Goodbye: ‘It breaks my heart’ …or does it?

We are packing up in Togo. This field service is over and we are preparing to go to Guinea. What legacy have we left behind? What impact have the people of Togo left on our hearts? As many crew members depart, and less than half of us are left onboard for the sail, I have witnessed many tearful goodbyes.  Many times I have heard the phrase ‘It breaks my heart’. Indeed, I have said it myself.

But is it actually true? Does it really ‘break my heart’ when I say goodbye? Or is it more that my heart is so full, it is simply overflowing.  

Imagine your heart is like a cup full of orange juice. If the cup is cracked or broken, the orange juice spills out. It makes a mess, and my hands get sticky. It the cup contained hot tea, my hands would be burnt and it would hurt. The same would happen if the cup wasn’t broken and I just kept pouring the orange juice in. It would overflow and run down the sides and make a mess, the hot tea would spill over and burn my hands. A broken cup and an overflowing cup can look the same. But the difference is, the broken cup ends up empty, the overflowing cup stays full.

It is the same with my heart. That is why I am growing to dislike the phrase, ‘It breaks my heart’.  I prefer to say, ‘My heart is overflowing’, because I believe that is the truth. When I say goodbye to someone I love, it hurts because I grieve the loss of their physical presence in my life. But my life is still richer, my heart fuller because I met them. I am thankful for the blessing they have been to me and the times we have shared together. Saying goodbye does not and should not ‘break my heart’.

And as a follower of Christ, I remember the promises of God which are:

I am with you always; I have loved you with an everlasting love; I have plans for you, plans to prosper you and not to harm you.

Then the question is, do I believe what God says? It is either true or false? There is no middle ground. No option to think ‘sometimes God’s with me, sometimes He’s not’ or ‘I know he has plans for me, but maybe they aren’t that good  because he doesn’t really  love me’. Little seeds of doubt can so easily creep in, eroding our confidence in God’s word, and ultimately our faith and trust in Him.

So for me, when I say goodbye, I chose to trust what God says is true. He loves me and is with me always.  And God also loves the person I will miss. He is with them always too, and He goes with them in ways I cannot possibly go. I don’t want to cling onto them any more than I want them to cling onto me. I want to be the woman who walks out the plans and purposes God has for me, even if that means leaving and walking away. And I want to release my friends to do the same. When they leave, I want to say goodbye and send them off, releasing them into Gods hands, to fulfil the plans and purposes God has designed for them.

Why is this important? Well it is all about speaking and believing truth versus lies. I believe we need to fight for truth. Why confess a lie, when you can confess truth. More on that another time. Meanwhile, as I say my goodbyes, I am not going to say ‘It breaks my heart’, because I don’t think it is true. The truth is my heart is overflowing and richer and fuller because I have known you. And I release you to go with God, in the knowledge of his love and to walk into all the plans he has for you.   

Fati's story....obstetric fistula surgery

Fati’s story

Fati has 4 children. All were born without any problems, but her fifth child was different. He got stuck. Slowly, painfully, she laboured for 4 days. Her husband found someone to help take her to the nearest hospital, several hours drive from their village. But the hospital turned them away. Fati and her husband did not have the money to pay for the caesarean section she needed. They tried another hospital, and another. But each time the story was the same. No money, no treatment. They became desperate so they lied. They told the fourth hospital they could pay for a caesarean section and so Fati was admitted. Her baby had long since died, but at least her suffering was over, or so she thought. She and her husband sneaked out of the hospital the very next morning before it was light. They ran away because they couldn’t pay. Fati noticed the wetness immediately, but she thought it would heal up as her body recovered from the ordeal. But it persisted. The wetness made her skin sore, but worse, a stench of stale urine became her constant companion. It was overpowering. Her husband left her and people in the village shunned her. She became an outcast, and relying on people’s pity and scraps of food thrown to her, like dog. Her life had changed beyond anything she could imagine. She existed, but wished she didn’t. She had no hope. Fati contemplated suicide. Fati has a vesicovaginal fistula (VVF).

Obstetric Fistula – medical details

A fistula is a hole, or abnormal connection between two structures. Obstetric fistulas (of which VVF is one type), are caused by obstructed labour and lack of access to obstetric care In obstructed labour the fetal head causes unrelenting pressure on the pelvic structures, damaging them severely. The bladder, urethra, vagina, uterus and rectum can all be damaged. The tragedy is that obstetric fistulas are totally preventable by access to appropriate obstetric care, which is why we don’t see or hear of them in the ‘west’. Moreover, there are few ‘western’ surgeons who specialise fistula surgery because there is minimal need.  But here in Africa, among the poorest of the poor, the need is great indeed.

Mercy Ships

I have just spent the last month working with Dr Lauri Romanzi, a fistula surgeon from the US. We have performed just under 50 fistula repairs, and trained a Togolese surgeon, Dr Sewa in both spinal anaesthesia and repair of simple VVF’s. Some of the fistulas we encountered were complex, difficult cases and we worked late into the evening many times to help all the women who were scheduled for treatment. Women with fistula suffer from a huge loss of dignity and self-worth. One of the wonderful things about fistula surgery onboard the Africa Mercy is that it doesn’t just treat the body but also the soul. The women receive a new dress and gifts when they are discharged which signify a restoration of dignity, identity, significance and self-worth. This is a time of celebration. There is dancing and many women share their stories. It is a moving occasion and we call it the ‘Dress Ceremony’.

Togo, Niger, and Ethiopia

Togo has recently made caesarean sections free of charge to all women. That is a huge step forwards in fistula prevention. The next step is to train more surgeons / medical officers /anaesthetists to perform spinal anesthesia and caesarean section, and improve access to these facilities. In the meantime, we will continue to train doctors like Dr Sewa to help his people and we will continue to need facilities like Danja Fistula Centre in Niger.

Danja Fistula Centre in Niger is a fistula hospital which officially opened earlier this year. It was built and is partially funded by The Worldwide Fistula Fund. A friend of mine, Sarah Walker, who used to be nurse on Mercy Ships, now helps run the hospital. They are short of anaesthetists. So anyone wanting to help for a few weeks to a few months would be most welcome.

One of the biggest Fistula hospitals in in Addis Ababa, Ethiopia. A fascinating history of this hospital, and more insight into the lives of women suffering from VVF is given in the book, ‘A hospital by the river’ by Dr Catherine Hamlin. Dr Hamlin has been describe as a ‘modern Mother Teresa’.

You and me
How will you be described?
How do you want to be described?

Introducing Darius

Darius is a 9 year old boy who comes from Cotonou. Cotonou is the capital city of the neighbouring country, Benin.

Today is Easter monday, and two weeks ago I met Darius. His eyelids had fused together last year and he came to have surgery to literally ‘open his eyes’. I don’t know why his eyes had fused together. But that didn’t matter. Here was a little boy, sat in front of me, who once could see but now was blind.

Sometimes making a diagnosis can be difficult in medicine. Doctors are like detectives, piecing together the clues to come up with a ‘who dunnit list’ of possible culprits. Most clues come from what the patient tells us. Examining the patient gives more information, creating a list of possible suspects (diagnoses). Finally, tests and investigations confirm or refute our suspicions.  Like most mysteries, the solving is best done when the evidence is fresh. Trying to figure out what happened years later is much more difficult. That was the situation with Darius.

Darius had been a healthy boy until last year. He enjoyed school and playing with his friends. Then, like many children his age, he caught chicken pox. Because he was malnourished the chickpox became a severe infection. What happened next is unclear. His mother thinks he had a severe allergic reaction to an antibiotic which caused his skin to peel especially around his lips and eyes. His eyes swelled so much he couldn’t open them. When the infection healed it fused his eyelids together so he couldn’t open them. A once happy boy, now sat quietly on the edge of his bed, head hanging down. 

But there was a small glimmer of hope. Darius could distinguish bright light from darkness. That meant it was worth surgically opening his eyes to see if the eyes themselves were damaged. There was a chance Darius might be able to see.

So we literally cut open Darius’s eyes. The left eye was badly damaged, but the right eye less so. More treatment was necessary. Darius would have to come to surgery every day to have his eyes cleaned and cared for under general anaesthetic. The surgery would be painful, requiring large doses of morphine. A tough ordeal for a frightened 9 year old, in a foreign country.

Over the last 2 weeks, there have been ups and downs. Initially Darius made good progress but then the progress slowed and he needed eye drops every hour. We were praying, his mum was praying. She stayed up all night praying when his eyes took a turn for the worse.  She has made a big sacrifice for her son. She has travelled to another country, leaving her other children behind, just to give this son a chance for sight. Darius is that precious. She doesn’t know when her son’s ordeal will end. Nor does she know if it will be worth it. Will Darius ever see again? I don’t know. I hope so, but his treatment continues.

As doctors, we do what we can. We wait patiently. Here on the ship we also pray. His mum does the same. She puts her son’s needs before her own. What parent wouldn’t?

This reminds me of Easter. The bible says God is our heavenly  father. As our dad, God also made a sacrifice for us. Just like Darius’s mum made a sacrifice.

God sacrificed his only son so we could be forgiven. God cares for you and me, just like Darius’s mum cares for him. Darius is precious to his mum. You and I are precious to God.  A parent will do whatever they can to help their child. God wants to help us too. He wants to hold our hand, in his nailed pierced hands and walk life’s journey with us. What parent wouldn’t?

This Easter, do you know how precious you are? Will you take God's hands offered for you?

Happy Easter Darius. See you in surgery tomorrow.