Say Good-bye and Go

So my time here has come to an end. My bags are packed (and not as heavy as I anticipated!) I am avoiding good-byes in my typical fashion. The last two times I left this ship were very different than this time. The first time I was leaving but didn't feel ready. The second I knew I was leaving with a date to return. This time I am leaving with no plans to return, but I am ok with it. I feel ready. I feel as if this season is coming to a close.

I will miss this place and these people fiercely but I will take so much with me. I know that God has used this time to prepare me for what lays ahead.

I know my transition back into life in the states will be tough, it is just so different and it's hard for me to switch my brain back to life there. So please pray for me as I have a whirlwind transition ahead, from life here to life as a graduate student in downtown Chicago in under 1 month.

As I go I just wanted to share with you one last look back and give a quick summary of what the VVF program accomplished. I like the numbers because they make me feel like we really did something, but they mean nothing without the stories and the faces. I have shared many of those so now here are some numbers.

6 weeks of surgery

120 surgical procedures on 99 women.

2 VVF surgeons

4 African surgeons trained in VVF surgery (2 Benin, 1 Rwanda, 1 Nigeria)

4 African nurses trained in care of the VVF patient (2 Rwanda, 2 Nigeria)

80-90% successful (success rates in VVF are debatable, so let me explain this a little. 90% of our surgeries were successful in that we closed the hole in the bladder. Many women leak some after surgery because of weak muscles or any other number of causes, to these women the surgery was not completely "successful" so if you include those women in the numbers than about 80% went home dry!)

Here is a collage of all of their faces. It was an honor to care for every one.

If you were praying for a specific women I should have emailed you with an individual update on them. If by chance I didn't and you want to know what happened with your lady, please email me or comment and I will try to get back to you.

Josephine Adankpo

The drums were beating a glorious praise to God. People crammed into the ward to celebrate the joy of the women who received successful VVF surgeries. Josephine stood happily among them. Dressed in a lovely new green dress, her head wreathed by a matching headpiece, she flashed a brilliant smile as she came through the door.

Josephine and her husband had four children when she discovered she was pregnant with a fifth. Despite the fact that she had a C- section in the hospital, her baby died, and Josphine suffered a childbirth injury called a vesico-vaginal fistula. This injury is all too common in poorer countries. It is caused by prolonged or difficult labor without timely medical assistance.

The constant leakage of urine resulting from VVF disgusted Josephine's husband. Because he had never heard of anyone ever having such a problem, he decided his wife must have been unfaithful. He accused her of being a prostitute and kicked her out of their home.

She and her three younger children went to Benin to live with her father. To support them all, she made tapioca to sell. But customers were repelled by the smell from her wet clothing and wouldn't buy any food from her. With no other resource, she was reduced to selling trinkets by the roadside.

Gossip and hurtful remarks followed Josephine wherever she went. She was so overwhelmed by shame, she hid in the house. She described her despair. “ When I slept and then I woke up, m y bed and everything around me would be wet. I would say to myself, ‘ What kind of life is this?' Then one day I heard there was a hospital ship coming to Benin . ”

Her hopes were raised when her aunt told her to come to Cotonou, because the Africa Mercy was coming to Benin to offer surgeries free of charge. She went to a screening and was accepted for surgery. But the first procedure didn't eliminate the problem. Disappointed, but undaunted, she went back for a second surgery. But by then, the ship had gone, and she was advised to travel to Togo, the site of the ship's next Field Service.

When the Africa Mercy arrived in Togo, Josephine called to say she would come to Lomè for the VVF surgeries. This time, her persistence and hope were rewarded with a successful surgery.

As she celebrated the wonderful gift of a normal life, Josephine exulted, “ I want to thank God. I want to thank the doctors and all the day-volunteers.” After seven years, she was dry!

Story by Elaine B. Winn

Edited by Nancy Predaina

Photos by Liz Cantu

Lonely

The past 6 weeks has been many things.... it has been hectic... it has been joyful... it has been heartbreaking.... and I know deep down in my soul it has been life changing. Not only have I had the privilege of being a little part of the process that has reached into the lives of 105 women from West Africa, but each and every one of those 105 has reached into my life and changed me a little too.

I can barely fathom that its all over.  Toward the end of the final week I knew it was time to be done. I was tired, no I was more than tired I was exhausted... I had poured out all that I had. It had taken every ounce of my energy, every critical thinking skill, and pulled from my whole spectrum of emotions. God has provided me with a good support system here and my "mom" here on the ship Joy (who happens to also be my boss) gave my strict instructions that I was to take this whole week off. I have taken her up on that!


So with my days off, I have gone to the pool and gotten a sunburn.... I have slept in and read a book... watched a movie and worked through some of the details for school. Tomorrow I am headed off to Ghana to visit a friend Alyse from home and will be there for 4 days and could not be more excited to be off this big white box for a while.

All that said I have noticed this little aching in my gut and I haven't been able to quite put my finger on it.  Tonight I let myself walk into the wards for the first time in a few days and as I walked in I found before me a room full of middle aged men (we transition from VVF surgery to general surgery which is a lot of hernia repairs). And as I walked in, it finally hit me. I miss them. I miss my ladies. What used to be 2 full wards, up to 40 of them at one time has now dwindled down to 5 and I miss them. I miss their faces and the giggling, the parades and dancing in the halls all the while holding catheter bags... the daily 4 pm praise session with the drums and the races to the bathrooms. These ladies have consumed my thoughts and my prayers and my everything for the past few months and now its over and they've gone home. I do realize that is the point and I praise God for all the wonderful things He has done in their lives but its like any of those experiences in life that comes to an end and you feel a little bit of sadness as it goes.

Last December the ship sailed away from Benin and I had this big decision in front of me as to either come back to the ship and coordinate the VVF program or to head to Sierra Leone and help with the maternity clinic there, or to stay home. God clearly told me to go to Togo and at the time I felt completely out of my league and confused as to why he wanted me in this position. But now half a year later and looking back it all seems so clear. There is no doubt I was completely under qualified for the job I just did, but God wasn't. And I have learned so much from this experience. I have skills I didn't have before and confidence I didn't possess before. I also have contacts with people and places that will be a big part of my future. The surgeon I worked with these last 6 weeks, Dr Steve is also working on a project in Niger where his organization is starting a VVF clinic there. As of now I have plans to accompany him and some of my good friends from here on a trip there in the spring!  I also am finally feeling ready to be packing up and heading home and this time I know I am headed back for years not months and this does not scare me in the least! (Are you excited to read that mom??)

I want to thank everyone for all the prayers you have sent up on mine and the ladies behalf. They have without a doubt carried us. For those of you who prayed for specific women, I think that has made a big impact on the whole thing and it has meant so so much to me. Next week I promise to email you all with updates about your ladies. As I mentioned before there still are 5 ladies here on the ship, so be prayerful for wisdom for the team as we decide how to tie up the loose ends pertaining to their care.  Thanks again...Maggie

Rikiata

RIKIATA BAWA

Rikiata is a spirited and capable woman, full of good humor and common sense. The mother of four children ranging in age from 6 to 17, she discovered almost two years ago that she was pregnant again. Although she had a C- section in the hospital, her baby died, and she was left with a vesico-vaginal fistula (VVF). This is a very common problem that occurs in poor countries where medical assistance is very limited or inaccessible. The injury is caused by prolonged or difficult labor. Often the mother is too small or too young for unassisted childbirth.

VVF results in incontinence. The constant leakage of urine soon destroyed Rikiata's trading business and her life. So, she went to visit her mother and stayed there.

Rikiata knew about Mercy Ships and called to see about a screening, but at that time the ship was in Benin. When the Africa Mercy came to Togo, the doctor called her and told her that she should come to a patient screening. Mercy Ships provided transportation for Rikiata and several other people from her village in northern Togo.

In just a few days, her life was dramatically changed! Her surgery was successful. During her recovery time in the ward, she was a great help as a translator because she knew the languages of the northern part of the country. Overjoyed that she was dry once again, at meal time she would say, “When they give me food, I tell them I am already full of happiness.”

All the women who have had a successful VVF surgery participate in a dress ceremony in the ward. They are each given a new dress and a chance to share their testimony. The drums begin, and the singing and dancing follow, as the ward echoes with the joyous sounds of happy women celebrating the return to a normal life.

Resplendent in a royal blue and gold dress and matching head-wrap, Rikiata led the group into the ward. Her brilliant smile reflected her great joy as she gave her testimony, “I wake up dry. I am overhappy! I can start my business again . Even my children are happy!”

Story by Elaine B. Winn
Edited by Nancy Predaina
Photos by Liz Cantu

Akissi

Akissi Nalalene

Akissi is a spirited teenager. Her gleaming white teeth brighten her contagious smile. Some things get lost in translation, but not Akissi's gregarious behavior. When asked for a photo, she swiftly poses with clenched fists showing off her buff arms – accompanied by her award-winning smile.

However, Akissi's life has not always been filled with smiles and laughter. She grew up in a rural village in the northern part of Togo. From a family of farmers, she learned to work long days under the brutal sun at a very young age.

At sixteen she moved to Cote d'Ivoire to be married to a man there. When she went into labor with her first child, she struggled for several days before finally going to a hospital. She received a cesarean section, but the baby was stillborn. Akissi was devastated.

Akissi noticed that she could no longer control her bladder. Her condition is called vesico-vaginal fistula, or VVF, and is caused by damage resulting from obstructed labor. It is very common in countries where there is little or no obstetric care.

At this point, Akissi's husband no longer wanted her, and he sent her home. It was a very long voyage from Cote d'Ivoire back to her village in northern Togo. Akissi did her best to cover up her condition. But the other people on the bus noticed the foul smell coming from her, and she was humiliated.

Finally she was back with her family in her village, Pkaple. Akissi struggled to endure everyday life. Her vivacious personality was stifled, and her head remained bowed in shame.

Then Akissi heard on the radio that doctors from Mercy Ships were coming near her village to see women with a leaking problem like hers. She attended the patient screening and received a date to make the journey to the hospital ship in Lomé. Excitement and hope filled her heart.

Mercy Ships arranged transportation for the women from the northern areas to get to Lomé. When Akissi arrived, she was overwhelmed by the bustle and commercialization of a large city, but she remained focused on her hope that in a matter of days she would have her life back.

VVF surgeon Dr. Steve Arrowsmith performed surgery on Akissi. When the nurses removed the catheter a few days later, Akissi was cured! For the first time in a year and a half, she was dry!

A few days later Akissi took part in a ceremony honoring the women who were blessed with successful surgeries. The sounds of drums, clapping and singing echoed through the ward as the women filed into the room in traditional African dress. Akissi wore a new cobalt blue gown with touches of golden yellow. Her face was lit up with joy.

Akissi stood up among her peers and a large crowd attending the ceremony and said, “Thank you to all the doctors and the nurses. Now, I can be among people. I no longer hide at home. Thank you Mercy Ships for all you have done.”

Thanks to the entire Mercy Ships VVF team, Akissi will return to her village and regain her sparkling, bubbly spirit. She looks forward to a normal life – a life free from shame and filled with joy.

Story by Claire Bufe
Edited by Nancy Predaina

Stories

Here on the ship we have a marketing department with writers and photographers that try and keep up with all that is going on around the ship and life here and document it. They have written quite a few stories about VVF and now that we are just finishing up and I am trying to catch my breath after a whirlwind 6 weeks. I find myself having a hard time putting it all into words. So while I process it all I will post some of the marketing stories for you, so you can see the faces and read the stories of a few of my ladies.

Hope Reborn

Akissi, an 18-year-old girl, waits patiently in line. Slowly, she moves closer to the examination area. She thinks back on the four months since her first medical screening near her home in northern Togo. She has been anxiously awaiting this day. The moment has finally come, and she prays that the doctor will say to her, “Yes, we can help you.”

Akissi is one of many female patients that arrived on the dock of the Africa Mercy with the hope of being reborn. These women are being screened for a debilitating condition called vesico-vaginal fistula, or VVF. Such a condition is common in African countries because of the lack of obstetric care. The Mercy Ships program, aptly titled “Hope Reborn,” will ease their suffering.

VVF is usually caused by difficulties during childbirth. Some women writhe in agony for several days before giving birth to a stillborn child. The prolonged, obstructed labor causes a hole to form between the bladder and the vagina, making it difficult to live a normal life. The women experience an involuntary discharge of urine, causing an unpleasant odor.

Maggie Schrenk, VVF coordinator and a volunteer on the Africa Mercy , has also been waiting for this day for several months. “These women are very special. I hold a special place in my heart for them. Today starts 6 weeks of surgeries that will repair their lives.”

VVF is a stigma in African society. Although the condition is prevalent, it is not a subject for discussion. In fact, people try to ignore it. Women suffering with VVF are usually shunned, becoming isolated from everyday life.

If more doctors knew how to repair fistulas, many women could be released from their lives of separation and despair.

That is why Dr. Steve Arrowsmith spends much of his time educating local surgeons. Dr. Arrowsmith is a VVF surgeon from the United States and has spent 23 years performing VVF surgeries and educating African surgeons about the technique. Teaching other doctors onboard the Africa Mercy is a unique opportunity that Dr. Arrowsmith appreciates very much.

“The ship is an amazing training platform,” Arrowsmith says. “You take these African doctors out of their home medical facilities, and all their distractions are taken away – no cell phone coverage, no pagers – and all their other needs are taken care of. It's a unique niche for the ship that nobody else can match.”

Screening day onboard the Africa Mercy is a long arduous day, but Arrowsmith and the VVF team are prepared and up to the challenge. By 11:00 a.m. they are two hours ahead of schedule.

Lindsay Nelson, VVF Assistant Coordinator, explains, “We are moving through the exams quickly, which is great. We will see about 60 women today. After Dr. Arrowsmith examines each one, the team will convene and decide who we will bring in for surgery, and who are inoperable.”

Spirits remain high throughout the day, and examinations are completed by 4:00 p.m. Maggie comments, “We will have ceremonies celebrating the ones who have received successful surgery. That day marks a new life for them and those are the moments I live for.”

There will be many of those moments onboard the Africa Mercy in the next few weeks … thanks to the hard work of the amazing Mercy Ships VVF team.

Story by Claire Bufe
Edited by Nancy Predaina