Koulouk Mbada Immersion Trip

Travel is fatal to prejudice, bigotry, and narrow-mindedness, and many of our people need it sorely on these accounts. Broad, wholesome, charitable views of men and things cannot be acquired by vegetating in one little corner of the earth all one’s lifetime.

—Mark Twain, The Innocents Abroad, or The New Pilgrims’ Progress (1869)

This needed a post of it's own.  

Steve is one of the onboard chaplains and has formed a friendship with a tribe chief named Songo.  Together, they arranged for us to visit his village for a cultural immersion trip.  I'm still processing it all.  

34 of us were on the dock at 4:45am to begin the journey to the village.  Songo met us on the dock.  I'm not sure what I expected when I met him for the first time but Songo is a delightful gentleman who wears polos and trousers just like anyone else.  I was expecting something more tribal and elaborate and was stunned to see him.  After the 3.5 hour bus ride, we arrived to the village of Koulouk Mbada.  We met the village elders, mayor, and Prefect.  The mayor is a woman who wore the most beautiful purple dress (I'm not sure what the local name for it is).  All of the men stood when she arrived which is a cultural norm that I did not expect.  Her position is highly respected.

We were divided into groups and sent off with our hosts to meet our families.  I'm quite certain this was the first time that most of the children had ever seen a light skinned person.  They were so inquisitive and just stared at us incessantly.  Bambi, Ayson, and I shared a room in the home were we were provided with all of our meals and a safe place to sleep.

It was hot.  Incredibly hot.  According to some weather sites, it was about 106 F, but it felt much hotter than that.  The sun is relentless.  Mornings are an industrious time while it is still cool and most everything stops about 11:30-12 until later in the evening/afternoon.  

The families were warm and welcoming.  We had a translator with us who helped as much as he could with the language barrier.  They speak a language called Serer which is a very new language to me as it did not seem similar to any of the other languages I have been introduced to.  It was very difficult to learn and pronounce.  We did our best and there was a LOT of charades.  LOL

We were taken to the local mosque.  We were not allowed to enter as we, aside from not being Muslim, had not done our absolution to become clean.  Women are allowed in the back rows if there is room, otherwise they remain outside.  Men wear simple patterns and there are no objects, paintings, or other distractions in the room.  The object is to remain in constant prayer and meditation with only God on your mind.  Any item or design that could distract you is removed. 

The clinic is about 2km away and consists of 3 rooms. The one pictured is the room where women give birth.  It is nothing more than a simple palate bed with a mosquito net over it.  There are no medications, resuscitation equipment, and only very limited supplies (her box consisted of a scalpel, umbilical cord clamps, and a surgical mask).  The midwife of 30 years was there.  She delivers between 25-30 babies here every month and our fast math added up to 9000 deliveries.  She told us that 2-3 per month experience complications that require going to another hospital but she did not elaborate. 

There is an elementary school nearby but all of the high school children walk 7km each way to school daily.  There is currently fundraising opportunities to help with the school.  The perimeter wall alone is a cost of over $50,000.  There is an agreement with the government that if the villagers provide 2 of the 12 proposed rooms and the bathroom, that the Senegalese government will step in to provide the remainder of the school.  If you are interested in donating to this cause, I will gladly put you in touch with Chaplain Steve.

My life is forever changed.

 

Days 4-7

I got a bit caught up in the business of the ship and didn't get an opportunity to update until now.  There is a lot to include here... :)

Day 4 was a pretty regular day.  I was a first case arrival at about 10am.  We have mealtimes on the ship and lunch is from 1130-1300 only.  It doesn't matter if you are the first one in or the last one, this is when you are able to get your lunch.  I'm learning about our Day Crew workers and how to interact with them.  They are such a joy to be around!  

Day Crew are Senegalese nationals who come on board for the day, they do not reside on the ship.  They help with multiple areas of the ship, the one that I interact with most are our translators.  Every patient going to surgery has a 1:1 translator at all times while awake and when waking.  Our Day Crew are kind, intelligent, and resourceful people. I am loving getting to know them.

I got to leave this ship and go out with some crewmates for ice cream.  This is my first real experience in Dakar.  It is an intense, loud, and crowded place.  People are constantly yelling at one another although rarely does it seem to be in any sort of animosity.  It just seems to be the way they communicate.  The gelato was divine and we headed back to the ship where I sat down for a cup of evening tea with some new friends for conversation.  I'm learning all about healthcare in the countries represented by my crewmates.  New drugs, new processes, it's all so impressive!  

Day 5 - I was a late start today which means I get to finish up the day.  I arrive to work at 1200.  My cabin is an inside cabin so I don't have a window.  This is glorious for a mid-day nap, but horrible for waking up on time.  I have learned that I must set an alarm if I want to get up or not otherwise I will sleep the day away.  With only one roommate, no light, no dogs, and no noises, my body will apparently sleep for quite a long time.  LOL

We ended up staying until past 8pm as the patient in our last case needed a little extra time and attention.  Anesthesia can  be a funny and tricky thing.  Our patients here have generally never taken medication before.  It's an odd concept as western cultures have utilized medications from birth onward where most here have never taken a tylenol.  We have to be very cautious in the doses that we give as they are very sensitive.

After work and a quick shower, my colleague and I walked to a nearby restaurant to meet the rest of the OR crew for dinner.  A glass of red wine and a gigantic plate of hummus were just what the week needed!  We had covered outdoor seating where we could see the lights of the ship. It was wonderful!  We were saying farewell to three of our PACU team.  It was starting to me just how quickly those bonds formed.  

Alice, Leslie, Emily, me

Day 6 - Dr. Peter is one of our anesthesiologists (or "aneethetist" as they say it in Australia) who helped organize a day trip to the Bandia Nature Preserve.  

13 of us (including my fellow PACU nurses pictured) climbed in a  van and drove about an our out of town where we were greeted with causually wandering monkeys and monitor lizards.  The monkeys are hysterical to watch and very opportunistic.  The preserve is large and we were taken on a 2 hour tour and then had lunch in their lovely restaurant. Giraffe, white rhino, multiple species of gazelle-type animals (I don't remember their names), buffalo, warthogs, hornbill birds, zebra, and many others were on full display for us to marvel at.  Our guide was fabulous and told us all about them and how they live naturally.  

Lunch was delicious!  The herd of wart hogs that trampled through the center of it was quite and experience and the sleepy warthog who was waiting just under the table (much like our doggos do a home) for a possible snack was hysterical! 

What an amazing week! 

Day 3 - First Full day

 My first full day in PACU was a pretty good one.  I've learned new things, new procedures, new conditions, new bacteria and viruses, new medications, and above all a new people!  

On board we have "day crew" workers who are local hires that come on board every day after going through training to accomplish various tasks.  The ones that I interact with most are our translators.  Every patient has a 1:1 translator in pre-op, holding, and in PACU.  Can you imagine waking up disoriented with strange people, with strange skin wearing a mask, with strange smells and not understanding anything that is going on around you?  Can you imagine that as a frightened child?  Our translators help us to communicate to both lessen their anxiety as well as help us care for them.  They are truly amazing and a gift from God.

I haven't yet been off the ship but I'm hoping to venture out tomorrow evening.  

Day 2 - Orientation

Lots of orientation.

I started the day with breakfast and an all hands meet.  Those of us who just arrived as well as those who are leaving were asked to stand.  I'm starting to feel a little less anonymous which is comforting.

After that we moved into OR orientation, met with IS to get internet and ship email set up, and then I finally got to see the PACU and meet my new colleagues.  I got to see the layout of the paperwork which isn't really all that different from what is normally done in the places I have worked.  After that I sat with a little girl who was sitting on her father's lap getting ready for surgery.  His faith in us was unwavering.  Caring for anyone's child is a humbling experience and this seemed more profound than most.  Strange people, from strange places, who speak strange languages are bestowed with the solemn responsibility to care for this little one.  It's humbling. 

This precious little one was obviously nervous.  You don't have to speak the same language to understand fear.  She colored a butterfly coloring page which helped to put her mind on something else besides the upcoming procedure.  Initially she refused to speak so we just sat there while I handed her crayons that she picked out.  With the help of the translator I got her to open up a bit.  I think I even saw a hint of a smile.  

Then, more orientation... 😆

Day 1 - Here we go!

Up to breakfast and then back for a nap.  I slept another 2 hours or so and feel much more human.  We had a great tour of the boat starting from the top of deck 12 all the way down to deck 2.  I'm signing up for a tour of the engine room. The Global Mercy (GLM) is huge (photo below of deck 6 that runs the length of the ship).  Common areas for families, children, and adult crew.  We got to see the bridge and all of what into makes this ship function.  The dining hall keeps us well fed and there are several recreational areas.  

My cabin is on deck 6 that I share with Caroline.  She’s a ward nurse on board who is also from the US.  

We had a worship service this evening and then fellowship time with my cremates.  I learned a bit how to play Quirkle.  It's a fun pretty fun game!

 

Let's Get This Show in the Air!

I’ve never been a good one at good byes or, as we learned to call them, “see you laters.”  After a fun dinner with my family, I headed off to the airport where my tear ducts got a good cleaning out.  I doubt I'm the first red-eyed passenger that TSA has encountered but, I digress... The flight to Madrid was uneventful although I’m quite certain that airplane manufacturers have started making the seats out of cinder blocks. LOL

A stop in Madrid allowed me to change clothes and freshen up a little as well as grab a snack and make a good call home.  

The flight to Dakar was unusual from typical US and western European travel.  The social norms are very different.  It's hard not to wonder if the route has anything to do with it. The plane and equipment were obviously old and with very few amenities; the seats didn't even recline.  I sat next to the kindest man who, despite our combined better efforts, I was very limited to understand.  My French is terrible.  Nevertheless, we shared a friendly trip in the sky and I got a view of Dakar at night.

Our drive was about an hour to the ship after we had gathered all who were arriving.  Homes without electricity, water, and even windows were lining the highway.  Things that we take so incredibly for granted are presumably luxuries. 

We arrived at the ship where I had the most dreadful badge picture taken; posing for photos after 20+ hours of travel is not ideal.  We had a brief introduction and then were shown to our cabins.  I briefly unpacked, grabbed a snack, and my eyelids closed.  

The rest can be done tomorrow.

I am here.

Thank You to My Sponsors!!

 This mission is completely independently funded.  Everything, including my time, is donated.  The financial support of those who love me is humbling and I am so very grateful!

Liana Bass

Amanda Donn

Scott & Alice Giblin

Nancy Greiner & Jason Savage

Dennis Hess & Michelle Sitton

Brian & Crystal Heverly

Alan & Brenda Leondard

Mike & Amanda Pickens

Erin Powell

Dr. Janet Rogers

Aruoture Shakarho

Alice Spence