Finally, A Hospital Tour

I had my first shift in the hospital today!  My job title is "Pediatric Ward Nurse", but I had both adult and pediatric patients.  This will probably be the case throughout my time here in Benin.  So many people have been praying, and although it was definitely an overwhelming time learning a new work environment, I know God is with me.  I had a preceptor today, who was a nurse to orientate me to the unit.  I am scheduled to work on the unit called "B Ward", which is a plastic surgery unit.  Next week, one of the plastic surgeons will give a medical presentation about some of the surgeries they do.  I think I may have a greater understanding after next week and hope to share some information about the plastic surgeries (it is not cosmetic, which I wondered about at first).

Burns

From what I saw today, many surgeries are needed because previous burn injuries that patients have sustained.  When these burns heal, they cause the skin to contract (shrink), leaving the patients' hands, elbows, shoulders, or other joints immovable.  This severely impacts peoples' quality of life when they lose the use of one or more limbs.  Think of how difficult it would be to not be able to pick things up with your fingers or to have your elbow bent inward and be unable to stretch it out!

There are various ways in which these injuries can be corrected, and often it involves taking skin from another part of the body (donor site), either partial or full thickness skin grafting, and transferring that skin to the area where it is damaged (graft site).

Burns are apparently quite common in many Beninese people we will see, due to using open fires to cook food, keep warm, and boil water.  As any of us know from trying to carry that hot cup of coffee or move a pot of boiling water to the sink, it is quite easy to spill and burn ourselves or others.  The same concerns are found here in Benin, with children burned accidentally, but unable to access affordable emergency services, rehabilitation/physical therapy, or corrective surgery.

Here on the ship, we usually admit patients the day before their surgery, have to prepare them for surgery, and then receive them back to the ward after surgery.  Today, I helped with preparing two patients for surgery.  We make sure they are aware of what the surgery will be, have them shower and we scrub the injury site (where the surgery will be performed) and skin graft site (where the new skin will be taken from), and give medications before the patients go to the operating theatre/room.

Eye opening

This type of nursing is completely different from nursing in Canada.  The wards, first of all, are very much a community environment.  There is a possibility of having up to 20 patients in one unit, which is a U-shaped room, having four rows of five beds.  The rows are shallow and the beds are fairly close together with only curtains to separate them, but most of the time the curtains are open and the patients will talk with each other like one large family.  At home, I am used to having one or two patients per room, with at most five in some hospitals.

We have the very important job of teaching good hand hygiene (washing hands after using the bathroom, before eating, before and after touching a wound) to prevent infection from spreading around.  I think it is a new concept for some of the children to be washing their hands so much.  They laugh at us sometimes when we remind them to wash their hands (:



Also, before any crew members, patients, or guests are allowed to enter the ship via the gangway (the long set of steps from the dock up to the "door"), we must wash our hands at sinks on the dock.  This is not only to keep ourselves clean, but to be an example for the people we are serving.

Other surgeries

One of the wards here specializes in taking post-operative maxillofacial patients, which are patients who have had surgical correction to repair facial tumors, cleft lips, and cleft palates.  One of the major problems with a cleft palate is that the patients (generally children) are unable to get proper nutrition because they cannot feed properly.

This evening, one of the maxillofacial surgeons, Dr. Gary Parker, presented on maxillary tumors, which are tumors to the top jaw bone (shown in red).



Image reference https://www.lecturio.com/magazine/maxilla-le-fort-fractures/

As Dr. Gary said, these tumors can "cause death by starvation" because slowly they take over the oral cavity (mouth) and can move teeth, the tongue, the other bones of the face, etc., which makes it very difficult to eat.  It was a fascinating discussion, and I never before realized quite how involved a surgery of this type can be.  They usually take hours, and require much skill and concentration.  It is sad to see that because so many people cannot afford healthcare or do not have any way to access safe and affordable surgeries, they develop such conditions.  What starts as a small growth would be quickly treated in developed countries, but in the developing world, the tumours grow unchecked.  Many people are ostracized and thought to be cursed, ugly, or unwanted because of their physical appearance, not to mention the physical struggles they would have just to survive.

Not only do facial tumours often prevent people from eating as the grows large enough, but tumours can eventually close off a person's airway, preventing breathing or swallowing.

It is amazing to be a small part of bringing hope to the forgotten poor of the world.  Part of why I have wanted to come volunteer with Mercy Ships is that it is a practical way to love people and show them kindness and mercy (James 2:15-18), because it does not quite seem like enough to just tell them that they need to believe in Jesus, without actually showing love and compassion.  James teaches that we must live out what we say!  Both words and actions are necessary.

French

My knowledge of French is returning slowly!  Many of the patients speak other languages (the majority speak a local language called Fon), but there is often a working knowledge of French.  It has been neat to be able to communicate a bit with them and with other crew members.  I have had at least one person think I was from the United States, and so she was extremely surprised to find out I know some French.  Once she found out I am Canadian, it made a lot more sense (:  It is only by God working that I even have a desire to be learning French again.  And now it is starting to stick in my mind since I can now speak it with people.  God is so good!