Cautiously Optimistic

The morning after I wrote the previous post about Nimambe, I walked into B ward around 0745 as I usually do to get a quick briefing from the night, before rounds start with the surgeons. I sat down with the charge nurse and looked over at bed 3 where Nimambe had been an occupant for the past 3 weeks, for the first time there wasn't a catheter bag hanging off the side of the bed. 

I hadn't quite worked up the courage to ask yet if she was leaking since the catheter came out 2 hours before. So I asked about a couple other patients then when it could no longer be avoided I asked. Yes so far she was dry and she was peeing!!!!!! Around here we get really excited when someone pees. 

All day I kept checking on her, she was dry.

 I couldn't bring myself to write about her that night. What if I celebrated too early and the first night she started leaking again. So I told myself I would wait until the next day. So Friday morning I went for mourning rounds and she had been dry most all night. She did leak but just little little bits, this is quite normal for these ladies as their bodies are relearning what it is like to keep urine inside, especially over night. 

That same day was a dress ceremony and today Nimambe would dance! In her time here she had seen more than 5 ceremonies of women who had come with her or after her. All the time she was just waiting, but today was her day. 

She almost seemed on the edge of tears all day. She barely even cracked a smile. I had this internal conversation. Why isn't she happy? Isn't only leaking a tiny bit so so so much better than she was before? It has to be crushing to have had this be your one hope and expect to be completely healed and then be so close but still not be perfect? 

Then I think I put my finger on it. She had her game face on. This had been such a long emotional journey for her and now here she was nearing the end and couldn't quite let herself get her hopes up. I totally get that. So she got all dressed up and went to the ceremony. She stood and quietly said she was thankful to God for letting her come all the way to the ship and thankful that she was getting better. 

Even though I understood why she wasn't more joyful, inside I selfishly wanted her to be. So last night as I sat to write an update about her I didn't know what to say. So I put it off again one more time. 

This morning I walked into B ward and there was a completely different Nimambe. She was joking and laughing and smiling. She was like that all day long. She got to go outside today for the first time in over 3 weeks and she had no interest in coming back in. I think she is finally allowing it all to sink in.

Early Monday morning she will be on a bus of other ladies going back north, going back home. I pray that will be a joyful reunion.

7 more hours

We take out Nimambe's catheter in 7 hours. I know when I round in the morning we will see if she is leaking or not with it out in. I want so badly for her to be dry. My heart aches for her. I also know there is not a single thing I can do about it. I am so thankful that in these times where we feel helpless that we can cry out to the ultimate help and the ultimate healer. I am lifting Nimambe up to you tonight Lord, and I am laying this at your feet. You have blessed me with the opportunity to have cared for her. I pray that if it is your will that she be dry, Lord bind that hole closed and make her bladder strong. In Jesus Name

A picture is worth a thousand words

So just a little photo that makes me laugh. This is the VVF surgeon Dr. Steve and a VVF patient. 

Nimambe

Nimambe was in the first group of ladies to come down from the north.  One of only two left here now from that first group. In fact the second group arrived just tonight and will be screened on Monday. Nimambe was quiet and seemed to take it all in. We soon found out she spoke French as well as Moba (one of the northern Togolese languages) so quickly she became invaluable as a translator. 

She had surgery in the first 2 weeks and the first operation failed the night after it was done. We took her back and tried again with a second operation and again she was still leaking urine. The difference was this time she was only leaking urine sometimes and sometimes she is dry. This gave us hope that maybe the hole inside was closed and she was only having some spasms causing the leaking. 

We waited a week and then did a test to see if the hole was closed. Dr. Steve and I took her to a separate 

room to do the test. Before we began we stopped and said a quick prayer, we had so much of our hearts invested in Nimambe. We begin the test and Steve looks up at me and whispers its positive. This is bad news there is still a hole inside. But then I ask why is she dry sometimes and not leaking all the time. He doesn't know and neither do I. 

Now all we can do is wait and pray hard. Maybe the hole is small enough that it will heal. I know God can close what is left of her hole. So please join me in special prayer for Nimambe. She has been through so much on this journey and has won us all over with her spirit but it will crush her to go home still leaking. I believe God can heal her and I am praying for such a miracle. 

Josephine

One of the realities of VVF is that not everyone will be healed. As hard as we try some of the women will go home in the same condition they came to us in. These cases are the ones that stick with you because they break your heart.  My head knows that God has it all in His hands, and I trust that even though I cannot begin to understand why these women are brought to us only then to have their surgeries fail, that God sees the big picture when all I can see is what's in front of my face. But even though I know this, when I have to sit across from a women I have come to love and have to say I am sorry there is nothing more we can do right now to help, it makes my heart ache to the core. 

Of all the women from last year in Benin that stick out in my mind, Josephine sticks out as the one who broke my heart the most. I don't know what it was about her. Maybe her quiet fierceness and her mischievous grin, but she found her way into a special place in my heart. When she came to us she had already been leaking for 5 or so years and had a previous attempt at repair. We operated on her not once but two separate times. Both time failed. Upon final discharge last year we gave her a card to return to Togo hoping we could try again. 

Our first screening was on May 24th, Josephine was on my list of potential patients to return from Benin but she didn't come. On Tuesday I get a page that their is a patient down on the dock that missed screening. At this point we had a very long waiting list and had already fully scheduled the first 4 weeks of surgery. So I put on my I am sorry but screening was yesterday and today is too late face and I went down to the tent on the dock. I am looking around for where the patient might be and I hear a familiar voice call my name. AHHHH Josephine!!!!!   I asked her why she did not come the day before,  she had been help up at the border and just now had made it. 

I went inside and asked Dr Steve if he would at least see her. He was in between cases and said yes bring her in lets do a dye test. (This is the diagnostic procedure we use to tell if the women has a fistula) We brought her in and the test was positive she did still have a hole that needed to be fixed.

We did a little adjusting of the schedule and were able to do her surgery the next week!  This was surgery number 4 so I told myself not to get my hopes up. The chances of a successful surgery go down with each attempt. I kept telling her not to break my heart (of course she couldn't understand me and would just smile back). Her surgery went well and there were no problems post operatively! Josephine was dry!  Her catheter came out and she remained dry and could for the first time in 7 years stand up and not have urine dripping down her leg! 

She stood at her dress ceremony and gave a beautiful testimony of faith and healing. She gave praise to the exact place it is due, to our heavenly Father and Healer. At the close of each dress ceremony members of the crew go and pray with each of the women, I went and prayed with Josephine. I kneeled down in front of her and she rested her forehead on mine and held my hands. I prayed that God will bless her steps from here and use her story to impact those around her and that He will continue to hold Josephine in his hands. Although she couldn't understand a single word I said she quietly said Amen along with me. 

Back North!

"To comfort all who mourn, To console those who mourn in Zion, To give them beauty for ashes, The oil of joy for mourning, The garment of praise for the spirit of heaviness; That they may be called trees of righteousness, The planting of the Lord, that He may be glorified." - Isaiah 61:2b-3

Friday morning the first 7 ladies headed back north. It has all happened so fast. It seems as if they just arrived and now in the blink of an eye they are returning home. Thursday evening I went to the hospitality center where the ladies were staying to say good-bye and finish up a few last minute details. I wanted to give each of the women a picture from their dress ceremonies. They looked so beautiful and joyful on that day and I wanted them to have something tangible to take with them and be able to show those from home.

I couldn't help but think about how excited these ladies must be to return home healed. My heart was full for them as I imagined them showing back up to their villages dry. Not only have they been changed physically but their spirits have changed as well. These women who less than 2 weeks before I met for the first time in these exact rooms were then shy and ashamed and now they go home full of life and joy! I pray that each of them has a beautiful reunion and can use this experience to be a witness to the work God has done for them from the inside out.

Their emptied room didn't stay that way long. Eleven more women came down on Saturday and we will do a small screening again on Monday. God has some big plans in store. The waiting list of names that seemed to be getting longer and longer is now getting shorter. Due to some change of plans with surgeons here on the ship there was going to be an empty operating room for 3 of the weeks of VVF surgery. So now Dr. Frank a VVF surgeon from Uganda is coming for those 3 weeks. This will mean being able to do double the patients those 3 weeks with 2 surgeons in 2 operating rooms. This all equals much more work for me but also many more women who have a chance at healing. These 11 women who just came down are from the waiting list! If you would like one of their names to pray for please send me an email and I will get you a couple names and let you know if and when they get scheduled for surgery.

Beautiful

We have officially been at it for 1 week now. Tonight I sat down with my dinner, alone and quite for the first time all day. The day had flown by, in fact this past week has flown by.

We started with a bang last Monday, we screened 66 patients and scheduled 50 of them for surgery. Since then we have had 5 days of surgery and done 15 surgeries!  The week has gone well and I am so grateful. Today the first 5 ladies danced. I have a love/hate relationship with dress ceremony day. Having a celebration party at 1030 in the morning basically disrupts the whole day and everything around it is chaotic but I wouldn't change it for the world, because for that hour we pause, we praise, and we dance!

Part of the VVF program here on the ship includes this dress ceremony. It is a celebration of healing. The women comes to us leaking urine constantly, she feels ashamed and outcast, she feels alone and hopeless. We do surgery and Lord willing when it is successful and she is dry we have this ceremony. The women gets a new dress and head-wrap, she wears a necklace she has made herself, she gets pampered and doted on, her make-up done and then she walks down to hall to the beat of the drums and makes her grand entrance into the dress ceremony. The room is filled with surgeons, the nurses who have cared for her, the crew who has been praying, and other patients. The ladies have an opportunity to tell their stories and to celebrate their new lives. Their new dresses are a symbol of that new life, a new start.

The ceremony starts at 1030 but all the prep work starts around 9. The ladies are taken off to another room where they get dressed and their make-up done. I wanted to sneak in for a quick peak. The door was locked but I smiled in the window and they let me in. I watched as Rikiata's head-wrap got the final fluffs, then a full length mirror was help up for her to see herself. A huge smile broke across her face, she almost couldn't look. A week ago today she arrived on this ship praying that here she would find healing and today she looks in the mirror at a brand new women, one filled with joy and beauty from the inside out.

So at 1030 we started, they danced down the hall like the owned the place and took their places in the five chairs set specially for them. At this same time I get a note slipped to me their is a patient on the dock, she missed screening because her mother had been ill and is it possible I see her now. I snuck out and spoke with her quickly and was back just in time to hear the ladies share their testimonies. This is always quite the process because it takes two translators to get what they are saying into English.

Adjatou speaks in Tchkossi, her native dialect, then it is translated into French, and from French to English. Ramatou stood behind Adjatou translating into French. As I sat there looking at Ramatou in her Mercy Ships scrubs tears welled up in my eyes.  Ramatou was a VVF patient last year. She needed 2 separate operations throughout the year but now is dry and healed. She is Togolese and speaks most of the northern languages along with French so this year we have hired her to work as a day volunteer with us translating for the patients from the north. As Ramatou stood their with her fancy new hair do looking all confident and in her element, I was again reminded so vividly that we are not just providing healing for their bodies, we are giving them a second chance at life.

Today these 5 women stood tall and proud they looked around the room without shame, they wore their new outfits  and they were beautiful!