ali's african adventures

Five hundred and forty-one.

Now that the pile has gotten this small, I can easily count through the names remaining. What seemed like an insurmountable task at the beginning has dwindled to a list of fifty-nine people.

The end of this outreach is turning into such a bittersweet time for me. Usually, my head is caught up in the successes right about now. I find myself running back over stories in my mind, remembering what we accomplished over the past months. This time, it's so different. This time, there is so much sadness mixed in with the joy.

Yesterday, I sat in the International Lounge along with all our Day Volunteers, the Togolese people who came onto the ship to serve their brothers and sisters alongside us this year. Together we watched a video slide show of photos from the outreach, and when the before and after photos of several patients came across the screen, the place erupted into cheers the like of which I haven't heard since the World Cup ended. We sang and danced and rejoiced together, and all I could think about was how many e-mails would be waiting for me when I got back to my room, how many more names I would be able to send out.

It's not just them. It's O'Brien and Anicette and Tim's dad and Mawuli, a dearly-loved patient whose funeral I attended last night.

I sat in a small Catholic church somewhere in Lome, the words of the Mass washing over me like rain, and I didn't realize I was crying myself until I felt the back of my hands grow wet. I stood and knelt and prayed and a wave of sadness threatened to overwhelm me.

Until I looked up to see the priest, eyes to heaven, holding up the cup, blessing the wine. A line of people moved slowly up to the front of the church, past the wooden pew where I knelt, to take Communion, and then everything was right again.

Because if all this rests on my shoulders, then I should let the sadness engulf me; there would be no way for me to stand up against this fight. And then I remember that it's not mine to win, that I could spend my life campaigning against the injustice in this world and never come close to the victory that was won on a hill outside Jerusalem almost two thousand years ago.

And for me, that puts everything back into perspective. Instead of a failure, this pile of pink sheets has become what I'm honestly seeing it as; a chance for all of us to take one more faltering step closer to God. Instead of looking at them and seeing what we couldn't do, I'm looking past them, at all of you, and seeing what we are doing. We are storming the gates of heaven on behalf of the poor, speaking the names of the forgotten ones in love.

And if our prayers are truly incense, like it says in Psalm 141, then heaven is fragrant tonight.

474.

I'm leaving that on its own line because I keep looking at that number, and I can't believe it's true. The pile of unmarked pink sheets is so small now that it actually seems possible that we can do this, that every one of these people will have someone praying for them from a world away.

They're almost all I think about these days. The last nine patients were discharged this morning while I sat at my computer, writing e-mails to all of you about the ones who never made it onto the wards. I stopped by A Ward before they left, and Josee shrieked my name, hugging me as we pretended to cry about our parting. I didn't actually cry until I left the ward and was back in my room, staring at the pile of pink sheets again.

We reshaped Josee's foot. We fixed Maurius' lip and Aissa's cheek. We built Tani a lip and a nose. We did so much. And there is so much left to do.

Thank you standing in the gap with us. For being the link that's going to hold us to this place long after the ship sails away.

On Thursday, I'm going to head off on an adventure around the world, carrying these names with me. I'm praying I can leave behind all six hundred sheets, each one with a little black dot in the corner.

It's just after midnight on the sixth of August, and I've just typed out five more names to add to what one prayer warrior, Heather, has called a "concert of prayer." Those five have pushed us over the halfway mark.

304. More than half of the sheets now have a little black dot in the upper right hand corner, the signal to myself that all is well, that this one has been taken care of, taken in, taken to heart by one of you.

Please, don't stop. I'm going to admit that I'm tired. It's emotionally exhausting to sit in front of my computers for hours and hours, reading through all these sheets, seeing entire life stories spelled out in just a few words and knowing all too well what lies ahead for some of them. My neck is aching from staring back and forth between the screen and the piles of papers, but I wouldn't trade this for the world.

Because I get to pray, too. Each one of these that I type out and send to you is another one that is more than just a name on a sheet of paper to me. I look at the boxes holding the different piles for the different types of surgeries, and I can go to sleep knowing that I've read more than half of the stories in them. I feel like I'm connecting with my own work in a way I never have before, and I wish I could find words to explain how right it feels.

So don't stop e-mailing me and commenting. Tell your friends. Post on Facebook and Twitter and whatever other newfangled technology I've missed in the last couple of years. Because there are still 296 pink sheets, two hundred and ninety-six of God's children who need to be lifted up to His throne again.

And while we're on the subject of prayer, can I add one more name to all of your lists?

Tim is one of my best friends on the ship, part of a group that's become family to me over the past few years. Just recently, we got to meet his parents and brother and sister when they came to visit the ship. Yesterday, Tim's dad passed away at a hospital in Iceland, where he and Tim's mum were on vacation. It was sudden, and there was no way for Tim to be there in time, so instead he's trying to figure out how to get back to Australia to be with his sister, who also wasn't able to be there.

Please pray for Tim and for his family. They're scattered across the world and their lives have just been shattered. While you're praying for the patients on your pink sheets, please pray for Tim, too.

Update #3 (5 August, 10:30 Africa time) : 239 of the patients are being prayed for. That is almost half, in less than 2 days. Keep it up. Spread the word. Pray.

Update #2 (4 August, 19:30 Africa time) : 164 names have been spoken for. God is stirring up hearts, and I am so humbled to be a part of His process in all of this.

Update #1 (4 August, 12:30 Africa time) : 102 of the names on the pink sheets have been e-mailed out across the world, and people are starting to pray.



We laid them out on empty stretchers in the recovery room. Six hundred pink sheets, filled with information we had gathered at screenings throughout the outreach. From all over Togo they came to us, and we sat with them, learned their names, recorded their pain, filed their stories in a desk drawer and asked them to wait for their healing.

Six hundred pink sheets.

They were the ones we turned away. The ones who were too sick or not sick enough. The ones who missed their surgery dates and couldn't be rescheduled because there were hundreds more to take their places. The ones we tried to call but couldn't reach.

Six hundred of them, and when I looked at all the pages strewn across the room I wanted to scream.

Because they've always been there. They're in every country we visit, but we've never seen them before, never made it to their villages to peer into the darkness of their little mud huts and bring them into the light. And this time we did, this time we drove to meet them and we said we'd call if we could help and then we never did.

Instead we laid them all out in an empty room and we did the only thing left to us. We prayed. We didn't finish today; there were too many, so we're going to do it again tomorrow. We prayed over each one of them. Over Yema, the little boy who just turned one in July, too small for his cleft lip to be fixed but probably not getting enough to eat at home because of it. Over Maka, eight years old with a left arm that can't straighten and fingers crippled from the burns he suffered when he was two. Over Abel, a young man with a hernia the size of a football who we tried to call and who never picked up his phone and so his paper was moved to the back of the pile again.

Over Yema and Maka and Abel and hundreds more, lives reduced to words on a sheet of pink papers. A pile of cleft lips. Important, more often than not checked on the bottom of the forms, no, no, no scrawled across the tops when we realized that time had run out. A handful of tumors, all marked positive for HIV and turned away because in the time it would have taken for them to get their CD4 counts done, we would have found five more to replace each one of them.

I cried this afternoon. Frustrated, angry tears, and I don't think I've ever been so aware of the scope of the need here in West Africa. By the end of an outreach, we usually have a few pink sheets left in the drawer in the OR office, lumps and bumps that didn't quite make it into the surgery schedule but weren't going to mean the difference between life and death. This time we found the forgotten, called out to the ones who've never heard the voice of hope and then we turned away because the time was too short and there were too many of them.

Six hundred pink sheets. Hundreds and thousands more sleeping on dirt floors tonight, nursing their pain and their fears as we get ready to sail away.

Pray with us. Please pray with us.

If you'd like to pray specifically for a patient, let me know in a comment or an e-mail, and I'll head down to the office and choose one or five or twenty names for you. If it's children who touch your heart, I'll find you a child to pray for. If you're drawn to those who have suffered burns, there's a whole pile of them. There are mamas and papas, old men and little girls, and they have all been told no.

Wouldn't it be incredible if we could find six hundred people willing to pray for these six hundred?

Please pray with us.

I was sitting at my desk in the office today, working on some mind-numbingly boring paperwork revisions when I felt a tap on my shoulder. I pulled the headphones out of my ears and turned around, expecting to be answering a question about where some box of supplies should be stored for the sail. Instead, a little girl clad in matching fabric from head to toe threw herself into my lap, shrieking my name.

Balkissa's tongue looks incredible. This second surgery has been a success by any standards, but it turns out God had bigger plans for little Balkissa than just the reshaping of her mouth.

The first time we met her, the doctor examining her heard something worrying through her stethoscope; the whoosh-whoosh of blood coursing through a heart formed wrong. And although the medicine we practice here is, by most standards, first-world, there are things we can't do. Diagnosing and treating congenital heart problems are definitely on that list.

Balkissa's not the first little one we've met with a faulty heart, and so we made sure she was strong enough for surgery and went ahead, leaving the murmur filed under the category of Things We Can't do Anything About. Her surgery, as you know, went well, but when she got home her tongue split apart again. A failure.

And this is where God's planning becomes beautifully clear.

When Balkissa came back to the ship for her second surgery, nothing had changed. Nothing except one of the anesthetists, a doctor named Paul. Paul wasn't here when we first met Balkissa, first heard her broken heart, but because she had to come back to us, he met her too and heard for himself.

Here's where it gets good, because Paul knows of a charity that does work here in Togo, a charity that takes kids to hospitals in the first world where they can get the treatment and surgery that they need for their heart defects. Today, one of our outpatient nurses took Balkissa to the clinic where they'd do an echocardiogram of her heart and decide whether or not the defect was something that could be treated. If it is, they'll make arrangements for her to fly off to another world, to another hospital (this one on land) where she'll be given yet another second chance.

There have been so many times that I've wondered whether any of the complications we see are for some sort of other purpose, whether God has plans for their coming back to us that go beyond just an infected wound or a broken-open suture line.

Today, I have proof. Proof that the hands weaving this story are so much more skilled than our own, that the heart loving through us is so much deeper than any I could dream up.

And speaking of hearts, I'll let you know what they find out about Balkissa's as soon as I know.

On Friday evenings, after work and before the sun goes down, we head out to a grassy field near the ship to play Ultimate. It's the perfect end to a week of work, and since the raining season has made temperatures dip to where it doesn't feel like we're stepping into a sauna when we leave the port, it's a sweet deal all around. This week, just like every other, it was made even sweeter by the watchful presence of close to thirty kids in various stages of dress and disrepair.

The rest of the players joke that having me on their team is a gamble, that when the kids crowd the sidelines, I'm a flight risk. Yesterday, their fears were confirmed; it appears that I've gone from a hardcore player to nothing but a big softie.

I made it through about fifteen minutes of the game before the kids started mimicking us, hopping up and down and pretending to throw a disc around. One little guy in particular caught my eye, goofy grin and frantically wiggling eyebrows in an impish face. When I greeted them in Mina and they shrieked with laughter, taking it in turns to see who could come the closest to my outstretched hand without running away in terror, I was sold.

I took a spare disc and a spare player, one of my friends from youth, Alannah, and herded my little friends over to the other side of the field. Conveniently, about half of them were wearing shirts in many shades of red. The rest were clad in every colour of the rainbow, but when we asked them what their team should be named, they agreed on the obvious choice: Noir (Black). One small guy presented a bit of a puzzle, with a shirt that was covered in red flowers on the front but totally black on the back. Since it made the numbers even, he ended up on team Rouge (Red). His allegiance was confused throughout the entire game.

The guy with the wiggling eyebrows introduced himself to me as Janneau, and it turned out that he understood my French well enough that he became my translator as I explained the rules of the game. These were met with much nodding of heads and more wiggling of eyebrows, and soon enough we sent Team Rouge over to the other end of the field (they only made it about fifteen feet before they were too excited and turned around) to wait for the throw.

What ensued was nothing short of mayhem. I lost my voice fairly promptly, since all thirty kids either looked to me for guidance or just fought tooth and nail over the disc whenever it hit the ground. And it did hit the ground. A lot. Because they threw it with sheer abandon, no receiver in sight, shrieking with the joy of the game.

We played until it was too dark to see, and then we all said goodbye. Janneau and Emmanuel and Komla walked me to the Land Rover, their little hands in mine all the way across the field.

I don't know if I'll be able to play again before we leave Togo, but if I don't make it back to the field, I'll know that there are a whole bunch of kids who have at least some idea how to play Ultimate. I'd say it's a pretty good legacy.


(Photo taken by PJ Accetturo at our field last year in Benin.)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Amen.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Here in West Africa, things are often so different.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Some days I hate Africa.

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

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

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

He was wrong.
I hate that he was wrong.

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

And it's just not enough.

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

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

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