Foul Pointe

After two days of orthopedic screening, learning to cast, examining clubfeet and a day of regrouping and teaching the day crew, Kalinda and I decided to take advantage of our last weekend without patients on the ward. We decided to head an hour north to Foul Pointe. It is a beach town where it is safe to swim in the ocean. Although we have a beach here in Tamatave, it is not safe to swim in due to sharks.

Having confirmed with day crew a fair price for a taxi bus and reserved a hotel room, we headed out on our adventure Saturday around 7:30am. Due to having an overnight bag and not knowing exactly where the bus station was, we decided to take a pusse-pusse. When we arrived, immediately we were swarmed by four to five bus drivers all declaring they were going to Foul Pointe. We thought there was no way they all could be going. We ended up choosing a bus that already had local people waiting inside. One of them spoke some English and good French. He confirmed that the bus was heading to Foul Pointe and would not leave until it was full (18 people). As the bus slowly filled, we thought were nearing the time to leave. We learned that 18 people means 18 adults (children do not count as they sit on someone's lap). After waiting an 1.25 hours, the bus was full outside and inside. 20 adults including the driver and 5-6 children. On the roof, we had several rice bags, a frame, mirror, furniture, bike, large hard suitcase, and more. The road was in relatively good condition. We rode for about an hour with 5-6 brief stops for police officers to check the paperwork of the bus. Our "friend" told the bus driver to stop at our stop. This was good as we had no idea where we were and could not see well out of the window.

Pusse-Pusse

Taxi buse

We got off the bus and were once again immediately surrounded by pusse-pusse. We saw the sign to the hotel stating it was only 250 meters away. We said we could walk. After walking on the dirt road we arrived to the Manda Beach Hotel. It was a resort! There were games and karekoe all afternoon. Kalinda and I enjoyed a wade/swim in the ocean. We wanted to go see the fish in the coral reef. We noticed that no one was swimming out to the coral reef. Persistence pays off. One of the guys with an outrigger boat had come out to where we had walked. We finally agreed on a price. He paddled us out to the reef by pushing on the bottom of the ocean with a long paddle. He got out of the boat in a shallow area and collected 4 sea urchins. Next thing we knew, he was smashing them. When we arrived to the coral reef, we saw it was dead coral. He threw the sea urchins in the water to attract the fish. We remained close to the boat as goggles only does not do as well as goggles and snorkel. It was still neat to see the fish in person.

One of the Bungalows at the resort

Heading out to the coral reef

Feeling the sea urchin move

We spent the rest of the afternoon relaxing in the pool and even swimming laps. Other people from Mercy Ships were there. It was fun swim laps for the first time in about a year. We decided to have dinner at the resort rather than eat at the local "restaurant." A couple others decided to eat with us. We ended up with quite the assortment for dinner: French fries, small pizzas, a zebu dish (Malgasy cow), French chicken dish, and a traditional Malgasy chicken and rice dish. After dinner we enjoyed socializing outside beyond our curfew on the ship. Curfew is early on the ship as it is not safe outside the port at night.

Zebu...none of them look like they have much "meat" on them

We put down the mosquito net and settled into bed with a fan pointing at us. In the middle of the night the power was off. We noticed as the fan was off. The mosquito net semi worked as there were mosquitos on the outside and inside of the net. Thankfully, malaria is less common here than in west Africa and we are on anti-malarial medications.

After a delicious breakfast by the beach, we went for a swim in the Indian Ocean. We made a sand castle and enjoyed the pool briefly again. We then walked to the fort on the other side of town. The fort was built by the British I think in the 1800s. It was used to protect against people trying to sell slaves.

East Madagascar gets a thumbs up

Indian Ocean here is so salty you can simply lift up your feet and float. 

Madagascar written in seaweed

We then walked back towards town attempting to hail every taxi bus that passed. We knew it would be difficult to find one as they leave a town farther north pack to the brim. After several failed attempts, a tour guide who was coming from even farther north was driving an SUV. He stopped to let out several tourists. We asked if we could get in. He agreed. He and Kalinda spoke in French for the whole hour back. He was very helpful with tour guide information for other areas of the island. It is difficult to get from one place to another. He gave us leeches (a fruit). They were delicious. It was a wonderful weekend away.  

In the Fort

Building on the left was the jail. The bigger building on the right was where the King lived

We took turns hailing a taxi buse

Bubbles

Tuesday, I was able to help with security/crowd control at the general screening. This year screening is being done over a month rather than in one very long day. Even so, a very large number came in the line the first day and the second day (Tuesday). Screening is quite the process with a pre-screening, then if they pass that, they wait in line for the more thorough screening. If they pass that, they receive an appointment card to come to the ship for an even more thorough screening by the specialty. 

Photo taken by Mercy Ships of screening line one day

Likely hundreds of thousands of bubbles were blown that day to help the children wait well in line. The bubbles bring smiles and laughter. They are an avenue for interaction without verbal communication. Some of the children who are nonverbal even smiled when seeing the bubbles. Some adults enjoyed blowing the bubbles as well. Laughter and screams of joy from children is one of the best sounds in the world!

Photo taken by Mercy Ships

As I reflecting on the day, I was reminded of other things that the bubbles bring to mind:
As I watched the bubbles, some popped immediately. Some floated for a ways on the wind. Some were reflecting the light in small rainbows.  They were different sizes and shapes. They all were fleeting. I was also reminded of the item in 1,000 Gifts of the soap bubble. We are to be thankful all the time.

All of our lives will "pop" sometime. Some pop/end what we think is prematurely. We are sad and disappointed when this occurs. New bubbles are quickly blown to bring more smiles. Similarly, if we are Christian, we know that we will have eternal life with Jesus. We are all different sizes and shapes. Often when the children come to screening, they do not have smiles and dull eyes. When exposed to the light of Jesus through the people on Mercy Ships, the smiles and light in eyes change. This reminds me of the rainbows seen on the bubbles in the correct lighting.  Lastly, thinking about the bubble floating in the wind, John 3:8 comes to mind.  "The wind blows where it wishes, and you hear its sound, but you do not know where it comes from or where it goes. So it is with everyone born of the Spirit." Mercy Ships is planning to stay here for a total of 8 months right now. We are trusting God to bring us the patients that we can help. We are in the patients life for several weeks to months. Afterwards our paths part.

Photo taken by Mercy Ships

Another thought related to bubbles is the answers given during the screening process. Some people's hopes are met. Their bubble expands some. Others, however, have their bubble of hope popped. Mercy Ships cannot treat everyone. They have to specialize and put specific parameters so they can help some people well.  I had not thought of this in the medical field, but sometimes if we do a procedure, we may make the condition worse in the long run.

 As exciting as it is to see so many patients at screening, it is so difficult to see so many adults and children that we cannot help. It is hard to know that if many of them were in the developed country they would not be in such dire circumstances. Many could be aided sooner often preventing the severe disabilities or malformations. We were reminded in briefing about security at screening, we may be the only person from Mercy Ships they encounter. Keeping that in mind, I would make a special effort to interact with the children I knew Mercy Ships could not help. Bringing a smile to their face and looking them in the eye showed then value.  There is a prayer team that will pray with patients who are not selected.

Many more bubbles, balloons, and stickers will be used as one way to show God's love for them. 

Labor of Love

This is the title to a Christmas song by Andrew Peterson. His song is about Mary's literal labor of love giving birth to Jesus. English is a funny language and the word labor can be used to indicate hard work no associated with giving birth to a baby. Being apart of Mercy Ships and during a time with such transition and now preparation, it has struck me what a labor of love this is. So many people from around the world giving their time and money to serve and share the love of Jesus those who are not loved and accepted by the world's standards.

People have sacrificed time in working long hours for quite some time, waiting for assignments, inconveniences of changing travel plans and housing accommodations, served on the ship in capacities not their own for longer than expected, cleaned the hospital including operating rooms and inpatient treatment rooms washing every floor, wall, and ceiling twice, washing mattresses, sheets, setting up beds, sorting through papers, attending meetings, learning new skills and ways of living in community with many different cultures, and other ways.

It was amazing to me how much love people have for those we have not even met yet. Screening days begin tomorrow. Excitement and anticipation to begin interacting with patients is high on the ship. As I was thinking about this, I was struck by the fact if we love these people this much without even knowing them, how much more does the Father, Son and Holy Spirit love them! He created them like he created us. We are all made in his image and knows them by name. He desires for all of us to become his sons and daughters. That truly is good news. The word gospel means just that, good news. It is special that He has chosen to use us to share His love.

View of the Ship from town

View from the beach close to the Ship

As I have walked around the town, it is a challenge to find people who speak good English. Most speak Malagasy, and some speak French well.  As I was thinking about the difficulty of communicating with the patients and their families, I was reminded that by simply smiling and making eye contact Jesus' love can be shared. 

This weekend I took to time to walk around the city. Kalinda and I walked for a total of 5 hours. It was a lovely day seeing two markets, different areas of the town, drinking coconut water, enjoying fresh icecream with fresh fruit incorporated, walking on the beach, sitting in the shade, and learning our way around town. We asked for directions to a market where the locals shop. We met one of the Day Crew. He generously walked with us to the market and showed us around the Bazar Kely. Kely means small, but the market seemed large to me. It was roughly organized by produce, grains, fish, metals, crafts, meat, and flowers. He also introduced us to his grandmother and aunt. The type of coconut we drank had an abundant amount of coconut water, but very little meat once cut open.

Independence Ave. It is lined with palm trees on both sides. The street lights are solar powered on this street

One of the many coconut stands. 

 
Today three of us went to a Episcopalian church.  It is an adventure learning a new city and how to get around. We took two Pusse-Pusses. As only two people can fit it one. After some hand motions and going to a different church, we arrived at our intended destination. We were immediately greeted by another day worker who welcomed us. We did not know anyone who attended church here. What a blessing to have a connection right of the bat. We had understood the service to begin at 9:00AM. It began at 9:30. It was very orderly and followed a liturgy in Malagasy. Johanna (her nick name) the day worker generously sat behind us and translated into English most of the sermon. Many of the women wore lace coverings on their heads for the whole service. We received a special welcome from the Bishop at the end. He reminded the congregation who Mercy Ships was and encouraged us to attend this church every week. When the service ended, we were greeted by many and thanked for coming. We rode back in a Tuk-Tuk. It is the same vehicle I traveled in some in Guatemala. Here, however, they are yellow and accommodate three people.

Tuk-tuk

At the church this morning. 

We all fit in the back seat :)

Now, to prepare for a busy week including Screening! Thank you so much for your prayers and support!

Learning can be Fun

Yesterday was the first full day of orientation with orthopedic rehabilitation team and nurses. It was a wonderful day. I tried new things, laughed, starting building trust, learned/ was exposed to a lot of new information.

The day began with Elise and I having plaster casts donned. We wanted to feel and experience mobility (walking and stairs)  with a short cast. While the casts were setting/drying we had a devotional about serving with the right heart. Serving the way Jesus did and wants us to do...selflessly. After devotions, Kalinda cut one side of the cast to show me how to do it. It also allowed me to experience it and gain confidence the cast saw would not cut me when used properly. I then cut the other side to bi-valve the cast. This is done  just after surgery to accommodate for swelling and to take it off.

First casts made with plaster

Cast saw in Kalinda's skilled hands

Dean and Elise and I teaching and learning

We also practiced ascending and descending stairs with crutches and long leg casts. It requires significant energy to perform the task. It is necessary for the children to do prior to hospital discharge as they may have stairs at home likely without rails. They will be able to practice daily as the hospital is on Deck 3 and they play on Deck 7 which is open to air in the afternoons. The children, however, will not have to climb all the flights of stairs as many will have long leg casts.

Short leg cast on and ready to teach the ortho nurses

After some orientation information, we returned to the inpatient treatment room for the first lesson of working with club feet. After discussing some of the details, it was time to cast. Dr. Frank, who enjoys teaching, gave Elise and I both pointers and step by step direction as we made our first casts. Experience is the best teacher. Making a quality cast is truly is an art. It will take doing it many times to skilled. After many good laughs and taking photos to document the occasion, Elise and I had to cut off the casts. I will admit, I was apprehensive of using a cast saw.

Kalinda and Dean's turn to be models for us

First cast. I still have a ways to go on perfecting my skills

Fun with Rehab Team!

If you are unfamiliar with one, they are noisy and the do have a blade. The blade vibrates rather than rotates. As long a the cuts remain perpendicular to the surface it will not cut the skin. Another key component is to keeping the saw in one place for long. The blade gets hot. If it is in one place too long, it can burn the skin. Rotating the blade to cut with a different area and cooling it with a damp cloth help prevent burning. The more experienced one becomes, the quicker one can take off the cast. It took me a good twenty minutes to cut both sides. I am happy to report to burns or cuts to skin were made.

Working hard

Success. Cast put on and taken off. 

I also was able to laugh with a couple of my roommates last night. Laughter truly is a mood lifter. It is was so nice to laugh. I am so thankful to be learning. I am learning information all the time.

Fine Adjustments

Keep reading to see why this picture is posted :)

As you know, it has been a road full of detours for all involved with Mercy Ships. The word that sums it up best is flexibility. It is so nice to be here. Although all organizations require teams of people to work together, it has been very evident here just how many different people and jobs are required to complete the operation of sharing God's love, hope, and healing. During my interaction with Mercy Ships two thing has been constant, everyone is needed and nothing goes according to plan. 

As mentioned I have been working in the dinning room for two weeks. It has given me a whole new perspective. I can honestly say that I took it for granted that there were always three meals a day provided. I even thought,  "Why don't they have ...?"  occasionally. As we have been saying while working there, everyone should work a shift there and in the galley to broaden their understanding of how it functions. It would likely increase gratitude. I am sure more consideration would be given to the little things that people do and don't do. It is long hours and physical labor. 

I have increase respect for them too. They work hard day in and day out, but have very little interaction with the actual patients. The crew is able to adopt a patient to encourage, play with, pray and visit. If the galley does not prepare, cut, bake, cook the food and the dining room does not set it up and clean up, the medical crew would not be able to provide the quality care. Patient would not have the necessary nutrition to heal. 

Cathy (on left) is now working in the lab. Martha (center) is "superwoman" she does not stop working in the dining room from 4am until 7:30pm. She is a team lead having to manage the dining room staff and food making sure everyone's needs are met as much as possible. She came to work with Mercy Ships when she retired from her job in the United States.  Such a hard worker. 

After a several long days in the dining room, I did not have the best attitude about it all. If fact, I would say I was doing it out of duty rather than a cheerful serving heart. I was grumbling about the little things and obstacles which seemed frequent. The verses in Colossians 3:23 that says "Do whatever you do as unto the Lord, not for human masters." Phil 2: "Do everything without grumbling and complaining so that you can become pure children of God without fault in a crooked and depraved generation." came to mind while washing dishes. I knew this, but was still having difficulty. While worshiping in the service on Sunday, we sang a contemporary chorus that included the lyrics,  "It is well with my soul"  from the well known hymn. I was convicted that it was not well with my soul. As we continued to sing the chorus, I heard the Lord say, "fine adjustments are needed for it to be well with your soul."

We are familiar with the saying needing and attitude adjustment. One way for me to fix my attitude is to adjust my focus. This fine and coarse adjustment is in reference to microscopes. When looking at a specimen, one first uses the coarse adjustment knob to bring it into rough focus. The fine adjustment or fine focus brings the specimen or part of  interest into better focus. I had not lost the coarse adjustment as I knew my current part to play was necessary and important. I had, however, lost fine adjustment/focus. My focus was blurred as I wanted to be serving in a different way. I wanted things to be simpler and easier. 

Coarse and fine adjustment knobs

Sunday evening was a time of fine tuning adjustments. Worshiping the creator of the universe did just that. It took the focus off of me and returned it to its rightful place, Jesus.  I know that just like the fine adjustment knob on a microscope can easily be bumped and make the specimen image fuzzy, life happenings can bump my focus from Jesus. My bunkmate has a wonderful prayer, "Lord, help me know and understand what you have for me today. Help me be your blessing to others." Although I have heard it and similar prayers, it hit home this week. During this summer and fall many, many people have had to make adjustments coarse and fine as the plans for the ships next destination and staffing numbers and positions changed. I will try to keep in mind to check the fine adjustment knob in my mind every morning when waking up. 

Fine adjustment images