The gift of surgery doesn't always feel like a gift

This is a long one, so come back later if you only have a couple minutes. Sorry-O! (In West Africa, we add O to the end of many words.) I'll get around to explaining my title, but first I thought I'd take time to share a few more pictures. Take time.......that's a very African thing to say. We use it slightly differently. There if you're walking down the street too fast, eating too fast, talking too fast, basically going through life too fast, a West African will tell you to "take time". Translated to American english, it means "slow down". Take time to smell the roses. Anyway...there may be a few random thoughts thrown in this one. You just never know.

This first picture is of one of the wards on the Africa Mercy. Private rooms? Private toilets? Think again! We are used to so much pampering here. There were 4 wards. Two of them have 20 beds. This is half of one of the wards. There's a wall separating the two sides, 10 beds on each side. There's one toilet for every 10 beds. Actually this particular ward has 15 beds and only ONE toilet. Remember that most Liberians aren't accustomed to using toilets so even though there's one there to be used, you may not want to. I'll get around to more of that in a bit.

This is the other half of the 15 bed ward, Peace Ward. That's a funny name considering it was typically the pediatric ward, so there was often not a lot of Peace.
Below is an example of the pictures that hang in every patient bathroom. Like I said, many Liberians don't have the benefit of using toilets. They squat where they have opportunity to relieve themselves. I'll explain that again in another post when I share more pictures of the city. Use your imagination until then. Anyway...these are examples of things not to do and ways to use it. Just because you usually squat, do not stand on this bowl and squat......good way to fall in. No, the nice white bowl of clean looking water is not for laundry. The final two are pretty self-explanatory. Finally, remember to push the button on the wall to empty the bowl when your finished. When I first saw these pix I was very amused until I worked my first shift. I was trying to think of new pictures to add for issues these didn't cover. What an education!!!! My first shift the ladies forgot about pushing the button and we nearly had a flood. Needless to say, with a less-than-perfect plumbing system to begin with, the poor plumbers were called more times than I care to admit.
This is Dr. Steve Arrowsmith, a urologist from the American Southwest, New Mexico, I believe. He's affectionately known on the AFM as Dr. Steve. The world does not have very many VVF surgeons, because VVF is not an issue in the developed world. Here is a brief explanation of VVF. One day if I see him again, I'll have to ask how he came to do what he does. He spent at least 12 weeks of 2007 in Africa doing surgery for free. In this picture he is sporting a hat made by one of his grateful patients. This man is a teddy bear in the purest sense of the phrase. He cares so much about each of his patients. He rejoices when they do well, and takes it extremely hard when they do not. I could share much more about Dr. Steve, but that will have to suffice for now.
That brings me to the final picture of this post. This is Fatmata. Her friends call her Fata (sounds like gotta, not fat). I was privileged to be one of thse friends. Patients are typically admitted the night before their surgery and have their pre-op. That's pretty much the same as surgery here at home-an IV, a bowel prep, etc. I admitted Fata and went through the routine. There is always a mixture of excitement, apprehension, and fear of the unknown. I have to say it would be very intimidating. For most, this is the first time they've been on a ship, been in a hospital, or had surgery. Add to that the fact that yes, most Liberians speak English, but their English and ours is not the same. It would be a scary experience. There's also the desperate hope that this leaking will stop. In Fata's case, this was not her first attempt at a VVF repair. I'm still not sure, but I believe this was actually her third. It would be hard to allow yourself to hope.

I was still getting used to the fact that it's completely acceptable to ask your patients if they want you to pray with them, but just before she settled in for the night, I asked just that. We sat together on the edge of her bed and I prayed. I had to wonder how much she understood, but I was grateful for the fact that God is big enough to hear us in any language. She thanked me. I gave her a big hug, and tucked her in for the night. I knew that night that Fata was going to be someone that would stick with me for life. I was struck first by her beauty. She has gorgeous milky skin, strong cheekbones, and eyes that speak volumes. They say a picture is worth a thousand words. There is a book in her eyes. We are close to the same age. I sensed that in a different time and place we may have been very good friends.

The next day Fata went off to surgery. One of my roommates was an OR nurse, so we often ate lunch together and talked about how our days were going. She talked that day about a very difficult case that did not go well. There was not enough tissue to perform a repair. It happens more aften than we would like that there is too much damage, but Shonagh said that this was one that Dr. Steve was taking very hard. It was not good news to hear, but it still didn't hit me until that evening when I went to work I learned that the difficult case was Fata. At the beginning of evening shift Fata was still pretty sedated from the anesthesia. I'm ashamed to admit that I was relieved to not be assigned to her because I was so sad for her that I just didn't know what to say or do, so I was glad to not have to interact. I remember later talking with Jo, another one of the nurses, and she said that when she broke the news to Fata she sat down on the bed next to her and just cried. She said that she has not cried many times while she's been on the ship, and she had been there for a year or so. As she described it, she just said that Fata's story broke her heart the tears came before she realized what she was doing.

Many times if the surgery was not successful the patients would recover for a couple days and then go home, still leaking. In Fata's case, she had an RVF, which is a rectal fistula as well as the vaginal, so she was also leaking stool. That was able to be repaired so she remained for about 2 weeks as she recovered. I'm ashamed, once again, to say that it was not without relief on my part that during those two weeks I was gladto not be assigned to her again. That's not to say that my heart didn't break every time I was in the room with her. She was so sad. It goes so far beyond a bad day. She barely spoke in those two weeks. Her bed was beside a wall, and she faced that wall all the time. As I learned more of her story through other nurses, I learned that she had been on the Anastasis the last time Mercy Ships was there. I believe she had also been done earlier in the year as well. That made this her third try. During that two weeks I found it hard to even look at Fata because my heart broke for her and I just didn't know what to say or do to make it better. Remember that VVF patients are treated like the lepers in the Bible. It felt like we had failed her and were sending her home to the wolves.

Toward the end of Fata's recovery period I knew that I had to spend some time with her. It was eating me up inside that just because I didn't have the words to say or anything to fix the problem, I was doing nothing to provide this dear woman with even a modicum of comfort. Through Clemetine, our ward chaplain, I learned that Fata was having thoughts of ending her life due to her deep disappointment. Clementine had also said that Fata was not a Christian. I prayed first and then went to the ward. It was uncomfortable. I was not working. I was just there to visit. After a couple minutes I sat on the edge of Fata's bed and made a bit of small talk. Due to the difficulty of speaking, small talk was no small feat. I quickly got down to business. Still not sure how to go about it, I simply told Fata that I knew that she must be feeling very sad and disappointed. I told her how sorry I was that her surgery was not more successful, and that she would be in my prayers. I got about as far as "I'm sorry" and she began crying silent tears. It was then that I realized that words were not what was necessary, just presence and love. I wrapped my arms around her and we just both cried for a bit. Shortly afterward, we went out into the hall to have a little more privacy. Sometimes those 20 bed wards can make private discussions difficult. She shared more of her story with me. She lives with her uncle who doesn't want her and is not nice to her. I got the impression that he's abusive, but I was having some difficulty understanding her. She said that her mother died in the war, she has no sister, and no aunties to help her. I asked if she goes to church and has any friends there, but she said that she's isn't able to go because of the leaking. She has no living children. I asked her if she knows Jesus. She shook her head and seemed to not be willing to broach that topic. She told me she was going home the next day. I promised to visit before she left. I then went to my cabin, lay on my bed, and cried harder than I have in a very long time.

I wasn't in my cabin long when the phone rang. It was one of the nurses in the ward, saying that Fata was asking for me. It had been decided that she was going to home a day earlier than expected. I walked down the hall. (I lived only about 50 steps from where I worked.) This time Fata and I found an empty room and talked. There were many more tears. We spoke more about Christ. She told me that she knew and trusted Him. I still had my doubts, considering what. I already knew, but I had to go on what she told me. Clementine and Esther, a translator and assitant to Clementine, came to drive Fata home. Usually the patients went by cab, but Clementine had been keeping close tabs on Fata for the last 2 years. Obviously Fata is dear to her as well. The four of us spoke a bit and then they drove her home. The picture above was taken just before Fata walked up the steps to the gangway. It's interesting to me that she's the one suffering and I'm the one with the bloodshot eyes. I promised her that day that whether or not we ever meet again here on earth, she will be in my prayers for the rest of my life. I've kept that promise. Barring a miracle, the leaking will be for the rest of her life. I wonder about her so often. Has that miracle occurred? Does she know Christ? Is she still leaking? Is her family caring for her? Is she getting enough to eat? Is she sleeping on the ground? Does she feel safe? Does she have even one friend? Does she feel Christ wrapping His arms around her? Clementine said that only the Holy Spirit could say the words to truly change Fata's heart. In the meantime, she said "I'm going to keep checking on the is one". When I first learned that the AFM was returning to Liberia, rather than Sierra Leone as originally planned, the first thing I thought of was that there could be continued follow up with Fata. The fact that I don't get to go visit Fata is the source of some of my deepest disappointment in not being able to return to Liberia. I've tried, without success thus far, to get in touch with Clementine by email. I'm going to keep trying. Until then, maybe longer, I will keep praying. Every time I pray with the desperate hope that if not on this earth, that Fata and I will be able to spend eternity together, worshipping with all of the might we have in our bodies that don't suffer with earthly hurts.