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!

My Little Shadow

At 3 years of age, she fell into a fire severely burning her right hand and wrist. Without money to go to the local hospital, her family turned to a Catholic nun nearby for help. Over time, her skin did heal but not without contracting so tightly that her wrist was forced into a bent position and her fingers fused together making them essentially unusable.

Then, they heard about Mercy Ships providing free surgeries and there was hope. This 4 year old little girl and her older brother left their family and traveled for 4 days across Madagascar to the ship for her surgery. They trusted that these white people who didn’t speak their language could possibly heal her arm.

When I first took care of Sasimeny, it was a few hours after her surgery. She lay in her bed, in and out of sleep from anesthesia. Even though she never complained of pain, her grimaced face and the giant tears rolling down her cheek showed evidence of the major surgery she’d just gone through. But she obediently sat up and swallowed every bad tasting medication and tolerated our constant poking and prodding that interrupted her rest. All the while, her brother sat next to her bed patiently stroking her hand and speaking words of comfort that would mean more than anything my English ones ever would.

The first few days are always the worst. That’s what we tell our patients before their operations. Then things get better.

For a while, we all believed Sasimeny was shy and quiet. She kept to herself, coloring in bed or watching the movies that came on TV twice a day. Across the room, there was another 4 year old girl who had surgery around the same time, but she was not shy at all. Variela loved to play and be held by the nurses (and argue with her dad about taking medicine!). Sasimeny would watch from a distance as we played balloon toss or built Lego towers on the floor. Then one day, as I sat holding Variela, Sasimeny reached out to be picked up too. I guess the vazhas (white people) aren’t so bad, now are they? From that moment on, Sasimeny and I have been inseparable.

Sasimeny (right) and her buddy Variela

Now, I call her my ‘little shadow’ because about 95% of my working hours she spends in my arms or very close by. She is a completely different little girl – playful, vibrant and full of life with a bit of a stubborn streak we assume comes from being the baby in a family of 6 older brothers! Some have given her the nickname ‘Sassy’ and it fits well. We taught her to play Jenga, blow bubbles and cover her face in stickers. But her favorite thing is being carried up and down the hallway snuggled in someone’s arms. Occasionally, I force her to walk which usually turns into us racing down the hall holding hands. Secretly, I don’t really mind. She’s been in our hospital now over 50 days and rarely spends a moment in her bed unless she’s sleeping.

Sassy and her balloon with another nurse, Kayla.

One day soon, Sasimeny will leave our ship and move to the Hope Center to wait for several weeks of outpatient appointments and rehab before she can go home. While the surgery we did here will make it possible for her hand to move again, it’s the months of rehab and exercises after the skin heals that will allow her to use it to its full potential. And that really is the goal. Her right arm will never look completely like the left one again. But hopefully, with lots of practice she will be able to pick up a ball, hold a pencil and carry a bowl. Someday, she will be able to go to school and learn like the other kids. And years from now, she will be able to get a job or care for her children. All things that would have been more difficult or impossible without this surgery.

I can’t deny that I won’t be a tiny bit sad when my little shadow walks (or, let’s be honest, gets carried) up the stairs and down the gangway off the ship. She is only 4 years old and will probably not remember much about her time here. But I hope I will never forget her beautiful face or big, inquisitive brown eyes. As much as I hope she will have memories of nestling into my shoulder after running around Deck 7, it’s a tough reminder that this is not about me. My job is to love each patient and take care of them while they recover from surgery – their job is to use the life we’ve restored to its fullest potential! And I have no doubt that Sasimeny will do just that.

Mile 18 - the marathon of Mercy Ships

I recently heard life on the Africa Mercy compared to running a marathon. Now, I obviously have no experience with running marathons (or really much running of any sort) but I think it's a parallel many people can understand.
In a marathon, you start off strong and feel like you can accomplish the world. For the first few miles, anything is possible and you know you're going to beat this race! Then about Mile 12 or so, the adrenaline is wearing off and the exhaustion kicks in. It gets really tough but you push through to get over the hump. Then about Mile 18, your body just wants to quit. Your mind knows the end is coming, but your body is tired and ready to collapse. It takes all the willpower you can muster to keep pushing to the end at Mile 26! The hope is that when you arrive at the finish, it will all have been worth it and you'll forget the pain that got you there. (Now this is based off the marathon runner who made the comparison. I have no idea if this is actually how it goes; it sounds pretty true to me. You runner types can prove me wrong if you'd like!)

All that is to say, right now on the ship a lot of us are feeling like Mile 18. The 'field service' cycle for Mercy Ships looks something like this: Arrive in a new country sometime around August, stay for 10 or so months until June, then spend June and July in a bigger country where repairs and maintenance are done on the ship. We've been in Madagascar for 6 months so far and we'll leave in another 3 months. For those of us who are here the entire field service (or longer), this is the hardest part to push through. The excitement of arriving and new people and lots of life-changing surgeries has worn off and life becomes routine. Anticipation is building for the next country the ship is getting ready to serve in but there's still a few months left here before that can happen. It's an emotional roller coaster that I've heard countless Mercy Shippers lament about whether it's their first time on the ship or they've been here 10 or 20 years!
There are some great lessons to be learned in times like these when I choose to be intentional and look for them (which my friends here will laugh at me saying that, because I hate being introspective!):

Patience is top of the list. We have a lot of patients but I need a whole lot more patience...yes, pun intended! This period on the ship involves a lot of decision making - from leadership, from individuals, about patients and surgical plans and policies and the future. This has forced me to see how often I'm not very good at being patient. I want answers now and I especially want those answers to go the way I want! Worst of all, I find myself being impatient with God. Why can't you show me your plans NOW? Why am I not growing in my relationship with You NOW? Why don't you heal these patients so they can return home NOW? Can't you fix the problems of Madagascar that we know You're powerful enough to change NOW? I'm learning that my lack of patience is based on a lack of wisdom and trust in God. I've been studying the book of James (talk about one wise guy!) and in James 1:5 it says this,

"If any of you lacks wisdom, you should ask God, who gives generously to all without finding fault, and it will be given to you."

Having wisdom doesn't mean I will have all the answers, but it does mean I will be wise enough to wait on the Lord...patiently. Have you ever noticed the 'without finding fault' part? God doesn't expect perfection - He will never be upset with me for lacking! It's never wrong to ask for more wisdom, and He will give it generously. Isn't that awesome?!

Another thing I'm learning is that each and every patient is just as important as the first. When I first arrived on the ship, talk was all about the first surgery, the first plastics patient, the first discharge, the first VVF dress ceremony and so on. As time goes on, we look at the numbers and statistics and talk about how many amazing things God is doing through this ministry, but we can often loose sight of the most important goal: sharing the love of Jesus to each person. Every single patient we have the opportunity to treat deserves the best care we can provide. Whether the first patient or the last, whether the surgery is simple or complex, whether the results are good or bad, whether they believe in God or not...it should not make a difference because God has brought them to the ship for a reason and He allows us the privilege of speaking into that person's life. Even if we never see the impact it may have on that person, we are planting seeds with each interaction.

I've also been learning to spread my focus to more than just the patients. Our ministry is not limited to only that. Each day I have the opportunity to reach out to the caregiver under my patient's bed, the day worker translating for me, the galley worker who made my dinner, my roommate who is having a rough day and the lady on the street who no one sees. What a privilege to be the hands and feet of Jesus to these children of God...if only I would take the focus off myself for a few moments.

One of the hardest adjustments to make in this place is people coming and going all the time. I was warned of this from the very beginning, but that awareness doesn't make it any easier. We have crew on the ship anywhere from 2 weeks to 20 years. There's an average of 20 or so new people who come every week - that also means 20 or so people leave every week! It's very difficult to find the balance between my need for relationship and having strong friendships, but also being open to meeting new crew and getting to know them even for just a short time. The key is realization that short term people are an important and valuable part of this work. Not only could we not do the things we do without all these crew members, they also bring a freshness and excitement to this place. Even just in a few months here, it's easy to become jaded and forget the beauty of the miracles that happen daily in this place. But new crew bring fresh eyes to see them again and reminders of the way it felt when you first experienced these things as well. Basically, it's worth it and I need to recognize that DAILY!

I could go on and on with the lessons I've learned through this time, but I'm sure you have important things to do and don't want to read this blog all day :) The last lesson I'll leave you with is this: Rest is OK! I know this one applies to everyone out there no matter where you live or what 'your job' is right now. We have this impression that we're going to miss out if we don't rush through life and fill our days with every opportunity that comes along. That's especially tempting here in Madagascar where there are always places to go, people to see and work to be done. I'll let you in on a little secret: the work will never end and the things to do will still be there tomorrow! But you will be better able to handle those things if you rest properly. Even God rested after He created the world and commanded us to Honor the Sabbath (a whole day every week!).

Going back to my earlier analogy - life is not a sprint, it's a marathon. There will be times that we're staring up at a hill not sure if our legs will carry us anymore; it's then that we must focus on the finish line and reason we are running at all.
Thanks for letting me share my heart and still loving me through my brokenness <3 p="">

That time I bored you to death rambling on about global surgery...azafady!

For my first post of 2016, I thought I’d dive head first into a topic that has weighed heavily on my heart since starting my work with Mercy Ships – surgery and its effect on Global Health. I’ll start by saying that this is a huge, deep subject which I will only touch the surface of so I understand if I lose some of you along the way. I will not be offended at all but I urge you to keep reading as it’s something I believe will help you understand Mercy Ships better and make you love this organization as much as I do :)

As most of you know, Mercy Ships primary focus is surgery and the Africa Mercy is a surgical focused hospital ship. Half of our hospital is operating rooms and the rest is made up of wards meant to care for patients pre and post-operatively. This means we can only treat about 10 or so types of diseases (which effect a huge portion of the population, but I’ll get to that later!). I’ve heard many who question our focus, myself included. Why limit ourselves to such a specific target when people are dying every day of all kinds of other diseases? This especially comes up in our screening process where hundreds of sick and injured people might show up to be turned away because they don’t fit our surgical scope. As hard as it is to see suffering and not be able to help, I’ve had to come to terms with two reasons why it must be this way.

Number 1: One of the core values of Mercy Ships is “to be people of excellence in all we say and do”. One way we live this out is that our leadership and assessment teams have chosen to focus on a few things and do them REALLY well. By choosing a small amount of diseases to treat, our surgeons can excel in those specific techniques and our hospital can ensure that each patient gets the best care possible. Basically, the easiest way I can explain it is that you have to choose between doing a little good for a lot of people or doing a lot of good for fewer people…but don’t get me wrong, it’s still a lot of people (we have yet to run out of patients that need what we can provide!).

Number 2: A focus on surgery can change a country in bigger ways than just the people who receive treatment. Over the past five months, I’ve heard at least 3-4 presentations about how surgery will be the key to the future of global health. Now, I understand we might be slightly biased because surgery is the focus of our organization ;) However, the rest of the world is starting to agree with us! It all started last year when the Lancet, the leading medical journal in the UK, published a group of articles called the Commission on Global Surgery. It was a huge study with huge results, basically summarized by this video:

See, surgery really is important! Dr. Mark Shrime, a surgeon from Harvard School of Medicine who comes to serve on Mercy Ships several times a year, wrote an article about this for the New York Times a few months ago. He also gave a presentation on it during his last visit here and that became one of the reasons I feel so strongly about this subject today. The whole article can be found here: http://www.nytimes.com/2015/09/26/opinion/how-surgery-can-fight-global-poverty.html?_r=0. I highly encourage you to read it. It’s not very long and he hits on a few really important ideas way better than I can. Here’s a couple of my favorite quotes:

“Despite the fact that nearly one-third of human disease is amenable to surgery, it remains overlooked in much of the world…To put this in perspective, H.I.V., tuberculosis and malaria — which have captured the global conversation — currently make up less than one-tenth of the global disease burden, combined.” 

“Moreover, reliable surgical infrastructure strengthens entire health systems. It is not enough to prevent maternal deaths during childbirth if a health care system cannot care for the children after birth. It is not enough to treat tuberculosis successfully if the patient then dies from a perforated appendix. Surgical scale-up is not and has never been envisioned to exclude other global health priorities — surgery is necessary to meet all global health priorities.” 

“For developing nations, it (surgery) is an economic issue. For the world, it is a moral issue, a question of equity. Surgery has been called the “neglected stepchild of global public health.” To achieve the recently approved global development goals, world leaders must explicitly develop systems to bring access to safe, affordable and timely surgery to those who need it.”

Do you want to know what the best part is? Mercy Ships has been doing this for almost 40 years and is pioneering the way to meet these global goals! Even better, we have an entire department committed to training and building up the capacity of the healthcare in the countries we visit so we can leave a lasting impact that reaches beyond the people who receive surgery in our hospital. As much as I love working in our hospital and caring for each patient who comes through our doors, I realize that this is only a small part of the mission of Mercy Ships. We are only in each country for a few months and can only treat a small portion of the population; but when we train surgeons, nurses and anesthesiologists or repair broken and abandoned operating rooms (just a few of the many projects our ‘off-ships’ team is working on) we are leaving things that will continue to make a difference for years to come.

All this can be summarized by one of my favorite quotes from our Chief Medical Officer, Dr. Gary Parker, “We cannot change the whole world, but we can change the whole world for one person”.

There is so much need in the world and it’s easy to get discouraged by all that we cannot help, but when I look at each patient we get the privilege to care for or the surgeons who are learning new ways to help their own people, I see that it’s worth it to change the world for that person!

Finally, you might be wondering why I’m bringing this up right now (besides the fact that I’ve been meaning to write about this for months). Well, so sorry (or azafady as they say here in Madagascar), but that reason will have to wait for next time – and it’s a really exciting reason so check back soon!!

Merry and Bright 2015 - Christmas on the Africa Mercy

Christmas is a BIG deal here on the Africa Mercy. I believe it serves two purposes. First, it keeps us too busy and distracted to be homesick. Second, they try to cover most Christmas traditions, even from different countries, so everyone feels included. There’s an event happening nearly every day of December! I’m pretty sure it would be almost impossible to be a part of every event – but what’s great about it is even if you miss a few (like for work shifts) there will be something else to make up for it later. The variety is amazing and each event becomes its own special AFM tradition. I picked a few to highlight so you could get a glimpse of what celebrating the birth of Jesus looks like on a ship in Africa!

Deck the Halls – the weekend after Thanksgiving, a large group gets together to decorate pretty much the whole ship! There are lots of Christmas trees, lights, garland and decorations to go around transforming this place in just a few hours. I wasn’t able to participate because I was working but it was fun to see all the boxes coming out as they prepared. Just like at home, there’s a special magical feeling once things are decorated and the season can officially begin!

Door Decorating Contest - To add a little cheer to the rest of the ship, many people decorate the doors of their cabins or offices. It became such a thing that they started making it into a competition and there were some really amazing contenders this year. I helped design and build the door of our ward at work. We were taking care of orthopedic patients so we wanted the theme to include something along those lines :) Even though our door didn't win, it was fun to see all of the creative decorating ideas and it made the ship so festive!

Cookie Bake – We have an amazing social activities coordinator (KJ) who puts together all the Christmas season events (and pretty much all the activities on the ship the rest of the year as well)! This is a huge job, which she does very well; however it’s way too much for one person. So each event has volunteers who help coordinate things. I volunteered with my friend Kathy to run the Christmas Cookie bake! Trying to get all the pieces together in the days before was a bit nerve wracking but we had some great helpers who made a huge difference. We couldn’t have done it without them! It turned out to be tons of fun and people seemed to really enjoy themselves.

Christmas Concert – One of my favorite parts of ship life is living in community with families. Some jobs require a commitment of several years and a whole family will move together to fulfill these needs. There’s an academy onboard the ship and they do all they can to make life as ‘normal’ as possible for the kids. Several of the Christmas activities have special parts just for them. One evening there was a Christmas concert with choirs (adult and children), instrumental pieces, and special music. Felt just like something I might go to at church back home!

Winter Wonderland – One of the most anticipated events of the year is Winter Wonderland. Imagine a Christmas craft fair and a bake sale combined with an African twist and that’s pretty much what Winter Wonderland is! I was working again for this one, but I did stop by for a few minutes to get some delicious treats and beautiful Africa ornaments. 

Gingerbread House Contest – I was not able to participate in this one but I did see the final products (and tasted some of the losers). Teams signed up to decorate a house out of REAL gingerbread pieces and the top 3 favorites were chosen to display. It’s hard to see in the picture but 1^st place was a Cabin in the Woods, 2^nd place was Malagasy Christmas and 3^rd was Wizard of Oz Christmas (complete with wicked witch crushed under the house!).

Advent Services – I never knew what advent was growing up as it was not something our family or church mentioned very much. As I’ve gotten older, I love the idea of spending the month of December in ‘expectation’ of Christ’s birth and it seems much more meaningful that just celebrating one day. I like to imagine that it helps to take the focus of all the ‘Christmas stuff’ and put it back on Jesus and what the season is really about. This year, the focus of our advent was God: the Giver of Good Gifts. Each Sunday we’ve been talking about a new gift that God has given to us including Power, Peace, Purpose, Provision, and Promise.

Carols by Candlelight - Another one of the most anticipated AFM traditions is Carols by candlelight. Many churches have some sort of candle light service usually on Christmas Eve, but this one was more unique than any I've seen before. Usually, it is held on the dock outside the ship. Rain forced us into our warehouse instead. Lots of people came, including the few patients who are left in the hospital over Christmas. This year, it was put together by our Australian crew who added a lot of fun and Southern Hemisphere Christmas humor (including an appearance by the AFM Wiggles!).

Christmas Shoes - One of my personal favorite events new to me this year was Christmas shoe gifts. On Christmas Eve night, everyone leaves a shoe outside their cabin door and then goes around in the night to pass out gifts! We don't have access to a lot of 'stuff' here so this tradition focuses on small or handmade gifts that may not be worth much but mean a lot to receive. I didn't think much of this one until I was actually a part of it. As I went around passing out gifts, there's such a fun atmosphere around the ship. Families, couples, groups of friends all spreading love, cheer and surprises to wake up for on Christmas morning! 

Coffee and Pastries/Christmas Brunch - And finally, on Christmas morning, I had the pleasure of helping in the cafe to serve pastries and coffee while everyone waited for Christmas brunch (the most celebrated meal of the year, I'm told!). It was so fun to wake up early and greet everyone Merry Christmas! There were children in pajamas, friends opening presents together and the beauty of community far from their own families but creating family together.

Guys, that's not even all the events that happened. I figured that was long enough though! I wish I could say Merry Christmas to each of you in person but if I cannot be home, there is no place I would rather be than living in this amazing community with friends I've grown to love. That baby born in Bethlehem was the first "missionary" who left his home in heaven, and I am honored to continue that tradition serving in Madagascar! And as a final surprise, here's a quick video I made as an update to my church in Florida. Hope you enjoy! 

Kairos

Let me interrupt these fun holiday posts for just a second to talk about something that's been on my mind the past few days.
In our weekly Community Gathering on Thursday, the speaker talked about this word 'Kairos'. I don't believe I had ever heard of it before but it's an important concept that I wanted to share.

Kairos is a Greek word used many times in the Bible. It is one of the two Greek words to describe time. Most people know 'chronos' which is Greek for minutes and seconds time. Literal and straightforward passing of moments like on a clock (chronological time). Kairos, however, is very different. The Webster's dictionary definition of kairos is "right or opportune moment". In Greek, it is used to describe an opportunity, season or fitting time. Kairos is qualitative and not easily measured.

Here are some examples of Kairos in scripture:

• Be very careful, then, how you live—not as unwise but as wise, making the most of every opportunity (kairos), because the days are evil. Ephesians 5:15-16
• Let us not become weary in doing good, for at the proper time (kairos) we will reap a harvest if we do not give up. Therefore, as we have opportunity (kairos), let us do good to all people, especially to those who belong to the family of believers. Galatians 6:9-10
• And who knows but that you have come to your royal position for such a time (kairos) as this? Esther 4:14

On his blog, Pastor J.R. Briggs puts it like this:

"Kairos is pregnant time, the time of possibility – moments in our day, our week, our month, our year or our lifetime that define us. It is a crossroads. It has the ripe opportunity to make you bitter or better. It is a teachable moment. It is the right or opportune moment. They are rarely neutral and always leave an impact on us."

So what does this have to do with Mercy Ships? I wish I could explain it better but I'm not that great with words. Basically, there are a lot of really big things happening with Mercy Ships right now. Most of them involve the building of a brand new ship specifically made for our purposes (instead of remodeled into a hospital like the current ship) and the capacity in the next few years to have 2 ships operating to reach many more people than currently possible! We also have a prime position in the future of global health because providing safe surgery is becoming a huge goal for many developing countries.

But of none of these things would be possible without God who shows Himself to us in so many miraculous ways each day! The right people, the right places, the right time...there's a million little stories of things that many would call "coincidences" but I would prefer to call them God's kairos moments.

I love how Briggs said in the above quote "pregnant time" because that feels so true. There's this sense of expectation all around. Like we've been waiting nine months for a baby to be born and the time is coming near. Every update on the new ship, media story or financial partner feels like one step closer to the kairos God has in store for Mercy Ships - and it's the coolest feeling to be a part of right now!

And it feels extra special during this season of Advent - waiting for the Christ child who came at a kairos time in history over 2000 years ago. The world did not know a baby would be the way to salvation. But God knew. Mary did not know that the little boy she carried would be crucified and resurrected to redeem a sinful world. But God knew. The shepherds did not know the infant they worshiped that glorious night would one day return to fulfill the longing and waiting of all these years. But God knew.

My prayer is that this Christmas season, as we look expectantly toward that baby and all that his birth represents, that we would trust God's kairos time. May we lay all our questions and fears and insecurities about the future down at that tiny manger and believe that He knows. And may we look for the kairos moments in our lives each day...moments that define us and leave an impact on the world around us.

Thanksgiving AFM Style

One of the most common sayings on the ship is "It's not wrong, just different" and I have decided this is going to be my motto for dealing with the holiday season far away from home. First up this week, was (American) Thanksgiving Day!

Back in October, the ship had a 'Friendsgiving' to celebrate all the countries Thanksgivings together. The idea was to not show preference to one country's holidays since it would be impossible to celebrate all the holidays of every country represented onboard. While we were sad at first, those of us from the United States decided to have our own Thanksgiving instead. We planned a little get together/potluck and gave into the idea that we wouldn't have Turkey...except that we did end up having turkey for dinner and it turned into a multi-national everyone eat all the food event! In the end, it was a great day spent with lots of friends cooking and having a delicious meal and stuffing ourselves until we couldn't get off the couch. Here's some of the highlights:

A few nurse friends and I after our trip to the local grocery to buy the ingredients we needed. There is a small shop on the ship where we can buy some basic foods and snacks, but anything more than that we have to get from one of the 2 shops in town (it's a very interesting experience!). Notice the large "pumpkin" Anne is holding on the left. We aren't really sure what it actually is but it worked very well for pumpkin pie and sweet potato casserole! 

Here I am picking out all the seeds from the pumpkin. I just couldn't have a pumpkin and not roast the seeds! They came out delicious and were a lovely fall treat. We needed something to do while we waiting for the pumpkin to roast...

Here's is one portion of the food assortment we ended up with. These tables kept getting fuller and fuller with all kinds of amazing treats - all homemade with ingredients found in town! We sure do have a talented and creative bunch of crew members :) Some of the highlights included several pumpkin and apple pies, a pumpkin cake roll, pecan pie, corn casserole, mashed potatoes, baked brie and (my 'unbiased' favorite) sweet potato casserole!

And finally, a group picture - there was about triple this many people in total. The rest are in another section watching a rerun of last year's Macy's Thanksgiving Day Parade!

I'll leave you with a short list of what I thankful for this Thanksgiving:
Health and healthcare when I need it
Family and friends (new and old)
Mercy Ships and the opportunity to live and work on this ship
The beautiful people of Madagascar who have welcomed us to their country and entrusted us with their healing
Surgeons, anesthesiologists, nurses, lab techs, pharmacists, radiologists and so many others who are giving their time to take care of our patients
The rest of the crew who tirelessly work to keep the ship running and never complain about being out of the hospital 'spotlight'
So many legs healing straighter on A ward (and all the other incredible patients too!)
A sweet, beautiful, healthy new niece back home
Fast internet and Skype that allows me to see her and talk to the rest of my family pretty much anytime
God- for His love and provision of all things
For amazing donors and supporters (like YOU!) who allow me to be here witnessing all these awesome things. Thank you!

Healing bones, healing hearts, healing futures

Two work posts in a row! Whoa, watch out!

I know I haven't written much about the details of what I do at work. But I really wanted to share some new things that are happening so all of you out there can be praying for some very special patients that will walk through our doors soon. 

Up to this point in the field service, I have been primarily working with plastic/reconstructive surgery patients and a few general surgeries. It has been lots of fun to see the transformation in each patient and I've learned so much! However, next week we will change our focus to orthopedic surgery. I've been looking forward to this for a while after hearing other nurses talk about how exciting it is to care for these patients and see the dramatic results, and I'm so happy they will be coming to A Ward where I work! We will see all kinds of orthopedic problems such as club feet and bowed legs. 

Here are a few of the incredible patients from last year: 

Even more exciting, I had the opportunity this week to take part in Orthopedics Evaluation Day. We invited each of the patients from last year to come back to see how they are getting along. My job was to ask a list of questions about if they are happy with their results and the difference it's made in their daily life. They also met with physical therapy and the Orthopedic surgeon to make sure they were healing properly.

Many of the patients seen in the video came back to visit and you would hardly know they just had major surgery about 1 year ago. They were running around playing, riding toy cars and getting into trouble just like any small child should. In talking with the parents, so many were overjoyed with the difference these surgeries have made in their children's lives. They could not say thank you enough and were excited to tell how their child can go to school and play with the other kids instead of feeling left out or unable to keep up. 

Taking part in this follow up day only increased my excitement for the new patients coming next week! Each of them is loved and important and deserves to live their life free from the shame and disability that these conditions bring.

Just a little bone humor for you :)

Orthopedics prayer requests:

~ Minimal pain after surgery

~ Bones to heal quick and strong

~ Patience and distraction for many small children who will be on bedrest and with limited mobility for some time

~ No infections post-op (a bone infection can be a death sentence in a place where there is no long term treatments available

~ Good rehab (can take months of frequent physical therapy to recover function)

~ (and a personal request) Confidence as I transition into being a charge nurse...when I feel like I don't know enough to answer all the questions yet!