patient stories

She came almost hesitantly around the door, her eyes searching for her son's. When she saw him, propped up on the shoulder of the recovery room nurse, she came close, peering at his face. Her eyes widened, and she threw her hands up to the sky, one short burst of praise before taking him in her arms and beginning to rock him back and forth, back and forth.

On a stretcher across the room sat the surgeon, divested of his gown and gloves after the operation. The hands that had placed the knots so carefully in the little baby's lip were still, folded in his lap while he watched the scene unfold in front of him. The mama who couldn't take her eyes off her baby's face, patting his back to soothe his cries.

I love watching the way their foreheads wrinkle, he told me. The way they just take it all in, like they can't even understand what they're seeing. I stood by his side, watching the mama and her little baby, a tiny family on the road back from brokenness. Later, I saw the tears fall from the grandma's eyes as she stared at the smooth, unbroken line of the little boy's lip.

And like the surgeon, I sat across the room, just watching them take it all in. Watching them turn his face to the light so they could look again and again, making sure that it was true.

Enyo gangi, Francois' mama told me, knowing that I speak just enough Fon to understand the cry of her heart. Gangi gangi.

It's good. It's so, so good.

Last week was hectic, to say the least. After all the rigamarole of opening the wards, orienting new translators (so many of whom don't seem to speak English) and ironing out the kinks in a system that seems to change on a daily basis, I was exhausted. Knowing full well that it was only week one out of thirty for the outreach, I was well aware that I needed to rest or else I wouldn't be able to head back down there this morning. To that end, I spent the weekend in my cabin. I ate zero meals in the dining room; the HoJ brought provisions and I subsisted on popcorn and garlic bread.

This morning, feeling well-rested and energized, I walked onto a completely different ward than the one I left on Friday afternoon. The patients were quiet and relaxed (all but Bobo, who felt the need to cry all. day. long.), the translators moved about their work with quiet efficiency, and the nurses were confident in their tasks.

The best part of the day was the very end. As the evening shift nurses filtered in, I realized that two of our ward disciplers were there too. Could we have worship, I asked them, and before I knew what was happening we were packed into the ward, singing and dancing. Someone had brought a drum from D Ward, and the sasa was shaking. We clapped and shuffled and belted out sings in three or four languages.

In my arms I held two-year old Kodjovi. He had his cleft lip fixed on Friday, the steri strips and little sutures sticking out of that lip the only indication that anything was ever wrong. When I moved, he bobbed his little head in response. When I held up my hand he used it to clap, his little feet rustling against my hips as he danced along with us.

We stood there, all of us, raising our voices to God at the start of the new shift. We put our arms out to each other, and all around the ward we joined hands. Small and tall and brown and white, some laying in their beds, others sitting on stools beside them, we intertwined our fingers and bowed our heads to pray.

While all this was going on, Francois peered over from his bed in the corner, his bright eyes making him look for all the world like a little baby bird. Our little chicken baby, once so scrawny, now weighs in at over eight pounds, complete with round cheeks and little rolls on his thighs. His mama mixes his bottles and baths him in a blue bowl and covers him liberally in baby powder. He is absolutely thriving under all the love.

Tomorrow, Francois will go to the operating room to have his cleft lip repaired. The mama who tried to leave her baby in an orphanage will have the chance to take him home with a smooth, straight lip. So while we all stood around praying, I snuck a peek over at Francois. His grandma was holding him, his mama's eyes shut tight while she mouthed the words of her own prayer along with us.

Tomorrow, we're going to see that prayer answered.

We couldn't do it.

The discussions went on through the morning, with doctors weighing pros and cons and reviewing x-rays and trying to see their way clear. But at the end of it all, the message was delivered to me in the ward. It's a no. We can't do the spinal, and her condition's not bad enough to risk it under general.

And yet again I'm faced with the reality that where you are born so often determines the course of your life. Because this little girl was born in a village in West Africa, there was nothing that could be done when her parents saw that her leg was twisted. Because Togo has just one doctor for every twenty-five thousand people, there was nowhere to go, no way to have it corrected.

It feels so wrong that we started to show her a way out, allowed her to hope maybe for the first time and then were forced to pull that hope out from under her and pray that she doesn't break when she falls.

I could see the tears in her eyes when she left today, dressed in her Sunday best, the clothes she had picked out to come to the ship for the surgery that she isn't going to get. I watched her walk slowly down the hall, her head weaving side to side with the broken rhythm of her walk, and I wanted to scream. To beat my fists against the walls and rail against the unfairness of it all. But instead I watched her, watched her walk away with her strange, jerky grace, and I prayed that I could learn to hold my head just as high as she did in the face of disappointment and pain.

And as her hand came to rest for a fleeting second on her still-flat belly, I prayed that she would teach her baby to be just as strong as she is.

What do you think?

Dr. Gary asked me that question so matter-of-factly, standing in the hall outside the OR office. Like my opinion would count in all this confusion. Like I would somehow know what to do. Like anyone could really know.

What do you think?


The day had started out less than desirably. Today is the presidential elections here in Togo, and as a result there are travel restrictions and the potential for civil unrest. We worked with a skeleton crew of translators, only one for each ward, and brought all the patients we wanted to operate on through next Tuesday onto the ship yesterday. The result was somewhere around fifteen or twenty admissions, all in various stages of paperwork with no fixed plan as to when they would be going to the operating room. It's usually a big jigsaw puzzle around here; the elections just magnified that exponentially and the result was something that felt vaguely like chaos.

Among the things that slipped through the cracks from the admissions process was a pregnancy test on the little fourteen year-old girl in Bed Seventeen. Since everyone was pitching in and helping out, her nurse sent off the sample to the lab this morning, expecting to be able to call the OR and get her scheduled for surgery to straighten her leg when the results came back.

The lab technician slipped through the door a little while later, her face ashen. I just need to make sure this is the right patient. Please tell me it's not. We compared ID numbers with what was marked on the slip and confirmed the truth. My little teenaged friend was going to be a mama.

Which is where it all gets heartbreaking and where I'm not sure I'll sleep well tonight, thinking of her down there on the wards. Normally we'd just say no. It's incredibly risky to give a pregnant mama general anesthesia in the first trimester, so sometimes for small procedures we'll hand out an appointment card and some multivitamins and tell them to come back in a few months. But in a few months the orthopedic surgeons will be long gone and this little girl will be sentenced live life a cripple, her foot twisted and her leg bowed inwards.

So when I stood in the hall and explained all this to Dr. Gary, our Chief Medical Officer, all I wanted was an answer from him. Yes or no, just don't make me be involved. Don't make me weigh a little girl's future against the future of the baby inside her. Don't make me give an opinion when I can't see straight through eyes blurred by these tears. Don't let me help you decide, because what if we decide wrong?

What do you think?

In the end, I don't know what will happen. There are doctors and anesthetists and surgeons all consulting with one another, trying to come up with a way to do the surgery without general anesthesia, trying to find a way to give both these little ones a future.

And tomorrow, when I go back to work in the morning, we're all going to have to sit down together and decide.

What do you think?

Little five-year old Jean Claude has more trouble than just the twisting of his left foot. We're not sure why, but he suffers from cerebral palsy. It's not always easy to get an accurate health history here; in North America mamas would be quoting Apgar scores back to us and citing down to the second the time their children were without oxygen. Here, it's a little foggier. We don't know if something happened at birth or before, but the result is our little boy in Bed Fifteen.

One look in his direction, and his face is transformed by the biggest, toothy grin I've seen in a long time. He shrieks his joy when toys are placed before him, rising up from his classic indian-style pose to rest on his knees and reach for whatever you're holding. He unabashedly grabs pens and cups and hair, and will nestle into your embrace like you're the love of his life.

We sent Jean Claude off to the operating room this morning knowing that he'd be much less pleasant when he arrived back. We're so used to seeing our happy, smiling kiddos transformed into growling bears, flat out on the stretcher when they're wheeled back from the recovery room.

Jean Claude tried to fake us out.

When the recovery nurses rolled through the door, my little friend was perched in the middle of the stretcher, sitting straight up with his newly-casted foot crossed over the other one. There were tear tracks down the sides of his face, but he was looking around at all of us, sharing small smiles from underneath the blue operating room cap that some kind nurse had tied around his head. From all appearances, he was absolutely unconcerned with what had just happened to him in the operating room.

His fake benevolence was short-lived. As soon as we got him into bed and left him in the charge of our pediatric orthopedics nurse, he took the first opportunity that presented itself to let us know how he really felt. With a small sigh, he flung himself face-down, his little body half off the side of the bed. His little blue hat floated to the floor, and I think it was only the new weight of his cast that anchored him to the mattress at all.

We posted a stricter watch over our little friend after that, and by the time I left the ward, I had only to call his name from across the room to be rewarded with his familiar wide smile.

I think Jean Claude is going to forgive us after all.

It's late in the evening on Friday. Unless I'm badly wrong, the patients downstairs are tucked in their beds, sleeping the night away. All except Emiline; she's going to sleep in her own bed tonight.

Emiline was the first. The first patient to be carried through the doors of Operating Room Three this outreach. Her left leg was twisted, and her grandma wasn't shy in praying for her healing. She did more than pray, though. Despite Emiline's classic five year-old Yovophobia (Yovophobia: noun. An intense, often irrational fear of white people. Not limited to nursing staff, although these tend to be the scariest.), her grandma brought her to the ship. They waited in the hot sun outside the admissions tent on Wednesday while all around them we pretended to evacuate the hospital. (This commotion, unfortunately, did nothing to allay little Emiline's fears.) They made their way down to the wards while Emiline staunchly refused to smile or even acknowledge the countless attempts at friendship; she wanted nothing to do with the scary Yovos.

Unfortunately for her, the Yovos weren't going anywhere. In fact, one of them (potentially a very tall, Canadian-American one) wrapped her up in a blanket and carted her off to the operating room, handing her over to a bunch of strangers wearing masks while a camera crew filmed the whole thing. (I'm getting to that, I promise.)

Afterwards, things weren't much better. Emiline came back from the operating room with a cast on her little left leg. We propped her up in bed like a tiny queen, making sure she was getting her medicines for pain, making sure stickers were always close at hand, making sure someone was always there to comfort her, but she just stared at us, stoic and unsmiling.

This morning, all of that love paid off. I was walking past her bed in the corner when I saw a flash of red. I peeked over to see Emiline hiding behind a piece of construction paper, the product of the latest attempt at friend-making on the part of her nurse. I gently tickled the toes sticking out the end of her new, white cast and was rewarded with the crinkle of a grin in the corner of her mouth. I tickled her again, and a tiny giggle escaped from behind the paper. We were finally friends.

Which is why it was bittersweet to round with the surgeons and realize that Emiline would be another first; the first patient discharged this outreach. Everything went perfectly with her surgery. Her bones are straight, her pain is almost gone, and she has a little orange card telling her when to come back and see us.

Emiline is sleeping in her own bed tonight, having survived her time with the Yovos, the first patient to be won over by love poured out.



Now, if you want to see Emiline, instead of just reading about her, there's a good chance that she'll appear on a Discovery Channel Canada show called Mighty Ships, airing sometime in April or May, I believe. There was a crew from the show here for the past month, filming the sail and the setup and everything that goes on on this crazy ship, and we're all going to be on TV! At least that's what I figure the snazzy hat they left me is all about.

The guys said I'll be on the show, but I'm not sure what part of the footage they shot of me is going actually make the cut. This may or may not be because I spent most of the time laughing / looking the wrong way / making faces / forgetting what question they had just asked me / goofing off. Which, really, is par for the course for me, so they'd better just go ahead and leave it all in.

We're all excited about how this is going to turn out; I'll keep you posted as I know more details.

There are patients in the hospital.

After what has felt like forever waiting, there are West African children snuggled beneath the blankets in the wards again. There are caregivers sleeping under the beds, translators speaking for us and teaching us a few faltering words in Mina and Ewe and Kabiye.

In the morning, when we first reported to work, we found nurses and translators and housekeepers and laundry workers but no patients. The beds were still freshly made, the patients all waiting outside in the admissions tent. We had a day to fill with more waiting, so like kids on Christmas morning we gathered in a circle in an empty ward, the feeling of anticipation filling the air and twisting in my stomach.

We sat together, brown and white and brown and white and we prayed and we sang. I sat with my hands outstretched while the Spirit flowed through my fingers straight from the lilting tongue of one of our translators. It was all consonants and sounds I'd never heard, but in her words I knew that she spoke of the same God who pulled us all here from our old homes around the world. When Kokou prayed in English, asking God to do something new here in Togo, the words of a song sprang to my lips. Before I knew what I was doing I had begun to sing.

Do something new in my life,
Something new in my life,
Something new in my life
Oh Lord.
Do something new in my life,
Something new in my life,
Something new in my life
Oh Lord.

Such simple words, ones I've sung so many times before in Liberia and Benin, but I felt tears in my eyes when I realized what I was asking. What we were all asking.

And so it felt natural when I raised my voice and prayed what the Liberians call a strong prayer to Daddy God, one filled with the name of Jesus and extravagant claims on His promises, echoed by amens from around the circle. It felt right to sit there surrounded by people I barely know and realize that we are about to start something that will change so many lives forever. It felt right to admit that things should change, that God should show up and do something entirely new. And it felt so right knowing right to the corners of my soul that He will.


(I should maybe have thought it through before praying so heartily for something new, since shortly thereafter we ran the first-ever hospital evacuation drill in the history of this particular ship. Far too much new all at once for my liking, I have to admit, and a little stressful for me; since I ended up being one of the ones to set up the whole thing and could see more than a few holes in the plan while we ran through it and couldn't help feeling a little responsible.)

But when that was all over, when all the fake patients were safely back in their classrooms (we used Academy students instead of the real deal, since that might have scared them beyond healthy levels), when I finally had time to stop and think, all that came to me was that time this morning. Sitting in a circle, feeling like the first day of school with my heart open wide.

It was all I could do to keep from dancing up the gangway while I led the first patient onto the ship, a little boy in a pink shirt who isn't going to be laughed at anymore. (That uncharacteristic attempt at professionalism may have had something to do with the fact that I was being followed rather closely by a camera crew from Discovery Channel Canada. No joke; more on that later.)

I tucked him in, kissed his round cheeks and felt the corners of his eyes crinkle as he smiled his shy little smile. I'm hoping to see that smile grow over the next few days as he realizes that, finally, everything is going to change.

Something new is going to happen.

Yesterday was the first time I sailed into Africa. I've flown in to meet up with the ship for the past two years, going through the rigamarole of airport security and baggage claim, the sticky drive to the port to finally walk up the gangway. Yesterday was different.

As we sailed in to the port, I heard the sound of trumpets, too faint to make out a tune. We passed the familiar canoes, at least one fisherman in each invariably bailing out the water while another stood to wave to the Yovos lined up at the railing. The water was aqua under an overcast sky and the Togolese flag flew proudly from the tugboats.

As we drew closer to the dock, the indistinct sounds from the band took on shape until I could pick out trumpets and trombones and maybe even a tuba. They were waiting for us on the end of the dock, playing African worship songs and drumming until I thought they would break their sticks. The women waved handkerchiefs wildly in the air and everyone was dancing the unashamed dances of the truly joyful.

As we pulled alongside our berth, they walked with us up the dock, shouting and waving and welcoming us to our new home. They joined up with another, much larger group, one with twice the drums and even more dance moves. My shoulders were warm in the sun and I was sweating through my shirt and I couldn't stop dancing with them, my cheeks hurting from the smile I couldn't stop.

Later, much later, when the sun was almost down, the dock was deserted. The drummers had long ago piled into their buses and the marching band had marched off to rest their tired lips. I was waiting in line for dinner when a friend caught my eye. There's a baby on the dock. Needing no further encouragement, I ran out into the sticky air to find Francois.

He's very small, our Francois; he'll be two months old on the nineteenth, and he weighs a little over five pounds. Huddled around him was a much smaller welcoming committee than the one before. No drums, no fancy clothes, no dancing. Just a mama, a grandma and a little baby, all skin and bones, his lip and palate split wide, his future hanging in the balance. With them was a nurse, who I later learned works at the orphanage where Francois' mama was planning to leave him. She didn't want a broken baby, but the someone had heard that the ship was coming, convinced her that there was another way.

I took him in my arms, his little scrawny legs hanging out the bottom of the damp piece of cloth he was wrapped in. I buried my nose in the cloud of his hair, black and curly and softer than anything I've felt before, and I breathed deep before handing him over to our feeding program nurse who was going to be overseeing his care.

I wanted the drums, then. I wanted the handkerchiefs waving in the air and the ladies dancing in their finest African clothes. I wanted the whole world to know that here on our dock, a mama was choosing life for her baby. But they just climbed into a Land Rover in the gathering dusk, heading to the off-ship house where he'll stay until the wards are open.

And like that, it has begun. Welcome to Togo.

I'm sitting in a darkened ward, empty beds all around me. The patients have gone, and all I can hear is the thrum of the generators instead of the chatter and swell of this place when it's full. Somehow, they have all gone.

Wasti was the first to leave this morning. Last night, we gave her the money for her cow, and it was one of my favourite moments of this entire outreach. We brought her to an empty room, away from prying eyes and listening ears. (You can never be too careful with that much money.) We pulled out a picture of a cow and she pointed to it, making a sign to show us that, yes, she used to have one of those. But it's gone now. I showed her the little plastic bag full of brightly coloured bills, and her eyes grew wide. She sat, frozen, looking at us, hardly daring to hope. We laughed and pointed to the cow, pointed to the money, pointed to her. Incredulous, she slowly pointed to her heart. For me? This is for me? More laughing and nodding and pointing, and after a short forever, she finally worked up the courage to hold out her hand. We dropped the bag in her outstretched palm, her eyes got even wider, and she threw up her hands, praising God in a language we had never heard before. She made lots of signs, and the only word we really understood was bebe. Through her wildly moving hands, we were made to understand that her baby was not okay before, but now he is fine. He is fine.

When we got back to the ward, after cautioning her not to tell anyone, she was bursting with the news, so she ran to her bed and scooped up Wasti from his pile of blankets. She held him close, kissing his little cheeks and whispering in his ears, telling him all about the cow and the hope for their future. And this morning, in the darkness of near-day, Esther and Liz and Natalie bundled mama and baby into a LandRover, all her bags of formula and rice cereal and her little pouch of money tucked securely under her shirt. They drove through the sticky air to the bus station where they piled them onto the bus and waved them away. Her family will meet her up north. Wasti is going home.

As the morning wore on, we raced around, trying to beat the clock. The translators were working until noon, when the ship threw a huge thank-you party for them, and we had to get everything done by then. Around ten, Therese and Beatrice and Josua climbed into the elevator and then headed down the gangway to a waiting car. Their nurse went with them, to see them safely to the clinic where they will be staying until their wounds have healed.

Not long after that, the next volunteer came bearing car keys. Christine and all her bags of supplies were packed into the car, and her nurse, too, headed out into the heat of the day, along with one of the translators, in search of the local private hospital she's being referred to.

I was left alone in the ward, two patients still in their beds. I worked methodically, enjoying the feel of charting and bandage changes and discharge instructions after such a long time sitting at the desk. When the first patient was dressed and ready to go, I turned my attention to the very last patient. It was only then that it hit me. The last patient was Benedicte.

Benedicte, the very first patient I took care of when I came back to the ship after getting married. There we were, alone in the wards, a little baby who was born with her lip and palate torn open who now looks normal. Who can now grow up with no idea of the ridicule she would have faced otherwise. She was the first for me, and it's only fitting that she was the last.

So I gave her grandma the instructions. I gave Benedicte one last snuggle, kissed her fat cheeks one last time, and they were gone.

They're all gone.

I just want you to know who you're praying for when I ask you to pray for Wasti. Here he is in all his glory, before and after. I found out today that, on the wooden bench outside the operating rooms, where we stop and pray for every patient that goes through, Wasti's mama almost said no. She was told that there was a chance he could die on the table, and there was a long moment where she almost said no. Her broken baby was precious enough to her that she was almost willing to stay an outcast, to endure the ridicule and spite, just so she could be sure of waking up next to him in the morning.

Now when she wakes up, it's next to a little boy who isn't quite so broken anymore. Which is what's keeping me going in the face of all the other wounds, all the other heartbreak.

That, and the fact that Kossiwa's papa came to collect her today. He took one look at the hole in her lip, gathered her in his arms and kissed her tiny cheeks. He loved her even before we gave them the paper that will allow them through security next year and onto the ship in Togo, where we hope to repair the damage. The small family left, Kossiwa's mama waving at me as she headed down the hall. Edabo! A l'anee prochaine! Until next year!

I'm looking forward to some more happy stories.

Little Wasti is doing better than anyone expected. He spends much of his time propped up, sultan-like, on a pile of the softest blankets we've scrounged from whatever linens haven't been washed and packed away for the sail. His mama dresses him in a motley assortment of clothes, and she makes sure to tuck the pillows securely around him when she leaves his side.

Today, Wasti was also wearing eyeliner.

This might seem strange, wrong even, that a six-month old baby should be sporting charcoal rims under both his wide, black eyes. Over here, though, it means everything. It means that his mama has decided that he's hers, decided that she wants to mark him as belonging to her, with all her wild, tattooed beauty. It means that, for the first time in his short life, she sees his future.

Over the course of the day today, Wasti's story was fleshed out, the pitiful bones we'd heard on Friday taking on heartwrenching shape. His mama is one of many wives. I'm assuming her husband is well-off, because when each wife came to stay, she was given a cow and a small piece of land, a pittance with which to scrape out a livelihood for whatever offspring she would produce for him. Wasti's mama made nothing but broken babies, and one after the other she sold her land and her cow, trying to find the money to put together the pieces of her shattered children.

It wasn't enough. It's never enough, here, and so she was turned away, sent from the village. I'm guessing that the sum total of her possessions is represented in the two small bags and several bowls that are tucked beneath Bed Twenty right now.

The ship was her last chance. She came on the razor's edge of too late; his would be the very last surgery of over six thousand for the year, and we almost said no. Go away. Your baby is too sick. He's too broken, just like everyone has always told you. No.

But instead, in the corner of B Ward today, there's a tiny family on its way back from the darkness. Wasti's mama looked hopeful as she told us that she's almost sure that they'll let her back into the village. That there's more than a good chance that she can go home again. I just have to figure out how much a new cow is going to cost so we can take up a collection for that little boy's mama. But all that will come in time.

For the next few days, my job is just to sit back and watch. To watch Natalie, our pediatric coordinator, work her magic as she teaches a completely illiterate woman how to tell time, how to count precisely, how to measure water and mix the formula so that her baby will get enough food. To watch a little boy soak in all the love he's never known. To watch hope grow in a barren heart.

To watch a mama find her way home.

My heart is so full right now that I don't know how I'm keeping it in my chest. It's threatening to burst, spinning colours and light into every corner of this ship.

It started last night when, in a truly symmetrical end to my day, I got wind of yet another baby on the dock. I headed out into the damp night air to find Wasti, a little one who had come to the ship from way up north earlier this week to have his cleft lip repaired. He was too sick, though, and so he was sent away to a local hospital. We knew it was too late, that there was no way he'd be well in time. And yet there he was, his eyes bright, his skin hot, but not burning like it had been. We brought him on the ship.

All through the evening we pondered, weighing life and death, trying to decide what to do. You see, Wasti is not a normal little boy. As far as we can figure, he was born with a condition known as holoprosencephaly. Normally this is fatal, but the fact that he just had a little cleft lip pointed to a less severe case. Either way, this little boy has a brain that is not normal, and a life expectancy even lower than usual here in West Africa.

As Wasti's story unfolded through no less than four translators, our path became clear. His mama is strikingly beautiful, her face covered in tribal tattoos. She has two children; Wasti has a big sister who was born with some kind of eye trouble. Much of the family's money was spent on her treatment, and when Wasti was born broken, too, his mama was cast out. Abandoned by her husband and shunned by her village, she had nowhere to go. Sending her home with a baby still broken on the outside, whatever might be happening inside, just wasn't an option, because unless he was repaired, there was no home to go to.

And so we prayed. We prepared little Wasti for surgery and we prayed strong prayers to Jehovah Rophi, the God Who Heals. There are currently three pediatric ICU nurses on board the ship, so the three of us got together and worked out who would be on call for all the shifts over the next few days, should anything go wrong. I drew tonight, and so I donned scrubs and booties and headed into the OR to see how the surgery was going and whether or not I was likely to be needed.

As I stood in the corner, quietly observing, the anesthetist, Michelle, called over to me. You can see much better from my seat if you come ventilate. I laughed, assuming she was joking, since the little boy, no bigger than a newborn at six months of age, was already totally covered with sterile drapes, a breathing tube in place. When she held out the bag attached to the tubing, I knew she was serious, and so I moved around to the other side of the table and took her place on her stool. She coached me for a while until she trusted me, and then she stepped away, leaving the bag in my sweaty little hand.

Throughout the entire operation, I sat no more than three feet from little Wasti, pushing air into his tiny lungs, my eyes torn between watching the monitors and staring at Dr. Tony's hands as he meticulously stitched Wasti's lip back together. I couldn't keep the grin off my face, incredulous at the thought that I was a member of the team performing the last surgery of the outreach, the surgery that seems so symbolic of everything we do here. Neat rows of sutures. A ticket home.

When the surgery was over and the breathing tube removed and Wasti was making a mockery of all our worries, I left to eat dinner. I shared the news of success with so many people I passed, people who had been upholding us in prayer. And when I had finished eating, I went back down to the recovery room to check on him.

Now, I know that God provides. It's just that I don't always see it as clearly as I did today. When the recovery nurse called the ward to ask if she could bring Wasti back, the ward told her no. That there was another sick baby. That the nurse didn't have time. I headed over to help, and ended up admitting Wasti back into his bed while his nurse worked with a team of anesthetists and other nurses to stabilize her other patient. Just the right people, at just the right time.

I settled Wasti's mama on the bed, propped up on a throne of pillows, her baby in her arms. I cooed and kissed, changing his diaper and mixing formula so she could start feeding him. And for the first time, I saw her smile. The austere beauty of her face was transformed, softened, as she gently touched her son's downy cheek with a finger roughened from hard work. She looked up at me with wonder in her eyes, and she laughed. She laughed and stuck her thumb in the air, repeating a word over and over in her language. Through those four translators, I learned what she was saying.

It's good. It's good. It's good.

And so surgery is finished for the year, and I can't think of a better way for it all to have ended. My hand is stiff from pressing the ventilation bag for an hour. My arms smells like sour milk from where Wasti drooled on me while I held him and his mama ate her dinner. My back is sore from bending over the bed, trying to get him settled.

But my heart is full. Full of hope and light.

I have two stories for you today. After such a long dearth, I suppose it's only fair. They really have nothing to do with one another except for the fact that they both happened during my shift this morning, neatly packaging the day together like bookends.

It started out with the dreaded 'outside call'. The phone rings a funny way and you know it's someone who has gotten ahold of the ship's number. Nine times out of ten, that person will not be able to peak English, and will assume that you, in fact, can speak whatever tribal dialect they've chosen. When I handed off the phone to one of our translators, I heard the phrase that clutches every charge nurse's heart. There's a sick baby at the gangway. Nine times out of ten, they're not babies we've operated on, and since we're not a medical facility, nine times out of ten we have to turn them away. But I'm a big softie, so I figured we could at least deliver the news in person. I already knew what I would say, some variation on the theme that runs through our days at the end of the outreach. I'm sorry. We can't help. There is no more time. I'm sorry.

I grabbed a trusty translator, Fulbert, and we headed to the gangway. Empty. We walked to the back of the ship, where we saw some people sitting on a pipe at the side of the dock. They were all old, with no children in sight, so we figured the only other option was the gate, all the way at the other end of the dock. We started to make the trek when Fulbert had a stroke of genius.

Before I knew it, I was perched on the back of his zemidjahn, the cool morning wind whipping through my scrubs as we raced down the dock. About fifteen seconds later, we had arrived. (Shortest trip ever, but at least we made it in style, and it's the only time I'll ever be on the back of one of those bikes.) The baby was on her mama's back, all covered with a cloth, and the papa explained that she was born with a tumor on her head. He showed me the size in his outstretched palm; at least the size of a small orange, and my heart sank. There was nothing we could do.

I went through my whole speech, and then lifted the cloth to find a beautiful little girl with a big lump on her head. Curious, I poked it. Soft. An idea hit me like a flash to lightning, and I turned back to the dad. Was she born at home? When he told me it was the hospital, I started to laugh. They used a machine, no? To pull her out? She was stuck? The papa was astounded, his eyes as big as saucers, wondering how on earth I knew all this, and I went on to explain that the bump caused by a vacuum-assisted birth goes away with time and that his baby was absolutely beautiful and would only grow more so.

After shaking hands and convincing the young parents that the lump would not, in fact, burst if the baby happened to roll onto that side of her head, we jumped back on our trusty bike and headed off into the sunrise. As we neared the ship again, Fulbert turned and summed up the entire experience.

A complete mission.


And then, much later, near the end of the day, I was reminded all over again why I love being a nurse. We've been caring for a lovely old lady named Christine who developed a huge infection at the site of a hernia repair. She's been growing such nasty bugs that for the last ten days, she's been shut into the corner of the ward, walled off behind curtains and forbidden from touching anyone or anything. Of necessity, she's been an outcast in the very place that was supposed to accept her. Over the last ten days she's gone from a joyful, outgoing woman to one who rarely speaks and spends most of her time sleeping. She's felt alone and cut off; she cried when I first hung the curtains on the day that her wound culture showed us the infection.

Today, after three more surgeries to clean away diseased tissue and more IVs that I can count to deliver the caustic medications to her veins, her final wound culture came back. With my heart in my throat I turned the paper over to read the words we were all praying for. No growth.

The party was immediate. Mel, one of the nurses, ran across the room and tore down the curtain. A very startled Christine looked up at me. The infection is gone? she asked, hardly daring to hope. Our smiles and cheers told her the answer, and she grabbed her walking stick and immediately left her bed. To the sounds of laughter and congratulations, she paraded up and down the ward, greeting all her friends again, lifting prayers of thanksgiving to her God. The two other women admitted with wounds raised their hands from their beds, praising God for her healing.

And when the surgeon came into the ward a little later, she leaped up from her bed again. He came to meet her, and she grabbed him in a huge bear hug, which he returned just as enthusiastically. She had tears in her eyes again, but this time it was so different. This time she was rejoicing.


Because of the Lord's great love we are not consumed, for his compassions never fail.

I know I've already mentioned how busy we are down on the wards. We're so close to the end of the outreach, and it's the time when we're faced with the reality that if we don't do the surgeries we've planned, they may never happen. Every morning, when we meet to decide who will be admitted for the day, we're holding lives in our hands, trying to weigh futures against the already-bursting wards. Suffice it to say, this is not my favourite time of year.

But in amongst all the heartbreak, there is joy. I was working in B Ward this morning when I heard the drums start to pound in A. Four of the VVF ladies had come back to dress in fine, new dresses. They had come to put on makeup and string necklaces and bracelets. They had come to dance, because they were dry.

In the midst of the celebration, I needed something from the desk in A Ward, so I tried to quietly sneak in and out. One of the disciplers called me to the front of the room. Sis Alice, you will pray for one of our women. You will present her with her gifts.

I tried to say no, to go back to my work, but when I looked at the bag she was holding out to me, I realized how foolish it would be to pass up the opportunity. I took the package and looked over to the ladies, four women in all their finery, sitting proudly in front of a room of people where only weeks ago, they didn't dare to show their faces in public. On the far left I saw the beaming face and wiggling eyebrows of one of my favourite ladies, Irene. I headed to her chair with my gifts and my meager French and I tried to explain what I was giving her.

Scented soaps, so she can wash and know that, in Christ, she is clean. A Bible, so she can study the word of God. A mirror, so that she can know how beautiful she is. She grabbed me around my neck, planting a loud kiss on my cheek, and we bowed our heads together to pray. I prayed in English, but she seemed to know what I was saying, inserting loud Amens! when I asked God to give her joy, to make her a testimony to her village.

And then I slipped back out. Back to the relative quiet of B Ward and back to the endless work that waited for me.

Much later, around eight in the evening, when I was finally finishing up some extra paperwork that needed to be done yesterday, I stopped in D Ward on my way back to my cabin. There in the corner was a familiar face. Anicette and her mama have been Mercy Ships fixtures this outreach, spending long months on the wards and in the Hospitality Center. Ani was far too small for surgery when she first came to us, malnourished because of her cleft lip and palate. But under the watchful care of our feeding program, she's gained ounces and pounds.

Today, when I went to her bed to give her mama a hug, little Ani's lip sported some sutures, the steri strips over top of them making a smooth, unbroken line. She gazed up at me with her big dark eyes and held tight to the finger I offered. Her mama, Zenabou, called over another patient's visitor and relayed a question to him in Fon that he then asked me in French.

Is she beautiful?

My heart shattered into a million pieces, thinking of all the patients on the wards right now. All the VVF ladies, all the little kids with crossed eyes and huge tumors and burn scars. They all just want to know if they're beautiful, and so I answered for all of them. For Irene and Bidemi and Belvida and Pascaline. For Anicette.

Oui, elle est belle. Hier. Aujourd'hui. Demain. Elle est belle.

Yesterday, today and tomorrow. They are all so beautiful.


(Photo by Meg Petock.)

There are some things I take for granted. Until today, I didn't realize that the act of flattening cardboard boxes was one of them.

I was sitting at the desk with my back to the patients today when I heard a woman exclaim in surprise. I turned around, expecting to see something dramatic, but all that met my eyes was Lindsay, who was in the middle of putting away the supplies that had just been delivered from the hold. She held in her hands a flattened cardboard box, and the patient in Bed 9 looked like she was about to faint from the sheer wonder of it all.

We started laughing, and Lindsay slowly pushed the box back into its original form, folding the tabs back together to make the square. Eugenie, the lady in Bed 9, stared, her eyes as wide as the moon. She shook her head and looked to her neighbours for support. Robbed totally of speech in her amazement, she asked with quick, birdlike gestures of her wrinkled hands whether they had ever seen something so incredible.

By now, the patient in Bed 8 had started to giggle. She, apparently, had seen this trick before and wasn't quite so flabbergasted. But Eugenie was still totally mesmerized, so Lindsay flatted and re-folded the box several more times while the little old lady's astonishment grew by leaps and bounds.

We couldn't keep something like this to ourselves, naturally, so we called another one of our friends over from the other ward to join in the fun. By this point, unfortunately, Eugenie had had about as much of the magical box as her little old heart could handle. As soon as she saw Lindsay coming with her big square of cardboard, she laid herself flat down and pulled the covers tightly over her head, only re-emerging when she was certain the danger was past.

We figured maybe she just needed to start out small, to overcome her new fear of magical boxes, so I scrounged up the smallest little container I could find. I brought it to her bedside like a peace offering, planning to show her that, indeed, she too could flatten and re-fold boxes. She grabbed it from my hand, and smacked me with it. And then she threw it across the room. Eugenie, it would appear, was having none of it.

So I put it on my head like a hat and minced back and forth in front of her bed until her reluctant laugh sounded through the ward and she didn't look quite so scared or quite so amazed, but just like herself again, her white, woolly hair resting on her pillow.

At which point we discovered that, somewhere in the midst of all the fun, one of Lindsay's other patients had gotten dressed and hopped in a car headed for the Hospitality Center without having heard a word of the discharge instructions she needed.

But it's okay. She, along with four or five other ladies will come back in the morning. Because tomorrow they dance.

For today, we're just going to work on the box thing.