here are some pictures from our adventurous trip to Cape Coast a town that is on the ocean west of Tema past Accra. The picture of the orange van is our transportation. The drivers stayed with us all weekend, we payed 19 bucks for round trip and the drivers drove us all around all weekend long. It was a little rickety, i don't think they have shocks in their vehicles but it was safe and fun! the view of the ocean and all of those boats is the fishing village we stayed in Elmina, we visited a slave castle that was built in the 1400's by the portuegese and then taken by the dutch and then shut down by the british. it was a powerful tour to see the slave trade and how it took place quite atrocious and brutal it's like the holocaust of africa. The top picture on the right and left are of the local men building their fishing boat. they cut down a huge tree and dig out the center to make the base of the boat and then they buid up the sides it's huge and very heavy. I still don't understand how they don't get out to the ocean, it's a rough sea here they always have people get caught in the undertow! If people don't have a boat they tie the huge nets to a palm tree on shore and you see these lines of 20 people pulling the nets as the waves wash over them, you've got these little kids and these old men fishing off palm trees it's the oddest thing. The fisherman fish at night so at sunset they make their way out into the ocean and then at about 7am they come into town and everyone gathers on the bridge and sings and welcomes them back, like every morning, it's a huge celebration. The boats are very colorful and fun they owners paint them according to their liking there were some unites states boats lots of brazil boats all have bible verses on them or the face of Jesus which is kind of funny looking on the side of a boat. The Ghanian people are very superstitious from their fishing boats to their health when we take them in for surgery they often have beads everywhere, fetishes they are called and they are beads prayed over by the local priest or witch doctor or whomever. Anyhow the middle picture is of Nicole another nurse and one of the teachers, Ginny. One of the pictures is of a woman carrying a huge bowl of fish on her head. None of the women carry with their hands, why use your arms when you have a head, they carry everything on their head, a small bag of food to a sewing machine! We spent the day at the castle then at the beach and then on sunday we went to the rainforest here in Ghana they have a canopy walk of seven different bridges that are suspended 40 feet into the air. It was beautiful. On our drive home we stopped to buy pineapples for about 0.20cents a peice and avocados. Our drivers got a little excited and were bartering for bushbeet, which is any animal killed in the bush which in this case was antelope the size of a large jackrabbit! We lost our enthusiasm for buying from the side of the road at that point. all in all it was a great trip! very adventurous. :)

My favorite patient right now is a 7 year old boy named Ebenezer, he has been here for over a month and will continue to stay as the grafts that were placed in between his fingers have failed and sloughed off so the surgeons are in the middle of deciding what the next step is. His joy is contagious, never bothered by the fact that he has been in a very small confined area for over a month he is always laughing, always smiling unless of course you have to change his dressings. His story I copied off the local newsletter here on the ship.
Ebenezer was out playing with a friend one day when he stumbled into a field where
charcoal was being made. The red-hot coals lay smoldering, hidden beneath a thin cover of topsoil. The heat was so intense it quickly melted Ebenezer’s plastic sandals to his feet. Confused by the sudden pain, the boy reached down in a futile attempt to brush away the hurt and so his hands were also badly burned. The pain quickly drove Ebenezer to his knees and he crawled to safety, leaving his legs burned as well. In the developed world, a child so badly injured would be immediately rushed to a specialized burns unit. But as in many poor countries, Ghana’s healthcare system is a pay-as-you-go service. Ebenezer was admitted to the hospital, but his burns received little attention because the family could not afford the cost. As a result the burned flesh contractedinto rock-hard scar tissue, pulling Ebenezer’shands and feet into misshapen claws.“The thing about burns is, if you don’t treat them ingood time they heal by what’s called ‘secondary tension’or ‘contracture formation’,” Dr. Tertius explains.“This means the wound pulls closed by itselfand that will pull your fingers closed in the palm ofyour hand or pull your shoulder up so that you can’tmove it…a frozen position.“So we release that and treat that with skin grafts.It’s obviously very satisfying to do that, particularlywith small children who come in with their hand in alittle ball and he can’t open his hand and you can releasethat with skin grafts and they do very well.They get a lot of function back in those hands.” Ebenezer is still in recovery onboard, but the grafts are holding and his prognosis is good. The boy’s mother, Matilda, is so impressed with the Mercy Shipshe’s decided the vessel and crew must be heaven sent. "I believe the nurses and doctors are little angels dropped from heaven just for my Ebenezer to get a chance at living again," Matilda says. "My boy is alive, he smiles and I see the light in his eyes." afford the cost.

I have had the privilege of caring for Ebenezer the past couple of days and he is remarkable. He limps around because his foot is completely bandaged and he loves watching Mighty Ducks. Every morning you will find him burrowed in his blankets, you have to dig for him for awhile. He wears a sweater that reaches to his ankles because he says he is always "freezing". He never complains of pain and is always up for playing with play dough. Selfishly I want him to stay forever, however I guess he has to go home sometime. For now he will be here for at least another week. And then it will be up to the doctors, if he goes home now he will have more use and function of his hands and feet than ever before so it is not a total loss however if we can fix his grafts and give him new ones it will correct the deformed part of his hands that embarrasses him so much.
My other favorite patient is named Gloria, she is 20 years old and has a badly deformed hand, she came to the ship to receive surgery on her hand to release some contractures and when she got here the staff found a very bad burn on her right foot. Apparently she had dropped an iron on her foot. Had she never come for the surgery on her hand we never would have seen her foot and she would have died of infection. The burn on her foot was badly infected and it was working it’s way up her leg. She has now had multiple debridements of her foot and it is healing miraculously well. The dressing change is quite painful and so we give her a little bit of morphine but she just grits her teeth and refuses to cry, she has a 2 year old son Joshua at home that she has to get back to. He was on the ship for awhile, he is very smart and speaks English and Twi already! The difference in her is that she is so brave and so strong never complaining about the pain never asking for medicine she just does as told and waits patiently for healing to occur. I am used to the patients at home who scream for pain medicine every hour, God has given her amazing strength and healing, it's awesome to see how the things we have to go without here in terms of medical supplies, different antibiotics that we don't have access to, these patients are still healing. There is pseudomonas on the ward right now and it's contained with that one patient, without any isolation. The rules and protocols that we follow at home in hospitals are ones that we have the ability to follow we have the supplies the equipment the capability and the money to make it happen. We don't have that here and it's been so incredible to see how people still heal, they still get better, infections don't spread and life goes on. It's pretty cool!

More Pictures..... Ward prior to patients arriving.
Local kids, they love getting their pictures taken, you just have to ask first;)
VVF patients prior to their discharge they are given a new outfit representing their tribe also representing the healing they have.
Eye patient returning to ship for follow-up appointment.
Patients taking walk and getting fressh air on deck.
Local boy in Tema, Ghana.

PICTURES!!

here are some pictures i took recently, we are asked not to take pictures of patients our first couple of weeks here until they get to know us. We are never allowed to take pictures of the nurisng ward for privacy reasons, so the actual ship photographer takes any ward pictures and I will try to post some of those here!

my windows!! actual ship windows they are very cool!
The ship in the port of Tema. It looks so small next to these huge cargo ships.
My bed is the green one, we are only two in a room for four right now, so that was just lucky!!
Traditional fishing boat! oddly enough everyone is dressed on this boat.

Life in Africa seems to the be the topic of conversation for every orientation I have been too except maybe ship safety and what to do if we have to abandon ship or need to muster! On average the families of Ghana have an income of $390 a year which is far higher than many of the surrounding countries. The HIV/AIDS rate is 3% which is higher than in the US it is also far lower than many of the southern African countries. Ghana is a very high literacy rate and many of the people have more than a high school degree however there are no jobs here in this country. It is extraordinarily hard to find work especially if you are educated. The ship employs almost 50 "day-workers" that are local men and women that are either translators for the many different languages or they are deck-hands. The food is quite interesting. Most of the food comes from Holland, the UK or the US. However it can take anywhere from 2 weeks to 8 weeks or longer for a shipment to arrive. Last night was the spaghetti which was the first spaghetti in 6 months or something. The port here is very corrupt and they hold the shipments ransom for payment. They honestly think the ship is very wealthy oh if only they knew that I was paying them to serve huh! :)
Today was my first day on the ward as they call it. Honestly the medical part of the ship runs along the B deck which is the only deck that runs from the head to the butt of the ship. Or the bow to the aft as they say. However you wouldn’t even know it is there unless someone pointed it out. I think that there are more deckhands (deckies) than there are medical staff. The ward has 50 beds and at the moment we are only half full. The VVF surgeries or vesiculo-vaginal surgeries are completed until November when they will do another round. Since the surgeons come for a couple of months a time they schedule patients according to the specialty of the surgeon. Plastics was here this last month currently we have multiple patients that had burns and contracture repairs. One little girl has over 50% of her body covered in burns that were largely around her neck, she was unable to move her neck. The surgeon released the contracture and placed grafts over the worst scars. She now has movement in her neck however she will need weeks of occupational therapy. The ship has an occupational therapist on board at this time and a physical therapist on their way next month which is very fortunate. My patients today included a 40 year old man that had a large tumor spanning from his left ear down his neck over to his chin. He had the tumor removed and because of the involvement of the tumor into his airway he was given a tracheostomy and placed in the ICU on a ventilator. As he was getting better the incision got infected which happens around here just because of what is in their blood and simply because we are in a tropical environment anyhow the wound caused his ear to lose blood and his left ear was lost. He was quite upset about that and is still very depressed about the loss of his ear however because the tumor reached from his ear to his neck his ear and inner ear were stretched all the way down to his shoulder and now that he has lost the outer ear and the skin been lifted up he can hear better than before. Poor guy doesn’t quite see how amazing that is. One of my other patients was a 22 year old girl, she is a refugee from Liberia. She was running from the soldiers in Liberia when she was pregnant she went into labor and remained in labor for four days, when she did give birth the baby was stillborn and there was extensive damage to her vaginal and bladder wall where her bladder leaked continuously causing multiple infections. She had to leave the baby and keep running, she ended up here in the refugee camp outside of Accra, she heard of Mercy Ships and the VVF program for women like her and she came. She has been to surgery 3 or 4 times, there is so much necrotic tissue and damage that she continues to leak however the surgeons remain hopeful that one day she will make a full recovery. She has spent many days very depressed and upset but today she woke with a smile, she sings songs continuously and I painted her nails bright red as can be! She has a huge faith in the Lord even after living through all of that and is an incredibly joyful girl.
The aspect of my job I love the most is the decrease in paperwork, we do a lot by pathways and flowsheets that make it easy for nurses that don’t have English as their first language. This decrease in paperwork amazingly leads to so much free time. I play with children and play games with patients most of the time. It’s amazing to see how much healing simply comes from love and time spent loving on these patients. The majority of them are rejected in their own community because they are deformed or disabled in some manner. They respond to touch in a way that we have lost in the western culture. Once the patient as been here for 48 hours everything is done once a shift, given that they are not critically ill or in the ICU. These are incredibly healthy people for the poverty they live in, their veins are beautiful for IV"s and they do not have chronic illnesses for most of them. They do not have diabetes or congestive heart failure, the only major congenital defect is cleft lip and cleft palate everything else is nonexistent. . I am continuously amazed by their health and how well they recover from these surgeries.
Aside from medical stuff I have had two marriage proposals:) And told that I am marriable because of my golden hair!! So I have now found my way to a quick marriage, I swear just get over here to Ghana. They love white and blond. I was told today by one of the interpreters that is a volunteer from a local church who I might add is at least 45 that he likes me and thinks I am nice because I am so pretty! Nothing like looks to get you by huh? We walk everyday it’s about four miles out to the sea wall where we can see not only the ship but out to the city of Tema I swear from the distance it is the most depressing think in the world. Shacks and pieces of plastic make houses. The fishing boats are unbelievable. They are about 5 feet wide and 25 feet long with a little motor and a guy in the back who is usually naked with a large piece of wood that is the rudder. As the boar motors along he maneuvers the rudder. Kind of funny looking. There is also a sail that is an old piece of plastic. Very inventive to use what you have right! Anyhow more later. Oh I will get pictures on here by Thursday I just haven't had time to download!! Best to all.

So taking a plane to West Africa can be quite and experience. When I left Denver and went through London I thought I was going to miss my connection. Security in London is extreme, everyone gets a pat down and bag check until they realize that you are going to Africa and then they leave you alone because as they see it no one wants to send a fiery bombed plane into Ghana. We left London 6 hours late so my flight into Ghana was dark and we got here at 2:30 am. When I called the ship to let them know I was so delayed the receptionist told me to look out for some other Mercy Shippers as there were three of us on this plane. God blessed me when I found Judy another nurse. That was huge to have another person going through customs with me and gathering baggage.
First impressions of the Ghanian people is that they are amazingly well dressed whether they are poor or not if they are flying they are in suits and dresses with these incredibly high high heels. I looked horrific next to them with my 9 hour flight from denver clothes and smell:)
When we landed the huge British Airways plane just taxied to an open area at the airport and the front and back doors were opened and we all got off and walked across the landing pad into the airport. The best part of such a late arrival is a relatively empty immigration and customs line. All we had to say was Mercy Ships and we were through the line no questions asked. These people are incredibly warm and gracious the majority of them knowing what Mercy Ships is just say thank you!
The moment I picked up my baggage I was surrounded by men that were either taxi drivers or luggage carries wanting to help me for a fee. At one point myself and the other nurse were so surrounded we couldn't see Albert the head chef that was the lucky man to pick us up. Once we were in the car and driving away I was surprised to see the relative modern roadways. However the modern and passable roadways were heavily littered with dead animals and every time you saw a huge semi guaranteed that the driver was streched out on a cot in front of the truck. Everywhere we drove by people were asleep by the road in front of the gas stations anywhere they could grab some land!
We arrived on the ship and I am fortunate to have one roomate rather than five. She's this absolutely gorgeous girl from England. She looks Ghanian actually very black with very strong features. The Ghanian people are very beautiful. The ship itself was the Victoria a luxury cruise liner in the 40s. The amount of work carried on from this ship amazes me from the surgeries to the prison and orphanage visits. The ship is docked in the Port of Tema and this is the busiest port in West Africa mostly because it is the safest. Therefore the ship sways all of the time when other ships pass it by. It's very weird to be rocking back and forth.
This afternoon we went into town to the market and the people were unbelievable. I saw one women carrying a 8 gallon jug of oil that was full on her head. The women carry everything on their heads!
Anyhow that's all for now. The staff on the ship are incredibly warm hearted and loving. My job begins on Monday more then:) Love to everyone:)

The Adventure Begins!

This is what I leave behind heading into a climate, environment and level of need that I have yet to ever experience. I can't beleive it's actually here. The planning for all of this has takent so long that two months seems like such a small amount of time to be gone. Thankfully flying into London is a little more relaxed than a week ago. And I was just warned by a friend who has been in Ghana that when I step off the plane to be prepared to be proposed to multiple times. Well so okay I can handle a couple of proposals here and there;) Mostly I am just prepared to sweat the temperature in Ghana today is 78 degrees however the humidity is at 98% I don't know about that one!! I cannot thank all of you enough who have supported me through all of this and have prayed for me. Check back here often for updates and pictures of my time in Ghana.
Blessings!!