All in a day...

This is a glimpse of what I do in a work day here. We are in full swing now with many patients on the ward, several returning for the first follow up appointment after surgery, and several continuing to receive Ponseti style casting for club feet. As is common anywhere, we can lose perspective. We see forests instead of individual trees.

This week, I was reminded of the miracles we are seeing and part of doing. One of the people who work in communications, Eunice, came down to interview the Vanya as it was her first cast change after surgery. Vanya's legs were exposed yet stable in splints. Eunice began crying happy tears when she saw the Vanya's leg straight for the first time. The Vanya's mom sweetly gave Eunice a hug in celebration. Although the rehab process is just beginning, it is good to step back and remember what the legs were like before.  Perspective...miracles are happening by the Grace of God we get to participate. 

Vanya while she was still on the ward (photo credit: Mercy Ships)

Ambre's mother expresses joy each time her daughter's casts are changed. Her feet are moving and flattening each week. Her mother's laugh is contagious and brightens my day and Ambre is cute herself.

Kalinda mobilizing a club foot prior to the casting. (Photo credit: Mercy Ships)

My buddy Ismael came for his first outpatient visit after surgery and was so brave. He only cried briefly when the staples were removed. Bubbles still are his favorite and calm him down quickly. He is standing and walking independently with the cast. 

Several teenagers are on the ward now. It is so different working with them than the young children. I have been enjoying reading French and English children's books with Mariette during her breaks while walking long distances in the hallway. She has a huge smile when I come to her bed with a new book. We have read Finding Nemo, Aladdin, Daniel and the Lion's Den, Paddington Bear, and the like.

Nestore is one of the teenagers, He wants to be a doctor and has gotten an early start on his dream (Photo Credit: Mercy Ships)

Here we encourage walking very soon after surgery to help facilitate the bone growth. With younger children we start with walker. Depending on the age, we progress to crutches or hand held walking. Next is walking independently. For the older children, we try to begin with crutches.

Sometimes we witness sit down strikes; sometimes screaming fests, but it leads to...(Photo credit Mercy Ships)

Moms' hard work and children learning to walk. (Photo credit Mercy Ships)

I am learning new skills daily here. We cast with plaster and fiberglass. Different techniques are required for both. I am getting better at both, but still working on making good casts. It definitely takes a team to up them on. Now that we are more than three weeks out from the first week of ortho surgeries, We are pulling Steinman pins, removing staples, looking at xrays to assess bone growth, and changing the cast to fiberglass cast when able. (We are running low on supplies as we are waiting for the container that has most of them to arrive. It was shipped ahead to Benin. When we switched countries, it did not switch as quickly as we did :) )

Translator/knee stabilizer, someone to maintain the foot position, and someone to apple casting material (photo credit: Mercy Ships)

Bubbles often help. (Photo credit:Mercy Ships)

Oh yeah, we progress walking and standing balance. The physical therapy that I am used to does not occur until a couple months after surgery when the bones or tendons have healed and the casts come off for good. This is when the range of motion and strengthening are in the forefront.

Photo credit Mercy Ships

Walking for the first time with a short leg cast (photo credit: Mercy ships)

The children have fun too. All lined up watching a movie. (photo credit: Mercy Ships)

In the evening visitor including relatives come. Stickers, bubbles, hugs and laughs with family. (Photo credit: Mercy Ships)

The babies and young children we have been casting weekly with the Ponseti method are also entering a new stage. They will be having small surgery (tenotomy- cutting the tendon in the back of their ankle) to gain the last of the needed motion. This surgery is performed under local anesthesia in the physical therapy treatment room by Dr. Frank with physical therapists assisting. The children are then placed in another cast. This one is worn for 3 weeks to maintain the stretch while the tendon repairs itself. The child then has to wear braces for several years.

One of the patients we have been casting for bilateral clubfeet. (Photo credit Mercy Ships)

Our youngest patient (Photo credit: Mercy Ships)