The Great Patient Search

I realized recently that I don't remember ever writing about how we find our patients. This process is called "Screening". It's a pretty interesting process that highlights the flexibility of Mercy Ships and the way the organization has grown over the years.

Mercy Ships is well known for something we call "Mass Screening Days". It may even be something you think of when picture Mercy Ships in West Africa...long lines of tired people standing in the sun or rain all day for a chance to be seen by a doctor and possibly receive a free surgery. Maybe it looked something like this:

Up until a few years ago, this is how screening worked. The ship would arrive in a new country after advertising for several months about what kind of problems we can treat. We would rent out a big facility (like a stadium or empty building) and have hundreds of volunteers from the crew spend 12-14 hours seeing patients all day long, giving them dates for possible surgery and saying no to thousands of others who did not fit the criteria. Generally, the entire surgical schedule for a country would be filled in one day. While it was an exciting day that many looked forward to as "Mercy Ships Tradition", it was long and hard and not very efficient.

Then came Madagascar. This country was a completely different animal. A huge island with a poor transportation system and a port located hundreds of kilometers from the capital city - the only city that most of the population can easily get to. How do we find patients in a place like this? One giant screening day was just not an option.
In comes this idea of a Screening Team. The idea had already been in the works for a while because people had begun to realize that there had to be a better way to do things than mass screenings. Unfortunately, in our world today, we have to start considering things like safety and spread of disease. Attracting thousands of desperate people to one public place creates many problems in itself. So why not send the Screening Team to the patients instead of having them come to us? This was trialed in small scale the first year Mercy Ships was in Madagascar and used almost completely to find patients for Madagascar 2. Last year, the team went to 13 sites all over the country, screened patients we could help and invited them to the ship for a specific date when they could potentially have surgery.

Screening Team - Madagascar 2015-16

While this process is still being tweaked, it seemed to work very well for that situation. Transportation was still an issue as it can take several days to travel to certain cities in Madagascar, but thanks to a partnership with MAF (Missions Aviation Fellowship), the team was able to fly to some of the far sites and even brought some patients back to the ship by plane as well! Once the patients came to the city where the ship was docked, they were given further examination and seen by a surgeon to confirm they were fit for surgery. The screening team is made up of nurses so they are not able to confirm until a surgeon sees each patient - but they do a pretty good since something like 95% (I don't have that exact figure) of patients brought to the ship were approved for surgery.

Screening Team after a MAF trip in Madagascar

I'd consider that a pretty successful system. In fact, it worked so well that they decided to keep a similar process for future field services with a few tweaks. For Benin this year, we have had a combination screening process. When the ship first arrived, we held 3 weeks of screening days in this city. While we are not located in the capital city, Cotonou is a large city and only 1 hour from the capital so a large portion of the population live nearby. For several months, Mercy Ships advertised about these screenings with a goal to fill about 50% of our surgical spots for the 10 months we will stay in Benin. This ended up having a huge turnout and thousands of potential patients were seen.

Cotonou Screening Center

 But what about the rest of the county? While Benin is much smaller than Madagascar, the rest of the country is more rural and not as accessible. When we agreed to come here, the government specifically requested that we do all we can to reach those in need in the north of the country farther from the capital. A new idea was formed. A group of Beninoise people were trained and sent out to different regions all over the country. Mercy Ships gave each of them an iPhone and created an app that can be used to take patient information and find out if the patient fits our criteria for surgery. These workers spent several weeks searching their region to find potential patients and sending the information back via internet to the Screening Team on the ship who approved or denied each patient to attend a local screening day in that region. Talk about Tele-medicine!

And now, the screening team has just returned from the first of 2 field screening trips to the north of Benin where several small screenings will be held specifically to see the patients found by these local screeners and give them a spot to come for surgery. Maybe it's just me, but that's a pretty awesome process! We're still waiting to find out how effective this method is, but if it works, there is the potential that it could be used in future countries, saving a lot of time and energy for the screening team and reducing the number of No's that must be said.

I even had a small part in the screening process this week! As Orthopedic Team Leader for the ward, I've had the opportunity to go along with our Orthopedic surgeon the past few days as he assessed about 100 patients with Orthopedic deformities to find which patients we could help. The screening team did a great job of finding many patients who will fit into our program. Although it was a long and full 3 days of seeing patients and organizing the schedule, it was very interesting to be a part of what goes on behind the scenes before our patients get admitted to the hospital.

Orthopedic patients waiting to be seen by surgeon during screening

Straight legs coming your way!

Working on the schedule after a long day of seeing patients.

Overall, finding our surgical patients is a huge blessing and challenge - and I am extremely thankful to have a Screening Team who can do this for us! They are often the first interaction a patient has with Mercy Ships and that's a big responsibility. Many patients leave happy with a surgery date but many others must be told "No". In fact, in Madagascar last year, the screening team had to turn away over 5000 patients. While we try to do all we can in each country, we have limited space, time and scope of practice that makes it impossible to say Yes to every patient we see. It's not an easy job and this team needs your prayers as they make hard, life-changing decisions each and every day!

Is a PICTURE worth a thousand words?

I've been on the ship over 2 months now and have yet to update at all about being back. I could list a variety of excuses for not posting enough, but mostly it all boils down to the fact that I don't like to write and I never know what to say - plus, the longer I wait, the more there is to tell you about! So instead of words, I thought pictures would be an easy way to update you on what has been going on here the past 9 weeks.

I met the ship in Durban, South Africa at the end of July. This cabin is my new home for the next 10 months:

I've been given a slight upgrade this year so I only have 3 other cabinmates and a little extra room. And just last week, we got our very own couch!

The view from the ship in the Durban port...this view is very different from our usual African country landscape. Skyscrapers?! 

August 1st, it was time to sail! Lifting up the gangway is the last step in the process: 

My friends and I stood on deck for several hours watching the whole process of leaving the port. This is our "we're so excited to be moving" faces!

We had a few days of rough sailing but mostly it was very pleasant. I really enjoyed the slower pace of life (forced relaxation when you can't leave the ship) and fewer people on the ship during the sail. My absolute favorite part was the sunsets:

After a few days of sailing, we stopped in Cape Town for a quick visit. Here's the ship being tugged into the CT port. This is one of my favorite cities and it was even more special to be there with the ship this time!

After our 3 days of rest, it was time to hit the seas again. We had lots of activities during the sail to keep us occupied including movie nights, a 'sock golf' tournament, becoming "Shellbacks" as we sailed across the equator, and worship on the Bow (a part of the ship ONLY open during sails).

Just about 3 weeks from when we left Durban, we sailed into Cotonou, Benin. An arrival party complete with Beninoise music and dancing were waiting to greet us!

The day of our arrival, a ceremony was held to welcome the Africa Mercy to Benin. One of our Beninoise crew members carried the flag in the ceremony.

The next 3 weeks were filled with SCREENING: 

 Aren't the colors of West Africa so amazing! These are the types of outfits people wear everyday. (I visited the screening center one day to help with crowd control and got to see so many Orthopedic kids like this - my favorites!!)

And CLEANING: 

At the beginning of each field service the nurses have to unpack the hospital that was secured for sail, clean everything and set it up to look like this so it's all ready for our patients to come.

Finally, on September 12, the doors to the hospital opened and our first patients received surgery! Now, after 3 weeks of surgery, our wards are filling up and the joyful chaos has begun. This is Valentin, one of our first burn reconstruction patients playing with a ward nurse.

And Miracle, another plastic surgery patient. with my friend Erin from Canada. This little one in particular screamed and cried pretty much the entire first 2 days he was here but now he begs to be held and played with all the time. I love seeing the transformation!

Well, I think that pretty much catches us up on the past few months. Sorry for the lack of updates but hopefully these pictures will make up for my few words. Things are off to a great start and it's so wonderful to be back in this place where I know I am meant to be - doing what God has called us here for: to bring Hope and Healing to the country of Benin. 

Prayer Points:

-Screening Team continues to search for patients. They leave next week to visit possible patients in the north of Benin.

-Our Hope Center opened last week to accept patients once they are discharged and they're still working out a few kinks in the system.

-Many, many plastics patients who are waiting for wounds to heal: pray for skin to grow and wounds to be free from infection

-Training classes are happening for local physicians, anesthesiologists and sterilizing technicians

-Continued unity for the crew and seeking God as we serve

 -Safety and peace for the country of Benin

A Full Summer

After leaving the ship in June and spending about 2 weeks in Cape Town, I finally made it back to the US. I actually only ended up having about 5 weeks between arriving and departing back to South Africa to meet the ship once again. The best way I can describe this summer at home is "Full".

First of all, it was full as in packed to the brim with so much to do! I flew straight to North Carolina where I got to meet my niece for the first time. Definitely the highlight of my summer! (Huge thanks to my brother and sister-in-law who let me stay for 2 weeks so I could get lots of snuggle and play time with her!)

Me and my niece, Lora (7 months)

My parents also came up to visit and we had a great time as a family. It doesn't happen often that we can all be together so we took advantage of the opportunity and had family pictures taken. Having a new baby in the family is lots of fun and a great excuse for new pictures!

It was incredibly hard to say goodbye knowing I wouldn't see them again for another year, but it was time to make one more flight - this time back to Florida. My 3 weeks in the Sunshine State were packed with several weekend trips to see my grandparents and church family, lots of eating out with my Mom and Dad at restaurants I haven't had for a year, and catching up with friends and supporters. There was also the craziness of unpacking, restocking and repacking my life again into two 50lb suitcases. (One afternoon was also spent with a reporter from the Palm Beach Post who wrote an article about Mercy Ships and my time in Madagascar. Yikes! What a weird feeling to read about myself in the newspaper! If you haven't seen the article yet, here's the link: http://www.mypalmbeachpost.com/news/news/local-education/royal-palm-nurse-changes-lives-by-tending-to-afric/nsBLG/ Welcome to any new readers who were directed here by the article!) 

These weeks at home were also full of blessings, some in ways I would have never imagined. As odd as it sounds, I was ready to be home, but at the same time, I was already looking forward to coming back to the ship! As much as I love ship life, the last few months here were hard. If you read my blog about goodbyes, you'll see part of why, but there was also the end of year exhaustion and loss of enthusiasm as things come to a close that is very draining. I physically, emotionally, mentally and spiritually needed a break. Heading home, I was looking forward to a time to refresh, recharge and grow...however, you know that saying, "You don't know what you have until it's gone"? Turned out to be very true.

I went home expecting to enjoy the family time, catching up with friends and western conveniences (which were all great!) but actually I was surprised how much I really liked getting to share about Mercy Ships! No, I still don't love public speaking (and thankfully, only had to officially do that once) but get me with a group of friends or at a table with one or two others and I will happily talk for hours. This has nothing to do with me wanting to talk about myself - that part I try to avoid! What I do love is to talk about my experiences, this ministry and the miracles God did in the country of Madagascar (and how excited I was to be heading to Benin!), It's not always easy and I had a few tough questions, but being forced to put into words what happened in the previous year made me appreciate this life and feel privileged and humbled to be a part of it. I don't know if it always came out this way, but inside I felt giddy at times talking about this place I love and I hope my face lit up as much as my heart does when I talk about it.

As I was talking with people back home, I realized that most only have a small idea of what we do. I know this life so intimately and live with others in the thick of it, so it was helpful to be reminded that not everyone has a full picture of Mercy Ships. I aim to do a better job in future blogs of explaining more of that part.

While I still claim Florida as 'home', I also call this ship my 'home'. Home is difficult thing to express. I love my family and friends and wish I would be with them more often, but I also love this crazy ship and the people here. Through my time away, I've realized more than ever that this is the place I'm meant to be right now. I'm blessed to have this opportunity and never want to take for granted what a gift it is to be serving here for this time - however long God allows me to continue. 

Cape Town Transition

Well, I’ve been back on the ship about 3 weeks and in the country of Benin for 4 days now! I have much to share but first I thought I’d give a little update about what’s happened in the past few months between leaving Madagascar and arriving here.

A few months before departing Madagascar, myself and a group of 5 other nurse friends decided it would be fun to plan a trip together as a transition between ship and home life. We also figured we would be ready for some relaxation after 10 months of hard work! We flew straight from Madagascar to Cape Town, South Africa and enjoyed about 10 days of exploring the city.

On our first day, we headed a few hours north to Aquilla Game Reserve where we spent 1 night in a gorgeous stone bungalow, ate delicious South African meals and enjoyed 2 safari tours of the reserve to see giraffes, antelopes, elephants, buffalo, hippopotamus, cheetahs, lions and more! This was the biggest splurge of our trip but it was so refreshing to be pampered for 24 hours and experience the nature of South Africa up close.

Back in Cape Town, we rented an Air BnB house to have room for us all to stay together. It was lovely and spacious and basically felt like a mansion after 10 months on a ship in Madagascar, haha! From our location we had bird’s eye views of Table Mountain above and the city below. Over the next week or so, we hit up pretty much all the major tourist sights Cape Town has to offer: Red Bus Tour of the city, Robben Island, Cape Point, Boulders Beach and Penguins, Winery Tour, V&A Waterfront, Table Mountain, plus lots of great food, shopping and exploring.

One of the days, we took a long detour a few hours away from the city to go Bungy Jumping!

Bloukrans Bridge is the tallest commercial bridge bungy jump in the world so, of course, we had to do it! The views were amazing and it was definitely a once-in –a-lifetime experience…but I don’t know if I’d be up for a repeat any time soon ;)

Cape Town is a beautiful city with SO much to offer and I’d highly recommend it as a vacation destination! (Good thing I liked it, because just about 6 weeks later I was back in the city again, this time when the ship stopped for a visit on the way to Benin - see future posts for more on that!) It was also relatively inexpensive, which made it a perfect transition for volunteers with no money coming from very low cost Madagascar. Those 2 weeks with friends will be remembered and cherished for many years to come, but by the end I was ready to head home and excited for the summer of ‘catch up‘ ahead!!

Madagascar II Recap

During my time at home in June and July, I shared this video put together by our Communications Team during some group presentations. I thought I would post it here so you can see all that happened during the Madagascar 2 Field Service 2015-2016!

1453 patients received free surgeries in Madagascar! It's so incredible to think of that number and how many lives were changed through Mercy Ships. But these individuals are more than a number.

It reminds me of a quote I once heard that says "Every number has a name, every name has a story and every story matters to God". We often use numbers to quantify the work that we do, but it goes deeper than that. These are people with stories and lives that will go onto completely different paths than they would have without the medical care that Mercy Ships provides. And it would not be possible without your help. Thank you!!!

Fifalina: Pint-Sized Courage

We are only allowed to post certain things about our patients in order to protect their privacy, which is why many of my posts are not hospital related. I could tell you hundreds of stories about the patients I've had the privilege to care for in the past 8 months, but to keep to those rules, I will let our amazing Communications Team do it for me! You may not realize that we have an entire team of people who work on the Africa Mercy taking photos and videos and writing patient stories to share with our donors and other media outlets. Not only do they interview the patients and caregivers to find out more details about their lives than I could, they also are WAY better writers :) We have a pretty large collection of these stories and photos that I plan to share so you can see the impact Mercy Ships has had on country and people of Madagascar. (If you missed the first post in this series, check out Laloa's story here.)
In the second of this collection of patient stories, you will read about Fifalina. One of the sweetest nine year olds I've ever met, Fifalina stayed with us in the hospital on and off for several months. She has a beautiful smile and the most positive outlook on a very hard life. Her favorite activity during weeks of bedrest was drawing perfect cartoon pictures. If you look at the before images below, you'll see why even I was doubtful of the success of this surgery...and maybe proof that miracles still happen!

The tiny nine-year-old struggled into the Mercy Ships admissions tent. Fifalina’s legs seemed to be slowly folding beneath her. They could no longer hold her erect. 

Her mother, Ludvine, says Fifalina’s legs were normal at birth. However, when Fifalina started to walk, she often fell, and Ludvine noticed that her legs began to curve. 

Fifalina’s father had to find work each day to provide for his family, but they managed to scrape together enough money to visit a doctor. He told them the little girl needed calcium and said there was nothing more he could do. Then the desperate parents sought help from a traditional healer who massaged Fifalina’s legs. Nothing helped, and her legs continued to weaken. 

This bright little girl was eager to attend school despite her physical challenges. Initially, Fifalina could walk the 30 minutes required. “Her curved legs were getting worse and worse,” Ludvine recalls. “One time she fell down at school. After that, her legs were really curved, and her knees could not support her.” So Ludvine carried her daughter on her back to and from school every day.

But school wasn’t always a pleasant experience. Fifalina whispers, “At school I'm always left behind. I can't play with the other kids. I'll play with the other kids when I'm healed.”

Ludvine first heard about Mercy Ships on television. “They said Mercy Ships is healing,” she explains. “At the beginning we did not know that they are fixing legs. I just knew about them removing tumors. They published a video. When I saw Vanya’s story*,  I wanted to see healing in my daughter.”

They learned of a patient screening nearby. “I believed they could fix my legs!” exclaims Fifalina. “I said to myself, ‘Let's just go there, and we will see.’” She was examined and given an appointment.

Mercy Ships consultant Dr Frank Haydon (USA) performed complex orthopedic surgeries,  correcting Fifalina’s twisted upper and lower legs by rotating her bones through more than 200 degrees. A series of pins now holds her knees and hips in alignment. After surgery, Fifalina was enveloped in full-leg plaster casts that weighed almost as much as she did.

At nine, Fifalina is the average height (according to the World Health Organization) of a four-year-old. The utter cuteness of this child, displayed in her infectious giggle and broad grin, disguises the valiant heart of a tiny warrior. Time and time again during her procedures, Fifalina smiled, bit her lip, and pushed through a pain-barrier that would make a grown woman whimper.

When her leg casts were first removed, Fifalina declared, “I’m going to learn to walk again!” Ludvine gasped and shed tears when she first saw her daughter’s straight little legs.

Months of splints and physical therapy followed Fifalina’s surgery as she bravely relearned to walk. Her muscles, weak from years of disuse, were retrained by a team of volunteer physiotherapists. Daily routines were performed with peals of laughter and entertaining activities.

Ludvine had plenty of time to reflect as they journeyed through the six-month long process of surgery and rehabilitation. “If they did not fix her legs, she would suffer a lot, and I would suffer too. If her legs were left like they were, I think she would end by walking on her knees. When I look at the photo before the surgery, I can see that her legs are so curved, like if her knees are going down. So if they did not fix them, forever it would be like it was. Our problem would get worse and worse. I would not be able to carry her on my back. Now she will be able to walk and just hold my hand!”

Finally the day arrived when Fifalina could achieve her milestone tasks unaided – balancing on one leg, walking with one foot in front of the other, and standing on tiptoes. These ordinary playtime activities were herculean and enchanting new experiences for this not-so-ordinary nine-year-old.

Ludvine thinks Fifalina would make a great teacher when she grows up, but the Mercy Ships crew members will tell you that Fifalina is already a pint-sized inspiration.

Story by Sharon Walls 

Edited by Nancy Predaina

Photos by Catrice Wulf, Justine Forrest, Katie Keegan, and Ruben Plomp

Fifalina was only two years old when her legs began to bend.  She received free complex surgeries to her upper and lower legs onboard the Africa Mercy.

Fifalina’s mother comforted and encouraged her daughter during her long recuperation.

Fifalina’s bones were corrected by more than 200 degrees of rotation.

Fifalina is now headed into a very different future.

The Goodbye Season - Part 2

(Written June 3, 2016 while flying over Madagascar. Posting now when I finally had time to sit down at the computer.)

Over the past few weeks, I have said many goodbyes to the people and places that have been by family and home for the past 9 months. As I said in the previous post, I call this “the Goodbye Season”.

The hardest by far of all the goodbyes have been the people. When you live in such close community like we do on the ship, people you meet, even just for a few weeks become more than friends. Life on the Africa Mercy has its own culture that is nearly indescribable and hard to understand unless you’ve experienced it. I have been extremely blessed to have an incredibly close group of friends that mostly came together to the ship in August with a few additions along the way – and what’s even better is that most of them will be back onboard for some time during the next field service in Benin, making the goodbyes much easier (more like ‘see you later’). It hurts my heart to even think how much harder “goodbye season” would be if I didn’t know I was coming back in a few months! Nevertheless there are a few friends who are moving on from life on the Africa Mercy and those goodbyes have nearly broken me. I joke that I have probably cried more times in the past 9 months than the previous 9 years! This place will do that to you! Thanks to technology and easy travel, there is a good likelihood I may see some of these people again, but the hole they will leave on the ship is hard to fill. I’ve found that with each person who comes and goes, I notice something memorable about them that changes once they’re gone. It may be an empty office, a missing breakfast companion or the spot we would share our coffee break – each person changes the atmosphere of a place and memories of them are all around.

The final goodbye is in process as I write this from thousands of feet in the air about Madagascar. Yesterday, we drove from our little port city of Tamatave to the capital city, Antananarivo, where we spent the night before boarding our flight today (‘we’ because I’m leaving with a group of 5 other girls and traveling to South Africa before heading home). Madagascar is an exotic country full of beauty and diversity. The people have been welcoming and generous – showing us all their country has to offer and laughing along with us in our feeble attempts to learn their language. “Azafady Tompoko, Malagasy Kely Kely!!” (Very sorry, little Malagasy!) I never imagined before coming how much excitement Madagascar would have to offer and how much exploring we would get to do while serving here. My fellow crew will laugh at this, but I naively imagined we would rarely leave the ship and I never considered the idea of vacation time, haha! Instead, I’ve had the opportunity to travel several times around this country and spend many weekends and days off out exploring the town! The past few days were spent revisiting all my favorite places: the little hidden café for coffee and homemade chocolate croissants, the Bazaar where they know who we are and what items are our favorite, the grocery store where I learned the French word for flour and how to buy yummy local Malagasy snacks, the man on Beach Road who chops open a fresh, cold coconut for me to drink for about $.30, the ice cream shop with the most incredible passion fruit sorbet, and the secluded Oceanside hotel with the goat cheese salad and best chocolate mousse (and where they don’t mind if you sit all day reading a book or chatting with friends!). And this is just to name a few. I’ve taken a piece of Madagascar with me in my heart and left a huge chunk of myself here on this magical island.

So how do I make sense of this inevitable part of the life I’ve chosen to live? This is only my first experience with ‘the Goodbye Season’ so I am not an expert by far. But I do know a few ‘experts’ who’ve experienced this 5 or 10 times before and even they say there’s no easy answer. It never gets easier to say goodbye unless you close yourself off and become hardened to people – something I will fight to never let happen! Why does God put us here to meet amazing people and visit incredible places and open our hearts to new friends – only to have them ripped away? There are many thoughts on this and each person has to cope with it in their own way. For me, I’ve come to the realization that God is not in the business of intentionally hurting us. Instead, he allows us to experience His awesome creation – people and places – even if only for a short time. I know in my heart that each person has been put in this place at this time for a reason. He doesn’t allow accidents or make mistakes. Rather than focusing on the sadness of leaving, I am forced to appreciate what each interaction has brought to my life. Each goodbye is a person who impacted my life; or maybe I was a part of something they needed during this time. Even in a short few months, I have learned so much from knowing these people, and I will carry those bits in my heart forever. Instead of pieces of my heart being ripped away, I prefer the image of my heart being molded and shaped with each person leaving their mark for me to cherish always.

I wish I could wrap this up with a bow all nice and neat, but the truth is I’ve shed a few tears just as I’ve written this out. Also know that I don’t write this expecting sympathy (except in the form of prayer for wisdom and comfort through these transitions). I write this from a place of authentic honesty and openness to show that while this life has so much beauty and wonderful things to offer, it can also be hard and take its toll on your mind, heart and emotions.

Want some more honesty?? I wouldn’t trade it for ANYTHING!!

The Goodbye Season - Part 1

(Written June 3, 2016 while flying over Madagascar. Posting today when I finally had time to sit down at the computer.)

A blog I read, called A Life Overseas, calls this time of year (around May and June) “The Leaving Season”. I guess it’s a common occurrence of missionaries living in other countries to travel, take vacations or return home from the mission field during these months. My personal opinion is that it should be called “The Goodbye Season” instead. Mercy Ships runs on a field service cycle: working in one country (this year, Madagascar) for about 10 months from August-May, then two months ‘shipyard’ period (in South Africa) from June-July to do basic maintenance and repairs on the ship, then sail to country next (Benin) in August to start all over again. Because of this cycle, about 50% of the crew onboard leave or take PTO in May or June. This is especially true where I work in the hospital, since we don’t need doctors or nurses to run an empty hospital.
I explain all this to say that the past month or so has been a season of emotions, mostly sad ones. People and places come and go all the time – it’s just the way of Mercy Ships – but it’s a billion times harder when all the goodbyes come at once and some of them are very hard ones. In this post and the next (it was too long so I had to split it in half), I will try to give a picture of what the past few weeks have been like in yet another part of ship life on the Africa Mercy.

Last week it started with saying goodbye to our final patients in the hospital. Although we finished surgeries the week before, we still had several patients waiting for follow-up appointments or final dressing changes and rehab. One small ray of sunshine in all of this was that our Hope Center closed a week early to start packing up so all the patients staying there moved back to the ship. It was fun to spend a few extra days with some of my previous patients who had surgery back in January or February :) On the last day, they were all ready to go home. It was such a touching thing to watch them all shake our hands or give one more hug, then the kids skipped down the hall shouting “Tsy Veloma” (no goodbye) over and over!

The next few days, any hospital crew still onboard were put to work cleaning and packing up the hospital to prepare for sailing. It was eerily quiet and a little heartbreaking to not hear children laughing, babies crying, women singing or even any Malagasy language spoken at all :( But with each surface cleaned or bed put away, I thought of each life impacted in that place in the past 10 months and how many more lives are waiting to be changed in Benin! It’s a lot of work but I know it will be worth it to see those first patients arrive on the ship in a few months.

The next goodbye was Friday when we had our Day Crew Appreciation party. I can’t remember how much I’ve written about our Day Crew, but they are Malagasy people the ship hires to help in translating, cooking, cleaning and keeping the ship in top condition. In Madagascar, we had over 300 Day Crew that worked in almost every area of the ship. At the end of each field service, we have a giant party to celebrate them and thank them for all their work. The captain and managing director speak, each department is recognized and the Day Crew put together special performances like singing and dancing. Then at the end, after lots of hugs and final pictures, it was time to say goodbye. This is an especially difficult goodbye for crew members who have been with the ship the past 2 years because they’ve gotten so close to the Day Crew being together almost 20 months. I am sorry now that I didn’t take the time to get to know our Day Crew as much as I should have and it’s a goal I plan to work on for next year. But I hope they know how much we appreciate their hard work, long hours, flexibility and forgiveness as we often make mistakes trying to navigate the Malagasy culture. Mercy Ships could absolutely not do the work we do without their translating, serving alongside us and answering our endless questions about Madagascar. I have heard from the Day Crew many times “Thank you for coming to help my country”, but what I want to tell them is “It’s an honor to serve Madagascar and thank YOU for loving your own people and serving them so well!”

It’s never easy to leave the country you’ve worked so hard in year after year and I’m sure people who have served with Mercy Ships for a long time would say that it never gets easier, but our organization chooses to visit many countries to provide our services to more people instead of focusing on one area. It’s a hard choice and neither way is right or wrong. One solace in these goodbyes is that I can see the potential we are leaving behind in Madagascar. In those 300+ Day Crew, there is the potential to change this country. They are intelligent, skilled, passionate and driven. They WILL do great things here and continue bringing hope to this country – and Mercy Ships was only the beginning for them!

God brought Mercy Ships to Madagascar two years ago through a series of circumstances no one could have seen coming…but He had a plan all along to bring the ship here and use this ministry to further His kingdom. We can leave this place knowing for sure that God is working in this country and that doesn’t stop once the Africa Mercy leaves. He goes with the ship, but He also stays behind in Madagascar and goes ahead of us to Benin as well.

“Great things He has done, greater things He will do.

Unto the Lord be the glory, great things He has done.”

Lalao, Free at Last

We are only allowed to post certain things about our patients in order to protect their privacy, which is why many of my posts are not hospital related. I could tell you hundreds of stories about the patients I've had the privilege to care for in the past 8 months, but to keep to those rules, I will let our amazing Communications Team do it for me! You may not realize that we have an entire team of people who work on the Africa Mercy taking photos and videos and writing patient stories to share with our donors and other media outlets. Not only do they interview the patients and caregivers to find out more details about their lives than I could, they also are WAY better writers :) Now that we've been in Madagascar for a while, we have a pretty large collection of these stories and photos that I plan to share so you can see the impact Mercy Ships has had on this country and people.

This first story, Lalao, is not a patient I had the pleasure to care for, but many of my friends did and I heard about how sweet and beautiful she was. I also chose this story first because it will be a change from the plastic surgery and orthopedic stories I've shared previously. Our last plastic surgeon left in March, so for the past 2 months I've been working with General surgery patients who have hernias, lipomas (fatty tumors) or goiters (enlarged thyroid). These patients don't always get as much attention in the media because their physical transformations aren't as dramatic and they usually only stay with us for a few days. But as you will read below, the impact can be just as great!

Lalao and her husband struggled to make ends meet. Five of their six children shared their one-room home in Madagascar’s capital, Antanarivo. Lalao’s husband worked on a rice farm, and Lalao helped support their family by working in a small local restaurant.

Their financial challenges increased 13 years ago when Lalao noticed a lump in her neck. As time passed, the growth increased in size. Despite the scarf she wore to cover her throat, the café owner dismissed her, saying her goiter would disturb his customers. “That left me in a difficult situation,” she shared.

The ever-cheerful Lalao set her hands to work at whatever came her way – washing clothes by hand, toiling in the fields. Her hard work provided less than one dollar a day, and the exertion made it difficult for her to breathe.

As the swelling at the front of Lalao’s neck grew, so did her anxiety. Sometimes she awoke during the night, choking and gasping for breath. “It affected my breathing. In the beginning, that was frightening!” she recalled. “If I lay flat, my breathing was blocked. I had to make sure my head was upright, and I woke two or three times every night.”

A friend heard an advertisement that Mercy Ships was screening patients for problems like hers, so Lalao went to the medical screening. She received both a diagnosis and a solution.

Mercy Ships could remove her goiter, but the treatment required pre-operative monitoring of hormone and blood levels. So Lalao and half a dozen other goiter patients had to make the trip to the Mercy Ship for check-ups once a month for six months. This made it impossible for Lalao to hold down regular work. Purchasing the tickets for the nine-hour round-trip journeys stretched the family’s finances to a critical level. “I had to travel so many times, and it cost a lot,” explained Lalao. “It was really difficult to lose my job and the money. It was hard for my family to pay for my travel. I did any work I could get just to help.” She even borrowed from her neighbors, who encouraged her to continue with her treatment.

When her surgical date finally came, Lalao sold the last four family chickens and bought a bus ticket to take her once again to the hospital ship.

Lalao’s transformation was immediate and complete. The free surgery removed the goiter which had plagued her for 13 years.

“I feel really free!” Lalao declared. “ I don’t need that scarf any more. I will give to my mother!”

Story by Sharon Walls

Edited by Nancy Predaina

Cabin Fever

I've been getting lots of requests for pictures of my cabin. I meant to add it to the ship tour I posted a few months ago but never got around to it, oops! So here's the long awaited Cabin Tour of 3431. Please excuse the mess (although it's relatively clean right now) and the poor photo quality (the lighting in the cabin is horrible). Ok? Thanks!

First up is the view from the doorway coming in. Our cabin is a 'six-berth' (meaning six beds), which is what most nurses live in. There's a huge variety of cabin types on the ship ranging from singles for management positions all the way to 10 berths, which are usually for galley, hospitality and housekeeping crew. The layout of each cabin can also be different depending on what part of the ship it is in.

 As soon as you walk into our cabin, you reach the bathroom on the left side. It's lovely to have our own bathroom in the cabin (not true for everyone), but it's teeny tiny and shared by six girls so you can imagine what a busy place it is ;) You can see here the toilet, sink, mirror shelf and shower. With the curtain closed on the shower there's just barely enough room to turn around without running into a wall! Let's see, other fun facts about the bathrooms on the Africa Mercy: 

• 2 minute showers (I think I've mentioned this one before- water on, rinse, water off, soap/shampoo, water on, rinse, done).

• We have surprisingly great water pressure and super hot water available pretty much all the time - which makes the 2 minute showers a little more acceptable.

• The ship's waste is run by a Vacuum system (imagine like on an airplane) where all water is sucked into our treatment system on Deck 2. It can make flushing the toilet at 2am very noisy!

• We share a 'Vac' system with the cabin next door so our whole room can hear every time they flush or take a shower, haha!

• Occasionally we get an overhead announcement something like this: "Deck 6 Vac System down until further notice". (AKA- you can't flush the toilet until we tell you...that's always fun to hear...)

• Twice a week, we are required to put Toilet Juice in the toilet to keep the Vac system clear. Kind of like Drano, I guess?

• We have a retractable clothesline that goes across the bathroom...but if it's open, you can't close the shower curtain. And the cabins are constantly damp so everything takes forever to dry anyway.

From this view, you can see into each of the 3 bunk spaces. There is a curtain that closes each section off to help keep out light and noise and for privacy. Each section has basically the same thing, 2 bunks, one wardrobe with a side for each person, a bookshelf and a fold down desk with a chair. I live in the back section straight down this hall.

Here's my section looking in from the opening to the hall. Our cabin is actually right next to a stairwell so it's slightly shorter than the others. Normally the beds are up against the left wall with open space and a desk, but instead our bunks face the other way and we don't have a desk. I've had two bunkmates - one was here for 2 months and worked in the dining room; and the other has been here for 5 months and is a nurse as well. 3 of the 6 girls in my cabin are here for 10 months like me and about 6 others have come and gone. It's pretty common in the six berths to get a new cabin mate every few weeks because crew come and go so often. The atmosphere of the cabin changes every time someone leaves so that has been an adjustment, but overall our cabin group has been very good with no major issues!

Here is my mess of a wardrobe. Besides our small bookshelf and a little bit of room under the bed, this is the only storage in the cabin. It must hold clothes, shoes, beach stuff/towel, office supplies, plus whatever other randomness I can shove in. I like to call it organized chaos because it looks like a mess but I know exactly where everything is! (Thanks to a tip from a Mercy Ships pro, I threw in that hanging shoe rack you see on the front of the door at the last minute and it has been a lifesaver for holding all kinds of small things!)

And finally, here's my cozy little corner of the world. I upgraded to the bottom bunk back in October which was a huge blessing! The mattress isn't very comfy and it was hard to adjust back to a Twin bed, but when I'm exhausted and my head hits that pillow, I consider how it could be so much worse. I love filling my walls with lots of pictures, inspirational quotes and Bible verses so I can look at them every time I get in bed. If you'd like to bless me with some new ones for variety, send away!

Well, that's all I can think of for now! When I come back in July, I will have a new cabin and will try to put up some pictures in less than 6 months ;) Hope you enjoyed seeing my little home away from home.

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Now a question for you: What else would you like to read about on this blog? I have a few ideas left to write about, but I'm curious what the readers want to know! I have just a few weeks left in Madagascar and then this blog will probably take a break during my time back in the States so this is your chance to find out all you ever wondered about. Do you have some burning question about the ship? Would you like more Madagascar info? Patient stories? Or just something random? Ask away in the comments or email me and maybe your question will get featured in a coming post!

Ready for Mercy Ships Take 2?

A few weeks ago, in another post, I mentioned a big announcement was coming soon. Well, here it is: I'm not done with Mercy Ships yet! I'm sure it doesn't surprise many people that I love this place and am fully committed to this ministry for as long as God continues to allow me to be here. That being said, I will be coming back again for another 10 months starting in August - this time we'll be sailing to Benin in West Africa! 
I've been dying to scream from the mountaintops (or at least Deck 8) about this big news, but I was waiting until everything was official before I let the world know! As much as I miss seeing my friends and family at home, I've been overwhelmingly grateful at the response of those who I've told the news already. It makes such a HUGE difference to know people are excited for me to come back and so supportive of the work we're doing here. So thank you, thank you, thank you for that! Below is the email I sent to those on my update list for anyone who I haven't been able to contact. Feel free to read more of my heart :)

I thank my God every time I remember you. In all my prayers for all of you, I always pray with joy because of your partnership in the gospel from the first day until now, being confident of this, that he who began a good work in you will carry it on to completion until the day of Christ Jesus. -Philippians 1:3-6

 Dear Friends and Family,

As I sit here on the Africa Mercy typing this email, I think of all the ‘good work’ that has been done in Madagascar in the past 7 months. Since September, Mercy Ships has provided 1167 free surgeries, seen over 5,000 dental patients and trained over 1,000 medical professionals - and that’s all with 10 weeks left before the ship will sail away. God is using this ministry to bring hope and healing to the country of Madagascar in many ways. All these numbers and statistics will never be able to capture the other side of the story where people who receive surgery are given dignity again…where parents of a disabled or disfigured child are able to dream for their future again…where hundreds of local workers the ship hires have learned what a difference it makes when work is grounded in the love of Jesus…and where physicians, nurses, anesthesiologists and hospital administrators have been empowered to provide safe care for their patients and make a difference in a broken system. I wish you could meet the people behind each of these stories to truly understand the impact this ministry has had in this place and to know that your support makes it all possible. Above, I used that verse from Philippians because I am so very thankful for your partnership and when I think of all that you’ve done, I am truly filled with JOY!

Patients recovering from plastic/reconstructive surgery enjoy free time on Deck 7

But the good work is not yet completed. There is much, much more to come, which is part of the reason I am writing today. Sadly, our work in Madagascar must come to an end, but that is only because in just a few months, the Africa Mercy will head to Cotonou, Benin and I’m extremely excited to announce that I will be going with it!

Benin is the country in blue and Cotonou is right near the tip of the arrow.

Benin is a small country on the coast of West Africa about the size of Pennsylvania. It’s a relatively stable and safe country that was a major part of the African slave trade and believed to be the birthplace of Voodoo. While Benin is a developing country, a huge portion of the population lives in poverty and there is less than 1 doctor for every 10,000 people. The Africa Mercy is scheduled to dock in Cotonou, the largest port city in Benin, from August 2016 – June 2017. Not only will I be returning for those 10 months, in July I also have the opportunity to sail with the ship to Benin from South Africa, where it will be docked for annual maintenance and repairs.

The Africa Mercy sailing into Madagascar, August 2015

 I’ve spent the last few months in prayer over this decision, but I fully believe God has called me to this place for longer. There are many ifs and buts that have gone through my mind; however, I have been forced to a place of complete trust in His plan and timing. God has shown me over and over again that He has me here for a reason and He will provide for all my needs. You are one of the ways He has done that! Whether you have given financially, prayed daily or sent a note or inspiring word that came at the exact right moment – each of you is so very important to allow this work to continue! Which means your work is not done yet…

Once again, everyone at Mercy Ships is a volunteer and we are required to pay our own travel expenses plus room and board to live on the ship. In the past year, I have been blessed to receive more support than I ever imagined possible, which means some of that will be able to go towards my monthly expenses for Benin. But I will still need to raise about $6000 to cover the rest of the 10 months. If you are one of my generous monthly supporters already, it’s easy to continue giving in the same way you do now. I appreciate you all so much for your consistent support the past year, but I also understand that finances can change and if you are unable to continue giving past your original commitment that will not be a problem! If you are interested in joining my Crewmates team, I encourage you to visit my Donorpages site here: http://mercyships-us.donorpages.com/crewmates/JenniferMullis/ Click the DONATE link to give via credit or debit card. If you’d rather not give online, please reply to this email and let me know so I can send you more information about other donation options. All donations given through Mercy Ships are tax deductible. Again, none of this would be possible without your support and God is using your gifts to further His kingdom!

Sasimeny and I sharing giggles on Deck 7. Read more about Sasimeny's story here: www.shinebrightmercy.blogspot.com/2016/03/my-little-shadow.html 

I’ve also been blessed by your prayer support and words of encouragement that keep me going on a daily basis. One thing I have experienced the past few months is the power of prayer! This community is built on prayer and it’s beautiful to see the body of Christ come together in this way. There are people all over the world praying for this ship, our patients and this country. I try to post several times a month on my blog (shinebrightmercy.blogspot.com) about what’s happening here and areas that could use prayer. Also follow me on Facebook (Jenny Mullis) or Instagram (username: jennjam23) for pictures, Mercy Ships links and videos, as well as patient stories.

Thank you again for prayerfully considering how you can support Mercy Ships in the coming year! I look forward to sharing more with you as I continue this journey to Benin in a few months.

Love to you all,

Jenny

PS- Because of this change, I will only be in the US for about 5 weeks in June and July. My schedule will be pretty full but I would love to see you and catch up on life! I plan to be in West Palm Beach from June 28 – July 20 or so with a trip to St Petersburg fit in there somewhere. Please let me know if you want to get together while I’m home!