Ward Life

Nursing mothers,

20 patients to a ward, not including guests and caregivers,

the spicy, earthy smell of African food,

curtains that hang from the ceiling by magnets,

translating through several translators and a fellow patient to speak to one patient because she comes from a remote Northern region of the country,

giving medication times by pictures of suns and moons

It is truly an adventure nursing on the ward on the Africa Mercy.  You never know what supplies or equipment you’re going to have one day to the next. And you’re not sure it’s going to work if you can find it.  You don’t know if your assignment will consist of four patients with nothing going on or ten patients, each of whom could keep you fairly busy all shift.

I’ve just come off a set of night shifts: 10 hour shifts on Thursday and Friday night, 12 hour shifts Saturday and Sunday night.  Nights are interesting. You spend a lot of time on the ward, but not necessarily a lot of time with patients.  Usually they’re sleeping the majority of the night.  This was not the case with these past shifts.  They were busy, which is fine.  It’s easier to stay awake that way.

“Sista, sista”, I hear from behind the curtain that blocks the light at night.

“Douleur” my patient says, and points to her feet, motioning with her hands an obvious throbbing gesture.

“I’ll get you medicine”, I say in English and crudely sign taking pills, to which she nods with a quiet “Merci”.

Such is communication when translators are nowhere to be found, as is often the case on night shift, or when they are all tied up translating for someone else.  We call it ward sign language.

Part broken French, part English, with a good portion of hand gesture.

The wards in our hospital are a special place.  It’s not a first world hospital.  There’s a two-year-old dying in ward B because we don’t have the medicine he needs to treat his type of cancer, which wouldn’t happen in a first-world hospital. But it’s definitely not an African hospital, where patients lie in the hallway bleeding to death from a broken arm they cannot afford to have fixed.  Our hospital is a strange in between.  We do our best with what we have.  Sometimes it’s not good enough.  But it’s more than nothing.  It’s a place all it’s own. At times comical; at others tragic. Always an experience unlike any other.

Luc's Story

The World feels too heavy with hurt today.

I’ve been five weeks now in a job other than ward nursing and tomorrow is my last day.  It’s been stretching, frustrating and fun, all in its turn, but today, the second to last, was the most difficult by far. 

I’ve been filling in as an admissions nurse by request of Frankie, the nursing supervisor, as they were short staffed.  I took the position reluctantly.  It is a desk job. You interview each patient with a translator, finding out previous health history, diet, last time patient had malaria (it’s not really an if question, always a when) and the like.  You explain to them the rules of the hospital, what to expect and obtain consent for surgery and blood testing. After that vital signs are taken and I draw blood for routine testing.  The translator and I then pray with the patient and off he, or she goes to the ward to take his, or her, chlorhexidine  shower.

A little boy and his mum came in to be admitted for a biopsy.  It looks like Luc has a form of extremely fast growing cancer called Burkitt’s lymphoma. For some biochemical reason beyond me, Burkitt’s is common in children with recurrent malaria.  It grows at a fast rate, tumors often doubling in size in two weeks’ time.  Without aggressive treatment disfigurement is inevitable and death is likely within a year.

Trying to complete little Luc’s admission took all the professional training and will power in me.  Four-year old Luc lay limp in his mother’s arms.  He looked occasionally at his mother, once or twice with trepidation at me, but primarily off in the distance with no fixed object.  A tumor larger than a softball protruded from his small face, making his eye bulge and his mouth difficult to close.  I had to concentrate on my paperwork and look at the boy as infrequently as possible so the tears would not spill down my cheeks as questions flooded me.  His little disfigured nose had been bleeding.  I tried to gently clean him up.  It was the one thing I felt was in my ability to do for him. Every time I turned back to him I demanded answers from God:

How could you, a loving creator, allow this kind of suffering?

Why don’t you do something about it if you really care so much?

What did this precious little boy do to deserve pain and death this way?

Why does the fallen nature of man so often manifest itself in the helpless?

I wanted to cry, and yell at God, and tell his mum it would all be ok. We would help them.  But the truth is there is little we can do. We have one type of chemotherapy and no radiation. If it doesn’t work, or the cancer metastasizes, there is nothing we can do.

I asked another nurse to draw his blood.  Poking this little one and causing even the smallest further discomfort would undo me altogether.  I took the ten minutes break to run to my room and let the pent up tears go for a minute.  I considered not going back at all. I couldn’t face his distant stare and limp cry again.  But something in me told me to do the brave thing.  After all, I hadn’t yet prayed with them, which was, in fact, the one thing I could do for them.

As I prayed for comfort and strength and Gods healing power in their lives, a peace came over me.  Not any sort of answer to all my questions.  I may never know those.  But a profound knowledge that God does see this hurt, this tragedy. Precious little Luc may be one of millions, but he is not forgotten.

They left me to be taken to the ward to see what medical treatment we can offer them. It broke my heart.

But in that moment, I knew without a doubt, that it breaks Jesus’ heart even more than mine.  And that was strangely a comfort.

“But tonight my heart is heavy, and I cannot keep from whispering this prayer ‘are you there?’ … Oh great God, be small enough to hear me now“  

Lyrics to a favorite song by Nicole Nordeman