‘Twas the Night Before Christmas…on the AFM

 

‘Twas the night before Christmas and all through the ship,

Not a patient was stirring, no pallets or lips.

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The IVs were hung from the ceiling with care,

In hopes Dr. Gary would soon be there.

The children were nestled all snug in their beds,

While visions of straight legs danced in their heads.

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Leeanne in her ‘kerchief, John in his cap,

Had settled their brains for a long sailors nap.

When out on the dock there arose such a clatter,

I sprang from my bunk To see what was the matter.

Away to my porthole I flew like a flash,

Tore open the curtains, threw up the sash.

The moon on the crest of the ocean below,

Gave a luster of midday to the pollution that glows.

rover

When what to my wondering eyes was in view,

But a flying Land Rover and eight tiny crew.

With a driver so yovo, so southern and quick,

I knew in a moment it was Reverend Nick.

Senior Chaplain Nick Cash leads worship on the bow of the Africa Mercy.

More rapid than zemis his small crew they came,

He whistled and shouted and called them by name,

“Now Eli, now Caroline now Abby and Emma .

On Lucas on Zaiden, on Jack and Hannah.

To the top of the deck, the top of the funnel,

Now dash, away dash away, dash away all.”

As the fronds that before the wild cyclone did fly,

When they meet with an obstacle, mount to the sky.

The Africa Mercy during sail from Durban, South Africa to Cotonnou, Benin

So up to deck eight the courses they flew,

With a Rover full of mangos and Reverend Nick too.

And then, in a twinkling, I heard up above,

The screeching chatter of children we love.

Down the red stairs and turning around,

Into reception Nick came with a bound.

He was dressed in blue scrubs from head to his toe,

Gave a nod to Jacqui who said, “Mikwabo.”

COM389 Jacqui Saward (AUS) Receptionist at work on the Africa Mercy.

A bundle of toys he had on his back,

He headed to the wards to unload the sack

He spoke not from the Word but went straight to his work,

He filled the children’s shoes then turned with a jerk.

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Then laying a hand on the side of his belly,

Up the elevater he rose in a hurry.

Quick to his Rover, to his crew gave a tug,

I think they all caught a GI bug.

I heard him exclaim as he drove out of sight,

Not, “Happy Christmas to all and to all a good night.”

But an important phrase we should all keep in mind,

“Use hand sanitizer, so you don’t all die!!!”

 

The Africa Mercy during sail from Durban, South Africa to Cotonnou, Benin

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8 by Friday

Faith is an interesting thing, prayer even stranger.  To think that I can intercede on the behalf of another person to the almighty God for healing and not only believe it will have an effect but wait in anticipation for the results is nothing short of mind blowing.

There was recently a patient on the ward who underwent a total thyroidectomy back in February.  Unfortunately, in the process her parathyroid gland was disturbed and stopped functioning properly.  Why is this important?  The parathyroid is responsible for controlling calcium in the body.  Calcium is necessary for nerve communication and muscle contraction.

Photo Credit Justine Forrest, Dr AJ Collins (AUS) General Surgeon and Dr Shehnarz Salindera (AUS) General Surgeon PAT16147 Hanta

Photo Credit Justine Forrest, Dr AJ Collins (AUS) General Surgeon and Dr Shehnarz Salindera (AUS) General Surgeon 

This patient, Gloria*, was receiving copious amounts of IV calcium as well as oral and still she was symptomatic with labs well under the normal range (8.4-10.2 mg/dL).  Week after week she continued on the medication without seeing any results.  It was to the point that, in my opinion, all medical options were exhausted and still no improvement.

One Saturday evening I was praying for Gloria and I felt the Lord say “8 by Friday.”  If this was her calcium it was a great deal above what she had been running and frankly seemed impossible but who am I to argue with the Great Physician.  The following Monday the general surgery team leader informed me that the goal for this patient was to have her calcium reach 8 mg/dL by Friday.  I just nodded and said, “Yeah, I think it will be.”  Little did she know the confidence in which I was making this statement.

As the week progressed Gloria’s calcium was steadily increasing as her dose was also increasing.  By Thursday she reached 8.4 mg/dL.  We were all in awe.  Friday morning I eagerly awaited her result.  It was exactly 8.0.  I almost started crying.  However, in the days that followed her medication was weaned back resulting in her levels once again dropping.  Many people onboard were discouraged and doubted if she would ever be healed.  Gloria herself started doubting.  Sure, she was 8 by Friday but she was also on a mega-dose of calcium so those levels weren’t necessarily a reflection of her true condition.  For me though, it didn’t matter how she got there, God was saying “I’m still in control.”

Weeks went by and still no improvement.  “God, where are you?”  One night I was reading my Bible and came across this verse in the book of Habakkuk

LORD, I have heard of your fame; I stand in awe of your deeds, LORD. Repeat them in our day, in our time make them known; in wrath remember mercy.

Habakkuk 3:2

I heard God once again speaking to me, this time simply saying “I will heal her.”  I was overwhelmed and convinced that this would be my declaration the day Gloria was healed – I would stand in awe of the Lord’s deeds!  I have seen that God works on his own time table in his own ways and who am I to doubt or question.  The only thing I can do is pray and have faith in his Word and his promises.

Fast forward of few weeks and Gloria’s levels are once again rising.  This time her dose was either remaining the same or steadily decreasing.  She was taken off IV calcium and still her levels remained in range.  Her oral dose was decreased and still she was on target.  Last week Gloria was discharged.  The day before she was sent home there was a party on the ward for her.  Our physician who has been managing Gloria’s care for the last 4 months walked over to her and put her arm around her – Gloria had tears running down her cheeks.  I’m sure she thought the day would never come.  There were a lot of people on the ship who thought the day would never come, myself included.

Photo Credit Catrice Wulf - Ward nurse Maria Geary (USA) cares for patient

Photo Credit Catrice Wulf – Ward nurse Maria Geary (USA) cares for patient

Gloria is not totally off medication but she is now on a much more manageable, oral dose with continued improvement.  I know God is not done.  I know he will heal her fully.  I know that he does things for his purpose and his time so he receives the glory.

On the day she was discharged a friend of mine and nurse on the ward was excitedly saying she too was amazed that Gloria has finally been discharged and said “Doesn’t it make you want to say ‘Go team.’”  I looked at her and said “No, it makes me want to say, ‘Go God.’”

We had nothing to do with her healing and I fully believe that.

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*The patient’s name in this post has been changed to protect confidentiality of the individual.

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the hiding culprit

Growing up I was a champion hide-and-seek player.  Maybe it was because I was small and could fit into small spaces.  Maybe it was because I had more patience than others.  Often, it was just because I knew where to look.  Lately, this skill has come in useful in the lab onboard the Africa Mercy.

Sometimes a patient will come in and you have no idea what is wrong with them.  The labs don’t make sense, the symptoms don’t make sense and unfortunately we don’t all have House, MD showing up with the answers.

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Eventually it clicks – a parasite is found and it all makes sense.  Maybe in Africa this should be my first thought and it certainly is now.  I am seeing things on a daily basis that I only ever saw in textbooks or on “teaching slides” when learning how to identify certain organisms.

Now that we are suspecting parasites the reverse happens as well.  The doctors, nurses and I in the lab will have a pretty good idea of what is going on with a patient but we cannot prove it.  Enlarged spleen, grossly anemic, low platelets, no other explanation – “I bet it is Schistosomiasis” – a disease caused by parasites in the genus Schistosoma.  S. mansoni has been the most common here in Madagascar. 

Schistosoma mansoni

Schistosoma mansoni

But if that is the case than why won’t the little bugger show itself.

It becomes a game of hide-and-seek and I am not a very good looser. The game has multiple players.  Sometimes I’ll find Schisto’s friends…

Ascaris lumbricoides (roundworm) and Trichuris trichiura (whipworm)

Trichuris trichiura (whipworm) and Ascaris lumbricoides (roundworm)

Necator americanus (hookworm)

Necator americanus (hookworm)

but I know they aren’t really the culprit.  Schisto is still hiding and I will not be defeated.  I continue to scan, make concentrations and scan some more.  I use an iodine stain to make things more visible.

Sure it takes a couple hours to do a full ova and parasite workup on a patient (I’ll let your imagination fill in the specifics of where the specimen is coming from) but I love every minute of it.  Finally there it is, Schistosoma mansoni, sometimes by itself and sometimes among friends.

Schistosoma mansoni and Ascaris lumbricoides

Schistosoma mansoni and Ascaris lumbricoides

There is something so satisfying in finally finding the parasite after scanning multiple slides for an hour.  It validates not only my time but my knowledge as a lab tech.

Victory!

On top of the personal victory in hunting down the darn thing there is victory for the patient who can now receive proper treatment.  According to the CDC, Schistosomasis affects more than 200 million people worldwide and is one of the world’s Neglected Tropical Diseases (NTD).

NTDs are a group of infectious diseases that are the source of tremendous suffering because of their disfiguring, debilitating, and sometimes deadly impact. They are called neglected because they have been largely wiped out in the more developed parts of the world and persist only in the poorest, most marginalized communities and conflict areas – CDC

In finding the parasite (and friends) we can then accurately treat the disease and help bring healing to the patient beyond their surgery.  Mercy Ship’s mission is to “bring hope and healing to the world’s forgotten poor.”  This is healing in every aspect of life – spiritually, mentally and physically.  I am so thankful I can be a part of this healing process.

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