aissa

In the first quiet moment of a new shift this morning, I noticed a small photo sitting on the computer in front of me. Without thinking, I picked up the slip of paper and half-turned to offer it to the girl I was so sure would be standing just behind my chair, waiting for her first job of the day.

Instead, my hand hung in the air for just a moment, unsure, until I remembered that Aissa wasn't on the ward anymore. She wasn't going to be hanging all over me while I tried to do my work, wasn't going to provide me endless moments of amusement by parroting back the words we teach her, wasn't going to be looking up to me, bright-eyed, to exclaim in wonder over her latest artwork creation. She's better now, and so she's not in the hospital anymore.

This morning, that victory felt a little bittersweet. I realize how quickly I grow accustomed to any constant in this place that is defined by change. Aissa has been our constant for over a month, and things felt out of place without her today.

Until I handed a new sheet of stickers to another little girl, who grabbed them from my hand and then grabbed my arm to make sure I was listening while she shouted with her newly reconstructed lip.

I love you!

And so it goes. Aissa leaves us, only to be replaced by Tani. Each one that goes will have another in their bed before nightfall and we will start all over again. Teaching, soothing, playing, laughing, crying, dancing.

Loving.

These are our constants.

If this is Monday, then I want nothing to do with the rest of the week. According to the rest of the nurses, this week has nothing on the last one, so it seems that I did, in fact, choose the best time to take a vacation; I just wish the palm trees and ocean breezes didn't seem quite so far away.

It all came down to simple mathematics, really. At the start of the day we had zero empty beds. By ten o'clock, we had found a total of five that could be discharged. There were eighteen in the admissions tent. For those of you not following, that's thirteen patients who were going to be sleeping on the dock if we didn't figure something out.

So figure we did. We sat in what should, by all rights, be a fifteen minute meeting for an hour and a half. We made deals and swapped people around and pulled coordinators away from their coordinating to consult, and by the end of it all we had managed to find space for every single patient. Provided two didn't show up, which we were pretty much counting on, since it was raining and over here, no one really likes to go anywhere in the rain. (Even, strangely enough, to get a free surgery. But I digress.)

One of those discharges was Aissa, and it broke my heart just a little to say goodbye to her. By seven thirty this morning, she was draped over my lap, gesturing to my iPod and holding the speaker to her ear to hear Audrey that much better. We hung out for most of the morning, and I got to hear all the new words she's learned this past week. This one! Cup! Ballooo! (She hasn't seemed to master the last n on that one, and usually doesn't even go for the word; sign language is more her thing.)

When it came time for rounds, we were near her bed for a while, hashing out the details of her transfer to the Hospitality Centre. When the crowd moved on and the doctors all left, Beth and I headed back to Aissa's corner. I pulled at the tape holding the end of her bandage, and she looked up at me with bright eyes. I nodded, and she reached up to start unwinding the gauze. A little at a time, she unwrapped her face until the last pieces of tape were removed. She circled her finger around her head again, asking me if I'd be the one to place the new bandage, and when I shook my head, her smile started to grow.

Little by little, with the help of Sarah, we explained it all to her. That she'd be going to a new place to stay, a place where she can go outside whenever she wants. That she doesn't need the bandage anymore. That she can eat whatever she wants now. She can eat rice, the one thing she's been craving for the last twenty-four days.

And then I taught her one more sentence. And when she headed out the door she shouted it us all of us.

I'm beautiful!

Aissa has a new face and a new life ahead of her. And for the rest of the day, when things continued to teeter on the edge of something that very much resembled chaos, I just remembered her little voice chirping back at me.

I'm beautiful.

Beautiful.

I know I talked about Audrey yesterday, but I have to mention her again, because she inadvertently ended up causing what might have been my favourite part of this entire week.

She wrote me an e-mail today, and one part of it rang so true with my experience here.

Man bears within himself a dignity he cannot lose, for he is created in the image of God. We all share this dignity, regardless of religion, race, or creed, and so we shelter one another, seeing Christ in every woman and every man.

I've thought this so many times before, just not in such simplicity. But it's so true. This afternoon, amidst the clamor of twenty patients, nineteen caregivers, three extra babies, and a whole lot of nurses, I realized all over again just how relevant those words are to our life here. We are the shelter for these kids; the wards are a sanctuary where, maybe for the first time, they can run and play and not worry about anyone laughing at them. No one shies away because the kid in the next bed over had her nose and ear and eye burned off in a fire. They just pass over the crayons and hold up their own bandaged limbs for inspection, because really, we're all broken, aren't we?

And then I got to the part where Audrey told me what to say to Aissa, who's finally been having a couple of spectacularly good days after a couple of spectacularly horrible ones. I pulled her onto my lap and delivered the message on the screen. Audrey says 'Hi.' Also, she says, 'I love you.' After thinking about that for a moment, Aissa turned to where she could look at me through her good eye, pointed right at my heart and shouted back at me at the top of her lungs.

I LUB you!

And then she rested her bandaged cheek on my chest, put her arms around me and said it again, quieter this time. I lub, lub, lub you. I lub you, while my heart threatened to burst into a thousand pieces and go spinning into every corner of the ward.

She has no idea what she's saying yet, but I've learned how to say it in Fulfulde, and so we're going to teach her the cry of all our hearts. We're going to tell anyone who will listen.

We love you, each one of you who comes up our gangway with all your hurts and all your fears. We see the image of God in your scarred faces. We see the Carpenter hands of Christ in your twisted fingers, His feet in your bent ones. We love you and we want to throw our arms around you and let that love break through your pain. We want to shelter you here.

We're going to tell them all.

There is something so incredible about watching a child transform, to go from fear to confidence, anger to pure joy.

When Aissa first came to us, she was frightened. We were tall and white and no one could talk to her, no one but Sarah-toe (the incredibly endearing way she pronounces her friend's name), and Sarah-toe couldn't be there all the time. And we imposed rules on her that made no sense, because we had no way to explain that we were moving her away from those cupboards because there were dangerous medicines inside them and we didn't want her to get hurt. And so when we picked her up and carried her away, she was being punished for something she didn't know was wrong, and she responded with fury.

She started out by having complete meltdowns every few hours at volumes high enough that those of us in A Ward were considering borrowing ear protection from the engine room. She pushed every limit we tried to set, thrashed against every single boundary, but somehow, somewhere over the course of the last two weeks, her heart has started to open to the love being poured into her from every side.

I think she sees me as something of a constant in her life these days. I'm there every day shift, sitting at the desk while she sits on a little wooden chair next to me, working away at the latest task we've assigned her. (Today she matched pre-op photos with the correct patients and brought me their charts so we could place the photos on the correct page. And then spent two hours cutting strips of paper into tiny little pieces into a garbage can. The task is really irrelevant, as long as we've given her something to do. Her other favourite jobs include doing her wound care, controlling the rate of her tube feedings, and using a syringe to draw up and inject her medications into her own feeding tube. She's seven.)

These days, instead of screaming and wailing, I look up to the sound of her little voice calling me from across the room. Alice-oh! Alice-oh! She'll want to show me her latest paper creation, want me to tape balloons to her head, want me to admire the bright pink glasses and toy stethoscope she's commandeered from a medical kit. She's at my side first thing every morning, gesturing to things she wants, eyes bright as she waits for me to come up with something fun to do.

Today, on one of her trips past my chair, she tripped and fell while carrying a wooden box full of Memory pieces. The box hit her leg right on the place where we took skin, and the pieces burst from the box and scattered all across the floor. Her reaction broke my heart; with a furtive glance of fear around the room, she crouched down, shoulders hunched to ward off the blow she thought was coming. When I reached to pick her up, she was tense, her sobs catching in her throat. I expected a meltdown any minute, and Aissa expected anger and abuse.

Neither of us got what we thought was coming. A translator ran over to clean up the pieces for us while I snuggled her into the curve of my arm and rocked her back and forth, speaking soft words of comfort I knew she couldn't understand. And Aissa just cried quietly for a few minutes before looking up at me with wonder in her un-bandaged eye. It was like she couldn't believe it was okay to fall down, that she could make a mess and not to get in trouble for it. And I think, in some way, she was surprised at herself for not getting angry when she got hurt. She's a smart kid, our little Madam, and I think she knows something's changing, knows that there's nothing to be afraid of here.

So she hopped off my lap, gathered her game, and headed over to play it with her uncle. After which she behaved like a model patient during her first dressing change, watching everything in her little mirror. I wasn't there for that part, but they say her wound looks good, that the graft is healing well.

So is her heart, I think.

Today marks fifty years of independence for Togo. According to our day volunteers, this is cause for celebration. Like the 4th of July or Canada Day, only much, much hotter and with more dust. Cyril, one of our translators, informed me early in the morning that there would be a parade in town at around two o'clock, and that it was in the best interests of all our patients to put them in a bus and take them there to enjoy it. I told him I didn't think it would be possible, so he asked me to at least think about it. Which I did, for a long time, and eventually came up with the only objection to the plan; I didn't own a bus. This satisfied him, and he settled for our version of a party. It was slightly less authentic, given the fact that it took place inside a hospital, but I think we did okay.

Just like everything else around here, things quickly turned from an independence day cheer into a full-out worship and dance party. We sang in at least three different languages while patients who hadn't been out of bed in days shuffled and danced alongside us. Lovelace and Aissa danced next to each other, Aissa's moves a little limited by the pain in her leg from where they took the skin to cover the hole in her cheek. Videssi shook a sasa from his bed and Chantal, true to form, was in the thick of it, laughing and singing and raising songs at the top of her voice.

It's moments like that when I look around in wonder at what I'm a part of. To know that this ship was bought and renovated and sailed across the world so that Maurius can live with a straight smile. (A smile, by the way, which I saw again today for the first time since his surgery.) So that Aissa can go out in public without covering her face. To see all these broken people being asked to dance, being told that they are lovely and valuable and worth a thousand celebrations. Sarah put it so perfectly on the day of Aissa's surgery.

It struck me then, the extravagance of God’s love. Who could have imagined that this little girl, who almost slipped away to die in obscurity would now be the recipient of the attention of a team of professionals, specialists in their fields? That all the excitement, effort, skill and precision would be for her restoration?

Extravagant love, should I have expected anything different?

Whether we're singing the return of a baby to the bed he used to sleep in or cheering for independence, we are always celebrating something on these wards. We are celebrating love.

(Not just love. Today, we also celebrated the fact that Aissa took her meds without a fight, calmly rinsed her mouth and grabbed the swab and mirror to do the wound care for her nose. All by herself. While wearing a tower of balloons taped to the top of her head bandage like a bizarre flower. We're celebrating that, too.)


Also, don't forget to register for the giveaway and to donate here for an extra chance to win!

There is much to tell and sometimes words feel so inadequate. It's so hard to explain just how it feels when I walk into the ICU to find baby Maurius nestled in Chantal's arms, a small dressing covering the hole where his trach used to be. Granted, he sounds like an anemic duck when he breathes, but each hour that passes is a triumph that none of us counts lightly. I wish you could know how it feels when my heart catches in my throat and everything gets a little blurry and through it all my heart is singing, singing, singing.

I wish you could be here to see seven-year old Aissa discover the world of MagnaDoodle. The way her eyes grow wide with wonder when she realizes that the magnetic letters on the wall can be used to draw, too. I wish you could feel the weight of her on your back, limp after her latest tantrum, her latest test of our love. Aissa is a little motherless child from Cameroon, abandoned by both her parents and hurt by so many people in her life. And so she pushes, screaming and hitting and doing everything she can to drive us away, and I can't help thinking it's because she figures we're going to leave her anyway. So why not get it over with?

The thing little Aissa doesn't realize is that there's nothing she can do to make us stop loving her. We've known her all of a week, and little Madam has already found her place among us, cemented ever more firmly with each little chirp in her tribal language in response to our English questions. We have no idea what we're saying to each other, and yet we play all day long, batting around balloons, painting boxes to hold little dollies and having long, drawn-out conversations on calculator phones. (The fact that they don't work as such makes no difference, given the rather profound language barrier.)

Aissa is going to the operating room tomorrow to have her face rebuilt, because where her right cheek should mirror the plump one on the left, she has nothing but a gaping hole, teeth and gums exposed. She is one of about ten percent of children who even survive a battle with noma, an infection that's treatable with simple antibiotics but which, if left unchecked, will literally eat away at the flesh of lips and cheeks and face. If you've never heard of it, it's because it doesn't exist in the developed world. Here in West Africa, it's a different story, a story where little girls face lives as outcasts because there just aren't any doctors.

But my heart still sings, because tomorrow Aissa will be made whole again. And as we care for her, our prayer is that the God Chantal prays to every single day will reach out through our actions, translate them into words to speak to Aissa and her Uncle Jean of the Love that will never leave her.