When You Can't Trace His Hand

At home back at Phoenix Children’s Hospital, every day I dealt with kids that died. I remember the day my first patient died after transplant and I went home and just sobbed, despite the fact that I barely knew her. But in time, with each passing death I encountered, I became somewhat immune. My heart couldn’t handle all the grief and I somehow began to block out the emotion after I’d seen so many children die.

So when I signed up to work with an organization that brings hope and healing to the forgotten poor, I wasn’t expecting a lot of death here onboard the Africa Mercy. More than that, I wasn’t expecting to get attached. Most patients that come through the ward on Mercy Ships come in and out in a matter of weeks. But Anicette and her reluctant little body just didn’t want to gain weight, and she was here for months in the infant feeding program last year. She was loved by everyone and we all got to celebrate in her achievements together. You can read about her in my previous blog post here. After many months of slow growth, she finally had her surgery to repair her cleft lip in November. Here she is just a few days before surgery - a chunky monkey!  We got to see her Mama care for and love this child so much. Anicette was transitioning off her specialized formula and doing great, so she was sent on her way, with the hope to return in 2010 for cleft palate surgery.

So it was quite the shock when she returned to us on Friday from Benin, emaciated beyond imagine and barely recognizable. As I picked her little body up I wanted to cry. I told her mama Zenabou that she did well for bringing her back to us. I hoped with all my heart that we could get her back to what she was when she left us in November.  Clearly there was something very wrong with her little body and its inability to digest nutrients, as she’d been throwing up and having diarrhea for weeks. I hoped we would have the capability to send away for specialized tests to work up whatever metabolic issue it was. I hoped to make a case to the formula company for her incredibly expensive specialized formula that worked previously onboard– a hope that she could get the formula for years to come if needed. Perhaps a large feat for a child living in Africa, but nothing is impossible with God.

But I didn’t get that chance. Yesterday, the overhead pager went off “Emergency Medical Team to A Ward” and my heart sank. I thought “please God we have a full code palliative care patient on A ward. Don’t let it be Anicette.”

But this little bundle of love went to be with Jesus yesterday. Her frail body couldn’t take it anymore when her airway became compromised and she was too weak to fight. I watched her mama Zenabou with wailing sobs as the nurse took her away from the commotion of trying to resuscitate her, and my heart broke.

As the doctor onboard said yesterday, while God didn’t intend for this, he did allow it. Our goal isn’t always to heal people. Sometimes it is to make the effort to help them in the best way we know how. Sometimes that results in death and sometimes in new life.

When Anicette died yesterday, Zenabou explained that Ani was her second baby she’d lost. Her other baby just couldn’t eat she said.  None of us knew she had been through this before.  Currently Zenabou is pregnant for the third time. So after asking for prayer for Anicette yesterday, today I ask for prayer for Zenabou. Pray for a miraculously healthy pregnancy. Pray that the baby in her tummy wouldn’t be born with the same problem that her other two children had. That she would be welcomed back into a village where she was previously cast out for having a child with a deformity. That despite her huge loss and grief, pray that Zenabou would feel overwhelming love and peace that surpasses all understanding.

“God is too good to be unkind. He is too wise to be mistaken. So when you can’t trace His hand, that’s when you must learn to trust His heart.”

A Prayer Request

They came to a local church in town this morning, a church known for the presence of Mercy Shippers. We are the white people with the means available to help, she said. She had heard that we were there, and although she doesn’t attend church herself, she didn’t know what else to do. So on the gangway I saw them, brought from the church to the ship. The characteristic picture of the emaciated child with the sunken in eyes, drowning in his little African outfit in his mama’s arms. She cried out in frustration when we tried to get a history of what was going on. “Nothing is working. My milk is drying up, and he is too weak to suck. He throws up what food I can give him and he can no longer walk. My husband has kicked us out because my child is cursed. I have no money to take him elsewhere. Please help me.”

There is a woman downstairs in the ward with bruises on her back; bruises from her husband who beats her and her children because she doesn’t have the means to bring in enough food for the family. She speaks to me so cautiously, and questions why I am asking about the food her malnourished child gets at home, leery of divulging too much information.

Or take Anicette, the poster child for the Mercy Ships feeding program last year in Benin. She traveled over the border with her mama this week to visit us here on the ship. It wasn’t a visit to say hello and tell us how well Ani was doing; she traveled cross country because she didn’t know what else to do. At fourteen months old, Ani has regressed to the weight of a one month old. Mom saw a picture of Anicette plump and happy on the door of the feeding program exam room, a realization of sad irony as she walks in with Ani, now skin and bones and crying in her arms.

I’ll be honest. This was a tough week. Despite all the joys that occur on board and how happy I am to be working in the ward, there are weeks like these where I just want to wrap up these families and take them home with me to the states. I want to take them to a safe place where fathers go to jail for beating their wives and where children get subsidized foods to keep them growing strong; a place where I know help is available for the long term.

 

But here in Africa that is not always the case. The sad reality is that there are only so many feeding programs in the country and more than that, when these kids are only moderately malnourished they may not even qualify for help. Sometimes I feel like my hands are tied when I’m seeing a child for malnutrition, but the only problem is they lack the finances to buy food.  If we can, we keep them here on the ship to fatten them up. Or we give them formula or money and send them on their way, hoping and praying that God will intervene for the long term. Despite the sad circumstance, I still trust that God is in control and He knows what is going on in each and every life here.

With all the resources available at home in the states, it was a lot easier to find the answers myself. But here, where the answers aren’t always obvious, I have to trust in God and have faith that God can and will provide if I ask audacious prayers beyond what I know is capable of happening. So I seek him and trust him and ask for his help every single day. Along with me, please pray for this little baby that came to the ship today with his mama that we couldn’t keep on board. Please pray that they make it to the feeding program in town and we gave them enough money to get situated there and grow. Pray for good care at the local hospital, which I’m learning, is often hard to come by. Also pray for the family with the abusive husband. Pray that this mama would be brave enough to seek help elsewhere and that these kids would gain weight while here. Finally, pray for Ani. Pray that she grows strong here on the ward as we figure out what went wrong and correct this problem now, so when the ship leaves again, she thrives.

Please also pray for me. I truly love the work that I am doing here in Africa and despite these sad events, I know that God has placed me here for a reason. I’ve invited the head of nutrition from the Ministry of Health to the ship tomorrow. I want to show him what we do onboard and collaborate with the local Togolese feeding programs already in place. So far, my contacts at UNICEF haven’t been able to offer much, so I am hoping and praying that he has something more encouraging to say. Please pray that Mercy Ships is able to help with the lack of infrastructure that exists in this regard.  As I’ve seen before, we serve a big God that can provide in really crazy ways. Give me some time, and I’ll tell you what He’s doing here in Togo with us.

“Now to him who is able to do immeasurably more than all we can ask or imagine, according to his power that is at work within us, to him be the glory.” Ephesians 3: 20-21

Home

Absence truly does make the heart grow fonder. After many weekends of Lome-filled ship life and a relatively peaceful election here in Togo, last week we were finally able to venture out of the city to see the African ways. Oh, how I've missed my African delights.

My six friends and I hopped into a taxi last Saturday morning and tried to get to the bus station. But detours and riots seemed to deter us from our portal to the north, so we found the first taxi that would fit us all, asked where they were going and hopped on for the ride. Three hours later, we arrived in Atakpame, the fifth largest city in Togo, with no rhyme or reason as to what we would do for the weekend.

Our first stop: the most expensive hotel in town. When dropping us off, the driver of our taxi assumed that because we were white we wanted to stay there! If only they knew we'd acclimated to the African standard of living.  We headed somewhere closer in town.  I've learned that the further out of the city you go,the more interesting the African observataions.  Never before have I been one of the only white people in an entire city. Here in Atakpame though, we were it. Everyone asked where we were from, and if we were in the Peace Corps.  I almost felt like we were on parade; mothers constantly waved from their windows and children pointed at us yelling "yovo yovo bonsoir!" (white person white person hello) the never ending children’s song that everyone in Africa seems to know. Oh the joys of minority living!

Here are the children carrying the yellow water canteens to the wells, happy to have clean water.

 We took a hike up to the mountaintop and came across this mural that I really liked:  knowledge is life.

After our short hike up the mountain we came back to have some traditional African food, including palm wine made from the neighboring palm leaves plus a few extra African treats you can see in our drinks 

The next morning we got up at 4:15 bright-eyed and excited for our excursion to see some hippos. Can you tell who the morning person of the group is?

We got on our zimi's and for two hours rode through the African grasslands to get to the hippos. Here is Davide leading the way.

I literally held on so tight I bruised my palm. My first zimi-ride in Africa was exhilarating. We took a break midway and our drivers informed us that before we could see the hippos, we needed to visit the chief of the village to ask for permission. So off we went to the village to meet the chief.  He was very gracious and invited us in for a nice breakfast.

Then, we were really off to see the hippos. Back on the zimi's and to the lake we went.

The first sign we were getting close.

We canoed over to see them and got relatively close. Here are me and Christina excited to finally see them after a full morning of travel!

There were a bunch in the water but just this mama hippo and her baby walking around.

It was only after our excursion that my father informed me that hippos kill more Africans than any other animal. I stumbled across this nice article on an African travel website:

"Despite being a vegetarian, the hippo is responsible for more human fatalities in Africa than any other animal, making it Africa's most dangerous beast. Hippos spend most of their day lolling about in water and can stay submerged for more than 10 minutes. If a small fishing boat or canoe filled with tourists happens to be above their heads when they come up for air, there's little to protect the vessel from capsizing. Females have been known to get extremely aggressive if they sense anyone coming in between their babies, who stay in the water while she feeds on the shore. Hippos can run at speeds of over 20 miles an hour and they have enormous jaws which host up to 20 inch canines. There's not a lot you can do if one comes straight at you."

We look so eager yet unassuming.  Sometimes ignorance is bliss =)

After our busy day with the hippos we headed back to Lome in an African style taxi, made for 14 people. However, it wouldn't be African if it had only 14 people. We had not only 21 people in there but a cat, two live chickens and a goat. No biggie though - the goat was in a bag on the roof, bleating at every passing car the whole way home.
Below, my proud African neighbor with his chicken!

No less than 24 hours later I came across this....

...so lets hope we don't get bird flu! 
Atakpame proved to be quite the memorable weekend away. It made me realize that while Africa has its oddities with its third world standards, I have joyfully come to call it home.

Just Another Stop To Get Gas

My Friday favorite this week involves a monkey - actually, two of them.  We were at the gas station and came across this monkey, fully clothed, with his son, shaking hands with everyone from the window of the car.  Only in Africa....

Friday's Favorites

I thought I would start a new blogging trend to try and post more regularly.  I'm calling it Friday's Favorites.   These are snippets of some of my favorite or most unique moments throughout the past week.  This week I have three Friday's Favorites. 

1)  I was visiting one of the kiddos on the ward today and we were playing a game with the translator.  Since I am working as an RD now I wanted to get a little perspective on the food here as that will be one of my tasks (to keep the patients happy and get them to eat).  I ask this 14 year old guy Mati if he likes the food here and at first he says yes, but then he gives me a confused look, changes his mind and decides no.  I ask him why and the translator replies "it makes him want to vomit!" complete with hand motion of the vomit.  I really hope not everyone feels that way about the food here, but I guess I have my dietitian work cut out for me! 

2)  This one actually came from one of the other nurses as I didn't see it myself, but I thought it was very African-esque.  Listed on the admissions form for the patient food restrictions:  "no snake please"....no worries about that one!

3)  And my final favorite's moment:  realizing this week that most of our donated rice cereal that we give to the babies is infested with weevils.  Yes, these fun little black bugs lay their eggs inside the rice kernels and eat away all the good nutrients. 

But more than that, coming to the realization that many of the mothers here have no problem giving this to their kids anyway (as a little extra protein never hurt.)  Never, ever would you see this happen back home.  I suppose though that here you've got to appreciate all the donated, expired products that have been sitting in hot temperatures for far too long creating ideal conditions for the little critters.  From now on the rice cereal boxes go into the deep freezer to prevent bugs, but I'm sure going to think twice about buying expired food products in the ship shop here on board.....yum.  I can't wait to see what other fun food issues come up!

Not Your Average Barn Dance

This past weekend the Togo Presidential election results were announced.  For safety purposes we weren't allowed out past the port gate (given the violence that had ensued with elections in years past).  So what do you do when stuck on a ship with 400 people all weekend long?  You have a barn dance on the dock (naturally) complete with instructor, microphone and plenty of sweaty dancing goodness!  (Please note the on-lookers standing on top of the containers - men from the other boats that wanted in on our Mercy Ships fun!)

Togo Part II

I previously wrote a blog about the country of Togo.  I said I'd update on what Mercy Ships is doing in Togo for this field service.  You can see some of that here in this PDF.  Pretty good stuff!