Ditto

Ditto. Or…… I could say ‘same again’. This month has been a repeat of last month. One where I felt God’s hand on absolutely everything, and I am not quite sure how I got through all I did. A healthcare education assessment visit to Guinea, a Program’s Conference (reviewing lessons learned and making future plans), a visit to Ghana for the West African College of Surgeons Meeting, and an International Maxillo-facial Surgery Conference here in Pointe Noire. I have given several talks and written several reports. I am tired but satisfied. When I started with Mercy Ships over two years ago, many of these things were mere ideas. It is amazing how far we have come, and I am grateful to so many people who have made it happen (over 100 crew members alone have helped with our one-on-one mentoring education projects). And that is just the tip of the ice-berg. I am also in awe of how ‘things or coincidences have just happened’, such as conversations occurring in the right order, chance meetings, being in the right place at the right time……it is the upward spiral of synergy. Or you could look at it another way and call it the reverse phenomena of the ‘swiss cheese model’ of medical errors (for those familiar with Medical Risk Analysis) I could go into more details but I thought I’d share something else I have been musing on. I remember what used to happen when I needed repairs or building work done around my house back home. I didn’t want to get ‘ripped off’ and always wanted a good deal on the price, but at the same time I always wanted the builder to earn a good wage. I wanted him to make good money, enough to feed his family and still have enough to be generous to others. I never felt these two aims were mutually exclusive. I have always believed it was possible because it is God’s heart for everyone to ‘prosper them and not to harm them’. That means me AND the builder. Stephen Covey would call this a win / win situations. Stephen Covey is the author of the best-selling book called ‘The 7 habits of highly effective people’. It was suggested a few years ago that I read this book as part of my Personal Development Plan for my NHS Appraisal (essential for my medical license). I highly recommend the book and I re-read it in preparation for some of the things on my plate this month. As I this last month unfolded, I found myself watching and using many things I had learnt from the book! The book also gave a terminology to things I had always intrinsically believed but never articulated so eloquently, such as win/win scenarios with my builders. ‘The 7 habits of highly effective people’ literally describes 7 principles or habits by which to live your life. The first 3 habits centre on Private Victories, based around being proactive, having vision and purpose and being disciplined in achieving these things. The next 3 habits relate to Public Victories and involve win/win scenarios, synergising and most important of all, seeking first to be understand before being understood. And finally, the 7th habit is an all encompassing habit which is about taking care of yourself. Not in a selfish way, but in a kind of biblical ‘love your neighbour as yourself’ type way, ie if you cannot love yourself and take care of yourself how can you do it for others. We must learn to value ourselves and our time. The book was first published in 1989 and has remained a best-seller for over 20 years. The principles and habits described have remained successful across a generation, and that is an achievement in itself as culture and work ethic changes. At the end of the book, Stephen Covey writes a personal note which says: ‘As I conclude this book, I would like to share my own personal conviction concerning what I believe to be the source of correct principles. I believe that correct principles are natural laws, and that God, the Creator and Father of us all, is the source of our conscience. I believe that to the degree people live by this inspired conscience, they will grow to fulfil their natures; to the degree that they do not, they will not rise above the animal plane. I believe that there are parts to human nature that cannot be reached by either legislation or education, but require the power of God to deal with. I believe that as human beings, we cannot perfect ourselves. To the degree to which we align ourselves with correct principles, divine endowments will be released within our nature in enabling us to fulfil the measure of our creation.’ I share these beliefs. I need the power of God to help change the darker aspects of my human nature. I cannot perfect myself. And I need divine endowments to help me do what I do, and to fulfil my nature and my destiny. The word of God stands forever and the principles in the Bible are true and useful for all aspects of our lives. Physical, mental, emotional and spiritual. As we align ourselves with these principles, we begin to fulfil our destiny and live as we were originally designed to live. Success is released in our own lives and the lives of those around us. I saw that this month. Just like last month. And what about next month…..something tells me I will be saying ‘Ditto’ …… all over again.

Explaining the inexplicable

Unexpected champagne.....warm crusty bread, Camembert, Gruyere cheese, red wine, chocolate mousse, coffee, more chocolates.....and unlimited free Internet access courtesy of the african airline, Air de Côte d'Ivoire. In the west we use words such as 'luck' or 'chance' or 'fate' to explain the inexplicable. Many people are uncomfortable with something being inexplicable. We want answers, we want to understand. Nothing wrong with that. But why, in a rather bizzare way, when we cant explain something, do we make up another inexplicable concept and call it luck or fate. What is luck and who gets it? What is fate and how do you get good fate not bad fate? Where I work in Africa, people don't believe in abstract concepts such as 'luck' or 'fate'. It is more personal. It is all in the hands of the God or gods, so the fundamental question when things happen is, 'who did this to you?' When bad things happen the mindset is often 'who cursed you?' And when one encounters a series of 'lucky events' the response is 'wow what favour you/I have!' What do you think? I ask because I am interested in how you might interpret the week I just had? Good luck or bad luck? Fate? Miracles? Blessings or curses? You probably know what I believe, but I will tell you at the end! I am writing this on a plane to Conakry, Guinea having travelled from Pointe Noire, Congo via Gabon, Ivory Coast, and Mali. Five flights and I am sitting in Business Class, seat 1A, having just been served champagne, European cheese, wine and chocolate truffles. My chair is so big and deep that my feet barely touch the floor and if I sit back in this giant seat my thighs are not long enough to reach the edge of the seat so my knees can bend properly! I was finally on route to Guinea three days later than planned. On Monday evening we had an emergency in the Operating Room (OR), which consumed my whole week and delayed my trip to Guinea. Simon was a young man with a severe abscess in his jaw which needed surgical intervention. When the team woke him up and removed the breathing tube from his mouth he suddenly and unexpectedly could not breath. A crisis call to the OR came over the ships loudspeaker. None of the 4 anesthetists including me were unable to reintubate the young man (put the breathing tube back in). It was also very difficult to assist his breathing using a mask or other airway device. So two maxillo facial surgeons performed an emergency tracheostomy (cutting a hole in his windpipe to place a breathing tube) just in time, to save his life. Simon had a lot of blood and pus in his lungs and we tried as best we could to wash this out and then supported his breathing using a ventilator (breathing machine) and kept him asleep with sedation and pain killers. We had great difficulty keeping him alive even with all our equipment. Even in England it would have been a struggle as his lungs were so damaged they could not absorb the oxygen well enough. I really thought Simon might die. So we cancelled my flights to Guinea, the team would have to go without me. Patients come first. Now was not the time to be planning future healthcare education when someone's life hung in the balance. Many people were praying for a miracle. By Thursday morning Simon had made a miraculous recovery, his airways pressures were lower, oxygen requirement halved, drains no longer bubbling and saturations the best for the last 3 days. At 5pm Friday (4 days after the emergency) he was sitting in a chair, without any of our machines and communicating with sign language. A miraculous recovery and I have not seen one so fast and neither had Alan, another consultant anaesthetist and intensivist from England. We all think we witnessed a miraculous recovery. From my perspective it was a busy and stressful week. Responsibility and worry on weighing on my shoulders. And then there was the visit to Guinea. Three of us were going to re-establish relationships with the Guinean government, port and logistics, and make a more formal healthcare education assessment (my role). The other two had left early on friday without me and my ticket was now booked for Sunday evening with teh remaining connections on Monday. That felt like good luck....or could it be miraculous provision on a more personal level? Simon was better, and I now had time to catch up on some much needed sleep. Fate or favour? And the story continued with the provision of free Internet at the guest house on Sunday evening after I flew to Brazzaville. Monday morning, free unlimited Internet at Brazzaville airport ( better than the with 45 minute time limit at Heathrow). Then my flight from Abidjan was cancelled so I was put on a later one, given a VIP pass to the airport lounge and upgraded to Business Class. Hence the champagne.....warm crusty bread, Camembert, Gruyere cheese, red wine, chocolate mousse, coffee, more chocolates ! All the free Internet access and flight delays meant I managed to catch up with all my backlog of emails and design some more training plans. Was this my lucky travel day....was the patients recovery just fate.....maybe? Or maybe there is a God who knew what I needed? God doesn't make people sick, that is the work of the evil one. But God does work all things together for good for those who love him. God worked a miracle to save Simon's life, I got a weekend I didn't deserve but did need, and even played a game of tennis and went swimming. Gods favour was on my travels, redeeming my time. I took 5 flights and ate 4 croissants (courtesy of the French influence on African airlines). I believe that God worked it to save Simon's life ( we don't normally do his type of emergency surgery on the ship), and so that I could still travel to Guinea and not be totally exhausted. We are building relationships in Guinea and asking them what would they like us to do to help, not just with surgical services but also with training. The saying 'give a man a fish and feed him for a day, teach a man to fish and feed him for a lifetime' has never been more true. One of our objectives in Guinea is to seek to understand what the training needs are as perceived by the ministry of health, the hospital directors, and individual doctors/nurses/other departments. Then we can try and match their needs to our training resources. Training is about change, not just of systems but of ourselves. And that is part of our vision, to 'transform individuals and serve nations one at a time'. That's why we are here. That's why I am here. And even though it is actually incredibly difficult to make a difference, to see the application of the things we teach effect lasting change, it is worth the effort. I believe in a God who really can do 'more than all I ask or imagine according to his power at work in me'. I am very grateful for the miracles I have seen this week in Simons's life and in my life - in real, tangible and personal ones that God gives me because he loves me. You see, I believe God is still performing miracles today. He hasn't stopped and he never will. What would it take, I wonder, for you to believe the same? To believe His love for you and his desire to bless you in the same intimate and personal way.

Grace

This month story is written by Catherine Murphy one of the ship writers, and I have added a few medical details and personal reflections at the very end. I have chosen this story because it typifies why I do what I do and have chosen to serve with Mercy Ships. Grace was one of our first patients up the gangway in Congo. On September 10th, we removed the massive tumor from her face. It’s been several weeks since her surgery, but 17-year-old Grace is as sassy as ever – and she’s looking like a whole new young woman. “God is good because He did a big thing for me. I did not believe that I could be saved, but God has had grace. Mercy Ships arrived in Pointe Noire, they treated me, and I am better today,” Grace says. Grace’s journey to the Africa Mercy began with an email. A hospital chaplain from neighboring Democratic Republic of the Congo met Grace at a hospital there. The chaplain, Pastor Gregoire, was shocked by Grace’s facial tumor, which weighed 4.9 pounds (2.2 kilos.) Pastor Gregoire came alongside Grace, counseling and praying with her. He says she was often so distraught that she cried all night. Sometimes she refused to eat or drink. “Indeed, she suffered,” he says simply. Pastor Gregoire took a photo of Grace and published it on his blog. A reader responded to his post, recommending that he visit mercyships.org, an organization that might be able to help. From there, Pastor Gregoire contacted the Mercy Ships Swiss office and exchanged emails with Christophe Baer. Through Christophe, Pastor Gregoire sent Grace’s medical records and reports to the Africa Mercy. The response was positive. Grace and Pastor Gregoire were asked to arrive in Pointe Noire, in the Republic of Congo, on September 2nd. Grace’s story is a chain of mercy forged by compassionate hearts, and their efforts were rewarded. She has been recovering in the Mercy Ships Hospital Out Patient Extension Center (HOPE Center), where she has become the champion UNO player. As Mercy Ships nurses will tell you, Grace dominates every hand – and don’t even think about challenging her to Jenga! Grace’s tumour was involving her jaw bone, so the first surgery (hemimandibulectomy) removed the tumour and replaced the jaw bone with a metal titanium plate. Three months later the second stage of the surgery takes some bone from the hip and puts it around the metal plate. The bone they grafts onto the metal and gives the jaw back it’s shape. This procedure is called an ‘iliac crest bone graft’. It is done three months after the original surgery to allow the mouth wounds to heal and to reduce the chances of infection in the new bone graft. Grace had this procedure (her second operation) just before Christmas. And she is recovering well on the ward and always says ‘hello Dr Michelle’ whenever I walk by. She is a very happy lady who brings joy and hope to the ward and the other patients. Near Grace’s bed lies, Angelique. Angelique is 22 years old and has a large tumor, rather like Grace, but Angelique’s tumour is coming from her cheek bone (maxilla) instead of the jaw bone (manidible). In a few days we will operate on Angelique and Grace will be discharged. This is why we are here. This is what I have spent the last two years doing. Someone once said, ‘transformed people, transform nations’. In another month, Grace will return home and begin school. She wants to be a nurse. May she go on to do that and transform many others people’s lives through what she does.