June 2, 2010

Here it is Wednesday. I'm really feeling the time winding down. Tuesday and Wednesday, I spent at the Hospitality Center with the Tech Team. Tonight, there is a presentation on the importance of preoperative measurements in calculating lens implant powers. We will also hear results from a study of surgical outcomes by Dr. Wodome. We will have doctors visiting from Nigeria, Benin, Togo, and Ghana.
Tomorrow, I plan to spend with the Field Team again. In the evening, I will do my laundry.
Friday, I will work a half-day. That gives me an opportunity to say goodbye to the Day Workers.
Saturday, I will clean my berth, pack, and leave for the airport at 7:00pm. WOW! What an experience!
Shannon has been such a great coordinator with a wonderful spirit. Woody is always upbeat and energetic and is a fantastic teacher. Joel has such a kind heart and that great Irish sense of humor. Logan is a gentle soul and fun to be around. I have been truly blessed to meet these people and serve with Mercy Ships.

May 31, 2010

I was surprised when I realized I hadn't posted in a week. Here goes.

I continued my work with the Tech Team at the Hospitality Center. However, Joel replaced Woody for one week. I also have just about wrapped up the Eye Team Manual.

On Friday, I was given the afternoon off to spend with Julia. We went to the Sarakawa swam in the pool and had lunch. Afterwards, Julia, Jean, and I went to a restaurant called Green Field which serves PIZZA. It's not exactly American-style pizza but it was pretty good.

On Saturday, I spent the morning and part of the afternoon with Julia and her sponsor child Brandine. Brandine is a shy, sweet little girl who really came to life when Julia started playing soccer with her. We had lunch together and had to say goodbye to Brandine. Julia and I planned to have dinner together before she left at 7:00pm for her flight. I got very emotional, I think because I am feeling very homesick now. However, we had dinner and she got off on time. At 7:30pm I went to the movie The Blind Side with J-Me. What an incredible story!

Sunday, I went to church with Emmanuel. The service was very long and was a celebration of women. There was reciting of verses from the Bible (in French and Ewe), singing, dancing, and preaching. Afterward, Emmanuel and I went to his apartment where his niece had made fufu. It was such a nice meal and a nice time. I took a taxi back to the ship and just read the rest of the day.

Today, I worked with the field team. We saw 280 patients! The Tech Team sees patients that have already been screened by the Field team, so this was a real eye-opener (no pun intended--really).

Kpalime Falls

Pronounced something like, "Balemay".

We had two cars and nine people going on Saturday. It was a very scenic trip passing many small villages and some amazing trees. The road is narrow and in disrepair in many places, so there was a lot braking and swerving (fyi, We don't wear seat belts. Either they're not in the cars or they're don't work.) After some time, we came to Mont Agou where we turned off the main road, drove through a village, and then up a mountain road. The drive up was thrilling. The road was very narrow and steep, rough, and had lots of switchbacks. The car's undercarriage was scraping and the car was battered. I finally told the driver to stop and that we could walk the rest of the way. I didn't want him to destroy his car. He kept on going. We arrived at a mission where, we were told, teens can go to work, rest, and have some peace. It was so peaceful and beautiful there with mango, orange, and papaya trees. We spoke with a young woman who had lived there four years and works at a healthcare facility in the village.

We walked down the mountain to the village, and the cars met us. I saw the first dog that I have seen in Togo in that village.

We drove on to Kpalime and stopped at the home of the sister of one of our day workers where a meal was arranged for later that day. We proceeded on to Kpalime Falls. There is a fairly short hike but it's fairly steep in places, and I did have some difficulty at times. Walonya stayed with me and made me a walking stick, which was so nice. We passed one of those giant ant hills, so I had to get a picture. Arrived at the Falls, and the hike was well worth it for that sight. It is truly a jungle paradise.

We hiked back to the car and drove back to Kpalime where we had a true African meal. We were served Fufu, which is pounded yams, and it looks like a lump of bread dough. A soup made of cabbage and chicken is poured over the fufu, and you use the fingers of your right hand to get some fufu, dip it in the soup, and enjoy. We were then served pap which is white corn cooked to a paste and, then, wrapped in a banana leaf until ready to serve. It has a different texture, very slippery. You take a piece and dip it in a sauce which is spicy sweet. We also had chicken which was seasoned perfectly and baked or grilled.

The amount of effort that went into this meal was tremendous. You should see them making the fufu. It's hard work. Unfortunately, my camera battery was dead so I was unable to take pictures of the meal.

We headed back to Lome and got to the ship with three minutes to spare before curfew.

May 21

Another YAG day. It was quite busy, and I was worn out. After the Celebration of Sight, we went back into the Hospitality Center where I demonstrated my version of the Chicken Dance-to their great amusement!!! I'm still working on perfecting the dance before I return to Washington.

After work, we came back to the ship, changed out of our scrubs, and headed to the street market. I definitely enjoyed it more this time, although after a few hours it starts to wear you down. Bought more fabric and some Yovo (I'll explain when I return) beads.

Thursday morning, after we finished with patients, we had an impromptu jam session with Innocent on djimbe, Shannon on shakers, and Woody on some sort of metal percussion instrument. It was amazing!

There is a bonfire tonight at Cocoa Beach, but I'm afraid I have to pass. I need some rest and quiet time before we set out for Kpalime tomorrow.

May 18, 2010

This has nothing to do with Togo, but can you believe it's been 30 years since St. Helens erupted? Wow!

I spent the weekend as quietly as possible, did a lot of reading. Julia spent Sunday at the Sarakawa which is a 5-star resort not far from the ship. I was supposed to go, but due to some confusion on my part, didn't-to my regret. Her pictures of the hotel and swimming pool are stunning.

Monday, the pace and flow at the Clinic was difficult. Not sure why, but it just wasn't smooth. Came back to the ship and had dinner. Saw Julia briefly (she was on her way to soccer). We have finalized plans, I think, for a trip to Kpalime Falls on Saturday. There will be 8-9 of us going in 2 vehicles. It should be an adventure!

Today, the flow was very smooth and we finished way early. We came back to the ship, and rather than go back to the Clinic, I started on the Eye Team Manual in earnest. I spent several hours working on it, and even though my purpose in offering to do the manual was not necessarily to see how all the units of the Eye Team fit together, it certainly does improve my overall understanding. We're hoping it will be beneficial in future Outreaches in South Africa and Sierra Leone.

YAG day

We start a little earlier on Friday-6:20am. After arriving at the Hospitality Center, the patients are dilated, auto-refracted and given reading glasses, if needed. The goal is to be about 2/3 of the way through the YAG patients (60 out of 90-100) before the surgeons arrive. My job during this was to help keep the patients moving in an almost organized manner. When the surgeons arrive, the YAGs begin! The patients then go to a tent outside of the clinic. After all patients have been given their laser treatment, we join them under the tent and the Celebration of Sight begins!

The Celebration of Sight is truly an uplifting and inspiring event. The patients pray, sing and dance in celebration. Several of our day workers participate or lead the celebration. I am working on my version of the "chicken dance" which I hope to have perfected before I arrive back home.

After lunch, we do a refraction clinic and see one-day postops. I was fortunate enough to be allowed to see the one-day postops which is definitely improving my slit lamp skills.

While I have really enjoying learning new things, for me the contact with the patients is THE most important thing. I love them and they inspire me.
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After work, we went to the Lome street market which is overwhelming to say the least. The street market is chaotic, noisy, and a little stressful. I believe I was called "Mama" at least a thousand times during the time I was there. I bought a pair of flip-flops, a writing pad, and some fabric. We stopped at the Seamens Club on the way back to the ship. The sandwich was very good, and I had a Coca Cola IN THE BOTTLE. The pom frites were delicious-salty and not too greasy. We were lucky in our timing-When we came out of the club, a Mercy Ships shuttle had just pulled up to drop off crew, so we took the same shuttle back to the ship.

A very good but tiring day.

Day 4 Eye Clinic

I'm on lunch break on the ship right now. This morning we saw cataract preops and 1-day postops. This afternoon we'll see 2-week postops. Tomorrow is YAG laser day and Celebration of Sight. I'm not sure what's going to happen at the Celebration of Sight, but it happens outside the clinic under a tent. I'm really looking forward to it. On Monday, we're going to try a schedule adjustment to start seeing the 2-week posts a little earlier.

I feel so small compared to the beautiful African people. They are so uncomplaining and accepting. In some cases, you wonder how they've managed to function at all they are so blind with cataracts. The cataracts we see are very visible to the naked eye. Dr. Glenn performs ECCE rather than phaco, and we really see great results. However, the cataracts are so dense that you can't see the back of the eye preoperatively, so there might be other things going on in the retina that just can't be visualized.

I have offered to begin writing a manual for the eye team. I also hope to work with a knitting/crocheting group at the Hospitality Clinic to teach local women these crafts. I'm hoping to do this 1-2 days a week. I'm here to work, so it'll be nice to have these extra chores to keep me busy.

The African Woman

I have been so impressed with the beauty of the African women. They walk so gracefully and with a regal air through dusty city streets with their wicker platters, baskets, or boxes balanced atop their heads. They are draped in such beautiful fabric that just seems to flow around their bodies. As they age, their necks and shoulders stay strong, and they carry themselves with such a noble air. Just had to share these thoughts.

Day 1-Eye Clinic

Met the Eye Team this morning and headed to the Hospitality Clinic in Lome at 6:45am. We saw 29 cataract evaluations, 24 2-week cataract postop exams, and some other miscellaneous patients. I felt somewhat unqualified, but my mentor Woody was very patient and helpful. I primarily did keratometry and auto-refractions, and I also performed tonometry and a few A-scans using a probe. I haven't seen Julia yet to see how her first day went.

Tonight, the plan is to get an additional orientation to ship protocol and procedures.

It's very warm today-hot, even. It's nice that the Hospitality Clinic is air-conditioned.

We're Here

Julia and I made the trip fairly uneventfully, although we had a number of delays along the way. Paris Charles deGaulle is quite an experience. They load you into buses, keep you confined on the bus for 15-20 minutes, drive 50 feet, and let you off. Then, you go to another area to which you have been directed and catch another bus. It was all very interesting and inefficient.

On the plane from Paris to Lome, Julia and I slept most of the time--we were wiped out. Customs in Togo wasn't bad. However, there are a lot of people there willing to help you who apparently don't work there (at the airport). Also, TP is not provided in the WC--you get a small amount and then tip the person. I also had a man going through my purse after it had gone through the scanner. He was VERY interested in my dried fruit, Gardetto's snack mix, and, especially, my gum. I offered him the gum and he took a few pieces. Thinking back on it, I don't really think he worked there.

Driving through Lome to the ship was fascinating. There is quite a nightlife (when it's cooler) with TV's mounted on stands on the sidewalk, street vendors, nightclubs, etc. There are scooters everywhere! I'm not sure what time we got to the ship. We were given some paperwork, some food, and a key to our cabin. I am in a 6-berth cabin, all the way to the back, and on the top bunk. I found my bed made, with a water bottle, coffee cup, cookies, and a welcome message. What a blessing to a weary traveler. All my cabin-mates had gone to Ghana, so I was by myself. I took a quick shower and slept like a baby.

Today, we had a ship tour provided by Amy. I had breakfast with Deniece and Rob, and Deniece was nice enough to let me use her computer to send an e-mail to Jackie. I met the group for the tour. Now, I sort of know where everything is. We have wi-fi, a Starbucks, a snack bar, a store, a bank, a laundry, a library--unfortunately, the pool isn't quite ready. I'm looking forward to tomorrow and orientation. It'll be nice to know exactly what I'll be doing during my time on Africa Mercy.

1 More Work Day

One more work day in Smokey Point and a few hours in Seattle on Friday morning. Tomorrow, I'll work with Cheryl on Tonopen practice.
I've spent the last few days apologizing for my haircut. I'm hoping it'll be a little easier to control by Sunday, but Dr. Rostov says it's very edgy which I liked.
I've ticked nearly everything off my list, except the final charging of my electronic gadgets. Now, if only I could sleep.

Counting my blessings

I am so lucky to have support from a wonderful husband who has never questioned my decisions. How did I get so lucky! I have had many moments of doubt in my ability to be of real service in this endeavor, but I have so many who have given me words of support and offered their prayers. Thank you!

As the day when I leave draws near, I find it difficult to sleep at night. My mind is so busy ticking items off my to-do list, realizing how much I'll miss my family, and I just can't seem to quiet my mind--I'm really feeling tired.

It's Getting Close!

8 days to go!

I have spent quite a lot of time working in the clinic with our technicians. They are awesome! They have patiently taught me a variety of technical skills (tonometry, refraction, slit lamp, retinoscope). I wish I could say I have mastered these skills, but it wouldn't be true; however, I hope I have retained enough to do my trainers proud.

I have completed 13 1-hour strength-training workouts and 6 1-hour cardio workouts since March 1. I've lost about 15 pounds, but the strength and flexibility I've gained are what I've appreciated most. I have two more strength and one more cardio workout before leaving.

I'm gradually gathering most of the items I need to take with me to Togo. It's difficult to know exactly what might be needed. Of course, I've referred to the list of recommended items, and I'm trying to strike a balance between what I really need and the inclination to overpack.

I'm not sure I'll be posting again before I go to West Africa. I plan to work for a few hours the morning of May 7, then, I'll drive to SeaTac, get checked in, and meet Julia at our gate. Our flight for Paris leaves at 1:45 p.m. In Paris, we'll connect with other volunteers who will accompany us on our flight to Lome, Togo. This is all very exciting!

Technical Preparation

I have such appreciation for and am so grateful to: 1, My Supervisor Jan; 2, Tech Supervisors-Tina, Claire, and Kathy; 3, Technicians-Anthony, Amy, and Christy. Thank you for being so willing to assist me in this effort to bring my skills to such a level that I may be of assistance to the Mercy Ships Ophthalmic Crew. Your teaching and patience have already been invaluable, and I look forward to continuing this educational experience with you.

I learned some technical skills 20 years ago, but the facility at which I worked didn't require the level of skill from technicians as that required at my current employer. For instance, retinoscopy was always performed by the M.D. , autorefractors were used in the screening process, only air puff tonometry was performed by the technicians, and few techs had the ability to use the slit lamp.

I am feeling much better about my ability to perform refractions, I have learned some slit lamp skills, and performed a very poor retinoscope evaluation. I am hoping to learn applanation tonometry and Tonopen tonometry this coming week. As I attain these skills, I will then practice, practice, practice.

Anthony recommended a book called The Ophthalmic Assistant. Thank you, Anthony! I study this book every evening, and it helps me to further understand what I covered with the Techs earlier in the day.

Information about Togo

The capital city of Togo is Lome, and this is the city in which Julia and I will serve. The Africa Mercy arrived in Lome the week before last. Mercy Ships volunteers have begun their pre-screening processes, and they have begun serving the citizens of Togo.

Togo is a very small country, long and slender, in West Africa. It is sandwiched between Ghana to the West and Benin to the East. It was under French Colonial rule until 1967 when it gained independence and Eyadema became its President. There is an area in Northern Togo which has gained status as a World Heritage Site because of its unique and interesting residential and farming structures, which are quite beautiful.

Unfortunately, for many British, Dutch, and French Colonies, there was a price to be paid for independence-sometimes in the form of dictatorial rule and/or economical struggle for the citizens of the former colonies. Certainly, the Togolese have suffered some of both. There is a Presidential election looming in 2010.

The Lome area of Togo is quite warm, but this is tempered by ocean breezes to the south and a lagoon to the north. The rainy season extends from April through July.

We're getting closer!

Julia and I have found a flight on Air France so we can go to Togo together. We'll be leaving from Seattle on May 7 at 1:45 p.m. We'll fly into Paris for a five-hour layover, then we'll head to Lome where we'll arrive at 6:50 p.m. on May 8. The flight is quite expensive, but the living fees on board the ship will be fairly low.

I'll begin working with the technical staff at NW Eyes next Tuesday and hope they can bring me up to speed over the next two months.