Mercy Ships - Compassion in a World of Need

A great clip to end off blogging about Togo. What an amazing 6 months!

Week up to the north

Christina (RN from Arizona), Jean (translator) & I took a week vacation up to the north of Togo. So many random TIA (this is Africa) moments, so many good laughs and talks. Definitely a huge highlight of my memories of Togo!

The first day we travelled up to Dapaoung, an all day trip. We finally reached a hotel at 10pm only to find all the lights out and the manager already sleeping. There was just one room left for the 3 of us & at this hour we didn't really have other options. So Jean somehow got to sleep with the hotel manager on a mattress infront of the reception desk. How awesome isn't that :) Christina and I crawled under our 'single' mosquito net in our sunken bed for a great nights rest!

We went to the bar next door for some supper...and they had run out of beer and wine, yes the bar ran out of beer & wine - TIA :)

Watch all those crawly's on the shower floor Christina...oh wait, is the shower actually working? :)

The next day we took zemmies out into the country past many villages, up the mountains to see the cliffs where some locals lived during a war in the 1800's. So fun to ride the zemmies! Togo is beautiful!!!

What? Jean, how did you get to drive the zemmie taxi?

Gate to the cliffs.

Pretty amazing how they coped with living in cliffs - the big oven, etc.

Christina

Amazing view! So beautiful!!

I want my Momma!

Crazy driver Jean! And he's still letting you drive his zemmie?

That night was the 'Miss Togo challenge' in Dapaoung so we hung out watching the challenge and playing cards. At night all the ladies bring out their local brew on the streets. Jean bought some from this lady so we could try it. The bottle is an old Voltic water bottle. This little girl is the daughter of the woman we bought the beer from. So cute! We bought some adamae (kinda like a mashed potato starch) and sauce for supper, with our local beverage. The beer tasted like yeast with something sour in it...I had one sip and had no desire for more :) The next day we headed to Mango to see the ABWE hospital that is being built there. So exciting to see this project! The missionaries there are amazing! One missionary lady took us out on their gator to this lake where hippo's are...we only caught a glimpse of their backs :( These kids were chasing the gator down the road :) When we were getting back to the mission guesthouse I saw a yovo (white person) playing on the soccer field - it was Jens from the ship who had left a few days before! Sooo awesome to meet up with him again! Jeans, Jens, Christina, and I. Our first night in Mango we checked in to the only hotel in town, in the back of this bar there were 2 rooms - 4 CFA per night ($8 USD). The next morning we found out..as the manager was wanting us to check out early, that these rooms were actually rented out by the hour...hence the used condom wrappers outside our door. TIA!!!

Needless to say we were thankful to be able to spend the 2nd night in Mango at the mission guesthouse!

We spent the day carrying bricks at the new hospital, took a tour of the local hospital there,(saw some kids with malaria, snake bites, AIDS, etc.), played some basketball, and stopped by the local police station. Hilarious to find out that people give goats for bail - TIA.

The next day we spent a few hours waiting for a bus to take us to Kpalime. Here's a lady sleeping under the trucks - common here with all the truckers.

Yay, our bus arrived ;)

Don't forget the goat! As we were crammed in the back of the bus, I kinda was pretty surprised to feel something tickling my feet...turns out there were chickens under the seat. So with the goat on top and the chickens under the seat our music consisted of baaa and clucking. TIA.

Another bus/tro tro...crazy! So many rollovers from this. We headed to Kpalime where the next day we headed to the Sisters of Charity mission for our last time spent with them. Other Mercy Shippers met us there. We had a little farewell party - sad to say goodbye.

Cicile Ahamogbe

Cicile Ahamogbe stands in front of a room full people. Tears well up in her eyes.
“If I cry,” she says, “ t hey are tears of joy. I could stand here forever, and cry and cry and cry tears of joy. Dr. Arrowsmith and all the nurses , how can I thank you?”

Cicile, 44 years old, suffered from a condition called vesico-vaginal fistula, or VVF. This problem, common in countries where there is a lack of obstetric care, occurs when a woman is in labor for long periods of time without medical help. The pressure of the baby causes a hole to form between the bladder and the vagina. The result is an uncontrolled flow of urine.
Cicile endured unbearable situations. She was incontinent for a year and a half, and she was treated as an outcast because of the odor of urine. The problem was caused when she was in labor for three days before finally receiving a cesarean section. Her beautiful daughter, Destino, is lucky to be alive.

Cicile lives in Kpalime, a town about three hours north of Lomé. She learned to cope with her problem during the day by going to the bathroom constantly. But at night the problem was most evident. She explains, “ I would wake up in the night with the children sleeping in my bed, and we would all be wet … t he blanket, my clothes, their clothes , everything .”

It became very difficult for Cicile to provide for her children. Sometimes her husband sent money, but for the most part Cicile had little or no money to feed or clothe her kids. The incontinence kept her in her house … very alone.

Before coming to the Africa Mercy , Cecile did not know anyone who had the same problem as she did. Once she arrived at the hospital ship, however, she met several women just like her, and she will return to Kpalime with a support system that will be invaluable. She says, “It helps to know others like you. I hope that we will all leave here dry. I have faith that the doctors and nurses of Mercy Ships can take care of us.”

Cicile's faith held true. Today, she attends her dress ceremony. She stands in a maroon dress with a white beaded necklace. She smells of lavender. She is surrounded by four other women. She is crying tears of joy. After two surgeries by VVF surgeon, Dr. Steve Arrowsmith, Cicile stands triumphant. “I am dry!” she exclaims. “I am dry forever!”
The dress ceremony celebrates rebirth. The women who have successful surgeries are given a new life, and that calls for celebration! They are no longer outcasts, and they are able to stand among their peers without shame. It is a wonderful day when VVF ladies, like Cicile, get to dance in a dress ceremony.

Cicile knows she is lucky and blessed. She poignantly states, “ Thanks to Mercy Ships, t oday my beauty has been restored. The ugliness is gone.”

Story by Claire Bufe Edited by Nancy Predaina

Cicile Ahamogbe on the ward. After the second surgery, Cicile was dry. “I am dry forever!” she exclaimed.

Clementine adorns Cicile with a traditional African head-wrap that matches her dress. The celebration begins, and Cicile claps, smiles, and sings to commemorate this blessed day. The 5 ladies celebrate being dry! Cicile is on the left, hands in the air.
Cicile stands to give her testimony. She speaks of her life, and how one and a half years ago she began leaking after giving birth to her daughter, Destino. Her daughter is alive and well. Cicile displays emotion as she describes the difficult life she has endured. The 5 VVF women honored today pose with Clementine and Dr. Steve Arrowsmith.

Akissi Nalalene

Akissi is a spirited teenager. Her gleaming white teeth brighten her contagious smile. Some things get lost in translation, but not Akissi's gregarious behavior. When asked for a photo, she swiftly poses with clenched fists showing off her buff arms – accompanied by her award-winning smile.

However, Akissi's life has not always been filled with smiles and laughter. She grew up in a rural village in the northern part of Togo. From a family of farmers, she learned to work long days under the brutal sun at a very young age.

At sixteen she moved to Cote d'Ivoire to be married to a man there. When she went into labor with her first child, she struggled for several days before finally going to a hospital. She received a cesarean section, but the baby was stillborn. Akissi was devastated.
Akissi noticed that she could no longer control her bladder. Her condition is called vesico-vaginal fistula, or VVF, and is caused by damage resulting from obstructed labor. It is very common in countries where there is little or no obstetric care.

At this point, Akissi's husband no longer wanted her, and he sent her home. It was a very long voyage from Cote d'Ivoire back to her village in northern Togo. Akissi did her best to cover up her condition. But the other people on the bus noticed the foul smell coming from her, and she was humiliated.

Finally she was back with her family in her village, Pkaple. Akissi struggled to endure everyday life. Her vivacious personality was stifled, and her head remained bowed in shame.
Then Akissi heard on the radio that doctors from Mercy Ships were coming near her village to see women with a leaking problem like hers. She attended the patient screening and received a date to make the journey to the hospital ship in Lomé. Excitement and hope filled her heart.
Mercy Ships arranged transportation for the women from the northern areas to get to Lomé. When Akissi arrived, she was overwhelmed by the bustle and commercialization of a large city, but she remained focused on her hope that in a matter of days she would have her life back.

VVF surgeon Dr. Steve Arrowsmith performed surgery on Akissi. When the nurses removed the catheter a few days later, Akissi was cured! For the first time in a year and a half, she was dry!
A few days later Akissi took part in a ceremony honoring the women who were blessed with successful surgeries. The sounds of drums, clapping and singing echoed through the ward as the women filed into the room in traditional African dress. Akissi wore a new cobalt blue gown with touches of golden yellow. Her face was lit up with joy.
Akissi stood up among her peers and a large crowd attending the ceremony and said, “Thank you to all the doctors and the nurses. Now, I can be among people. I no longer hide at home. Thank you Mercy Ships for all you have done.”
Thanks to the entire Mercy Ships VVF team, Akissi will return to her village and regain her sparkling, bubbly spirit. She looks forward to a normal life – a life free from shame and filled with joy.

Story by Claire Bufe Edited by Nancy Predaina

Akissi Nadalene (center) with Alizma Kotoir (left) wait at the Hospitality Center for their surgery date.

Alizma Kotoir (left) and Akissi Nadalene wait in the ward to find out if their surgeries have been successful.

Alizma Notoir (left) and Akissi Nadalene play connect four in the ward as they wait till their discharge day. Mercy Ships will transport them back to their village in Northern Togo.

Akissi is “made up” for her dress ceremony.

Akissi Nadalene is adorned with beautiful jewelry as she waits for the beginning of the dance. The dress ceremony symbolizes “rebirth” into a life without leaking. A captivating headdress is structured for Akissi's head. Her outfit is complete!

Akissi, center in blue, anxiously waits for the procession into the dress ceremony.

Akissi (second from right) sits among the 7 women being honored in the dress ceremony for being dry.

VVF - Vesicovaginal Fistula Time - Part II

I love these women! My heart breaks for them and what they've been through -something I can't fathom. I was priveledged to be a part of the VVF team on the ship, working with screening, teaching the day volunteers, charge nursing etc. We had eagerly waited for these 6 weeks to come and excited that the patients were now here! I think all the nurses on the ship were a bit hesitant to work with these women, because it's new to all of us (except the RN's who've previously worked on the ship). But all the nurses, staff, and nonmedical staff on the ship fell in love with these ladies. It's impossible not to.

VVF (vesico vaginal fistula), is a birthing injury resulting from obstructed labor. This obstructed labor can last from 3 days up to a week. This pressure causes a hole (fistula) to form between the bladder and vagina (sometimes also the ureters and rectum) causing women to constantly leak urine and sometimes stool as well. In most situations the women ends up delivering a stillborn child.

Most times women's husbands leave them, making them fend for themselves. These women then try to grow produce to sell in the market, but no one wants to buy from the women who smell like urine, thus making it hard to make a living. Not only do they struggle from their physical condition but also huge mental, emotional, social, and spiritual challenges! This entry I will explain a bit about the happenings, then later will include some patient stories.

We had a screening day on May 24th when 67 women came to the ship to see if they were a candidate for surgery. Many of these women have been to many different Dr's before and told there was nothing that could be done for them. Many visited traditional healers and tried different remedies, many women just didn't have the $ to afford these surgeries.

These women are beautiful. It's heartbreaking to see their solomn faces as you know there's so much of a life story behind those faces.
The women waiting on the ward to be examined by Dr Steve the VVF surgeon.

The pilots entrance (another one of our 'waiting areas').
I remember walking down the hall screening day and a wall of foul smelling urine just suddenly hits you. I couldn't help but laugh to myself...it was some good comic relief to think that we're going to have to get somewhat used to this smell for the next 6 wks.

It was so awesome to see these women being able to relate to other women in the same condition, having gone through similiar experiences.

Ghana world cup fever on the ward! It was great!

After the ladies catheters were removed, prior to them being discharged we had a dress/dance ceremony for them. New dresses were given to the women to signify a new life/healing. They are such beautiful women! They've felt so much shame with their conditions so for them to see themselves beautiful is awesome!

Love their smiles when they see how beautiful they are and how God has created them beautifully!

Love it!

The ward would celebrate...you could hear the celebrations a few decks up and down the hall.

The women would had a chance to share their testimonies.

Other post op women waiting for their catheters to come out to be the next ones to dance :)

Beautiful women!
Here is a photo taken from Maggie (VVF coordinator)'s blog. It's a collage of all the VVF women who came to the ship. Although each story is more important then numbers, I think numbers still play an important role in stewardship, accountability, etc. so here's a few:

6 weeks of surgery

120 surgical procedures on 99 women.

2 VVF surgeons

4 African surgeons trained in VVF surgery (2 Benin, 1 Rwanda, 1 Nigeria)

4 African nurses trained in care of the VVF patient (2 Rwanda, 2 Nigeria)

It's so encouraging to read how Jesus had compassion on women in very similiar condition - the woman with the issue of bleeding in Mark 5:24-34:

24. So Jesus went with him.
A large crowd followed and pressed around him. 25. And a woman was there who had been subject to bleeding for twelve years. 26. She had suffered a great deal under the care of many doctors and had spent all she had, yet instead of getting better she grew worse. 27. When she heard about Jesus, she came up behind him in the crowd and touched his cloak, 28. because she thought, “If I just touch his clothes, I will be healed.” 29. Immediately her bleeding stopped and she felt in her body that she was freed from her suffering.
30. At once Jesus realized that power had gone out from him. He turned around in the crowd and asked, “Who touched my clothes?”
31. “You see the people crowding against you,” his disciples answered, “and yet you can ask, ‘Who touched me?’ ”
32. But Jesus kept looking around to see who had done it. 33. Then the woman, knowing what had happened to her, came and fell at his feet and, trembling with fear, told him the whole truth. 34. He said to her, “Daughter, your faith has healed you. Go in peace and be freed from your suffering.”