It's all about the kidney juice......

....or pee, or wee, or whatever you prefer to call it.

My first stint in VVF Land is completed! Although we've had VVF patients on the wards for a few weeks now, I hadn't been assigned to them until last Tues.

The first night was quite busy and hectic. I came away with the realization that it really is all about the pee - what does it look like? what color is it? how much? where is it coming out of? does it smell bad? (not that pee ever smells good) are there blood clots in it? After asking myself these questions about multiple patients every hour for nine hours; I didn't even want to go to the bathroom myself, because I had seen more than enough pee!

I think VVF land is more emotionally challenging than the other surgeries, at least for me it is. The patients must be checked every hour for the first 24 hours after surgery to make sure they aren't still, or start back, leaking and that they have at least 30ml of urine. 30ml of urine an hour is the minimum to indicate healthy kidney function, and that the person isn't dehydrated. We give each lady a 1.5 liter water bottle on admission and encourage them to drink 2-3 L per day. This helps them to keep their kidneys flushed out so that they aren't as prone to infections, and to help insure adequate hourly output.

It's always a bit anxiety inducing each time I check the chux pad under each one; will it be wet? or dry?? I always breathe a small sigh of relief and happiness when they are still dry. Although it may not seem like a big deal to some people, I know how much hope these beautiful ladies have put into having this surgery. One girl that is with us is only 19 years old, she has been wet for five years. It's saddens my heart to think of a 14 year old going through this. First of all being pregnant, and then, not only losing her baby, but also having this horrible stigma attached to her, and living her young life not knowing if she will ever be able to be healed or if she will have to live the rest of her days with this curse. Although this isn't how God intended it to be, a woman's worth (here) is largely based on her abilities as a wife and especially her ability to bear children.

Screening day

It is the most amazing thin to see the radiant joy on the faces of the ladies that the surgery has worked for. But at the same time the sadness and loss of hope written on the faces of the ladies that haven't been healed, is heart breaking.

Once a week or two, there is a dress ceremony to celebrate a new life for the ladies that have had successful surgery. Each lady is given a new dress - to symbolize her new life. Clementine - a Togolese lady that works on the ship, plans and organizes the dress ceremonies. She takes the ladies to another ward and helps them get all dressed up with makeup (if they want) and their new dresses, then they sing and dance as they come back down the hall to the VVF ward. The Dress Ceremony has begun!

Getting ready for the ceremony!

It is a time of singing, dancing, telling their stories, and thanking God, and immense joy. The crew are invited to attend and join in with the celebration. I haven't made it to any this year, but I can remember from last year how exciting it is. I like to observe all the different people. The ladies in the ceremony and how they are glowing. Then there are the ladies that have just had surgery and still aren't sure if it has been successful but are so very hopeful. Also there are the ones who haven't had their surgery yet, but you can see the hope in their faces that soon they will be the one up there dancing and singing. And then, there are the ones that have had their surgery, and it hasn't been successful. I always wonder what is going through their minds, sadness, disappointment, despair, even jealousy maybe? My heart goes out to them as I watch them watching the joyous dancing and singing, even though at the same time, their hopes have been shattered. So I silently pray for them, that even though they haven't been physically healed, hopefully they have experienced the love of Jesus through us while they are here, and that they will still have eternal hope.

Telling her story

This is my prayer, that each patient will see the love of Jesus through us; through me and through each crew member that they come into contact with.

Ready to have her surgery!

Playing games on the ward

Lead VVF surgeon - Steve Arrowsmith

Life in Togo

I got the chance to visit one of our translators at her home a couple weekends ago. It really put into perspective how fortunite and privileged I am. At home I always considered myself to be middle-income; not wealthy, but not barely scraping by each month either. After seeing Amele's house, I realize that actually I'm very weathly in comparison, and should never complain about what I don't have. Amale's house is less than half the size of our cabin here on the ship approximately the size of my parent's back porch. Our cabin isn't big compared to my house back home, or even an apartments back home, although it is considerably larger than our first cabin. But after seeing Amale's house, I feel like I'm living in luxury. It's all in the perspective, I guess.

I was so amazed, and blessed - I think that word gets used too much sometimes, but it definitely applies here - by her wonderful hospitality and generosity. She had decided to teach us how to cook African food. I'm not the best cook to begin with, but turns out it was quite easy, because it was seafood soup! Started out by heating water on a small kerosene stove - that was sitting in a cardboard box, Yikes! Then in go the greens, which became very slimy, followed by saltpeter mixed in water (which just looked like muddy water). After that cooked for a little while, in went the prawns (shrimp), crabs (shell and all!), oil mixed with some spices that turned it red, and some sea salt. While we were making this, Amele's friend was cooking on a small wood stove beside us making.......well.........I don't know what it's called, but it's a thick, sticky concoction made out of water and cornmeal.

Then it was time to eat! Don't need utensils here, just dig in......with your right hand that is. It is very rude to use your left hand to eat with. It was quite tasty, although I had my doubts when I was watching it cook. The process goes like this: dip your fingers in the soup, pinch off a bit of the doughy stuff and use it to scoop up some soup, swirl your hand around a little bit so that the sliminess breaks and doesn't drip on you, and pop it in your mouth! Yum! Then, if you're brave, or African, you choose a nice morsel of crab and eat it - that's right - shell and all! Crunchy! I wasn't brave enough to try it, but one of the girls with us braved it and took a small bite. She said it wasn't too bad, but I didn't care to share that experience with her.




After we finished eating she took us around to see the lake nearby and we found a wonderful climbing tree. So we all climbed it and took pictures. There were several Africans around just standing there watching us, I'm sure they were thinking "these yovos have really lost it!" But it was lots of fun!

It's always interesting to see other ways of living, to get a small glimpse into someone else's life, and wonder "how different would my life, and views on things, be if I had grown up here instead?"

Amele's friend

Greens.....
...oil and spices.....
...crabs and prawns!
Stirring the cornmeal and water.....before it got thick and sticky
finished product!
Jolene, Esther, Amele, me, Becca.