This is a video of John walking before surgery....

I love this video!!! Here he is 7 weeks post-op!!

The question I know many will have is WHY?? Why are his legs like this? Although specifics aren't known for certain, deficiencies in their nutrition are likely the cause. The reason it causes the deformity is due to an impairment to the growth plate of one or both legs that causes it not to grow on one side. The osteotomies performed will correct the curve and encourages proper future alignment.

Its hard to believe that two months has gone by and I'm actually leaving here tomorrow! I will certainly miss so much about life on the ship, but am looking forward to going home as well. I wanted to show a few more pictures of the last week here to wrap up and will also download a video of John when I get home! Please excuse any typos.... its late and I'm tired....

Me and Jane White, one of the best nurses of all time and constant friend on the last two outreaches
The rehab team- me, Olivia, and Anna the Coordinator: the white powder all over our clothes is plaster of paris from doing club foot casting

Today was the 50th anniversary celebration of Sierra Leone's independence from the British. All of our day workers and many of the staff celebrated with Sierra Leone's flag colors of green, blue, and white. Some of the crew sang the Sierra Leone national anthem for the day workers at lunch. There was partying here day and night all over town!

This was the only way I survived my extra-firm twin bed! I found this raft in the boutique, which is a room on the ship where everyone takes their unwanted things.

If you know who Beth Moore is, you might appreciate the fact that we tried to dress up like her for our last night of Bible Study- big Texas hair, matchy-matchy outfit, bedazzled clothing..... this picture doesn't do us justice.

Allison Green, Olivia and I on Easter Sunday brunch.... I'm going to miss these two soooo much.....
When I woke up Sunday morning and couldn't sit through Easter service without intense pain in my sacroiliac joint, Liv reminded me why..... the night before we were talking about the fact that years ago she bet her college roommate that she could fit into her suitcase. Long story short, I made the same bet.... I paid for it by needing an hour of PT, massage, and Percocet the next day!
Two little boys we saw walking in town

Liv, me and Chuck at Becky's house in Grafton last weekend

Some of our ortho patients having a race down the ward hallway!

Estelle Pretorius, my favorite South African

This was one of my patients who tried extra hard to communicate with me- he was so patient and always had a smile- except for this picture of course :)
These are our Ponseti model feet- they are used as teaching tools when learning how to do club foot casting.

Me and Ole' Raustol, an orthopedic surgeon from Virginia: he offered to check the strength of a wheelchair that we had recently purchased as it looked really shotty....

We were blessed with a baker named Alfred for the last 6 weeks who made homemade rolls, pretzels, and croissants every morning. This was his homemade good-bye to us and is mine to you!!! Thanks for reading,

Jana

IN LIEU OF GIFTS.....

Natalie Claypool is my college roommate's precious 11 year old daughter. This year, for her birthday, she wanted to have her usual party with her closest girlfriends, but she wanted it to be more unique. She felt as though she already had plenty of toys and games to play with and didn't want her friends to bring her new ones. She asked that instead of bringing gifts, each girl would consider donating money to a cause. Before I left, her mother asked if I might be able to find a project to spend the funds on in Sierra Leone. Of course, there are tens of thousand of people who need financial help here of one kind or another, but its not always easy to get hooked up with an organization or group that you trust to use the money wisely.

Fortunately, I have been lucky enough to become friends with several missionaries here who have made this task manageable. Chuck Luke is a missionary (around my age) who is a nurse and works for Pioneers. He and his church are involved with an orphanage in Grafton which we visited yesterday. Mama Anne Marie Sesay is the primary caregiver of 70 orphans. Amazingly, she has dedicated the last 26 years of her life to caring for abandoned street children by providing food, shelter, and love in a Christian home. She and several other volunteers were desperate several months ago as they no longer had a place to call home. Chuck's home church raised the money to rent a house for them for one year and also provided a few months of food for them. It costs around a dollar a day to feed each child, so this quickly adds up when there are so many mouths to feed.

Superman had really wet pants, but a really big smile.....

They all crowded around for their "snap" and mobbed me to see it afterward....

This photo, hanging in their office, is of Aminata, who was found laying on a pile of leaves at the dump when she was about two weeks old. They have cared for her since then and....

She is now 2 years old and happy as can be.... seen here with Olivia Roberts, one of my best friends, who is a physician's assistant.

The orphanage's Vision Statement

My tickle-monster fingers had a hard time staying away from this boy- he was soooo cute!

Obama.... CHANGE you can believe in

More cuties....

Anne Marie and the other volunteers who care for the children

The money raised at Natalie's party was given to Anne Marie yesterday and no doubt will be used purposefully. I initially thought perhaps the kids could get some new educational toys or games or that the money might be used to provide improved bedding. But.... often in Africa, the basics aren't even covered and they are top priority. Their most immediate need is for work to be done on their septic system/latrines. Anne Marie has run this orphanage for 26 years without losing any children to disease, malnourishment, or accident. Obviously, she is the best one to judge where the money will go..... thanks to all of Natalie's friends who helped to provide hope and love to these kiddos!

This story was written by a crew writer....

Baby Barbara Receives Life

Babies born with deformities in West Africa start life as victims of the West African superstition that abnormalities are signs of a curse. When Barbara was born with a cleft lip that extended up into her nasal cavity, her father pronounced that she was a “demon child.” He ordered his wife to take the tiny infant into the bush and leave her for dead.

Barbara’s brave mother, Aminata, refused to abandon her child. As a result, she was thrown out of her house and moved in with her sister. Without a way to support her family, Aminata was forced to separate her four other children and send them to homes of other relatives.

Broken and devastated, Aminata had reached her darkest, lowest point. Then God stepped in and brought a ray of light. One day Aminata met a woman who said that Barbara was not a “demon child.” She also said that Mercy Ships would arrive in Sierra Leone in just a few weeks. Volunteer surgeons onboard the Africa Mercy could fix the baby’s lip – for free!

Barbara’s weight was drastically low because her cleft lip prevented her from getting the nutrition she so desperately needed. In fact she weighted less than 4 kilograms (8.4 pounds). On top of that, she had contracted tuberculosis and was placed on a TB program at a local hospital.

Shortly after the Africa Mercy arrived in Sierra Leone, Barbara was accepted for cleft surgery. However, because she was below the acceptable weight for surgery, she was enrolled in the Infant Feeding Program. Nurse Melissa Davey, of Philadelphia, was able to teach Aminata a different feeding method to ensure weight gain for the tiny child.

Currently, Baby Barbara comes to the ship for weekly check-ups. She is slowly gaining weight, despite all her problems. Soon she should be ready to meet the surgeon who will repair her cleft lip – and “erase” her curse – and give her a beautiful new smile!

Story by Elaine B. Winn

Edited by Nancy Predaina

Photos by Tom Bradley

SLE1103_INFANTFEED_TB17_LO

Baby Barbara Bangura and her mother Aminata

wait at the Infant Feeding Station on dockside

in Sierra Leone.

SLE1103_INFANTFEED_TB22_LO

Baby Barbara has a tight grip on the nurse’s hand at the Infant

Feeding Program tent, dockside In Sierre Leone.

Its hard to believe another week is nearly over.... we finished up adult orthopedic surgeries on Friday but still have some of the patients in the ward. The new PT arrived yesterday and will be treating most of the patients who remain on the ward and I will be working with Liv in post-ops for these last 2 weeks. It will be just like old times- casting together, giving each other a hard time constantly, kids screaming the majority of the day as we come at them with a cast saw!

Here are a few pictures of the last week here in Sierra Leone....

Dr. Johannes Bernbeck, from California, preparing for surgery

This patient has a severe genu valgus deformity. This is thought to be caused by a nutritional deficiency and is treated in several different ways surgically. This girl had a femoral osteotomy, which requires a wedge be taken out of her long bone and pinned in place- after about 6 weeks of casting, she will hopefully have a nice straight leg permanently.

After surgery and casting- looks pretty good, huh?

We also treated many unhealed broken bones. Many that we saw had been walking around with a broken leg for years.
This surgery required a rod and screws to allow the bones to be a position that allows healing and weight bearing without pain.

One of the anesthesiologists getting his hair braided. This has become extremely popular over the last few weeks! A little 4 year old girl braided my bangs in about 2 minutes with her Barbie Doll's comb.... I won't be coming home with a weave- somehow, I don't think that would look good with my Derby dress!

This little squirt is one of my favorite patients of this outreach. Her name is Isanta and she has a bit of a developmental delay and cerebral palsy. She had surgery to place 8 plates (which over time will hopefully help her legs to straighten) and additional surgery to lengthen her hamstrings in hopes that she would be able to walk. She and her mom came here from Guinea and it has been amazing to watch her progress over the last 5 weeks. I was getting her prepared for discharge this morning and was trying to figure out which walker to give her to take home. I had a choice between a pediatric rolling walker, which fit her perfectly, but was very rickety or a geriatric rollator walker with a seat and fancy basket. Not sure why these were sent to Africa, but I'm glad they were! Its too tall for her, but its so sturdy, which will be perfect for the hilly, rocky village she is returning to. We also received a donation of Skechers yesterday and I gave her a pair too. Her mom was in tears. She told me through the translator that this was one of the happiest days of her life. Her friends in the village had told her to "throw this child in the forest". They said she "was evil" and "from the devil". Now, she says "I am so happy because I get to take my little girl home and I have what I need for her to walk. God will bless everyone here for helping us".
I haven't mentioned many of the other services here on Mercy Ships and will try to do a better job of that next week. Here you can see a patient being checked in line at the dental clinic.

John is now walking! I have changed his shoes 5 times, as he was unhappy with each pair I fashioned for him.... I finally found a crew member's son (Noah Peet) who was willing to give up a pair of Crocs for him this morning. John is elated with his worn-out, but functional Crocs. Thanks Noah!

Delivery of barracuda in the reception area. All of our food gets delivered here, but the staff was expecting that the fish was going to be gutted and cut into portions before it arrived....

Using abusive language in this area will cost you $12. Not sure how it is enforced....
We had a severe water shortage over the past week- things are beginning to return to normal. I was able to wash a load of laundry this morning. I had to get up at 5 am to get the spot, but Liv and I now have clean stuff!

I went diving last weekend with Olly and Dan. The visibility was about 5 feet and we saw pretty much nothing but our fins.... very strong current and undertow made it a real challenge, but its always fun to get out there anyway!

Man digging through the trash looking for treasure in the streets of downtown.

Sign at the bottom of the gangway as we leave

This sign at the local free emergency hospital is a little difficult to read- it says "No Money transactions for blood transfusions. Please bring donors". Blood here is only typed, but not checked for disease before tranfusing into someone else.
Surgeons making a fashion statement in their new african shirts

Thanks for taking the time to read! I'll be home soon- Jana

As I sit here and type in the lounge on my morning off, I am so happy to be alone for just a little while. I have my feet up, staring out over the ocean, watching fishing boats sail by out the window. The ship has over 400 crew members from 30+ countries and it is nice to find this hideaway spot from them all even if it is only for a few hours. I've learned that I take my alone time at home for granted and now appreciate being able to clear my head and prepare for the rest of this busy week.

We will finish up with adult surgeries this week, but pediatric will continue until the middle of May. The screening that took place 10 days ago went perfectly. Many surgical spots were filled, everything was orderly, there was no rioting. We really couldn't have asked for a better day.

Liv and I spent this weekend with a missionary family from a little city about 12 miles outside of Freetown. Of course, when you have to drive through the main road in Freetown, it doesn't matter how close the neighboring cities are- you are going to spend at least 2 hours in traffic to get 2 miles down the road. This weekend was no different- there was a parade to celebrate the 50th year of independence from England and we ran right into it. There is a huge celebration at the end of the month, but I think there are mini-parties constantly leading up to the big day.

They are cleaning the streets every Saturday and preparing for the potential arrival of Queen Elizabeth who supposedly will be coming for the big day. Every Saturday until the end of April, the residents are required to clean the streets and clean their homes until 10:00 am. If you are caught in your vehicle or outside your house before 10 am on Saturday, you will be arrested. I hear that white people won't be arrested, but few of us are willing to take our chances.

We had a fantastic weekend with our new friends- we went to River No. 2 beach, hiked to a waterfall, visited an orphanage and the Hope Center that they run, had a fantastic lunch at a nice restaurant, and got to go to the local supermarket. I forgot how good getting off the ship is for me mentally. I feel relaxed and ready to start the second half of my time here! Here are some more "snaps" (as the locals call them) of the last few weeks.....

A view of the ship from a walk we took into town
10,000 Leones is about $2.40. I took out a quarter of a million yesterday- sounds like a lot, but its about $80.

This is a little hut where they sell items during the day- the cotton tree behind it is one of the symbols of independence here in Freetown.

Kids and adults here are happy to have their snap taken- especially if you show it to them afterward....

Dr. Frank Haydon, ortho surgeon, examining a patient after his Xray, along with a translator.

Putting on a cast after determining he had a unhealed fracture.

Cast saw is used to remove another's cast

When the doctors decide that the answer is "yes", surgery is scheduled and patients are given their card to return for re-entry to the ship.

Kids playing in the ward

This little girl just lit up the room everytime someone new walked in

John- I showed pictures of him pre-operatively in my last blog. He is now over 2 weeks post surgery and doing unbelievably well....

John with Dr. Frank- he is so happy his legs are straight. The Krio way to tell the doctor "I'm happy, thank you" is "me gladdy, tenky".

We have alot of donations here, but ran out of cast shoes.... we are now having to make the cast shoes out of tires and yarn.

Liv at the waterfall

Fishing boats at the beach

Me and Liv- it was very windy!

This is most people's favorite beach.....

Relaxing at the waterfall