Here are Pamela Graham’s latest emails from the Mercy Ship Africa Mercy in Benin. She received a needle stick injury on 2nd April; her two emails about that, dated 2 and 27 April, follow her more general one below.
18 April
Things are going fine here, after the initial shock to the system of this alien environment I have settled in. General routine begins with breakfast at 6.30, devotions at 7.30 and work at 8. Normal working day seems to be from 8 till when you get finished, and on call around twice a week. The weather is still very hot and sunny with a few days of rain but the rainy season is due to start any time now and so our days of the sun are now numbered.
I’ve made my way round most of the theatres now, which includes eyes, general, VVF, max facs and ortho. Ortho is interesting here, many bowed legs and club feet. So easy to fix, well, it looks so easy, we’ve been putting in 8 plates onto the lateral (outside) side of the femoral condyles which stop growth on that side, this lets the bone grow on the medial (inside) side. Over a period of a year the leg will straighten out. It already looks great by the time they leave theatre. Lots of club feet too, and it seems like a simple enough operation, I’m not saying I could do it, but the outcome is amazing for what happens under the knife and the children wake up with a completely new life ahead. The surgeons seems to enjoy teaching, you just don’t get the chance to write everything down, it is so evident though that surgery is only a part of the massive need here.
There are set meal times on board so if you miss it ... you’ve had it. It also means that if you choose to lie on Saturday and Sunday morning you don’t get anything to eat until your evening meal and for me this is too long! You can buy snacks from the ship’s shop which is not open at the weekend so you have to be prepared if you know there is a chance you might sleep in, you have to get food to keep you going. The only problem is the supplies in the shop are all American, namely biscuits and the rubbish stuff they call candy and I’m trying to stay away from it. Biscuits and a jumbo pack of M & M’s chocolate for breakfast ... eh thanks but I’ll pass. One problem I am encountering, the peanut butter here is good and I’m eating too much and becoming ‘cuddly’ as one of the anaesthetists like to call it, in other words, fat! Resistance is futile, please pray.
We had to abandon a VVF repair a few weeks ago which was the first time I have been in an op where we have decided to do that. The tear in the bladder wall was too high to repair and we stood for hours before it was decided nothing more could be done. We are hoping to refer the lady to another surgeon who can repair the fistula abdominally which will depend on when they happen to come along. I was quite upset by that, just to think that this lady would wake up to be told that it didn’t work. She probably had to move heaven and earth to get to the ship in the first place and probably as her last chance of hope. This is definitely the area where I feel most for the patients, this condition has been such an eye opener and there are so many factors that would have to change to make these stillborn babies live, and for the mothers to deliver safely but ultimately what would save this disaster is a simple Caesarean section.
The doctor who has been serving here on the ship for VVF has worked in Ethiopia for years dealing with the dilemma there. One of the major problems there is that the terrain is so treacherous with valleys and steep hills, that it makes it almost impossible for a woman to get herself to the hospital, and most of the time they are solely responsible for getting themselves there as the husbands don’t really see it as their job, or particularly care. We were seeing to a woman who had suffered with leaking urine for five years and she was the same age as me. When the doctor
investigated he found a stone sitting in her birth canal. I may have told this story before but it has been one of the biggest things so far. If you don’t like medical stories don’t read the next sentence. When we took out the stone it was in fact the baby’s skull which had been there from five years ago. The lady in question did eventually have a Caesarean section but because it was still born they took the baby out of the womb in parts and left the head in there. Quite disturbing.
I live in a very varied and cultured environment but with only two Northern Irish folk we are thin on the ground. There are over 40 nationalities serving on board I’m told. The predominant nationality is definitely American. The next most predominant would be Dutch. I have spoken with people from Ireland, UK, Norway, Sweden (whom I really like), Holland, Germany, Austria, Russia, Poland, South Africa, Zimbabwe, Canada and America to name a few. There are also African people serving on board from Togo, Nigeria and Ghana and lots of other places.
There is quite a varied schedule with things happening most evenings. Aerobics on a Monday night, in house teaching on Wednesday and option for bible study on Daniel in the evenings; Thursday night is the main community meeting with ice cream served after while Friday and Saturday nights are usually chill out nights with whatever going on. You can go out to eat at the restaurants in the area. I have been to a few and have been impressed, except for the bicycle chicken which I have been served on a few occasions, which had less meat on it than a budgie’s leg.
Starbucks is usually open most evenings although I have decided not to partake in Starbucks or to over-indulge in the goodies. I need a reminder of where I am and when you have all these indulgences around you just become de-sensitised to your surroundings. I don’t feel good when some of the day volunteers (people from Benin who come in to help on ship, translating) walk around and see all the ‘stuff’ we have here when they have to go back to their homes in the city which are predominantly shacks. There is something wrong with that in my head and although its not a big sacrifice it is a reminder of the purpose and point of why I am here.
It is difficult to get your head around the fact I am still living in my western culture on this ship and yet outside on the dock is poverty like I have never seen it. I went to a stilt village the first week I was here and was shocked by what I saw, it’s hard to describe, these children have a fascination with pens, all they wanted were pens or chewing gum and I didn’t have either. These shacks for houses hovered on stilts in water. The water was about 3 feet deep but they went everywhere in the village in canoes, like a Venice except it wasn’t like Venice at all! I’m sure the water was typhoid rich and I really didn’t fancy falling out of the boat. There was nothing there but shacks on stilts in the middle of nowhere, secluded from civilisation.
Had to move the ship at the weekend to refuel. We successfully took on 700 tonnes of oil and moved back to our original dock space this morning. As I didn’t get to sail with the ship this has been my first experience and it was great. All very formal and structured. The gangway was lifted last and we knew we were on our way shortly after that. The tug boat came and pulled us out from both sides and guided us out of the tight space and soon we were sailing to the other side of the dock. The tug then literally nose pushes the ship into the side. Very interesting and we tie up.
Been having a few good days of riddle telling which started in theatre with Dr Parker, we told riddles for a few hours which has now spread to midship and I’m still hearing them. Gets the mind working and sometimes there is only so much you can do on a ship!
2 April
So despite praying against needle stick injuries, you have guessed it. I got one today and didn’t think anything of it as it didn’t pierce my glove. but, have found out some horrible news about the patient that I cannot bring myself to say it but I will let you come up with the answer. I have had blood taken and have started anti-retroviral drugs but I’m really scared and all I want to do is come home.
I will see the doc in the morning and he can tell me the outcome. People tell me the rate of getting it is slim but they also said the chance of any of these children having it was slim and one of them does and look what happened.
27 April
I want to thank you for praying for me as I think it has been the only thing that has kept me calm through this situation.
Most recent news is that I will go for another blood test either this week or in two weeks’ time. They are questioning if it should be 4 or 6 weeks after the event. It’s to give more of an idea of what is going on in my blood, although I won’t be able to tell much until at least three months. If anything was going to be there it should show by three months. So, hopefully I will get this three month blood test a few days before I come home, around the 25th June. I’m hoping they will do it for me here and not send me home to get it which would be a nightmare trying to explain it at the Health Centre, especially the one I am registered with, who don’t do communication that well.
I had a bad day on Friday and have decided I cannot scrub anymore, it’s not worth the fear. I am circulating in the OR and even that can bring anxiety on. I was thinking about trying to find something else to do for the next two months, some admin things, however there doesn’t seem to be a space for that just now and we are so short of OR nurses that it would seem wrong to escape the responsibility.
There has been another nurse who has got one also. She is 72 years old, long since retired and devastated also. The medication is tough on her also but she is still on it, whereas I came off my mine. Needle- sticks have never happened on the ship before apparently, but since arriving in Benin there have 18 incidents and we have only been here for 9 weeks. It’s scary. Benin is very dark, it’s the home of voodoo. People practise Christianity and voodoo very interchangeably.
Wanted to keep you posted and if you could remember me in the next while.
Thank you sincerely everyone
Pamela Graham
