ali's african adventures

Another little sparrow fell today.

I was on an admin day and didn't know how things were going on the wards, so around shift change I stopped by the ICU to check on O'Brien. I was met by Hannah, who shook her head, her face speaking volumes before she ever said a word. He's going, she told me, and I looked to his bedside where his mama, Evegenie, held him, the monitor showing numbers so, so low.

I knelt by his mama's side and put my hand on her knee, explaining to her that his heart was slowing down. That it wouldn't be long now. And as I spoke the words, the numbers fell to zero, and I knew that he was gone. I took the little tiny stethoscope that hung on his IV pole and listened even though I knew I wouldn't hear anything. I'm so sorry. His heart has stopped.

The tears streamed down Evegenie's face, falling unchecked onto my hands as I gently peeled the tape from his cheeks and nose, pulling out the tubes that had been hurting him for so long. We took out his IV as Evegenie sobbed quietly, making the same, wounded noises that every mama makes when her heart gets shattered.

She looked up to the translator, and asked if I could take a photo for her, and so I flew to my room for my camera. I stood by the side of his empty bed as she held him up for me to focus my lens, and I took the picture, praying that it would come out even though I couldn't see a thing through my tears.

We spent the rest of the afternoon doing all the things that you do when a baby goes back to Jesus. We bathed him and dressed him in a soft little pair of overalls. We gathered food and water to sustain her on the journey back to Benin. We made prints of his hand and foot and laminated every photo of him we could find so his mama would have something more to take home than just the little broken baby who had flown too soon.

It feels like falling, trying to make sense of all this. Like the ground has just dropped out from underneath me and I can't find a place to stand. I don't understand why our prayers made the difference between life and death one day but not another. I don't understand why so many of these children have to go back, why the only reason O'Brien died is because he was born in West Africa and not the first world.

I do know that Christ has overcome, that the victory over death has been won, whether I can understand it or not. I know that I've seen a different kind of miracle today, one where the healing is forever, not just for a few weeks.

It's just hard to fall so many times and not know when it's safe to get back up.

Today was a strange day, so full of contrasts. It's that mix of joy and heartbreak that's so common here, the mix that somehow never feels quite right.

There was Maurius, sitting like a king on his bed, propped up in a wash basin, tucked in all around with lappas so he couldn't fall down, reigning over his corner of A Ward with wide eyes and ready smiles. He's drinking all his milk by mouth now, and if he keeps this up he'll be home by the end of the weekend, fat and happy.

But then, of course, there's O'Brien in the corner across from him, struggling so hard to breathe that his tiny heart has started to fail him. And so, under the watchful eye of King Maurius, we bundled O'Brien up and made the walk back down the hall to the ICU yet again, the place where we saw his life miraculously spared just a few weeks ago.

Knowing what happened before, we haven't been hesitant to pray for healing, gathering in little groups all across the hospital to plead God for life, but miracles have been slow to appear today. Instead, we've watched as his body struggled to get enough oxygen. We've tried everything short of a ventilator (something that isn't an option anymore, given everything else going on), and still his body is failing him. We've been MacGuyver and Inspector Gadget and the Professor from Gilligan's Island, rigging up one failed solution after another to help him breathe, but nothing is really working. Right now he's wrapped up in his mama's lappa, a wire hanger twisted around to form a frame for the plastic bag, being filled with pure oxygen, that he's resting inside, and still he struggles.

I don't know what's going to happen with O'Brien. I don't know how many days God wrote into his book before he was born, and my heart trembles to think that we might be nearing the last page.

And down the hall in A Ward, after praying for our little sparrow baby at handover, we all stood in a circle with Aissa in the middle, and we danced the chicken dance. Nurses and translators and a little girl with her head all wrapped in a bandage, dancing the chicken dance right in the face of all this pain.

It's hard to get used to it.

.....

In other news, I wanted to share a photo of Liz, Aissa and I on Togo's independence day, while we had Aissa hard at work churning out those Togolese flags. (Remember; give her a task, and she's set.) It's hard to see behind the flag she's holding up, but you can catch a glimpse of the balloon tower taped to her head. She is one classy kid.

And speaking of classy, there's just one more day to register for the giveaway. Don't miss your chance to win a little piece of Africa! I've been having so much fun hearing from so many of you who don't normally comment. It's amazing to hear about people who've adopted from Africa, people who have a heart for this continent, people who've done hilarious, dangerous things and people who think that jaywalking somehow counts towards living life on the edge. (coughDinacough) I think I'll definitely be doing this again soon.

There is something so incredible about watching a child transform, to go from fear to confidence, anger to pure joy.

When Aissa first came to us, she was frightened. We were tall and white and no one could talk to her, no one but Sarah-toe (the incredibly endearing way she pronounces her friend's name), and Sarah-toe couldn't be there all the time. And we imposed rules on her that made no sense, because we had no way to explain that we were moving her away from those cupboards because there were dangerous medicines inside them and we didn't want her to get hurt. And so when we picked her up and carried her away, she was being punished for something she didn't know was wrong, and she responded with fury.

She started out by having complete meltdowns every few hours at volumes high enough that those of us in A Ward were considering borrowing ear protection from the engine room. She pushed every limit we tried to set, thrashed against every single boundary, but somehow, somewhere over the course of the last two weeks, her heart has started to open to the love being poured into her from every side.

I think she sees me as something of a constant in her life these days. I'm there every day shift, sitting at the desk while she sits on a little wooden chair next to me, working away at the latest task we've assigned her. (Today she matched pre-op photos with the correct patients and brought me their charts so we could place the photos on the correct page. And then spent two hours cutting strips of paper into tiny little pieces into a garbage can. The task is really irrelevant, as long as we've given her something to do. Her other favourite jobs include doing her wound care, controlling the rate of her tube feedings, and using a syringe to draw up and inject her medications into her own feeding tube. She's seven.)

These days, instead of screaming and wailing, I look up to the sound of her little voice calling me from across the room. Alice-oh! Alice-oh! She'll want to show me her latest paper creation, want me to tape balloons to her head, want me to admire the bright pink glasses and toy stethoscope she's commandeered from a medical kit. She's at my side first thing every morning, gesturing to things she wants, eyes bright as she waits for me to come up with something fun to do.

Today, on one of her trips past my chair, she tripped and fell while carrying a wooden box full of Memory pieces. The box hit her leg right on the place where we took skin, and the pieces burst from the box and scattered all across the floor. Her reaction broke my heart; with a furtive glance of fear around the room, she crouched down, shoulders hunched to ward off the blow she thought was coming. When I reached to pick her up, she was tense, her sobs catching in her throat. I expected a meltdown any minute, and Aissa expected anger and abuse.

Neither of us got what we thought was coming. A translator ran over to clean up the pieces for us while I snuggled her into the curve of my arm and rocked her back and forth, speaking soft words of comfort I knew she couldn't understand. And Aissa just cried quietly for a few minutes before looking up at me with wonder in her un-bandaged eye. It was like she couldn't believe it was okay to fall down, that she could make a mess and not to get in trouble for it. And I think, in some way, she was surprised at herself for not getting angry when she got hurt. She's a smart kid, our little Madam, and I think she knows something's changing, knows that there's nothing to be afraid of here.

So she hopped off my lap, gathered her game, and headed over to play it with her uncle. After which she behaved like a model patient during her first dressing change, watching everything in her little mirror. I wasn't there for that part, but they say her wound looks good, that the graft is healing well.

So is her heart, I think.

Today marks fifty years of independence for Togo. According to our day volunteers, this is cause for celebration. Like the 4th of July or Canada Day, only much, much hotter and with more dust. Cyril, one of our translators, informed me early in the morning that there would be a parade in town at around two o'clock, and that it was in the best interests of all our patients to put them in a bus and take them there to enjoy it. I told him I didn't think it would be possible, so he asked me to at least think about it. Which I did, for a long time, and eventually came up with the only objection to the plan; I didn't own a bus. This satisfied him, and he settled for our version of a party. It was slightly less authentic, given the fact that it took place inside a hospital, but I think we did okay.

Just like everything else around here, things quickly turned from an independence day cheer into a full-out worship and dance party. We sang in at least three different languages while patients who hadn't been out of bed in days shuffled and danced alongside us. Lovelace and Aissa danced next to each other, Aissa's moves a little limited by the pain in her leg from where they took the skin to cover the hole in her cheek. Videssi shook a sasa from his bed and Chantal, true to form, was in the thick of it, laughing and singing and raising songs at the top of her voice.

It's moments like that when I look around in wonder at what I'm a part of. To know that this ship was bought and renovated and sailed across the world so that Maurius can live with a straight smile. (A smile, by the way, which I saw again today for the first time since his surgery.) So that Aissa can go out in public without covering her face. To see all these broken people being asked to dance, being told that they are lovely and valuable and worth a thousand celebrations. Sarah put it so perfectly on the day of Aissa's surgery.

It struck me then, the extravagance of God’s love. Who could have imagined that this little girl, who almost slipped away to die in obscurity would now be the recipient of the attention of a team of professionals, specialists in their fields? That all the excitement, effort, skill and precision would be for her restoration?

Extravagant love, should I have expected anything different?

Whether we're singing the return of a baby to the bed he used to sleep in or cheering for independence, we are always celebrating something on these wards. We are celebrating love.

(Not just love. Today, we also celebrated the fact that Aissa took her meds without a fight, calmly rinsed her mouth and grabbed the swab and mirror to do the wound care for her nose. All by herself. While wearing a tower of balloons taped to the top of her head bandage like a bizarre flower. We're celebrating that, too.)


Also, don't forget to register for the giveaway and to donate here for an extra chance to win!

I've seen this done on loads of other blogs, and yesterday the thought struck me for my very own; why not do a giveaway? The more I thought about it, the more it made sense. You all have given me so much. You share verses with me, you write poems, you send packages from the other side of the world. In all that, you are Aaron to me, holding up my arms as I fight these battles. I think Aaron should jolly well have gotten some appreciation after all that.

(At this point in the entry, my mother might want to stop reading, because what follows is a blatant disregard for life and limb.)

Today, two friends and I headed out to the artisan market in town. Frustrated by our absolute lack of success at hailing a taxi, we opted instead to ride zemidjahns. That's right; I braved West African traffic on dirt roads on the back of a spluttering motorbike, driven by a man who may or may not have a license but who most definitely could not for the life of him keep his eyes on the road. I held on for dear life as we navigated inches away from other cars and had to duck to avoid getting hit by the back of a cement truck. And I did it all for you.

There's a jewelery maker in the market. We stood in her tiny shop while she sat at her bench, blow torch in hand, smoothing out imperfections from another necklace. And when I saw this one, I knew one of you should have it.

So here's the plan. If you want to be eligible to win what I am reasonably sure is a locally-crafted silver Africa necklace (although she could have been fooling me with that torch), say so in a comment on this post. While you're at it, tell me something dangerous you've done for no good reason. (Although, in this case, getting the necklace definitely counts as a good reason for risking my life on the back of a zemi, so I suppose I should probably mention the time I walked across hot coals because the guys I played frisbee with dared me to...) I have to approve all comments before they show up, and my spam filters are set tighter than a pair of support hose, so if you don't see your comment within twelve hours or so, e-mail me at alirae[at]quist[dot]ca.

And just to make things more interesting, I want to throw in even more chances to win. You see, we're planning on sailing to South Africa in just over three months to have our generators replaced. The ones we run on now are so loud that we've been unable to use two of our operating rooms and two of our wards this year. Not only will the new generators allow us to open the entire hospital, but they'll be much more reliable and much less of a struggle for our engineers to maintain.

So here's the other plan. If you want to be even more eligible to win a little piece of Africa, head on over here and donate to the Power the Vision campaign. Every donation, no matter how small, is another chance to win. Once you've donated, either leave a second comment or just e-mail me and I'll add your name to the list a second time.

I'll draw the winner on May first, so get your comments and/or donations in by five PM eastern standard time on the thirtieth.

Send your friends over, and we'll make a week of it. And if this turns out to be fun, we will most definitely be doing it again!

EDIT: The giveaway is now closed. Stay tuned for the announcement of the winner!

At handover this morning, instead of a Bible verse, we settled for misquoting the Black Eyed Peas. I've got a feeling, that today's gonna be a good day. That today's gonna be a good, good day. Personally, I wasn't feeling particularly hopeful, having been up since before five and feeling more than a little ill. Right now, it's hard for me not to worry at any signs of sickness, because my Hepatitis B test has come back positive again. For those of you who don't know, I contracted Hep B back in Liberia after a needlestick injury on my second day of work on the wards. Subsequent tests looked like everything had been cleared from my system, but when I went to be a blood donor again this year, the test came back positive. Right now there's nothing to do but wait; I won't be back to the first world before Christmas, so unless there's a local lab that can run further tests, we'll watch my liver and hold on for December.

All that to say that any kind of flu-like symptoms make me feel the slightest hint of panic, since having The Hep in 2008 felt like having a flu that lasted for several long months at a time. It wasn't fun, and I'm not really hoping to go through that again. Today, I felt, was not really going to be such a great day.

Will it surprise you to hear that, just like so many times before, I was wrong?

Maurius came home to B Ward today. Ever since his surgery, he's been in the ICU, going through procedure after procedure. Twice they tried to remove his trach and have him breathe on his own. Twice he failed, one of those times miserably. He's had special IVs and feeding problems and so many struggles. But today, all that was taken away, the hole in his neck closed for good. Today, he came back to us, to the little corner bed where Chantal has been sleeping every night, waiting for him.

They came into the ward like a parade, Chantal carrying Maurius, Natalie (his nurse) carrying the feeding pump. And as soon as they walked through the door the place erupted into cheers and clappings and spontaneous songs of worship. Our baby had come home, and everyone in that place knew that a great victory had been won. Even Lovelace, who we don't think will live to see her own healing on this earth, grinned up at her papa, clapping her hands at the joy all around her, celebrating for another little one who has been given back life.

Chantal headed for her little bed in the corner, Maurius like a prayer in her outstretched hands. She knelt as the tears ran down our faces, singing in a voice shaking with joy, singing praises to Mawu who has done this great thing for her son.

A little boy came home today. It was a good, good day.

There is much to tell and sometimes words feel so inadequate. It's so hard to explain just how it feels when I walk into the ICU to find baby Maurius nestled in Chantal's arms, a small dressing covering the hole where his trach used to be. Granted, he sounds like an anemic duck when he breathes, but each hour that passes is a triumph that none of us counts lightly. I wish you could know how it feels when my heart catches in my throat and everything gets a little blurry and through it all my heart is singing, singing, singing.

I wish you could be here to see seven-year old Aissa discover the world of MagnaDoodle. The way her eyes grow wide with wonder when she realizes that the magnetic letters on the wall can be used to draw, too. I wish you could feel the weight of her on your back, limp after her latest tantrum, her latest test of our love. Aissa is a little motherless child from Cameroon, abandoned by both her parents and hurt by so many people in her life. And so she pushes, screaming and hitting and doing everything she can to drive us away, and I can't help thinking it's because she figures we're going to leave her anyway. So why not get it over with?

The thing little Aissa doesn't realize is that there's nothing she can do to make us stop loving her. We've known her all of a week, and little Madam has already found her place among us, cemented ever more firmly with each little chirp in her tribal language in response to our English questions. We have no idea what we're saying to each other, and yet we play all day long, batting around balloons, painting boxes to hold little dollies and having long, drawn-out conversations on calculator phones. (The fact that they don't work as such makes no difference, given the rather profound language barrier.)

Aissa is going to the operating room tomorrow to have her face rebuilt, because where her right cheek should mirror the plump one on the left, she has nothing but a gaping hole, teeth and gums exposed. She is one of about ten percent of children who even survive a battle with noma, an infection that's treatable with simple antibiotics but which, if left unchecked, will literally eat away at the flesh of lips and cheeks and face. If you've never heard of it, it's because it doesn't exist in the developed world. Here in West Africa, it's a different story, a story where little girls face lives as outcasts because there just aren't any doctors.

But my heart still sings, because tomorrow Aissa will be made whole again. And as we care for her, our prayer is that the God Chantal prays to every single day will reach out through our actions, translate them into words to speak to Aissa and her Uncle Jean of the Love that will never leave her.

It hit me today, while already starting to think about what we'd do with a chronically ill patient after the ship leaves, just how short this outreach is. We're already in our ninth week of surgery; the last day is scheduled for the thirtieth of July. Just over three months and the ship will be pulling up anchor and heading to South Africa for a new set of generators to be installed. (It's going to be a massive undertaking that's rumored to involve actually cutting a huge hole in the side of the ship. But I'm not a technical person so don't quote me on that!) If all goes according to plan (and with Mercy Ships, very little does) the Africa Mercy is set to be in Sierra Leone in February of 2011.

Our contract ends on the twelfth of August, three and a half months from now. We have no plans to sail to South Africa with the ship. I'm a shaky sailor at the best of times, and I'm not sure a trip around the Cape in a ferry would be a memory I'd treasure. So what's next?

I feel like a kid who just woke up to find that a surprise blizzard has blanketed the town and school is unexpectedly out for the day. You know how that feels, right? How the whole town stretches out in front of you, untouched, just waiting to be explored. Vast expanses of snow just waiting for your footprints.

That's kind of what the world feels like for us right now. So we're going to go leave some footprints.

We've just mailed a cheque to our travel agent, securing our seats on an around-the-world ticket. From mid-August until just before Christmas, we're planning the World Domination Tour Oh-Ten. (Name subject to change when I come up with something better; any suggestions?)

We're going to spend time in Zambia, Zimbabwe, Botswana, Namibia, South Africa, India, China, and Thailand with friends of ours from the ship, Julle and Elliot. (Get used to their names; you'll hear them again.) Jelliot (as they're more abbreviatedly known) will then head home while Team Chandra heads out for Australia, New Zealand, Fiji and Mexico before heading home to New Jersey and/or Toronto for Christmas.

I just got giddy typing all that out. We've been thinking and planning for quite some time now, but since the money has changed hands, I'm feeling secure enough in the plan to share it with you. We're not taking much; a backpack, a camera, a notebook and a Bible. I'm going to re-learn how to live without technology, how to write with pen on paper, how to see the world through my lens.

And when we hit places with internet cafes, I'm going to share it all with you.

This is going to be fun.

What I need from you is any information or suggestions of things to do in any of those places. I know some of you have either been there or actually live there. Places to go? Things to see? Let me know!

My boss refers to it as the formerly unknown and utterly unpronounceable volcano, and when it first started to erupt, none of us paid it much mind. After all, we're in Africa. It's in Iceland. You can't do much better if you're going for polar opposites.

Our first indication that this was going to be more than just a one-night headline came when the Saturday flight was canceled. You see, we live in Togo, a country small enough that flights happen only once every couple days. They'd grounded the Thursday flight, but we didn't realize right away that this far-away, mythical volcano was going to have so much to do with us. Until we realized that every single flight coming into Togo from developed countries runs through France. And if no one was allowed to leave France, there was no way anyone was going to be allowed to land there either.

I don't know how many crew are currently stranded on board the ship, but the number is growing. And as each day passes, so is the number of crew who can't get here. Even flights from South Africa go way up north to connect through Charles de Gaulle, and so our plastic surgeon, Dr. Tertius, is among those who are waiting at airports.

I met a little girl in the hallway today. Her name is Dani, although it's hard to understand the words that come through lips twisted by scars. She was supposed to see Dr. Tertius at screening today, along with about a hundred other patients. They were all supposed to see him, and we were supposed to fill up the five-week block of surgery, and suddenly this volcano takes on a whole new meaning.

The cloud of ash covering Europe means that instead of five weeks of plastic surgery, we will only get to do four at best. If you figure between four and five patients a day, that's over twenty people who will be denied the chance to live out their lives as members of society, twenty people who will continue to suffer from limbs locked in scar tissue and eyes frozen open and so much pain.

I look on the news and read about people so frustrated at the delays, the economic impact on the stock market, the financial hit the airlines are taking, and all I can see are those twenty-some people who have never even heard of Iceland, but whose futures have just been blotted out in a huge cloud of smoke and ash.

The orthopedic surgeon who's been stranded here has decided that, even if the air clears and he gets a seat on a plane, he won't leave before Thursday. There are a few more kids in Togo who will get to walk on straight legs and strong feet, and I have to believe that God knew all of this. I have to believe that He'll bring the right patients to us when Dr. Tertius finally does arrive, just the ones we need to fill the remaining four weeks. So please pray for God to intervene, that the ash would disperse so our surgeons and nurses can get to the ship. Pray for the people who will have to be told no once we are finally able to screen them. Pray for all those stuck here on board who should have gone home days ago.

I've never prayed about a volcano before. I guess there's a first time for everything.

When the intercom sounds its tone overhead, everything on the ship stops, waiting for the announcement. It generally strikes a mild chord of fear in my heart, since all too often these days the sound has prefaced the calling of the Emergency Medical Team or the duty anesthetist or someone else that needs to respond to the latest emergency.

Yesterday, the call signaled something much more lovely. All those who have personal items on the Togo Three container, you can pick them up at four thirty on Deck Seven. I've never ordered anything big enough to be sent on the container, but I knew there was something on there bearing my name, as I'd gotten an e-mail about a week ago alerting me. I wasn't entirely sure what it might be, but I had a suspicion.

It turns out I was right!

Back at the beginning of the outreach, my sister-friend in Canada, Dina, asked if she and her kiddos could put together a package of things for the other kiddos on the ward, the ones they pray for every night. Yesterday, that package arrived, and it was absolutely splendid. It's not every day that you get a big old box in the mail, and that sort of thing isn't something that can be opened alone. I headed over to my friend Julle's cabin, and along with Jenn and Liz, the four of us dug into the box of treats.

Seriously, I think Dina and her four kids must have some secret package-putting-together gene in their collective makeup, because this was one for the books. Every corner was filled with goodies, little notes written on packages to give us ideas for crafts. There were doctor kits, absolutely perfect for doing teaching with little ones before surgery. The craft supplies were in abundance, and we were practically shrieking as we put together pipe cleaners and butterfly shapes and glitter glue and imagined the mobiles we'd be able to make to hang over babies' beds. We found flowers that will be perfect to use on name cards for our VVF ladies. We immediately thought of artistic kids who would love the canvas and paints. And there were googly eyes! And play-doh! And socks for puppets!

And when we got to the clothes, we knew right away who should be wearing them. (Carter's onesies, incidentally, are perfect for babies in the hospital; they aren't itchy at all, and the necks stretch to accommodate all kinds of tubes and wires.) The four of us picked out the best ones we could find and headed down to the wards. O'Brien was sleeping in his mama's arms, like he always does, so we just left the clothes with her, receiving a smile and a thank you in return.

Maurius, though, was wide awake, staring up at the balloon mobile some crafty nurse had made him. Except for the trach, he's just a regular baby these days, always looking around to make sure he doesn't miss a thing that goes on in D Ward. We quickly had him dressed in a soft suit printed all over with jungle animals (which I'll have a photo of once it goes up on the communications drive), and propped him back up on his throne of pillows.

Chantal came into the room just as we were leaving, her smile as wide as the sky when she saw her little man dressed in his finest. She repeated her constant refrain, and we echoed her words. Akpe na Mawu. Akpe kaka.

Dina and kids, thank you so much for this incredible blessing. Just like everything else on this ship, it came at just the right time. Today was the last day of orthopedic surgery; plastics starts on Tuesday, and we know from past experience that there will be plenty of patients who will be staying for weeks on end in our windowless ward in the bottom of a ship.

Except this time, there's no way they'll be bored.

I feel so silly today, like a little kid who threw a tantrum because she didn't get her own way, when really her papa was planning on giving her a second scoop of ice cream all along.

I got the call late last night, while I was lying awake in bed and worrying about Maurius. Just so you're aware, he's had another episode, and they're taking him back to the OR to put in a trach. For Maurius, an episode is nothing to be scoffed at, nothing like on TV, where everything is neatly packaged by the end of the show. In this case, nothing has been that simple. He'd somehow managed to block off his breathing tube for the second time in less than eight hours, and the doctors were simply unable to get another tube in its place. There were no other options.

Sleep was a long time coming last night as I sat on my couch and prayed even as I raged at God, unable even in my anger to stop asking Him for hope. Why can O'Brien have a miracle while Maurius suffers through yet another traumatic procedure? Why one and not the other? And yet I couldn't stop myself asking Him for wisdom, for skill, for sure-handed surgeons. Questioning His will and asking Him to provide all in one long, jumbled-up prayer that I'm sure the Spirit had to interpret for me because I know I wasn't making any sense.

So many of you have written and reminded me that it's okay to question, that it's okay to be angry, and I'm so grateful for that reassurance. Your words mixed with His in the dark of the night, and I found that I was able to trust even through my hurt. Remembering that the promised light is only for the next step. That even though right now all I can see is the snake across my path, the step after that, when the Light moves forward with me, might be something so incredible that I'll wonder why I was ever scared to begin with.

And so of course, with the morning came the light. Mercy new with the dawn, and Maurius is surprising us all. I sat with him while his nurse took her lunch break and the ventilator continued its relentless pulse. His bottom lip stuck out in a constant pout, and he kept trying to pull on the tubing connected to his new trach. The solution was obvious, although I'm not sure who ended up benefiting more from it when I stuck my finger in his chubby little hand and he held on with all his strength. His forehead smoothed out and his heart rate inched down a couple points and I sat there, the pain in my heart easing just a tiny bit, hardly daring to breathe while I watched him do so effortlessly. Such a change from yesterday, and his soft fingers clenched around mine let me hope in a way I hadn't dared before.

It appears Maurius has decided to stay with us, because when I checked on him again before leaving for the day, the ventilator sat in the corner, unplugged and silent. Maurius was wide awake, glaring at us with his furrowed brow, needing just a little oxygen blowing into his trach to help him breathe. He's apparently not a huge fan of all the fuss, and would most likely prefer to be in his mama's arms, chugging a bottle.

All that will come with time. Maurius is at the start of a long road, but the Light that's shown us the path this far will lead us home, I'm sure. And somewhere, in the background, I can almost hear God laughing at me. Not mocking or derisive, that laughter; just the amused chuckle of One who could see from the beginning that there was really nothing for me to get mad about in the first place. The One who knew I was going to get that second scoop of ice cream, and forty seven more, if only my bowl were big enough to hold it all at once.

I'd like a bigger bowl, please.

I feel like I sometimes paint too bright a picture of my heart around here. Like I'm some kind of faith-filled warrior who can trust God through anything. Like there's always a lesson to be learned in every situation, a lesson from a loving God and so everything is okay. So maybe it'll shock you when I tell you that I'm angry today. I'm frustrated and disappointed and I'm actually just plain angry at God.

Maurius went into the operating room today. I was headed to a meeting in the office when I passed by his mama, Chantal, huddled with the nurses in the waiting area. I stopped to pray, one hand on her back, the other on Maurius' chubby foot, and then they went in through the heavy, sliding doors and I went on with my day.

Just a few minutes later, there was a flurry of activity and people being paged to OR Four, and when we turned on the camera in that room, we saw another huddle around Maurius, this one made up of surgeons and anesthetists and nurses and everyone was moving faster than they should if everything was okay. We stopped our meeting right then and there and sat in a circle and prayed to a God we've seen do miracles before. Truth be told, after what happened last week, I expected the same again. I expected to watch on the silent screen while the tension rolled out of shoulders and the crash cart rolled out of the room.

Except that's not what happened. Maurius is very sick. His lip is fixed, and he looks like a new baby, but that new baby is so awfully sick. The infant tubing for the new ventilator is held up somewhere a few miles away in customs, and the old ventilator just isn't precise enough, so we've had to roll a great, hulking anesthesia machine over from the OR just to breathe for him. None of us can see the light at the end of the tunnel right now, and it makes me so angry I just want to scream.

How is this fair? Why this kid? After all his mama's done, after all we've done, why on earth would this happen? And why doesn't God just step in like He did with O'Brien? Why is He waiting, off in the wings somewhere, while we watch this baby suffer?

I know this doesn't make me a good Christian, all this doubt. But I look at that little one with his lip all held together with steri strips and I want to shake my fist at the sky and demand to know why it had to come at such a price. Why, just once this year, something couldn't go right instead of so horribly wrong.

Why can't something just go right for one of these babies?

It would seem that God is not joking when He lays a verse on my heart. This morning at handover, at the fresh start of a new week, I just felt led to remind us all of the verse from Lamentations where we are promised that God's compassion never fails, that His mercy is new with each morning. Something prompted me to pray for us all to be filled with compassion and mercy, and you'd think I'd know by now what that meant; we were going to need it.

Nothing spectacularly bad happened today. In fact, there were pockets of pure light in the midst of it all. We discovered that Obre's name is truly O'Brien, and couldn't stop laughing when his mama shared with us that he's most definitely named after an American tennis player O'Brien's dad had seen on TV once. O'Brien himself (the small one) continues to do well, improving slowly but surely.

I took one of my favourite kids ever, Aziz, to the OR while his nurse was at lunch. She had given Aziz his pre-medication a few minutes earlier, so it was expected that he would be a little dopey while we carried him down the hall to the waiting area. (That medication had the absolute opposite effect on a kid earlier in the day who had insisted on riding a little toy fire engine the entire way down there and would have ridden right into the OR if they'd let him.) When I settled him on the bench, he tucked himself into my side and grinned up at me with a strange little smile which actually turned out to be the smile of the child who has successfully held his medication in his mouth for a good fifteen minutes and is incredibly proud of his sneakiness. When I finally convinced him to swallow it, we went on with the checking in process until we got to the part where we ask the mama to confirm the surgery. She told us she had absolutely no idea what surgery her child was about to have, so I jokingly told her that if she didn't know we might as well all pack up and head home. Aziz seemed to think this was a bad idea, and his little seven-year old voice chirped up. Pied gauche! Left foot! He was absolutely right, and so we considered that box ticked.

All of this (and there was more; there's always more) would have been fun if it hadn't been for the utter chaos that surrounded the shift. At one point, I looked around and counted the people in the ward. Right then, there were seventeen patients, fifteen caregivers, eight translators, five nurses, two physicians, two physiotherapists and a housekeeper. There were fifty people in that one room, and since the already-low ceilings are still strung with colourful paper chains from Easter and the kids' toys are filling every corner of the ward, there clearly wasn't enough room for all those bodies. It's not that things were horribly bad, it's just that it's nearly impossible for them to be good when there isn't even room to breathe. Compassion is sometimes hard to come by when you can't hear yourself think.

When it looked like the number of discharges would almost balance the admissions and we'd still have two beds left over, I decided that we could endure the cacophony for one more day before the madness spilled over into the silent A Ward. We discharged patients left and right, sending little kiddos and their casts out one after another, and just after lunch there was finally a moment of quiet.

We've got one hour until it starts all over again, Jenn reminded me, and I groaned in anticipation of the renewed noise levels when, right on cue, the phone rang. News of one more patient, a little girl who would be admitted along with her papa. Two more to stuff into the already full-to-bursting room, and I just couldn't face it. Lovelace was the proverbial patient that broke the charge nurse's clipboard, requiring a complete reworking of the afternoon assignment and a massive shifting of half of the patients next door, but it's okay because I wouldn't have missed out on Lovelace for the world.

Little Lovelace, the not-quite-five year-old girl with huge tumors distorting her jaw and the top of her head, crying as we put in the IV she'll need for the surgery where we'll take the biopsy that will decide her fate. A child who's already endured more in her short years than I can imagine for an entire lifetime. Her papa shows her pictures on his cell phone and plays the ringtones to soothe her cries, and I have no idea what her future holds.

All I know is that those wards are watched over by One whose compassion never runs empty. One whose mercy is new every single morning, no matter how much the chaos might threaten to consume us.

I spoke too soon about our little man Maurius. It seems so unfair that these little ones who struggle so much just to gain weight should struggle in other ways too, but Maurius has aspiration pneumonia, the same problem that almost took Obre from us. It's not uncommon among these kids; it's a wonder more of them don't suffer from it, given the fact that there's an open hole in the roof of their mouths, just inviting milk to slide down into their lungs.

We knew Maurius choked a bit while he drank his milk, but last night he started coughing even more than usual, and an x-ray showed the telltale signs in his lungs. His surgery was canceled and he was started on antibiotics and breathing treatments to help him heal so that we'll be able to reschedule his operation.

With all this going on around her, Maurius' mama sat on their bed, looking forlorn. She could almost touch her heart's desire, and yet we snatched it from her outstretched hands, and she was bewildered at how fast the plans had changed.

I don't even know her name, but that woman and I have become good friends. She delights in my open admiration of her baby, and will call me over to his bed whenever she thinks he's looking particularly cute, knowing that I'll give him all the praise he deserves. Today, though, she was quiet, openly disappointed, so I came up with a plan to cheer her up; I printed out the photo of him that I posted yesterday, the one where he looks so near death with his skin hanging off his bones.

I scrawled a note on it in a language I knew she couldn't read, and then got a translator to speak it to her in Ewe. Look how fat I've gotten! Love, Maurius. Her response was just what I hoped. Her face brightened and she jumped up, throwing her arms around my neck and slapping me on the back like we'd both just won the Stanley Cup. We danced for a moment while Maurius looked on from the bed, a slightly-wheezy buddha-bellied little man, grinning his lopsided, broken grin.

Figuring my mission was accomplished, I turned to head back to my desk, but she caught my arm and pointed to the low ceilings of the ward. We both looked up as she shared her heart in words I could understand, words I spoke with her in her joy. Akpe na Mawu. Akpe kaka. Akpe. And then she knelt next to her bed, eyes tight shut, hands folded, and spoke those words over and over again. Thanks be to God. Thank You so much. Thank You.

Even though Maurius' lip hasn't yet been fixed, we are already winning this battle. She has chosen life, and she has chosen it in the name of Jesus. In just two months Maurius has gone from near-death to bursting out of his clothes, and we know she will not stop fighting for him until she can kiss him with an unbroken lip.





And now, almost directly across from Maurius, tucked into the other corner of the ward, are Obre and his mama. He's officially out of the ICU, and the plan in his chart is simple; when he can keep his oxygen levels up without the little puff of oxygen near his face, we wait two days to make sure nothing happens and then we send him home to continue getting fat. That's it. Just wait and watch and marvel all over again at what Mawu has done and what He is continuing to do down in those wards.


(Keep praying for our little ones and for Hettie, the nurse who oversees our Infant Feeding Program. So many of the babies have been tough cases this year, and she's doing an amazing job working with them.)

When I met Maurius, he was skin and bones, just like so many of the little ones we've seen this year. His mama loved him, it was clear, but the hole in the roof of his mouth was just too big; she didn't know how to feed him.

Despite his deformity, Maurius came to us in style, dressed in the typical outfit of grown African men; a cloth suit with a button-up shirt and pajama-style pants in matching fabric. He weighed less than a newborn but was already sporting clothes far beyond his years, and the first time I saw him I burst out laughing.

Mama, I told her, when I could breathe again, you have a little man in a big man's clothes! She laughed along with me and told me that, with God's help, he would soon be big. Her faith was well-placed.

Today, I found myself drawn to Maurius' bed over and over. He ended up being admitted a day early, so we've had lots of time to enjoy a happy, pre-surgical baby. (For some reason they're never quite as much fun once they've been through the operating room.) Have you clicked on that little thumbnail to see his photo bigger? Go do it, and then come back and I'll tell you how he looks now.

Gone is the listless baby with tired eyes. Instead, he holds his head up, wide-eyed and bright, looking around the room to make sure he doesn't miss anything. He smiles at the slightest provocation, the sides of his lip splitting even wider with his grins. Where the skin used to hang in wrinkles off his bones, he's got round rolls and dimples. And instead of ribs showing, all you can see when you lift his shirt is a big, plump belly.

Tomorrow Maurius will go to the operating room to have his lip repaired. And when he comes back, we'll dress him in his little cloth suit again, a suit that's starting to get tight around the waist.

Big man in a little man's clothes.


(And, in other cleft-lip-baby-news, Obre is still doing splendidly well. He started receiving formula through his tube again today, and it hasn't caused him to have any problems breathing. We are still in awe as we watch him grow stronger.)