I LEAVE IN 9 DAYS!!

Ok, people, here is, what could be my last blog post, depending on how lazy I am before the end of 9 days. To all who have been nagging me to update my blog, even though I secretly hate you, I thank you for giving me the drive to actually do this. I just have had no idea about what to write about, so this blog will be regarding some of the patients our ship has been treating since we've started. 

In the last blog I wrote, I talked about the wards, and types of patients we will be treating, specifically for me, the plastics patients. Recently, I took care of a patient, Mariette, who has been living with a mass on her back for the last 30 years. This mass weighed approximately 4.5 kg, or almost 11 pounds. Here is her before picture:

She was one of the first patients on my ward to receive surgery. After the surgery, she was crying her eyes out because it was the first time in 30 years that she was able to lie flat on her back. CAN YOU IMAGINE? Her daughter came by to visit the second day after surgery and as soon as she saw the tumor was gone, she was tearing up and going around thanking every single nurse and doctor in the room because she was so thankful. This is what I experience every single day, and this is the reason I do what I do. 

The next ward that I am truly blessed to witness is the OBF, or the Obstetrics Fistulas ward. Women who have had long labors during childbirth (often because they have no access to care, are afraid to seek good care, or the nearest hospital is over 50 kilometers away) who develop these fistulas that cause them to leak urine or stool constantly from their vagina. Over 75% of women who develop fistulas have endured labor that has lasted more than 3 days. Because of this problem they develop, most of them have been shunned from husbands, families, and society. When I was first learning the about Obstetric Fistulas, we were told that no only do they lose their child during childbirth, but most women die during these labors as well, so these women aren't victims, these women are survivors. these women are so incredibly strong and have lived through so much, including loss of a child, as well as a having to live with the burden of a fistula afterwards.

For these women, this surgery is changing their lives forever, and as a celebration to their survivorship, Mercy Ships holds a dress ceremony every few weeks for these women. During the dress ceremony, we provide new dresses for these women as a metaphor for a new, clean start in life. These dresses will no longer smell from urine or stool, and will represent a brand new start in life. Here is a picture of a dress ceremony from last year:

Experiencing this transformation is truly a once in a lifetime opportunity and I feel incredibly lucky to be here. This is why I do what I do, and I love it. Not only did people think I was insane for quitting my job to come here, but also PAYING to volunteer my time to do this was just unheard of. But I wouldn't have had it any other way, and I'm sure most of you would feel the same way too if you could experience what I have in the time that I have been here. This experience has changed my outlook on nursing, and on life for the better, and I cannot wait to see what's in store next.

I know this post is incredibly delayed, but I've finally found some time to update the blog. I know you are all on the edge of your seats, waiting with anticipation. 

Lindsey and I arrived to the city of Tamatave on August 30th after a very long delay that included the ships turn around to South Africa after they found two stowaways on the ship! That's right, stowaways. 

The first week here was mostly just orientation to the wards and learning how to acclimate back to paper charting, calculating medication doses with calculators, calculating drip rates (which for none medical people, we never have to do anymore). I'm pretty much a nurse that has jumped back to the early 90s as far as nursing is concerned. But it's been great thus far!

I had an orientation on the ward I'll be on as well. There are currently 4 wards on the ship: A-ward- this is the ward I'll be on. It is specifically for the plastics patients which I'll go into later. B-ward- this is the women's health ward who will be getting vaginal fistula repairs; D-ward- this is the ICU ward along with Maxillofacial surgery patients, and lastly E-ward- which will be general surgery that includes hernia repairs, goiter removals, etc. the ship is equipped with pretty much everything you'd see in a hospital; Things like lab, CT scanner, X-ray machine, 5 operating rooms, etc. 

 This is A-ward!

This is what a typical ICU bed looks like.

Now about what I'll be doing. I will be caring for plastics patients mostly. What this means is that I will be caring for patients who are getting skin grafts for burns they have sustained. Burns here are very common in younger patients in Madagascar. They happen mostly when they trip and fall into open fires (they don't have electricity or stoves), or when they have seizures and accidentally fall into fires, electrical fires, etc. With these surgeries, the goal is to give patients more range of motion with their affected limb more than anything. Often times the burns have molded their arms to their sides so the surgeon will release the contracture and place a skin graft over it. We try to teach the patients and caregivers that we can't take their scar away but if we can give them a new range of motion then we've done what we can. This is common misconception with the patients. He other types of patients we get are patients that are getting surgery to remove extra finger and toes. This is called Polydactyly fingers or Sindactyly fingers, meaning an extra toe or extra fingers. I'm so excited to be taking care of patients like this. This is a completely new field for me, and I'm excited to learn something new!

This is a patient mercy ships treated last year. These will be the types of patients I take care of during my time here.

I've been seeing patients patients since last week and it's been great! Plastics starts this week so I've been seeing mostly general surgery patients. These people are truly amazing people I must say. I mean every patient there is so incredibly thankful for our help. We had a patient who has had a tumor on her back that was the size of a soccer ball for the last 30 years and just now got it removed. She was ecstatic at her ability to lay flat on her back for the first time in 30 years. When the daughter saw her mom, she burst into tears. Every patient has a story like that, and this is something where we are truly making a difference in people's life. They cannot believe that the care they are getting is completely free. Oftentimes in the local hospital, patients must bring everything they would need for care, including their own gloves. Can you imagine? I don't think we take enough time to appreciate the access to healthcare that we have in the states and it's something to be truly appreciated. 

Everyone here on the ship is doing their part to leave this country with accessible care. We are currently training hundreds of local midwives, surgeons, dentists, biotech people, in new techniques to safely deliver care to their people after we leave. The dentists are seeing an average of about 150 patients a day doing extractions, fillings, or crown placements. It's truly amazing work that's being dome here.

And lastly I'll speak to the Malagasy workers we have here. There is 1 translator to every 2 nurses on the ward that do all of the translation for us. I can honestly say that we would not be able to do what we do if it weren't for them. They are so good with the patients, and are the best at communicating to us to what the patient needs from us for a quick recovery. The general consensus that they all say as to why they are here is that they just want to help their people. If they can help their people overcome their fears about their surgeries by simply speaking for them and to them, then they know they've made a difference. 

I am so lucky to be here. I'm sorry this went on forever, but I hope it gave a little glimpse into what I'm experiencing here on a daily basis. 

  So I've been out of touch with lots of people for the last 3 days, but I can say that I had one of the most beautiful times of my life these last few days, and I'm so excited to share it with you. 

  Lindsey and I left on Sunday to go see the sites of the Baobab trees as well as the Grand Tsingy de Bemaraha. Just a little history of the tsingys: the tsingys are a big formation of rocks, that were at one point under the sea before Madagascar was formed. It was made an official world heritage site in 1990, and has only been open to the public since 1997. It consists of some pretty intense hiking, as well as some amazing caves to climb through; pictures to be followed. 

  The Tsingys Are located in a very very remote area of Madagascar called Bekopaka, so it took us 8 hours to drive there with some very very rough roads, and two ferry crossings with the most ghetto ferry. I don't think I've ever been so thankful for paved roads in my entire life.

On the drive over, we encountered some villages that were in complete poverty, and in some of the most desolate areas. It was not uncommon to see people with hardly any clothes, no shoes, straw houses, and no running water. 92% of Malagasy people live below the poverty line, often living off of less than two dollars per day.  But despite all of that, it was also not uncommon to see the biggest smiles on their faces as we passed, and nearly every person made a point to wave at Linds and I. These simple gestures speak immensely to me in so many ways. It truly made me feel extremely humbled, and it just goes to show that people can find pure happiness, even in the most horrible conditions. It made me think of how incredibly blessed I am to be where I am, and the opportunities that I have had in my life. It's so easy to get caught up in the sometimes trivial things in my daily life, but at that moment I was so humbled and had to take a few minutes to reflect on those things and that for me, some things could be so much worse. 

  Once we arrived, we stayed in the cutest bungalow that is shown below, and made some new friends as well. We befriended a German couple, where the girl is studying the behaviors of specific Lemurs for her PhD, a fellow American who has been living in Mozambique for the last 3 years for her career, and a South Korean man who did the hike with us. It was so great being able to have dinner with a group of people who spoke English! We bonded over our love for this country and delicious rum, something that Madagascar is famous for apparently. 

 On Monday we did the hike of the Gran Tsingy. Our hike was lead by our guide, Brown, (yes, that was his real name), and has grown up in the Tsingys his entire life. He lead us through the most dangerous parts, through pitch black caves crawling on our knees, showed us fossilized coral from when the country was under water, and more importantly, showed us the cutest LEMURS! That's right people, I saw Lemurs! Pictures below. The hike was by far the most beautiful, spectacular place I've ever seen in my entire life. Words cannot describe, nor can pictures, at how amazingly unreal this place was. I would recommend this to anyone to do at some point in their life. 

We left Tuesday morning and returned on Tuesday night. On our way home, we stopped by to see the famous Baobab Trees that are endemic to Madagascar. We were lucky to get a glimpse of them as the sun was going down and it was magnificent. The trees have been around for thousands of years, and are some of the most unique trees on earth. During this time, I was able to pet a chameleon as well, which was terrifying. 

  The next coming days are filled with traveling, and a stop or two on our way to Tamatave, where we will begin serving! 

WE MADE IT!!!

Bonjour! (The only French word I've learned thus far)

  I finally arrived in the capital of Antananarivo after 27 hours of flying, two layovers, and three disgusting airplane meals. I will say that for the most part, all flights went smoothly, aside from being on what I think was the most outdated Air France plane I've ever experienced. I honestly thought that was going to be my last flight ever after being on that plane for 10 hours. 

  When I arrived to Madagascar, it was approximately 2 in the morning and I was exhausted. I waited in customs for an hour and a half and when I finally got through, I was sooooo relieved that my bag had actually made it all the way here. Let's be real, we all breathe a sigh of relief when we see our bags come down that luggage carousel.

  Upon leaving the airport, I took a taxi to my hostel, and on the way there I had some interesting encounters with my taxi driver which included him not knowing what a nurse was, as well as being completely ripped off. I take it as a right of passage in my opinion.

  When Lindsey and I saw each other in the hostel, we gave each other huge hugs in finding another person who spoke English. Lindsey put together a plan for us to leave the capital last night on an overnight bus to the city of Morondava to do a tour of the Baobab Trees, and tour of Tsingy de Bemaraha. Now that is where the good stuff occurred.

 Things we learned on this 19 hour, yes you heard me, 19 hour bus ride to Morondava: 

1) need to learn how to say toilet in French

2) need to overcome fear of peeing/pooping in bushes with other people around 

3) being crammed in a medium sized van/bus with 17 other people is no where near as exciting as you think.

4) the bright side of no electricity is the extra one million stars you get to see once it gets dark

5) if you don't swat the old man next to you'd hand away, it will remain there for the next twelve hours. Linds and I took turns sitting uncomfortably close to this man the whole trip.

 We finally arrived this morning to this small beach town and got to our adorable bungalow on the beach for 10 dollars a night. We intend on spending all day beaching, and relaxing. There is a photo of the bungalow below. 

And I'm Off!!!

    As some of you may know, I, along with a fellow coworker, Lindsey, will be serving 7 weeks as a nurse in Madagascar with an incredible organization called Mercy Ships. Mercy Ships is an organization that has been providing reconstructive and live-saving surgeries to undeserved populations around the world for over 35 years. The Mercy Ship is the largest civilian hospital ship that provides state of the art medical care to those in desperate need-free of charge!

Lindsey and I am leaving a week early to explore around the country, before beginning our service which starts on August 28th, and ends October 11th. I will arrive in the capital, Antananarivo, and from there, I will be taking a 6 hour bus ride to the city of Toamasina, or Tamatave. Mercy Ships is docked in this city for 10 months out of the year. 

So as I embark on this truly unique journey and attempt to navigate myself through a developing country, as well as learning to pick up French, I will try my best to blog my way through Madagascar, so that you guys can experience the miraculous things that I will be seeing. This is a once in a lifetime opportunity, and I intend on taking full advantage of this opportunity to its fullest!