Entries by Ali C.

It's Saturday. The first full week of surgery for the year is finished, and somehow we all made it through. It's been a busy start by any standards, with three max-fax surgeons all operating at once, and given my current state of constant exhaustion I've been spending most of my time just keeping my head above water.

Sometimes my job here can become just that: a job. That's more true than ever these days when it's all I can do to make it through rounds every morning. All three surgeons took on difficult cases, and the max-fax patients quickly spilled out of D Ward and into the domain of nurses who haven't had the same amount of training in our specialty. Add that to a team of brand new nurses and the inevitable ironing out of kinks that comes with starting over in a new country, and it's no wonder that I've found it hard to see more than just the tasks in front of me.

Yesterday, close to the end of my shift, the OR called for their next patient, a man who we originally operated on in Benin back in 2008. The tumor in his jaw has started to grow back, and so he needed to have a second painful surgery, a second long recovery. His nurse was still on orientation and had never brought a patient to the OR, so she asked me to walk her through the process. I gladly agreed and we worked through the pre-operative checklist together, collected his bag of IV fluids and made the short walk down the hallway to the bench that serves as the waiting area.

We went through the checklist a second time with the OR nurse, and when we asked if he had any last-minute questions, his response was quick. God will take care of me. I am ready. We bowed our heads, laid our hands on his shoulders and prayed for him, and as he disappeared through the door, his nurse collected his flip flops and we turned to go back to the ward.

When I realized she wasn't following me, I turned back to find her leaning against the wall, tears filling her eyes. That's the first one, she told me. That's the first time I've seen that part.

I looked over at the worn, wooden bench, the same bench that stood outside the operating rooms on the Anastasis. Every patient who has ever received surgery on either ship has sat on that bench, been prayed for before they walk through the doors and into the promise of their new life.

It's not just a job. That new nurse reminded me of that yesterday as we stood together in the hallway and cried. It's not just a series of tasks to be completed, a list of things to be checked off before I can come back to my cabin and rest. Stacia, one of the other team leaders, calls the hospital hallway the Hallway of Hope, and she told me yesterday that she cries for joy every single time she brings a patient down it to sit on that bench.

I love this time of year. I love how the new nurses are seeing all this through fresh eyes, experiencing for the first time everything that I got to experience for the first time four years ago. I only have fourteen more weeks before I have to leave the ship and head home for the rest of my pregnancy, and I think I'll take in every single moment between now and then.

Stay tuned for more stories. I already have a few, and it's only been a week.

A disclaimer before I begin: this post has nothing to do with either the hospital or the baby. But I can't help being excited and sharing this!

I grew up going to a small church in New Jersey. We all sat in exactly the same seats every single Sunday morning, everyone knew everyone else, and there were connections all over the place. My high school Sunday School teachers were my dad and my dentist. The guy who taught the middle school class was the principal of my middle school. His son, Stephen Collucci, is who I'm writing about.

Food and Wine magazine just announced that they're searching for The People's Best New Pastry Chef. The honour will be given to one of fifty nominees from all over the country, and Stephen is up for the award!



He's the pastry chef at Colicchio & Sons in New York City, and I just went onto their website and realized that their Tap Room is high on my list of places to visit once I'm home for maternity leave. (Sister - fancy a trip into the city?)

I know that most of you don't know Stephen (except for all of you back at TRBC!), but please take a minute to go onto the Food and Wine website and vote for him. You don't have to register or anything; it's just a simple click of a button.

Here's hoping I see a familiar face in a famous magazine soon!

Wednesday was screening day at the local stadium here in Lomé. It's the one day of the year where we see as many potential patients as possible and schedule as many surgeries as possible for the upcoming field service.

The first teams left the ship on Tuesday evening to stay overnight and manage the people who would come to get in line the night before. For those of us who come from countries where medical care is easily accessible, the thought of waiting overnight to see a doctor isn't something we can really understand. But here in West Africa, this is the reality.

I was in the second wave of Land Rovers to leave the ship, and we pulled up to the station in the early dawn. The line stretched out as far as I could see, people dressed in every colour of the rainbow, waiting patiently under the watchful eyes of the local gendarmes.



When the jobs for screening were originally handed out, I was assigned to a pre-screening station just inside the main gate. However, this little baby of ours is not the most cooperative kid. I've been pretty sick ever since I hit five weeks, and standing all day in the heat wasn't really going to be an option for me. Instead of pre-screening, I ended up at the opposite end of the process, the final check table, comfortably situated in a breezy piece of shade.



Somewhere around 3,500 people came to the stadium in hopes that they would be chosen. They came with their hopes and their fears, and so many of them had to be turned away. 1,600 were allowed through the gates, and every single one of these were seen by the teams inside. Some were given dates for surgery, others were given cards to come back to be seen by physicians and surgeons on the ship before we could make a final decision. And some were escorted directly to a huddle of chairs under the spreading boughs of a huge tree where a team sat waiting to pray with the ones we had to turn away.



My table was the last stop before the exit, and throughout the course of the day I saw every single person who was given a yellow card. Those yellow cards are the golden tickets, the passes that get them through the port gate and onto the ship to be seen. My job for the day was to collect paperwork and check that each person sitting across from me knew when to come back to the ship and what would happen that day. That was it. Just make sure that the ones chosen knew when to come for their chance at life.

Usually at screening I'm the one saying no. I have to see the hope in their eyes and I have to be the one to snuff that slight flame. It's so easy to feel hopeless on that side, to feel crushed by the weight of the pain and the need here in West Africa. But on Wednesday I couldn't stop smiling. I was finally able to see how much we can do instead of how much we leave undone.



A few times, I saw patients who I had taken care of last time we were here in Togo, in 2010. They had brought sons and mothers and friends to be seen and when we recognized each other, there were invariably hugs and dance parties. I saw one little boy who was being seen in the outpatients department during the entire 2010 field service. We were never able to do his surgery because of stubborn wounds that just wouldn't heal. To be quite honest, I never expected to see him alive again, and when his mama slipped her arms around me and told me c'est fini, I couldn't help crying just a little. He has a card to come for screening with the plastic surgeon when he gets here, and we see no reason that he won't be scheduled this year.

The first patients will be admitted on Sunday afternoon, and the first surgeries will be on Monday. Please pray for our patients, for the new nurses who will be learning the ropes in the upcoming weeks, for the empty spots still on the staffing plans. We will be here in Togo until June, and there is much to be done in such a short time.

(All photos courtesy of the fabulous Mercy Ships communications department.)

Without further ado, I'd like to present the reason for my lack of blogging over the past couple months.



We're due August fourteenth, and we're more excited than I can possibly put into words.

Much more to come on this and many other subjects, but for now I'm heading to bed. At least now I don't have to make excuses about why I'm so tired!

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

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

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

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

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

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

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

We're in this together.

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

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

It can get old.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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







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

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

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

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









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



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



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





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





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







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

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

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

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

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

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

To quote our friend Hassan, Amen.

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

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

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

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

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

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

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

I think I expect too much.

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

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

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

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

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

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

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

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

We should round like this more often.

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

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

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

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

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

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

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

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



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

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

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

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

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