April 4, 2010

“Once Christ is risen, the gravitational pull of love is stronger than that of hatred; the force of gravity of life is stronger than that of death… The Lord’s saving hand holds us up, and thus we can already sing the song of the saved, the new song of the risen ones: Alleluia!”   -Pope Benedict XVI

Have a joyful Easter!


Bob, Lauren and I arrive at the church around 7:45, and we are heartily greeted by our nine translators. Circle up for prayer. Sometimes it is in English, sometimes in French, sometimes in Yaruba. As the others unload boxes of sunglasses, medicines, charts, and other odds and ends from the back of the truck, I take a casual walk outside to survey the crowd. The people organize themselves differently at each location, and even within one site it can change drastically from week to week. Every morning is a new puzzle.

West Africans have yet to understand the concept of a “line.” Instead, they assemble into clumps and lumps and amorphous masses. At our most organized cinic, I gaze at the expanse of people in front of me and can usually recognize the divisions: Children with their mothers to the far right, elderly adults to the far left, men and women in separate blobs squished in the middle. Each group bleeds into the next. The crowds number six hundred, eight hundred, a thousand–who knows for sure. Monday, Tuesday, Thursday, Friday. Each day they wait for us.

Pierre is from Benin. At around 62 years old (his guess, not mine), he is our oldest translator and carries the most authority, and so is my right hand man to address the crowds. We always approach the group together: My standing next to him instantly bestows him with legitimacy, whether I like that or not. Here is Pierre, measuring in at just under five feet, clutching a megaphone, and my less-than-mighy frame, facing such a swell of people! What a sight it must be! I speak softly to him, and he translates to the people in Ewe. We explain the order of the day: Children first, then the elderly, then the adults. The yovo will hand out numbers. Do not come to her, she will come to you. If you start crowding/shoving/pushing/smooshing, she will not hand out any more numbers.

Mothers tug little arms through the double doors. Most of these young eyes are infected or itchy. Bob bends down, shines the ophthalmoscope into an eye, talks to his translator, who then bursts into a string of incomparable speech to mom. Eye drops here, ointment there, re-papoose the child, and they are on their way. Sometimes the problems are more severe. At one Friday clinic–held in a poor part of town–nearly all one hundred children presented with trachoma, a bacterial infection that can lead to scarring or blindness. Transmitted through contact with infected people or objects, or by flies.

Outside, Pierre and I sort the elderly. Several hundreds are gathered, but I must choose between fifty and one hundred to bring in. As Pierre explains that I will hand out numbers, the group nods in unison and responds emphatically when he exhorts them to be respectful during the process. I will only give numbers to those sitting down, he says. (Survival tactic learned from the first few clinics: Distributing anything means an instant gigantic doughnut of people around me. I now insist on bums on the ground or in chairs, and–voila!–much less smooshing.) Arms reach out from every direction, tugging on my back, my arm, my sleeve, my leg. “Help me! My seesta! Help me!” “Yovo, yovo! Save me!” Fingers point to eyes that shine back at me, bright silver with cataracts.

Inside again, three translators test the visual acuity of every adult. Your optometrist probably employs a chart with different letters, starting big and bold at the top and waning to minute print at the bottom. Here, to factor out illiteracy, we use tumbling E charts, and patients twist three fingers to indicate the direction of each E. They then filter to the center of the sanctuary, where a queue forms to see the doctor. Many require eye drops and fervent instruction to wash the eyes and eat foods rich in vitamin A. Some will have surgery to remove a cataract or pterygium, and are scheduled at the next table with Lauren. A few cannot be helped by medical intervention. Blindness. Impending blindness. They are led to a corner where Isaac, a quiet translator, waits to pray with them.

This work often makes me wish I could be ten places at once, because the inside workings of the clinic are enough to keep me bouncing from door to door, translator to translator, Bob to Lauren. Indeed, Bob’s initial explanation of my job, way back in January, was, “Don’t sit down. When you sit down, things start to fall apart.”

But the crowds outside again demand attention, so off we go! The groups of adults have either managed to organize themselves by this point, or else are in complete disarray. Some days I stand before them in silence, simply thinking about how order can be created from disorder. How to distribute numbers to the seven lines that have formed when I asked for one. How to act in a way that motivates each person to stay where he or she currently is, when surely the most advantageous method for the invidual is to plow forward to be the next to clutch a number. Even the most civil person is taken captive by the desire to be first in line.

Eventually, all of today’s patients (and some wannabe patients) are inside, and the clinic rolls on, successes and laughter, hitches and glitches and all. We end in prayer. Thank God for His people. And thank God for His grace.

A Jungle Escape

March 27, 2010

A weekend away in Kpalime to hike Togo’s tallest mountain (hill). Mount Agou is dotted with villages, and their children enjoyed skipping alongside us, eating our snacks and marvelling at the balloons we inflated for gifts. During the descent, gray clouds rolled through, and the skies opened up in a fantastic inauguration of the rainy reason.

Magic plastic numbers

March 17, 2010

Smoosh a boat full of Westerners into a country of West Africans, and you find that many cultural differences are irksome or complicated or both. Some differences, though, just make me grin:

Before being scheduled for eye surgery, each patient provides Lauren with personal information such as name, cell phone number, tribe, language, etc. Most queries receive fairly straight forward answers, but the one sticking point is age. You and I list our birthdate as a trio of day, month and year. Not so in Togo, where the important information is not any of those bits. What is important is the day of the week on which you were born. In fact, many people are named after their birth day. If you were born on Saturday, your name is Komi. On Tuesday, you are Komlan. So the average patient can certainly tell you that he was birthed on a Thursday. But ask whether that was 50, 55, or 70 years ago, and all you get is a shrug–only God knows. The sort of thing that drives our statisticians mad.

To encourage order when bringing people from outside to inside a clinic, I always distribute small cards stamped with sequential numbers. Otherwise, moving people inside is a bit like turning a medicine bottle upside down and hoping that only two or three pills fall out. I can point to ten people I want to follow me, but then I turn around at the doors and a swell of fifty has gathered behind me. At the end of the day I reorder my numbers, but each day a few go missing. Apparently, patients sometimes keep the “lucky” numbers. This means forsaking a coveted spot in line, since you must have a number to come inside, but I suppose the hope attached to that card outweighs the hope of medical intervention. 137 ran away last week, and I haven’t seen 59 since our first day out. I’m hoping that once the bandits abandon faith in their laminated yellow squares, they will trod back to the clinic, line up, be examined by the docs, and return their numbers. It would be nice to have a complete set again.

Ward Church

March 7, 2010

With shore leave prohibited, I cannot venture to my regular church downtown for Mass. But one path blocked means another opened! Today I joined in the church service held for hospital patients, dubbed the “ward church.”

Fifty people, patients and crew, pack into one ward. Children with double casts on their legs are carried in and propped up on empty beds. Four mothers walk in quietly, carrying blankets that envelop teeny tiny babies. Each infant has a cleft lip, palate, or both. This defect makes nursing incredibly difficult: Without a solid surface to press the tongue against, baby’s mouth cannot create the suction necessary to drink. Many are brought to the ship severely malnourished and must enter a feeding program to chunk them up before surgery.

Clementine, a long-term Togolese crew member with a peaceful yet regal presence, leads the service in English. A Togolese day volunteer stands beside her to translate to the tribal language Mina, and then other translations begin to pepper the room: French on one side, Ewe in the back corner, maybe Adja as well. A small boy with double casts whimpers in his mother’s arms, his legs itching under the plaster. A few tears leak from mom’s eyes onto the boy’s forehead. But soon enough the drums appear and voices are raised and songs are belted out in the half yell/half sing characteristic of African worship. A foot taps, hands clap, and bodies jive back and forth across the narrow aisle. A woman thrusts her torso in praise, tossing to and fro the toddler papoosed to her back, his neck jolting almost violently. I cringe with fear of whiplash or worse, but a few minutes later he is freed from the cloth sling and crawls over to a day volunteer, apparently unaffected. The melodies die down and transform into spontaneous prayer. I close my eyes. Even with no understanding of the languages, I can hear the urgency of petition, the fervor of thanksgiving, and I thank God for something I have never thought to thank Him before: That He listens to every word spoken to Him, and that His understanding far surpasses my own.


March 6, 2010

News of a Mercy Ship landing spreads far and wide. Some will walk, hobble, and limp through countries, across borders to seek help. These photographs (taken by the ship’s photographers) show the orthopedic and maxillofacial screenings. Somehow grief and hope can coexist in the heart: Imagining the devestation caused by deformity, but knowing that, for many of these, physical and emotional healing is within reach. Finally.


March 5, 2010

Off-ship clinics were cancelled today, so instead of coordinating/organizing/instructing/managing/fetching, I held babies and played with kiddos. Now this is my kind of Friday =)


March 4, 2010

Rarely am I out in Lomé past dark, and very rarely until our 10 pm curfew. After all, as a yovo [a better pronunciation than “yova,” apparently]  woman I should never go beyond the ship without either a man or at least two other yovo women. At night, no yovo should travel on foot, be you man or woman.

Last night, however, curfew was pushed up to 6:30 and the gangway closed with every crew member on board. The ship will remain in lockdown throughout Thursday, and beyond that is unknown. Today is election day.

Every billboard, concrete wall and pole in the city is plastered with political posters, mostly endorsing one man, the current president. I must tread lightly here, because Mercy Ships has been graciously welcomed and hosted by the Togolese government, and we are strongly encouraged to consider this when writing in the public domain. From conversations with our translators and local friends, though, I’d be willing to put a fat stack of cash on the current president claiming victory. Legitimately? You can do your own research.

What we do know is that elections in Togo have produced violence in the recent past. Most opinions I have heard about this election predict relative peace, but it is smart for this organization to be overly cautious. Many international NGOs in Lomé are monitoring the situation. If things get really sticky, we can quickly load the Land Rovers and dockside equipment and sail out within hours: the benefit of a boat-based mission!

The eye team plans to hold our Friday clinic tomorrow, but that will depend entirely upon the security situation overnight. After a security update at 6 am, our 8 translators will call me to check on the status…assuming the cellular network is running. Togo Cell, the country’s main provider, is operated by–you guessed it!–the government, and they switch it off at times to make it more difficult to organize riots. We are also subject to the ban on road traffic in place today, and possibly tomorrow, for nonessential vehicles.

So while the president’s supporters and the opposition parade today in white and yellow, respectively, tooting car horns and filling the dusty streets, I am enjoying a quiet day in the AC, for once far from the masses.

Trial Runs

February 27, 2010

Week 1. Clinics: 4. Total crowd numbers: 3,500. Total amount of people screened: 1,400. Eye surgeries scheduled: 199.

My aim is to let you know a lot about little bits, so that instead of feeling like you are looking at a sketch of what I do and see, you feel that you are in the midst of it, if only for short moments. And I would also like to tell you much about the human aspect of this ministry, which is the why of it all. But I will do neither in this post, because the clinic logistics are exciting and fascinating and worth a mention. (And because that’s my job.)

Clinic Day 1: Smooth sailing. An orderly line waits outside heavy gates, opened and shut by the conservative judgements of 2 Togolese security guards. Dr. Glenn, the ship’s chief eye surgeon, joins us for the day in order to train two of our ophthamologists in criteria for appropriate selection of cataract patients. A warm introduction to the field.

Clinic Day 2: And then there was Tuesday. The Assemblies of God church sits right on a busy road. Driving in, the first sight is the mass of people filling the church grounds. They watch our two cars park and shuffle towards us en masse. We walk into the church, and–surprise!–a few hundred loitering around in the sanctuary! Thoughts swirl, we turn to each other, dumbfounded. We agree to try to make it work, and if things get sticky, we will pack up and leave. It takes twenty minutes of shooing, but eventually everyone goes outdoors, and now there is some breathing room to pull out chairs, tables, medical equipment. The first few patients are screened, sent to doctors, scheduled for surgery. Arms and heads reach through the doors and windows, all made of widely spaced metal bars. Bodies push at every door, and the hinges groan under their weight. You can tell when things begin to feel out of hand–when the feel of a group changes, when the decibel level rises a bit, when the simmer looks like it wants to turn into a boil–and that’s when it is time to act. Ok, call for backup. The ship’s security department deploys a “surge team,” which arrives to take over crowd control. Assert authority over the process. Move people away from the doors. The waiting crowd now sees patients flowing through, and tensions relax.

Day 3: Ready for a chaotic repeat of Tuesday (we go to the same church on Thursdays), my spirits soar as we round the corner and see a thousand people, yes–but all waiting calmly, some seated in plastic chairs, a good fifty yards from the church building. Order in the chaos–what a relief! Part of our team has arrived early to sort people into relevant groups (children, elderly, men, women) and distribute numbers. Two ship security personnel monitor the fronts of the lines. Each day and church layout poses different issues, so each day we have utilized different crowd control procedures. Today’s method works beautifully! The only tiff occurs when we announce “fini” and a group eager to be seen rushes the church and breaks in the door. Still, I gladly dub today a success. Don’t worry, we put the door back on its hinges. =)

There was a fourth clinic, but I think the preceding excitement is sufficient to both quell your curiosity and send me straight to bed. Goodnight!

A whopper of a prayer request

February 21, 2010

As I recently told a friend through email, it is in situations such as this, when the task looks large and I feel small, that I truly appreciate intercessory prayer. So, thank you for praying!

Tomorrow we will hold our first eye clinic. The patients will be many, and the Mercy Ships staff will be few. We have picked over the procedure in theory, but I can’t imagine what the day holds! Please pray…

…that those whom we can help will be brought to us

…for peaceful crowds

…for coherence within our team

…for endurance through the heat

…that we will communicate with one another in love and patience

…and for safety.

Thank you