ali's african adventures

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.

Here is my little Sia; this was on Friday just before she went back to the operating room to have the dead tissue that used to be her left eye removed. She looks even better now, and she's like a new kid these days. She smiles and laughs and plays and just hangs out like she owns the place in her own quiet way.



She's due for her next dose of chemo this Friday, if all is well with her bloodwork. We're still trying to figure out what will happen with her when we leave, so please be praying that the way will be shown clearly in front of us.

(Photo courtesy of the talented Deb Louden, ward nurse and photographer extraordinaire.)

Since I've been in bed all weekend nursing a nasty cold, I don't have any updates or stories from the wards. It would appear that I handle proper illness with much more grace than I do a simple cold. Whatever the case may be, I haven't left the comfort of my cabin for more than a few minutes at a time. Not even to head outside to the deck or the dock. Which, speaking of, I've never shown you.

Since I live on a home whose backyard changes at least once a year depending on where we drop anchor, I figure it's only fair to keep you updated on the changing view.



This composite was shot during the forklift incident a couple weeks ago. (At the bottom left is the Terex machine trying to fish that poor forklift out of the water) At any rate, the view from this particular dock is absolutely wonderful if you can get past the four-high row of containers hemming us in. We have a beautiful mountain view, little houses creeping up the side of it, topped with university buildings.

At the far left there's a little area fenced off for a basketball court; dinner last night was a barbecue out there with everyone sitting in beach chairs and balancing plates on knees. All along the containers we park our Landrovers, and on the far right is the narrow walkway where we come and go from the dock. Well, technically, on the far right is a sunset. Every night you can find people up on Deck Eight watching the sunset. The sun slips below the mountains on the other side of the harbour as smoke rises from the fishing villages and the call to prayer sounds from city mosques. On a quiet night you can hear two or three at a time.

There's not always much room to roam here in West Africa, and it's nice to have a berth with a view this year.

If you downloaded any of the November wallpapers, please accept my scatterbrained apology. I somehow managed to make all three of them with the month starting on Thursday, not Tuesday. I didn't notice until today when I started trying to make outpatient appointments on absolutely the wrong days.

Please accept my hearty apologies and these newly-uploaded backgrounds which have calendars that actually start on the correct day.







(However, if you just want them for the photos, then feel free to disregard all this!)

Little Sia is still on D Ward; I've been off for the last two days, and when I walked into the room this morning I thought I was seeing things. Where before she had a tumour the size of a small orange, now the contour of her face is nearly normal again. Burkitt's responds so quickly to treatment that it's almost unbelievable.

She still cries every time we come near her with a needle, something that unfortunately happens every day since she's had a few issues after getting her dose of chemotherapy, but she's eating again, which is a start. She and her little sister, Kumbah, sit facing each other on the bed at each meal, Kumbah more often than not offering her big sister a handful of beans or rice.

Today, for the first time, Sia was up and walking around the ward with Kumbah when one of the nurses for some reason decided to scoop Kumbah up in a pillowcase. Don't ask me why any of these sort of things happen; I'm supposedly in charge of the place, but my hold on the reigns is always just a little tenuous. Be that as it may, the effect of this move was something I really hadn't expected.

I looked down a Sia and she was laughing her head off. She's spent the last week curled up in bed, not speaking a word; I've never ever seen her smile. Today she laughed.

Sia's future is still uncertain. We're working on finding a way for her to get follow-up care when we leave, and with only three and a half weeks until the hospital closes for good this year, we don't have a lot of time. God is God of the details, though. He knows each curly hair in each of the braids on Sia's head. He's written each day of her life in his book, and although we don't know right now just how many days she has left, we've bought her this time at least.