The Face of Africa

In February this year the country of Togo had their Government Elections. Election season is always a time of unrest in this country as the history of the pain and suffering of 1993 echoes in the minds of every person here . During the month of February most of the people left the city of Lome to seek safety in the countryside as the memory of the violence is still fresh. In the 1993 Election 300,000 Toglese fled to neighbouring countries for safety; most had returned by 1996 however many are still abroad and some still in with refugee camps. Politically this country is still unstable which may be the cause of the unrest here and also the tension in the atmoshere. The Togo Government asked Mercy Ships not to do a mass screening in February in hopes of preventing large crowds and riots so screening has been carried out in smaller groups and teams have also travelled to the north of Togo.

There are local doctors and nurses from all parts of Togo being trained in the eye surgery rooms. Every day Dr Gary has two Togo surgeons (Dr James Amaglo and Dr Christophe Bissa) working with him-he is teaching them different, safe and effective ways to do surgery. There is one Maxillofacial surgeon for the seven million people of Togo. Maxillofacial surgery consists of working upon the face, soft tissue and bone reconstruction. Dr James Amaglo has been connected to Mercy Ships for sixteen years and whenever the ship is in Togo he comes onboard to glean new techniques and skills to help in the huge workload he has here. Just recently Dr Gary taught Dr James and Dr Bissa how to carry out Cleft Lip surgery. A Cleft Lip/Palate is a congenital abnormal facial development that occurs during gestation. A cleft is a fissure or opening-a gap and a non-fusion of the body's nasal structures that form before birth. One in seven hundred children are born with a cleft lip or palate and every ten minutes somewhere in the world a child is born with a cleft palate. This cause huge problems for the infants nutrition and ability to eat and most die in their first year from malnutrition, others will go on to survive however the battle to speak and be understood will continue to follow them all their days. In the Western world a child would be operated on at the first opportunity, here in West Africa an infant born with a cleft lip is considered cursed. The voodoo belief encourages the family and village to rid the child of the “evil” spirit b

y burying them in a wooden box and leaving them to die. If these children are spared, it is a result of the parents bravery; usually one of the parents standing on behalf of their child, fighting the village elders for the child's life. I could not believe it when a lady entered the Operating Room the other day with a cleft lip she had lived with for thirty four years, I wondered about the years of pain, ridicule and scorn she had endured.

It would be so easy to quickly point a finger at the cruel way they treat each other here yet to see these deformities and have no explanation must also strike fear in their hearts causing these people to act in irrational ways and believe in a religion that sacrifices their own children. With education and the visible change a one hour procedure brings the mindsets of entire villages are slowly being changed here and through many sources we hear the most wonderful stories of how parents stand confidently for their defenceless children who are born with cleft lips. Now that Dr Amaglo and Dr Bissa are equipped with the skills and knowledge of how to draw the puzzle pieces of the cleft lips together to form normal mouths we can leave Togo knowing that more children will receive surgery that will leave them smiling for the rest of their lives. Investment is key here and what we hope to leave, not dependency upon a big White Ship that sails in with free surgery.

A few weeks ago Dr Amaglo and his wife hosted a group of Hospital staff at their house. It was a wonderful night and with the help of their friends they put on a feast of African food and really honoured us-with live music and all.

As I mentioned in my last blog entry there is less freedom here in Lome (than last year in the Port city of Cotonou, Benin) to explore due to safety concerns so sadly it limits adventures however this weekend for the first time in six weeks I headed away with friends to Kpalime. It is further north and we stayed at a Baptist Hospital that has been here for 25 years, they have a nursing school there also where they train local people. It was a peaceful place and my ears rung with the silence as I realised for the first time in such a long time it was quiet. The airconditioning on the ship is nearly non-existent on the ship at present and it is clearly evident that we need to get to South Africa to have new generators put in. It works in the Operating Room however the rest of the ship is very warm and at times I feel like we are a tin can sitting in the African sun cooking. The generators all over the ship for this very reason are extremely noisy and working overtime, so silence is precious and hard to find.

We were just fourty five minutes from the Ghana border so we headed there and managed to visit the highest waterfalls in West Africa which are located in the town that sits directly on the border. Although I had the opportunity to visit this particular waterfall last year it was still a wonderful experience and great to get away.

That night we were given a tour of the hospital by one of the Doctors and it was incredible to see how they make do with the limited resources they have, some sights I will never forget. Towards the end of the tour he asked us if Mercy Ships had a Paediatric Ventilator and carried on to explain that they had a two day year old baby that required surgery on an Onphalocele. A very rare condition that is an abdominal wall defect which results in the abdominal organs protruding out of the umbilicus (navel) in a sac. A operation that many general surgeons tend to dislike performing as it has many complications. He asked if we could take the child with us back to the ship and explained that they had performed the surgery six times before and five of the children had died; I felt all the air leave my lungs when he said this. And so began the first of many phonecalls, yes we had a Paediatric Ventilator (a machine that helps children to breath after surgery) however we did not have the surgeon...and sadly their General surgeon was unwilling to come with us to the ship to perform the surgery-it was not an option as there were so many patients there that needed medical care at the hospital, he was the only surgeon there at present. All of a sudden I found myself at this point where I realised that the only hope, the only option was to leave the child where it was to have the surgery with the slim chance of survival. My heart felt so heavy, in my world...where I grew up there would be another option...there would be another way even if it involved taking a massive loan from a bank. Yes I believe in hope, I believe it is the anchor of the soul and because of this I had to walk away for a moment and cry tears of despair and pray...there was no other option.

I am thoroughly enjoying the work being done here. Each day is filled with amazing surgery and lives that are transformed. I am not saying at home lives do not get changed daily, however the drastic and extreme change takes my breathe away sometimes. If I do not keep reminding myself of what we are doing I can let the routine and familiarity of eye surgery get the best of me-everyday approximately thirty (often more) people receive their sight back. Light flows literally back into their lives and the loved ones around them who have cared for them for such a long time. As I witnessed four operations on children under the age of five who were completely blind receiving eye surgery and sight I realised that nothing here is ever mundane...only my attitude.

Everyday is filled with miracles here. Plastic surgery has just finished and Dr Tertius Ventor performed complex surgery and managed to operate on seventy patients in the time he was here. It was such a priveledge to be apart of the surgery for a man who had been carrying a seven kilogram tumour on his shoulders for 17 years. A tall man in stature he walked into the Operating Room looking towards the ground because of the weight of the tumour I was struck by the physical burden that he had been carrying upon his shoulders for all of those years. Research has shown that if the body receives physical trauma “lipomas” which are a fatty soft tissue (non-cancerous) tumour can begin to grow giving the look of a huge lumps or growths on a person's body. He told us that he had been beaten by the back of a rifle seventeen years ago and that was when it had begun to grow.

Mark Shrime was here for two weeks as an Ear, Nose and Throat surgeon and during this time carried out some miraculous surgery. I watched amazed as he removed a 1kg Goitre (swelling in the thyroid gland) from a Lady's neck, afterwards it looked like he had applied a bandaid or a plaster over her neck; there was no sign of what had been. As she had arrived in the operating room I had heard her struggling with every breathe.

Some days here are thirteen hours of work, others are eight. One night an Operating Room team worked till 2am in the morning-removing an extensive tumour from a lady's face. Regardless of the number of hours and how tired I feel I am grateful for every day and don't want my time here to end. There is no payment received for this work and for these hours yet I love it and love being apart of the work that is being done-good changes are taking place in every area of life-the physical, the spiritual and the heart of every person who boards this ship.