Tuesday, April 28, 2015

The coming weeks.

Here's my schedule for the coming weeks:

Tomorrow I get in a car for a four-day road trip to the interior of Madagascar to follow-up with Peace Corps Volunteers who did the HBB training.

I get back on Saturday night and then head out Tuesday morning to fly to Fianarantsoa and for two more days of HBB follow-up.

I will fly from Fianarantsoa to Antananarivo, where I will meet up with Michelle and we will both fly the next day to Mahajanga where we will follow-up Checklist training.

We will both then return to the ship on Friday evening, unpack and repack, and then travel back to Antananarivo on Sunday.  After a quick overnight, we leave together to fly to Johannesburg, South Africa where we will get the necessary visas to go to the Republic of Congo.

Thursday, visas in hand, we will fly from Johannesburg to Pointe Noire, where the ship was docked for the last field service, 2013-2014.  We will spend time in three cities over two weeks in Congo, every day packed full with supplementary training, follow-up, and visits - trying to determine if what we did there in pioneering our Healthcare Education program actually left an impact. 

After two weeks in Congo, Michelle and I head to Berlin where she speaks at a conference and I will be madly writing reports for the end of the Madagascar field service as well as the Congo trip.  We will also explore a bit and hopefully have a few hours to breathe after a full on, non-stop several months.  Then I have a brief layover in London where I bid Michelle goodbye for a few months and then head through Madrid on my way to the Mercy Ships International Operations Center in Lindale, Texas, where I will spend a few weeks working from dry land while the ship makes its way to Durban, South Africa for the annual shipyard maintenance period.  It's been three years since I have been there, so it will be a great time to reconnect with team members and friends from that side of the pond.  Then, finally, I will head to Minnesota, to Seattle, to Colorado, and to various other yet-to-be-determined locations before eventually making my way back to Madagascar to begin the second field service in Toamasina.

Phew. 

It's a strange end to the field service - I've sailed away from Sierra Leone, Guinea, and Congo field services onboard and this time of year is usually one of sadness tinged with hope and a season full of goodbyes.  This year I'm leaving long before the ship does and when I return the ship will be in the same place I left it; almost as if nothing has happened. 

One of the joys of ship life though is not only am I trying to get massive amounts of work done and papers ready and supplies packed for the next several trips but my home will be sailing... twice... in the time I am gone, so I have to secure everything for 20 degree rolls in the open sea, find people willing to care for my plants, and toss any food that will expire while I am away.

I had a moment today when I actually stopped and thought, "I live on a ship.  How weird!" Yes, three years in and those moments still happen.  I love what I get to be a part of and I hope to be able to post updates from time to time; but at the same time don't be surprised if you don't hear from me either! 

Thanks for your support and encouragement!!  --Krissy

Thursday, April 23, 2015

To the table.

It’s a beautiful moment when somebody wakes up to this reality, when they realize God created them so other people could enjoy them, not just endure them.  ~Donald Miller, Scary Close

 ~~

Awhile back I was hosting a team and we were all planning to go out for dinner. I was feeling lethargic, uninspired, burdened, tired, and all around uninterested in going to a restaurant with a dozen or so other people. I couldn’t possibly expend the energy required to put on shoes and face a crowd.  I blamed it on being tired; I blamed it on my introverted personality; on a long week, on too many people, on whatever else I could say to convince myself it really was okay for me to skip dinner.

 
Then a dear friend saw beneath the surface, and spoke the truth.  A truth I didn’t even realize was truth until she said it. I think you are doubting that you are wanted.
 

She left the room and I dropped to my knees, the truth of her words burrowing deep and conviction confirming that which she somehow knew to be true. I had made an agreement with a fallacy; somewhere along the line I had become convinced that I was simply a burden, an irritant, a nuisance.  Who was I to join a bunch of doctors for dinner? I wouldn’t offer anything worth saying, I couldn’t possibly think that I would actually be welcomed into that crowd, I would probably just make a fool of myself and say something stupid anyway.  I didn’t have anything to bring to the table. So why go?

 
Recognition is key. Recognition is freedom. Recognition meant I could intentionally pursue truth and life to the full and put on some shoes and go out to dinner, regardless of how it felt or what I heard or what I believed.

 
The end of that story is that dinner was beautiful; the conversation rich and the blessings flowing from me to them and back to me again. The end of my story is yet unknown; with the greater questioning lingering in desire - a desire to know that I have something to bring to the table, regardless of the size of the table or the venue or the company surrounding it, but how do you walk in that without crossing over the hazy gray line into arrogance and pride?

 
As I wrestle with that question the words of a dear friend come back to me; his response as I asked this very same question several years ago. The very fact that you are asking the question indicates you won’t cross the line.  A truly arrogant person wouldn’t even ask the question.

 
~~


In the book referenced earlier, Scary Close, Donald Miller also talks about one of the things he loves the most about his then girlfriend/now wife:
 

She truly knows she is good for people.  It’s not arrogance, nobody who knows Betsy would think of her as prideful.  Yet she knows that when she gets close to somebody she will likely make their life better.

 
Sigh.  I want that.  I want to know to the depths that because I speak and breathe life and God is in me that just by coming to the table people will see Him.  

 
I’ve mentioned this to a few friends in recent days, and they all say the same thing.  And I think, what? You? You think that too??  You are amazing! You have SO MUCH to bring to the table! How can you not see that???

 
And they say the same about me.  But neither of us know it in ourselves, both of us cringe at the thought of facing that table of strangers but both of us longing to know with conviction that who we are and who we carry in us will, and does, and delights, in affecting those around us… for good.

 
~~
 

As I watch the cursor blink for a few minutes and wonder what words will come next, a flicker of a story drifts through my consciousness.  I believe, help my unbelief.  Someone said that to Jesus once; I find myself saying it again today.  I want to know and believe, to the center of my soul, that I have something to bring to the table; I want my friends to believe it; I want us all to believe it. 
 

Because you know what? You do.


You have life to offer and so do I and there’s something about courage and something about being brave enough to step out in faith and something about trusting that when all rolled up and lifted up leads to that place my heart longs to go… to the table, to blessing and being blessed, to being enjoyed not just endured, to resting in the beauty of relationship and a shared meal or a shared heart and a shared pursuit of life to the full.  
 
 

Sunday, April 19, 2015

Dreams to Reality.

I’m back in my ship home after ten days up in Antananarivo; the days have been full and challenging yet fruitful, with strategic meetings about medical training programs for the next field service in Madagascar mixed in with running current healthcare education programs and trying to measure the impact of what we have done.

It’s exciting work – there was a moment this week when I came alive in a way I haven’t ever before. After three days of teaching pediatric anesthesia we took a day to invite the previous participants from the obstetric anesthesia course we held back in December to return and tell us how the course impacted them; their personal practice as well as their hospital and teamwork.  If I’m really honest I wasn’t expecting much; I mean, I hoped all our blood, sweat, and tears over the last two years of moving this medical training program from dreams to reality actually has left an impact but it’s hard to really know for sure.  Well, I had the opportunity to ask those questions, and the answer was a resounding YES, your training has affected me, my practice, my hospital and my patients. 

Incredible.

One anesthesia nurse who attended learned newborn resuscitation for the first time, and then everyone in his hospital saw that the babies he was delivering were all healthy, so they asked him to train them, too.  He did.  Now everyone there knows how to resuscitate a baby well and according to him, in the last three months at least a dozen or so babies that would have died are now alive.

Another anesthetist explained how the course taught her she needed to have a backup plan ready when putting a patient under anesthesia, in case plan A didn’t work.  When I asked her what she would have done in the past, she explained that if plan A failed everyone would be yelling at each other and trying to find the equipment and supplies for plan B while the patient was deteriorating on the table.  Now she has everything she needs, and a plan in place, and she is calm and ready to handle the issues.  She told me that others in her hospital saw how she did this, and how much better it was for her and for the patient, and asked her to teach them, too.  So she did. 

So many of the people we talked to said the most important thing they learned was to ask for help.  “I believed I had to do it on my own” is the common working environment here, and the freedom and encouragement to ask someone else to help them has left a huge impact not only on them as individual practitioners but also on their hospitals and colleagues; several comments were made about how now people in their teams communicate better, people know what they will do and what needs to be done, and the stress of saving a life is now a team effort, not balanced on the shoulders of one person who feels out of their league and overwhelmed with the expectations.  

They learned how to systematically evaluate and stabilize a patient; they learned how to respond to life threatening conditions with accuracy and confidence; they learned how to use specific tools in a better way and they learned how to communicate with others more effectively.  They didn't only just learn these things, though - they applied them, saved lives, and taught others how to do the same.  I could barely contain the tears as these stories flowed out of their mouths and I hastily scrawled what I could on my paper questionnaire; with French and English and excitement and joy all melding together into chicken scratch that is pure gold. What we do here really does make a difference.   

Somehow in the coming months this will all be written up into reports and papers and press releases; we find ourselves pioneering once again as we try to figure out how to measure success, and then to get their stories out into the hands of people of influence and favor and means and the courage to try and do something about it. I can’t even believe I get to be a part of this; I’m honored and grateful and humbled and excited to see where the coming weeks and conversations and travels and meetings bring us in the journey of making even more dreams into reality.  It was once just a dream that a hospital ship could bring hope and healing to the forgotten poor.  That dream became reality.  It was once just a dream that it could also bring world class medical training opportunities to those who are most in need.  That dream has become reality, too. It is still a dream that it could be a catalyst for transformation of an entire national health system.  That dream can become a reality.

Let’s do it.
Our SAFE faculty - from England, Canada, USA, Belgium, Ireland, and Kenya. What a privilege to partner with these incredible people to bring dreams into reality.  (Photo courtesy of Steph B)
 

Saturday, April 11, 2015

Transformation: Safe Anesthesia

Anesthesia [an-uh s-thee-zhuh] n. --General or local insensibility, as to pain and other sensation, induced by certain interventions or drugs to permit the performance of surgery or other painful procedures.

I don't think anyone would disagree that anesthesia is pretty important in surgery.  Yes, they put the patient to 'sleep' so they don't feel the pain of surgery, but they do much more than that. While the surgeon is focused on fixing the problem; removing the tumor, repairing the defect, or releasing the contracted skin, the anesthetist is keeping them alive  - making sure the patient keeps breathing and the heart keeps beating and the blood keeps flowing, adding more when necessary.  They also handle critical events during the surgery - if suddenly the blood pressure drops, or the patient has an allergic reaction to something they were given, or various other life-threatening situations, along with the important job of making sure the patient wakes up!  (medical friends, please forgive the simplistic description!)

But what if you were an anesthetist who knew you had to handle some of these critical events, but didn't have the skills or materials to do so?  What if you knew you would be okay if you had an adult patient, but a child appeared on your operating table?  Anesthesia is consistently one of the top requests for training in the countries I have served with Mercy Ships, and continuing anesthesia training is often unavailable in these areas.  So we have partnered with the Association of Anesthetists of Great Britain and Ireland to offer two SAFE Anesthesia courses - SAFE stands for Safer Anesthesia From Education - and we offer SAFE Obstetric Anesthesia and SAFE Pediatric Anesthesia.

SAFE Obstetric Anesthesia was held in Antananarivo back in December, and I meant to write about it then but never did! We taught basic anesthesia skills and critical care for pregnant women and newborns.  The participants were so excited to have the opportunity to learn new skills and refresh their abilities using our teaching materials and manikins, and we received great feedback on the course.  We will be inviting some of those participants back this week for some supplementary training and to see if they have been able to apply what we taught back in December!

SAFE Pediatric Anesthesia is this next week so I find myself now back in Antananarivo, excited to welcome the facilitators for this course who are coming in from the US, Canada, England, and Kenya!  It's such a privilege to come alongside the anesthesia providers of Madagascar, offering them hands-on workshop teaching where they can practice what they are learning and hopefully improve the care they are able to offer to Madagascar's littlest patients. 

Preparing for the course - a table full of anesthesia equipment!  A few years ago I wouldn't have had any idea what any of this is... now I can name almost all of it, and most of it in two languages!