balkissa

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Amen.

Balkissa is seven. She came to us swathed in a dark headscarf, tears running down her cheeks every time one of us so much as looked at her. I have rarely met a child so scared, and I can only imagine the kind of life she's experienced that's made her this way.

I might have stared, too, if I had met her before my time here. Before long familiarity with extremes in pathology bred this comfort I feel around the ones cast aside.

We don't really know what caused her problem, her history vague like so many others in West Africa, but she came to us with a tongue too big for her mouth, split down the middle like a snake's. Her lower lip protruded under its weight and she was unable to close her mouth.

On the morning of surgery, her doctor, Dr. Leo, said something so poignant. In the Western world, little children use their tongues to lick ice cream. I hope, when this is all finished, that Balkissa will be able to experience that part of life, too.

But it seemed that enjoying ice cream wasn't in Balkissa's future, at least not any time soon. She returned to us from the OR much as she left; shy and fearful, sleeping in her corner bed with her blankets pulled over her head to shield her from the world.

It's been days since her surgery, days in which we counted ourselves lucky if an interaction with Balkissa didn't result in those huge, silent tears. Days where the closest we'd get to playing was a little seven year-old girl, sitting on a chair, holding a rag in front of her mouth to catch the drool the still flowed freely. Honestly, it's been a little discouraging.

But in one moment this morning, everything changed.

Balkissa's mama was sitting on a stool next to another patient's bed, little Ali. Apart from sharing the best name ever, Ali is one of the cutest kids around. He's also a boy, a fact that has the translators hooting with laughter when I try to claim the same, very Muslim, very masculine name. Balkissa and Ali's mamas have bonded, and we often find them in one corner or another, chattering away in the fluid tones of their language.

As the mamas talked, I looked over to catch Ali's eye and make him laugh with a silly face (not hard to do, now that he's over his initial yovophobia). When he started shrieking, Balkissa's mama turned to look at me, and that small movement was enough to upend her stool. She crumpled to the ground in an undignified heap, and without thinking, Balkissa broke out laughing.

I hadn't ever seen her smile, and here she was, cracking up at the sight of her mama in a pile on the floor. When she saw us laughing along with her, breathless in our own joy, something seemed to click in Balkissa's little head. Somehow, we stopped being the enemy, the people who were going to make fun of her, the people who were going to hurt her. With one swift fall from a chair, we became conspirators, sharing a secret that finally made having fun okay.

We stood in our customary circle to pray at the end of day shift, raising our thanks to God for sparing the life of a woman whose nearly-forty pound tumour had just been successfully removed, and Balkissa ran over to join us, no trace of her former fear anywhere to be found in her racing steps. Absolutely confident in her place among us, she leaned up against a nurse's legs, squeezing her eyes shut tight and then peering between cracked lids to see whether I was watching, her face breaking into a perfect smile when she realized that I was, every single time.

This is my favourite thing about this place. Watching them finally realize that we're in this together, that there's nothing about them that will make us love them less. That they can have massive tumours or snake-like tongues and no one will stare. No one will mock.

Because we're in this together. You, me, Balkissa, all of them, each one who finds shelter with us. We are all image-bearers of a beautiful God, a God I saw so clearly today in Balkissa's bright eyes and ready smile.