small body burns with fevers. He's struggling to breathe but fighting all our efforts to help him. And we're at a loss. We talk about him constantly. We sit at dinner, and instead of socializing with friends, we huddle there, heads bent together as we try to come with a new plan. We talk about him in the halls as we pass nurses who are on shift. We visit on our off hours, just to see how he's doing.

I know I'm taking this too personally. I know I'm not the only one who cares about Baby Greg and I know I'm not the only one who can care for him. But these days, this whole nurses' club seems terribly exclusive. There are only a handful of us here who are experienced and comfortable with caring for such a sick baby, and we're being looked to as 'experts.' It's scary, really. I came from a health system with a ton of oversight. It sometimes felt like I couldn't make the slightest move back home without going through a complex hierarchy of charge nurses, residents, fellows and attendings. If I didn't know an answer, there were always about twenty people within reach who could help me out. Here, the doctor (an orthopedic surgeon) asks the nurse (who, thankfully, was Jenn, an incredibly skilled NICU nurse) which antibiotics he should give. Here, the few of us who are comfortable caring for Baby Greg can't get sick, because there just isn't anyone else to call to cover for us.

It's such a strange paradox. I love working here because I love the challenge of making something out of nothing. I hate working here because, all too often, I'm expected to make something out of nothing. With Baby Greg, right now it feels like we have nothing. We don't have the right doctors. We don't have the right supplies. We don't have enough nurses. We don't have the answers. But I can't look his mama in the eye and tell her that. I can't bear the thought of explaining to her that she might lose yet another child.

So we'll keep fighting. We'll keep coming up with new plans and inventing new equipment and praying for miracles. Because, right now, that's all we've got. And I hope it's enough.

I remember one of the last days I worked in the PICU back in the States. I was in charge, and it was early in the shift when I got the call from the ER that baby Mark (not his real name, since America actually has HIPAA laws) was on his way up. Mark had been at home, snuggled in with his parents, when his heart just stopped. We had no idea why. What followed were three weeks of heartbreak and confusion and pain for his family as they watched him slip away. Mark's mum was the constant. She never left his side unless it was one of the nurses she trusted caring for him. She kept meticulous notes, writing down facts and numbers and events as if a complete catologue could somehow be the key that would allow her out of her prison of grief. She played classical music constantly, explaining ruefully that she didn't think he was going to make it, but just in case a miracle happened, (and she firmly believed it could) she wanted to give his little brain the best chance it had.

I spent long hours in that room, whether I was caring for Mark or not. I would sneak in after my shift, pull up a chair, prop my feet up next to the baby, and we would talk about anything but what was going on in that bed. She told me stories about meeting her husband and related the funny things their two-year old had said. I told her about Liberia and about why I was quitting the job I so clearly loved to go live on a ship for a year or two.

I wasn't working the day Mark went to be with Jesus, but the nurses I work with called me to let me know it had happened. Truthfully, it was for the best, and we all know it, his parents included. As Mark's mum walked out after saying goodbye to her baby, she handed the CDs to his nurse. Please give these to Ali. I want her to play the music for the kids in Africa.

Why on earth, you must be asking, are you telling this story? What could possibly posess you to bring that all up again? Why think about it? It's because I'm listening to that music right now, sitting in the ICU next to another baby who needs a miracle. The strains of Canon in D weave in and out through the sounds of his labored breathing, and I'm left praying for the impossible.

Baby Greg is a tricky one. Born with a tumor on the side of his neck that was slowly growing to cut off his airway, the only chance for his survival was an operation to remove it. What we didn't know before surgery was that his little airway never had a chance to form properly. It's weak and floppy, and it means that now, despite the fact that the tumor is gone and may never return, baby Greg still can't breathe. In America, this would be simple. We would throw in a trach, set mom up with homecare nurses and supplies and send Greg home to wait until he outgrew his condition (which, almost invariably, these kids do).

But this is Liberia, my heart cries. Liberia. Which means that, yet again, the latitude and longitude of this sweet baby's birth will most likely be the parameters that rule his death.

I don't often do this, but I have a proposal for you: I'll hang out here in the ICU. I'll jury-rig CPAP and I'll suction his throat and I'll put his food right into his stomach through a tube so he can use every ounce of his energy to grow. And all of you, oceans away or maybe living just down the hall on this very same deck? Please pray. I'm firmly convinced that we have a God who absolutely loves to do what we think is impossible, so let's storm the gates of heaven for baby Greg. Pray that he would gain weight and that his airway would strengthen so that he can breathe well without all the support we need to give him right now. Pray for his mama. She's young, but she's already lost two babies, and rumor in the village has it that she's cursed. And pray for all of us, that we would make wise decisions and that we would be able to care for and love on baby Greg in just the way he needs.

Go team.

Part of the discharge instructions my friend Grace had to deliver today to a patient who had had eye surgery:

Mama, she must not carry anything on her head for two weeks. You understand me?

If I can't be at home right now, there's nowhere I'd rather be than right here. I am surrounded by some of the most amazing people I have ever met. I don't think I've ever felt more loved or cared for than I do right now.

So I'm going to take my coughing, sneezing, sore-hearted self and I'm going to keep on watching So You Think You Can Dance with Jenn. Because that's what's making life good right now.

Things have been amazing with my job recently. I've been privileged to care for some of the most beautiful patients, and I've been feeling so content and satisfied and just plain fulfilled in my work here. I've been writing story after story about joy and miracles and successes. It seems like all sunshine and roses, and I don't want to be painting a false picture.

So I have to be honest. The truth is, I'm tired and I'm heartsick and right now, I just want to go home. I saw a photo last night of my brother and sister and cousin and friend sitting around my kitchen table drinking tea, and I dissolved into tears. I called home this morning to talk to my mother and was given the next piece of horrible news. Every. single. time. that I call home, it's something else, and it hurts. It hurts so much.

It's not like I can sit down with my mum and cry and just hash things out. It's not like I can go out to breakfast with daddy and hear the words of wisdom that he always gives to me in that chrome-lined diner. I can't jump into sister's hammock while she perches on her stool and calms my restless fears. I'm halfway across the world, and that world is getting bigger every day as my family and all the people I love recede into the dark distance.

I've gotten into the habit recently of writing down verses that jump out at me while I'm reading my Bible. Just now, I needed to calm my heart before going to work, so I pulled out my book and starting reading through the pages.

And God is able to make all grace abound to you. (2 Corinthians 9:8)

Great peace have they who love your law, and nothing can make them stumble. (Psalm 119:165)

For no matter how many promises God has made, they are 'yes' in Christ. As so through him, the 'amen' is spoken to us by the glory of God. (2 Corinthians 1:20)

Who has measured the waters in the hollow of his hand, or with the breadth of his hand marked off the heavens? (Isaiah 40:12)

He is wooing you from the jaws of distress to a spacious place free from restriction, to the comfort of your table laden with choice food. (Job 36:16)

Save me, for I am yours. (Psalm 119:94)

The Lord will fight for you. You need only to be still. (Exodus 14:14)

There is nothing to add.

When faced with the immanent death of her child years ago, my aunt asked my brother's father-in-law in despair Is there any good news? He looked at her and said quietly Yes. God is on the throne.

So I cling to that truth. As I search for solid ground, I find some kind of shaky solace in the fact that there is a God who knows more than I do. I'm scared to move, that much is true. I'm scared that this little patch of firm ground will dissolve underneath me if I take a wrong step.

I might just not call home anymore.

I spent the duration of ward church on Sunday in the company of a tiny baby. His name is Alfred. I have no idea how old he is or what his father's name is or anything else about him. He was placed in my arms by his smiling mother, and he snuggled into the corner of my elbow and slept through the singing and drumming and dancing.

It was a joyful service. As soon as we had sardine-wedged ourselves properly into the ward, we started to sing, and almost everyone felt the need to leave their hard-fought slot on bed or chair and stand up to praise. Alfred slumbered through my swayings, nestling in his touqued head a little closer when the drums got too loud. When we were finished singing, no one wanted to stop praising, and the words of the saints rose through the low ceilings of the ward.

With the sounds of prayer all around me, I looked down at the small boy in my arms. His little face was almost perfectly formed. Almost. Soft lashes curled against creamy brown cheeks framing a tiny button nose. Running down his top lip, though, a neat row of stitches. Because Alfred was born with a cleft lip, a gash splitting the top of his mouth wide open and, if it had been left that way, condemning him to a life of ridicule. And he had come to us to have that life put back together.

I stood there and just couldn't stop looking at those sutures. As patients and nurses and crew members prayed around me, it was nothing short of overwhelming to think about what had gone into those few little stitches holding together that small lip.

People from around the world leave homes and families and familiarity and come to live on a ship where everything is held to the walls with magnets and the horizon is never still. There are deckhands and officers and electricians and cooks and toilet cleaners. There are children and carpenters and teachers and pastors and librarians. There are doctors and pharmacists and anesthetists and nurses. We are hundreds of people thousands of miles of home, and we are all here so that the hands of a surgeon can quietly sew together the broken pieces of a child's life.

Three or four hundred people for five or six knots. In no other reckoning would this kind of arithmetic be acceptable. Faced with the broken body of Christ, I can figure things no other way. In the most extravagant gesture this world will ever see, God stripped himself of everything but that dim reflection of his own glory that our humanity implies. He put on skin and squalor, and he poured out his love without reservation. For the healing of bodies and souls, giving everything was not too much.

I'm glad I live and love among people who are led in the same way.

These people come near to me with their mouth and honor me with their lips, but their hearts are far from me. Their worship of me is made up only of rules taught by men.

Therefore once more I will astound these people with wonder upon wonder. (Isaiah 29:13)

We sat on the floor as people talked and laughed around us. Three nurses and a surgeon, calmly discussing miracles. Agreeing that, yes, we can go ahead and call Jitta one. Once more, wonder upon wonder.

I never want to get numb to it. At home, the question was always Do you ever stop caring? And they were talking about horrible things. About accidents and abuse and children dying right there in front of me. We were all just working away, it seemed, waiting for the day we didn't feel it anymore.

Here, it's the opposite. When I sit around with my coworkers and say I never want to get numb, I'm referring to miracles. Miracles that I've seen and am seeing and fully expect to go on seeing for as long as I'm alive. And I never want to stop recognizing them for what they are. God's hand reaching into this fallen world, taking something broken and setting it back into its proper place. A mother, tidying up her child's scattered toys. Only this is so much more than a doll being placed back on its shelf. This is Jitta, awake and looking around, with a brain that, by all accounts, works.

If the surgeon who spent all day with his hands on that brain says it was God's doing, I think I'll call it a miracle, too.

I've decided to compile a list. I'll add to it whenever circumstance smiles on us.


Things We Don't Get to Say to Mothers at Home

"Mama, it is not good for baby to eat the slipper."

"Mama, the baby must not pee pee on the floor."

"Mama, do not let the baby beat his nurse. It is not alright."

"Mama, the baby should not fall out of the bed. You must move over small."

Oh, I love my life here.

Darkness surrounds the ship. I sit here in the dim light of B Ward, ensconced in the throbbing hum of the generators. Every so often, I can hear one of my patients turn over in bed, but for the most part, they are still. Nights can be long here. When all my patients are either weeks out from surgery or small enough to be comforted easily by a close-lying mother, I'm left with not much to do but think. Tonight, Bendu is on my mind.

I was talking with a coworker yesterday as we realized all over again how dangerous it is to grow up in poverty. For those of us blessed enough to have been born into Western society, we take for granted clean, running water and electricity. We know that turning on a tap provides us with drinkable water, and we know that plugging a lamp into an outlet produces light.

This isn't true for the developing world. I have no statistics to share about the number of homes with electricity here in Liberia, but it's safe to assume that the percentage is dismally small. Bendu is one of the many women who live by the light of the sun and kerosene lamps. One night, a few months ago, she got into bed with a book. What happened next is a mystery, but as close as we can figure, she had a seizure and knocked over her lamp. Her face and arm were horribly burned, and she came to us with open wounds and eyes that were rapidly losing sight. These days, Bendu is not easy to look at. Her face and head and arm are swathed in thick gauze. Her nose has been twisted out of shape. Where the dressings slip, the raw, angry-looking skin shows through. One of the other children on the ward started crying when she came near him the other night.

Bendu is one of the most beautiful women I have ever met. Over the weekend, she was my patient, and I was the one to change her bandages. It's a long and arduous process, so to distract her from the pain, I started asking her about her family. She told me about her brothers and sisters. She shared that she just finished high school and was getting ready to go to college when she got burned. I will be an accountant, she told me, through teeth clenched in pain. Will be, Bendu? I asked her, testing her resolve. She nodded, determination written all over the parts of her face I could see through the gauze and tape. This is why I must get better. I must go to college like my friends. I turned away, fighting with myself to hold back tears, but the moment was over as soon as it had begun. True to form, Bendu was on to the next thing. Do I have eyelashes? she asked me, grabbing her mirror and taking a long look. I think I might need them someday.

That's Bendu all over. She refuses to believe that her injury is going to stop her. She wanders around the ward, visiting other patients and playing with the kids and learning how to knit with fingers already stiff from scars. Tonight, when I came on duty, one of the first things I did was fire up my computer and have a dance party with her and the mother of one of my little boys. We shuffled around an empty corner of the ward, laughing and shaking and showing each other our moves.

She's twenty-four years old. My age. And I can't help but try and put myself into her slippers. I sit here and I imagine what she must be going through, and I don't think I could do it. I don't think I could keep smiling if I had to tip my head at a specific crazy angle just to be able to see past the bandages. I don't think I could chat about my family while my wounds were being soaked in bleach. I don't think I could laugh if any movement meant pain.

I remember the prayer I breathed over and over during screening day in February. That God would help me to see the people there as both loved and lovely. Sitting here with Bendu asleep a few beds away, it's so sweet to realize how often that prayer has been answered. Yes. Yes. A thousand times yes, I hear Him say. These are my beloveds, and they are so precious to me. Loved and lovely.

Ward church started out just like it always does. Far too many people packed into far too small a space, drums and sasas beating and shaking wildly, voices lifted loud in praise. I was sitting at the back of the room, figuring it was a good vantage point to keep an eye on all my patients while still being able to enjoy the service. Not that I really thought anything would happen; Jitta was five feet away from the closest infection risk, and the rest of my kiddos were barely even sick. I settled in to soak in the music.

In the middle of a particularly animated song, a commotion at the front of the room caught my eye. With that slow-dawning wash of horror (you know the one, right, that takes about half an hour longer to register than it probably should?) I realized that it was the mother of my little boy who had his cleft lip repaired last week. And, by all appearances, she was having a seizure, right there in the middle of church.

What followed felt like something out of a strange indie film about loud circuses. I elbowed my way to the front of the room, past Africans and Americans all still clapping and singing, thinking to myself I have to get that kid out of there or she is going to bust his little lip wide open. Nurses were popping off of beds all over the ward, one grabbing a curtain, the next running to the locked narcotic box to get some diazepam. I scooped up little Alusain, who was screaming by this point, although I couldn't hear his cries above the drumming still going on about two feet from my spinning head. Once I had him safely in my arms, I turned to his mother. She was being kept from falling off the bed by two translators, wonderful Liberian women who were still just singing at the top of their lungs, laughing and praising God. When the nurse showed up carrying a curtain they laid it at the foot of the bed and kept on singing and dancing. I have never been so confused in all my life.

It finally dawned on me what was actually going on, and it was at this point that I took little Alusain and walked out of the ward, into the cool of the hallway where I could laugh. Because his mother wasn't having a seizure; she was in the spirit. The Liberian women had recognized it right away, and did exactly what they should have done - kept her from hurting herself while carrying on with their own worship. She eventually calmed down, sat up and reached for her child. And that was that. The service had continued on all the while without a hitch.

I keep thinking about what a cultural commentary it all makes. The difference between the responses was, I think, telling. All the Western people in the room thought it was a seizure, and we reacted accordingly. The Liberians recognized it for what it was and also reacted accordingly. None of us were wrong in our actions, but I can't help wishing that my first thought had been a different one.

You see, I come from an extremely quiet Christian tradition. At my church at home, we sing acapella hymns and I would never dream of even clapping along. There's nothing wrong with this. In fact, more often than not, I find myself longing for the quiet, contemplative reverence I'm accustomed to during meetings. But the longer I'm here, the more I find myself drawn to this louder, less inhibited worship. I get the sense while we sing here that the people around me just have too much joy to hide. And so it comes out in smiles and laughter, clapping hands, shuffling feet and shaking hips. The Liberian people sing louder than anyone I've ever heard, and it doesn't seem to matter whether they're anywhere near in tune. All that matters is that they're praising God. (It's a joyful noise, not a tuneful one, that He asked for, after all.)

Maybe I'll try coming out of my corner in the back of the room one of these days. Maybe I'll clap along to more than just one or two songs. And maybe I'll be able to forget myself enough that I can raise my voice and move my body without regard to anyone else around me. I think God might like that.

(But I might start coming to church with some valium in my back pocket, just so I don't feel so unprepared.)

I am in love. Again.

This time she’s two months old and weighs just over seven pounds. Her name is Jitta, the British pronunciation of which, coupled with a popular song, has prompted us to affectionately christen her Jitta-Bug. (True to my PICU track record, her bedspace is now covered in boxes and signs and little notes, all signed with a small orange butterfly.) She shared the same birth defect as my little growly-bear, Sadiatu, only Jitta’s was a little more involved. Not only was there a hole there, but Jitta’s little frontal lobe was poking out through it. Seeing as how the frontal lobe is responsible for higher thought and personality and lots of important things like that, this made us all a little worried.

You see, Jitta-Bug is a long shot. Spending all day in the operating room is tough enough, even if you’re not a tiny baby. And this tiny baby was born with a brain that isn’t quite right, and chances are, even with the surgery, she’s not going to be normal. (That is, provided she doesn’t succumb to infection, always a huge risk with this operation, and one we’re scared to death of. You should have seen the people-free zone being enforced around her bed at ward church this morning.) Surprisingly, when all this was explained to her mother, using her sister as a translator (it’s always helpful when cousins come in for surgery at the same time), she just laughed. You see, in Jitta’s village, her mother and brother and half her family are already considered ‘slow.’ They didn’t think it was such a big deal after all.

This doesn’t change the fact that my small Jitta-Bug needed a miracle. There wasn’t any way you could look at her situation and feel confident of a good outcome; she was coming into this particular race too far behind to have any real hope of catching up. So we did what seemed totally appropriate; we started praying for miracles. We laid our hands on her, dwarfing her miniature body, and we stormed heaven with our cries.

Jitta had her surgery on Thursday. I only had three other patients, so I spent my day popping in and out of OR 4, watching in awe as the dream team (Dr. Gary and Dr. Mark) delicately peeled back Jitta’s scalp, removed the front plate of her skull and oh-so-slowly pulled her brain back where it belonged. I’ve never seen anything like it.

When I heard she was out of the operating room and in recovery, I went down to check on her. Walking into the room, I was greeted with a wall of blue-clad backs, a fortress of concerned nurses and anesthetists. From behind the barrier, I heard the sweetest sound: an angry baby, crying for her mother. At the foot of the stretcher, Dr. Gary was sitting, a bemused smile on his face. Long day? I asked him, and he just grinned. This baby shouldn’t have been awake. She shouldn’t have been fighting with the nurses or screaming her little head off. By all accounts, she shouldn’t have even made it.

But she’s tucked in next to her mother in the corner of B Ward right now, head swathed in bandages so thick she looks like a q-tip. I’d be lying if I said the road ahead of her isn’t a long one, but as of this moment she’s eating and crying and pooping and tearing her bandages off and making little squeaky baby noises and snuggling into the crook of my arm when I hold her. Which is often.

We asked for a miracle, and I think we’d be foolish not to recognize that one has been given to us.

When I walk onto the wards at two in the afternoon and am handed an assignment sheet bearing only the names of Alfred and Emmanuel, it's safe to say that the shift is going to be quiet. Both have been here forever, both get their vital signs taken once a day and neither really has any medications or involved procedures to be done in the evenings. With the exception of a surprise admission (which turned out to be four for the price of one; family-style hospital trips are all the rage here) the shift rolled along very much as I expected. I hung out with my fellow nurse, Sarah. We made folders for photos. I chatted to the other patients and wandered around with a sleeping baby on my back. It was quiet.

After dinner, we had all had just about enough of the sleepy pace of things. We were, in a word, bored, and the hours until ten o'clock needed to be filled. Somehow.

It turns out that Austin, one of our longer-term patients, is a musician. His first admission was to reduce the size of his massively overgrown toes. Things were looking good, but going home in Liberia means going back to dirt and damp, and dressings just don't stay clean. Austin's foot got infected, and so this second admission was to amputate one of the toes. I was working on A Ward the day they told him his toe would have to be taken off, and he was devastated. Austin is a young guy, and he was pretty convinced he'd never walk again. It was a rough couple days after surgery for him, with pain and anxiety mixing to create the most heartbreaking fear.

But Austin has his spirit back now. And last night, he sang and rapped for me. He laughed his head off while I tried to sing one of his own compositions along with him. Baby Girl, you fine-o. Baby Girl, you fine-o. You walkin' like a stranger, you talkin' like an angel, you look like made from cream-o. I say you fine-o. Once we had gotten that song down pat, he asked me about what kind of music I like. I searched through my files on the work computer and came up with Audrey and Mike singing Hallelujah. He asked me if I had any more songs by 'that guy,' and so I ran down to my room to get my computer.

We ran through a couple Tenth Ave songs fairly quickly until landing on Times. It stopped him cold. He sat up, leaned forward and listened intently. I want for you to give me the words to this one, please. Since I hear God speaking to me every time I hear that song, I was only too happy to oblige. I grabbed a pen and paper and wrote furiously.

When I finished, I handed him the page, started the song again and went to check on my patients. From the other side of the ward, I heard him singing. Your love is over, it's underneath. It's inside, it's in between. Oh oh, oh oh, oh oh.

We played the song over and over until the battery died and my computer shut off. At which point he brought the paper over to his friend a few beds down, a kid who will find out today whether or not he has cancer. Heads bent close, they studied the words. Another patient, Friend, stopped by for a visit. Come see this song, man! Austin called. It's a fine gospel song. Brother Mike sing about love. So Friend got to hear about this overwhelming love too.

I don't know if Mike and the guys have any idea how powerful this song really is. Borkai and Friend and Austin. Cancer and burn scars and missing toes. In times of confusion and chaos and pain, God's love over and underneath it all.

I was scheduled to work Friday evening, which made me rather sad, since supper was a picnic-style feast of barbecue ribs served out on the dock, followed by relay race festivities marking the year anniversary of the passing of the torch from the Anastasis to the Africa Mercy. I wasn't sure I wanted to be a part of the race, but I definitely wanted to sit outside and linger over my pork and beans. This season is well on its way, and it won't be long before we're trapped inside by the rains. So, despite a sweet sunrise chat with God, it was with an admittedly heavy heart that I dragged through my morning.

Needless to say, I was more than a little excited when I got a call from one of the charge nurses just before lunch. How would you like to do an activity with the patients instead of working this afternoon? My dinner on the dock suddenly became a happy reality and I foolishly agreed to be part of a relay team. (As a side note, while HCS+ won their first heat but were eventually defeated in the finals, I would like to submit that our flame-bedecked urinal was the best torch of the evening. I'm just saying.)

It was at this point that I hit a small snag; I couldn't come up with an activity to save my life. Our craft cart consists of beads, thread, crayons, paper and playdoh. That's about it. I couldn't even rustle up paper plates to paint, and it got closer and closer to three o'clock as I combed the internet, my sister's brain and the imaginations of every friend I came across to try and find something creative to occupy a crowd of people, aged two to sixty, who didn't really even speak my language.

I had pretty much despaired of presenting anything exciting when I walked past Ines in the hallway. She's the mum of my favourite ships kids and the coordinator of Mercy Ministries, the groups that go off the ship and into orphanages and homes for the handicapped and such. She's amazing, and I'm not just saying that because she quickly supplied me with an idea.

Armed with playdoh and clipboards, I headed down to the wards. I passed out supplies to patients and mamas and began to tell the creation story, encouraging them to create along with my words. I hit my first roadblock when I noticed that half of the patients didn't know how to get the sticky substance out of the cans. Even the ones who had their playdoh in a hopeful lump in the middle of clipboards balanced on knees didn't start making anything until somewhere around the third day; abstract concepts just aren't that easy to fashion out of an unknown material.

Once they had all caught on to how the playdoh actually worked, they got excitedly down to the task at hand. With exclamations of wonder and comments about how God did a better job anyway, they started creating. They fashioned miniatures from their lives, and across the board, in every single ward, they all made the same things. Snakes, spiders, cotton trees, fish and cooking pots. They displayed these treasures to me with shy enthusiasm. Alimou, once I had scraped together enough French to explain what on earth was going on, made just one simple sculpture: a canoe with an oar. Pirogue! he told me, joy sparkling in his eyes.

They were so engrossed. Playdoh and the creation story. When's the last time you were able to stand in front of a room full of adults armed with only playdoh and the creation story and feel confident that you'd be able to entertain for a couple of hours? In what world are people eager enough, simple enough, grateful enough to let playdoh and the creation story be enough? Snakes and cooking pots and pirogues. Works of art created by hands created by God.

It was good.