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.”

A few more patients

Kossin Delou

Pre-operative

Post op


Dr Gary Parker (maxillofacial surgeon) screening Kossin

Just out of the OR

Kossin and his father - 3 weeks post op.

Sixteen-year-old, Kossin Delou, spent four years of his life sheltered by his family and kept out of the public eye due to an enormous tumor that dominated the left side of his face. When the tumor first appeared, Kossin visited local hospitals in Lomé, Togo. But his family could not afford the necessary surgery.
So, the tumor, which started from Kossin's upper jaw, continued to grow. It soon covered his eye, hindering his vision.
As the insidious growth enlarged, Kossin's life became more difficult. Kossin's father is a local pastor, and the church is an important part of his family life. But people viewed the tumor as a curse, so Kossin's shame prevented him from attending church.
In fact, the children who were once his friends now ridiculed him on the streets and at school. He even felt like an outsider among his own siblings.
His emotional turmoil intensified as his dream for his future began to fade away. Kossin wanted to study at a university to become a teacher. He wanted to enrich the lives of children with knowledge and love. His grotesque facial deformity would prevent him from pursuing his education.
Then Kossin came to our hospital ship, the Africa Mercy . After many hours of surgery, he emerged with a newly constructed face.
Joy radiated from Kossin and his family. His father, Pastor Delou, says, "In this life each one of us need s help in some moments of our life. I can say that through Mercy S hips, we have found that help. Y ou can have a bad story - but, before the end of your life , God will open a door and smile deep into your heart. I know that God is working through Mercy Ships for the best in my life and in Kossi n 's life ."
Kossin is ecstatic about his new life. He can go to church with his family and friends. He's no longer an object of ridicule. And - best of all - in September of 2010, Kossin will be able to start school to fulfil his resurrected dream of becoming a teacher.

Written by Joy Clary Edited by Nancy Predaina Photos by Debra Bell and Liz Cantu

The great difference between working Emergency back home and working on the ships surgical ward is that we actually got to spend time with and get to know our patients. I had Kossin as a patient a few days and had the opportunity to hear his story in talking with his father. Kossin's father is a local pastor of one of the church's in Lome. He explained how Kossin was not permitted to go to school because of his deformity, even though he had the books and uniforms. Kossin's friends mocked him so he had become shy and withdrawn not leaving his house. Kossin's father was mocked by others saying 'God can do miracles through you, yet your own son can't be healed'. Kossin's father's reply was that in God's time he would be healed.

Because witchcraft is much more prevalent in Africa witches tried to get involved in Kossin's life, trying to practice their witchcraft on him. When one witch was on her way to the Delou household she was struck dead. Pastor Delou rebuked these witch's work. What an amazing man with a big faith! So encouraging!

Afi

This is Afi. She is 19 yrs old. I don't know her story but I wish I did. Although she was my patient for a few shifts, I did not make the time to hear her story, and in hindsight I really wish I would have. She was so shy and withdrawn, so sad. Comparing 19 yr olds 'self image' problems back home to hers...well let's just say, there's not any comparison. I don't remember her ever having visitors, I'd like to think some did come on my days off. She had multiple surgeries and will be flown to Sierre Leone next year where the ship will be docked. Please send up a prayer for her.

Abel

The first day I saw Abel, I couldn't believe my eyes! So many of these conditions seem so surreal and literally you can hardly believe your eyes!

Abel & his father got to meet Togo's President Gnassingbe when he visited the ship.

Abel walking with his crutch's & straight legs at our hospitality center.

Cast's off, home time!!

Abel had a normal childhood until a problem arose following an injection. His parents noticed he was having difficulty learning to crawl. His muscles had stopped growing, but his bones had not. As a result, his legs were not growing correctly because there was so little musculature to direct them. They began to bend backward at the knee, forcing his upper thighs out behind him. His parents took him to three different doctors, but none of them knew what to do for him.
Despite this condition, the resolute Abel learned to lean forward, correcting his balance enough to walk, climb and do just about anything any other active boy can do. He even became the goalkeeper on his football (soccer) team. The only thing he couldn’t do was ride a bicycle, since it requires sitting straight on the seat and pushing down on the pedals.
Abel’s physical deformity made him the target of ridicule from other children. But he remained optimistic thanks to his joyful spirit and his wonderfully supportive parents.
One day, there was an announcement on the radio that a Mercy Ship was coming to Togo, offering free surgeries. Abel’s hopeful father took his son to an orthopedic screening in Lomè.
A few days later, a wonderful surprise awaited Abel when he awoke after his first surgery onboard the Africa Mercy. His left leg was straight out in front of him, wrapped in a cast! As he admired his newly straightened leg, he asked his dad if his right leg would also be straight after the next surgery. His father assured him that it would. Abel jubilantly declared, “If the other leg is going to be like this one, I am going to give a big thanks to the Lord.” And a second surgery did straighten his right leg. He also had a third procedure – plastic surgery on his knees.
Through the round of surgeries and post-operative care, Abel’s sparkling personality and brilliant smile earned him many new friends among the crew and among the other children recovering at the HospitalityCenter.
Even though Abel loves soccer, his long-term goal is not to become a famous soccer player. He is now determined to become a surgeon, like those on the Mercy Ship, “because of the things they have done for me,” he said.
Finally, after more than three months of surgery and recovery, it was time to return home to the village of Homa, deep in the bush. Abel and his father, accompanied by a Mercy Ships team, climbed into the Mercy Ships Land Rover to start the six-hour journey.
And it was quite a journey! The Land Rover struggled for more than two hours to traverse the muddy, deep-puddled pathway to Homa. In fourth gear, the intrepid vehicle clawed its way over mucky mounds and through watery ruts. Occasionally, passers-by paused to see if the car would win its battle with the road. A semi-truck stuck diagonally in the mud almost ended the trip. But the Rover squeezed by, narrowly missing the swamp on the right and the side mirrors of the truck on the left.
Perseverance was rewarded when they finally arrived at the village. As villagers recognized the Mercy Ships logo on the vehicle, they ran to spread the word. Soon the Land Rover was surrounded by curious villagers who wanted to see what the volunteer doctors had done for the boy with the backward legs.
The suspense ended abruptly when the star of the show, a very happy Abel, climbed out of the vehicle … with two straight legs! There were gasps of surprise, disbelieving stares, and cheers.
Abel, dressed in his cheerful blue and yellow outfit, was the center of attention. The other boys in the village stood quietly nearby. Could this be the same Abel that they had insulted, beaten up, and called names?
Abel kicked a small soccer ball with his wonderfully straightened legs, and not one of the boys moved. Abel, who had never retaliated during the mistreatment, smiled graciously at them. He was clearly the uncontested victor on every level.
A beautifully prepared meal was provided for the Mercy Ships crew at the home of the village pastor. It was enjoyed with great appreciation.
The Dalome family – all 20 or so members – squeezed together for a photo commemorating this fantastic and unforgettable moment. Abel’s grandfather joyfully pronounced, “Now, I know there is a God because I see Abel has straight legs.”
When it came time for the team to leave, the villagers vigorously shook the hands of each crew member and expressed their thanks, saying, “God bless Mercy Ships.”

Story by Elaine B. WinnEdited by Nancy PredainaPhotos by Debra Bell and Liz Cantu

After long time...

'After long time'...a few email titles I've received from friends back in Africa. It's been just over 2 months now since returning home - sometimes it feels alot longer. It's amazing how you can adjust so quickly to being somewhere then everything changes again. Not a day goes by I don't think back to the previous 7 months. Definitely have moments of missing Togo & the ship. Work - kids running/screaming on the ward, drool hanging from maxillo-facial patients mouths, translators breaking out into singing and drumming each shift, spending time with patients, hearing testimonies. Life on the ship - community, hanging out with your coworkers, movie nights in the cabin, community meeting, football (soccer), volleyball at the hospitality centre, eating supper out on deck 8 overlooking the ocean, going on weekend getaways, afternoons at the market, mango smoothies. Hanging with the translators - ice cream, eating adamae/acumae at a local restaurant, playing card on the ward. So many good memories to cherish!

I've been wanting to post more from Togo since I've returned home, but with life getting in the way unfortunately, it was kinda left on the back burner. So here I am a day before I leave for Niger, procrastination at it's finest...quickly trying to post a few more things and bring a bit of closure to Togo.

Starting with the last entry about Lovelace...she ended up passing away on July 27th - she's in a much better place now - able to run and jump with no pain and...no tumors!!

I want to introduce you to a few patients I had the opportunity to work with. The stories I'm posting are from the communications department on the ship.

Lawson

Lawson is a gentleman I met at the first day of screening. It was great getting to know him and seeing him from screening, surgery, post op, and followup appointments on the ship.

His gentle eyes betrayed his desperate hope. ? I came here so I could get help ,? said Lawson, struggling to speak clearly. A large growth stretched his mouth and cheeks horribly, causing his teeth to stick out in all directions. It had been growing for four years, inhibiting his breathing, eating, and speech ? and, eventually, his ability to work.
The tumor destroyed his life, separating him from everyone and everything he loved. The people in his village would not sell him food because they said he was a devil. His wife left him, leaving behind their three children. Without work or food, he could not provide for his family.
So, Lawson, once one of Ghana's most prominent football (soccer) players, now hid inside his house.
Then, a radio announcement said that a hospital ship, the Africa Mercy , would soon be coming to Togo, offering surgeries free of charge. Daring to hope, Lawson left his children in his mother's care and went to the patient screening.
Lawson was literally at the brink of death as the tumor slowly suffocated him. He was immediately admitted to the hospital ship, with surgery the next day. It took three doctors eight hours to remove the benign growth and repair his nose, upper lip, and cheek. The large amount of blood required during surgery was donated by crew members.
Lawson was overjoyed when he touched the bandages on his cheek ? the tumor was gone! There will be more surgeries within the next year to complete the reconstruction of his face, but the immediate result saved and restored his life.
Unable to hold back tears of joy, a delighted Lawson exclaimed, ?I can't believe what has happened to me. It is a miracle! My way was crooked, but now my way is straight. Now, I am a man!?
Lawson can hardly wait to surprise his family with his transformation. He is anxious to eat real food again ? especially his mother's ademe, a stew made with legumes, fish and red oil. Then he will think about starting his new life.
He has photos of what he looked like before surgery and after. ?I want to show pictures to everybody, so people can see what Mercy Ships did for me. Everybody who sees me, they will be surprised,? he grinned. ?I survived! Praise the Lord! Hallelujah! Amen!?

Written by Elaine B. WinnEdited by Nancy PredainaPhotos by: Debra Bell