Screening Day!

Monday was one of the biggest days of our outreach, screening day! This is the day we have been preparing for throughout the past week. For several on the ship they have been preparing for weeks, and the advance team had been preparing for almost 6 months! The plans were in place, the procedures written, and the word had been spread throughout Guinea that we were here to serve their people. The line began forming on Sunday evening, and many waited all night in the heat and rain for a chance to have their life changed. Many volunteers patrolled the lines all night, passing out water and food to those who were waiting with the hope that we could help them. I cannot even begin to imagine standing in the rain throughout the night to receive desperately needed medical care for myself, my child, or my loved one. I am an impatient American- just waiting in line at the DMV, or waiting for my morning cup of coffee tests my patience. Never in my life have I had to wait for years to have a chance to see a doctor. Actually I honestly don’t think that I have ever had to wait more than a day to be seen. Here in Guinea, before the sun had even risen, I was already deep in reflection for the privileged life that we live in the US. 

We left the ship at 5:30am in a caravan of Mercy Ship Land Rovers, driving through the city before it had began to wake. It honestly felt like we needed a soundtrack to our day. I’m not sure what song would have played, but definitely something inspirational, building in gusto as we entered the “compound” our security staff had created. It was very organized, we felt like precious cargo being transported under the cover of night. Even driving through the gates, we could see the long line that had formed, and then quick, the gate snapped behind us. We entered the building using our headlamps and  flashlights, very secret mission-ish. The day was already filled with overwhelming moments, before the sun was even up, realizing the task that faced us. After meeting with our translators, the day began as soon as we had the sun’s light to see our patients and read the paperwork. Praying before hand was beautiful, it is encouraged that we pray in our own languages here. So there we stood, about 20 nurses and 20 translators praying in several languages but all to the same loving, caring, amazing God.

The progression of the day went like this: After waiting in line for hours, they were seen by a “pre-screener” before being allowed to enter the building. This role was filled with nurses who knew the specific criteria we had based on the surgeons available. They have the hard job of saying, “I’m sorry, but we cannot help you” to so many people who come for medicines. Medicines for cholera, high blood pressure, body aches, head aches, or infections. Because we are a surgically based hospital, we simply do not have the resources to help all those that we would like to. I am so very glad that I did not have this job. My heart would have been so overwhelmed, and it breaks just talking to some of my friends who had that task. After being allowed in, they sat with “registration” and were give 2 pieces of paper for the day labeled with their name, contact information, languages spoken, and a number. They then came to the “histories” station where I was serving. It was here that they sat, patiently waiting. They moved down in chairs one by one, snaking their way to the front. After reaching the final chair, many celebrated. I have never seen so many people excited to step on a scale. They were thrilled, because after moving through more than 50 chairs, they took off their shoes, they got their weight on the paper, and then they were able to come and talk to one of us! We did a set of vitals, asked a series of questions regarding their medical conditions, and their reason for coming in. For some it was a very visible problem, for others it wasn’t until the lifted up their long robes that their deformity or tumor was visible. It was here that I sat for 8 hours. I learned after the 3rd patient, that EVERY SINGLE person here has had malaria. After that I started phrasing my question not “have you had malaria?”, but “WHEN was the last time you had malaria?”. For many they said “always”, or “two weeks ago” rarely did I hear a time more than a month prior. It was here that I saw blood pressures well over 200 consistently for adults and only once found a patient on medication to control it. This is their normal-- so so far from what I am used to! I saw people literally starving and dehydrated because their tumor does not allow them to eat or drink. I saw a child who could barely swallow with an oral tumor that had only been growing for 2 months--another 2 weeks and I guarantee this toddler would not have survived. I talked with a mother of a little girl who literally has 6-10 seizures a day in addition to her cleft palate, unable to obtain medications to slow or stop them. I saw grown adults with cleft lips- something unheard of in the states where surgeries begin weeks or months after birth to correct this birth defect. I can honestly say that I have never physically seen an infant with a cleft lip. Each and every one of them were BEAUTIFUL. When they smiled their little split lip just touched my heart. And their mommas, what beautiful women who came bringing their babies and children to be cured and spared from a lifetime of ridicule. The patience and determination that it takes to feed these little ones is insane. Because they are not able to breastfeed due to the inability to create a suction, they must be spoon fed almost constantly to provide for the caloric need. We saw goiters the size of soccer balls, facial tumors the size of softballs and limbs unable to be used to to burn contractures. I talked to a patient with such limb complications that she could not physically sit down. I saw such severe bow legs that their gait was twice the size of normal. Once they release photographs from the day, I can share with you all so that you can visualize the people who will forever be engraved on my heart. 

I saw countless men, women, and children who were desperate. Desperate to be helped, desperate to be seen as a human being with worth, and desperate to be looked at in the eye despite their disfigurements. I had many wonderful translators, and for many of them it was overwhelming as well. Some said that they did not know there were this many people in their country needing medical help. These people are usually hidden, afraid to be out with everyone else for fear of harsh words, looks, and the reminder that many believe them to be cursed. I saw many people talking as they waited. Mommas of children with similar conditions chattering away, people who had come in with their tumors covered, began taking off the coverings as if proudly saying “at last I am around people where I belong”. We saw people sitting with people of similar conditions. Adults uncovering their cleft lips for each other. I was talking with friends later, and we discussed what it must have felt like. Remember with me for a minute a moment in your life when you were vulnerable to those around you. It was uncomfortable, but you did it--and then you found out so many other people around you had the same thought, struggle, or feeling. How freeing it was to be able to SHARE your load with someone. To feel KNOWN at your core of being, to be ACCEPTED.  For them to see that they are not the product of a “curse”, but that there are people who WILL care for them. I believe that even as emotional of a day it was for me, that the feelings I experienced were merely a fraction of what some of them felt on Monday. 

After they left my station they were sent to the specialties where the surgeon examined them and they were given a physical to determine whether they were surgical candidates. Once the surgeon saw them, they had a few different courses. What a mix of emotions for each station!

--Some were sent directly to schedule their surgery and were given a patient card which allows them access to our hospital ship. Celebration! We are going to help them and change their lives! Their date was determined based on their condition. For those with life threatening conditions, they will begin coming today to be admitted and have surgery. For others, the date of their surgery is a few months from now. Ohh the joy we feel and the anticipation to see them again! To have them here with us, and the learn about their lives, hear their stories, and to see so many spirits transform- both ours and theirs! I cannot wait....

-- Some were sent to schedule CT scans, X-rays, or Labs to determine our ability to help them. We are hopeful that we CAN help them....prayers that their tests have this outcome. 

--Unfortunately we cannot help every single person here in Guinea. This is what breaks my heart, that even though we are doing so much good that we have to tell people that we can not help them.  Many are sent to the palliative care team to help them live out the remainder of their days with dignity and respect with the best care they could possibly have. This is the part of any job that is hard. To have a desire in your heart to help, and to be unable to. This is the part where you can get stuck. We can question what we are doing here, why does this have to be the reality for so many people, and why can we not fix every single problem. But we must remember that we live in a broken world. That we are not God, and that his heart aches MORE for his children. That though we are unable to help every single person in our path, that we are able to change the future for so many. That I will be a part in changing the path for some, and that MY life with be changed by having a part in this story. 

As of now, here are the numbers that have been released. 4,500 people came to the screening on Monday. 3,500 of them were patients. Almost 2,000 of them entered the long process I described, and without further testing about 850 surgeries were scheduled for our 10 month outreach. Hundreds will be coming for further testing, and we are leaving space for those who will show up on the dock and those we will find on our adventures inland. 

As this outreach officially begins today I ask for your prayers. Prayers that surgeries are completed safely and accurately. Prayer for us taking care of them after their surgery and their recovery, prayer for their spirits as their lives change aboard this big white ship. Prayer that I can figure out how to be a pediatric nurse, and prayer that my heart is soft. Prayer that I do not become overwhelmed, but inspired and changed.  I know that my story is just beginning here, and I pray that I can reflect in the moments ahead and give praise for all that is happening around me, in me, and through me. 

One last fun fact for the day. I saw on one of of scrolling TV’s in the dining galley that there are 32 nationalities represented by the crew this week- How amazing! 

I hope this post finds you all well today, and that I was able to describe for you what is happening in this journey.  I hope that you can take a minute in your busy lives to think of us in West Africa, and to know how much I appreciate your support. I am so thankful--Grace and Peace