Monday, 13 February 2012

Screening Day

Screening day is a day that is hard to put into words, but I will do my best...

Long before the sun rose, the day began.  In truth, for some of my friends, it began the day before with security and pre-pre screening.  But that's their story to tell.  Suffice it to say, two amazing nurses (Laura and Maaike) spent the night with a group of "big ugly guys" (that's what they advertised for on ship) as security to help keep the line peaceful at the stadium. The nurses acted as screeners, telling people if it their problem was something we might be able to help them with.

Dennis (above) appointed himself personal bodyguard to my friend Laura, and later to another friend (Melisa).  Lets just say, they felt pretty safe with him at their backs. 
We left in two large convoys, one about an hour and a half after the other.  My roommate's alarms went off somewhere around 3am.  I slept another hour and a half.  Which means I missed the pre-dawn beginning and instead arrived as the sun rose, about 6am.
There was plenty of setting up to do in the dark, getting ready to open the gates and begin screening at 6am.

Chairs set up and waiting.  Hope is tangible.  Who knows who will walk through our doors.  Feel the anticipation with me. 
Before beginning, as we looked out over the empty spaces, we prayed.  Prayed that those we could help would be there.  Prayed that we would be used as God intended.  Prayed for all those already in line.
Lines were kept peaceful in part with the cooperation of the Gendarmes (policemen) sent by the city of Togo.  They worked together with us to keep the line organized and the people calm.  Without their help it is hard to say how much extra security we would have needed.

As our staff got to the stadium, people divided up into their assigned roles, and extra instructions were given.

The dayworkers (locals who work with us as translators and cultural guides and many other roles) were also a part of every team, and helped to make the day the success it was.  Without them, we wouldn't have been able to do this.  In many ways, they are the backbone that keeps everything working.  The essential connection between us and our patients.

When we drove up, the line stretched across the field.  I can't even guess how many people were there already at that hour.  And it just kept growing.  A grand total of approximately 4000 people showed up.
Some had spent the night. 

People of every age and stage showed up.

And finally,
after who knows how long spent in line, they reached the gates.  The pre-pre screeners worked tirelessly through the night and day, assessing people and advising them which surgeries we did and who we might be able to help.  Once through the first of two gates, the pre-screeners began their jobs of weeding out who we truly could help and who we sadly had to say "no" to.
Here's Maaike using posters to show what kind of growths/tumors etc that we can help.

This was a specific surgical screening, and even though we do eye surgeries, those screenings are done seperately.  Anyone coming for an eye problem was advised of the time and place of those screenings.

The desperation for help meant people would wait in line no matter how hungry or thirsty they might be, for fear of loosing their place in a seemingly endless lineup.  The long day under the African sun leaves everyone at risk of dehydration.  Coca-cola donated thousands of waterbottles, and we had a team of people whose job for the day was distrubting them along the line.  Wheelchairs were put to good use to move the heavy stacks of water.
Sandwiches made the night before (peanut butter and jelly) were also handed out to any and all in the stadium and in the lineup.  I may have had a sandwich and a drink unceremoniously placed in front of me when I kept refusing to leave for a break because there was still too much to do and a neverending lineup of people to be seen.  It's what friends do.  Thanks Annika!

Whether in line or waiting in chairs in the stadium grounds, children can use a little extra attention, so we also had a team of people who went around playing with the kids.  Bubbles, stickers and chalk all make universal toys that don't require language. 
Once the prescreening is finished, a new kind of waiting begins.  Instead of standing in the sun in long lineups, people are brought to sit in chairs and wait their turn, moving through stations where all kinds of assessments are done and information collected.
In a place where not everyone has an education or is literate, signing a consent is difficult.  Many people sign with a simple thumbprint.

Consent recieved, it's time to ask questions.  Learn what happened, when it started, how it has affected them.  Any other health problems.

Vital signs are checked, giving us a baseline.  How healthy are they really?
The "pink slip" is normally a term for losing your job.  The pink papers here, though, are what we write our initial assessment on.  This paper travels with the person from station to station, slowly adding more and more information.  At one point I gathered up a couple of papers that were then passed on to another person who took them from the room for a moment... and I looked at the person the paper belonged to.  They were watching the path of that paper intently.  Everyone else clutched their papers as though scared to loose them.  This paper... it is gold to them.  It's like the passport you bring into another country.  It says who you are, where you belong.  Without it, you could be kicked out.  This paper was the beginning of their hope.  It represented the chance they had waited and prayed for.  The chance for change, for new life, for healing.  It wasn't yet a promise of change, but the hope was there, clutched in their hands, tangible.
Little by little, they are filtered through various stations and specialties.  Some get ultra sounds.

Some get biopsies.

Some get blood drawn.
Dr. Parker (above) is our only long-term surgeon.  He specializes in all kinds of facial surgery, especially to do with cleft lips, tumors and replacing missing things like noses and cheeks.
Jess is our dietician.  She helps with any children at risk for malnutrition such as babies with cleft lips and palates.
In the end, the fortunate ones end up here.  Scheduled for a surgery date.  My job was similar, in the General surgery screening, where I scheduled people for a follow-up screening with a surgeon.  In total 475 people were given dates for further test (ie: CT scans), screenings, or surgeries.  Unfortunately our general surgeons haven't yet arrived, so our hospital physical saw people, assessed who was fit for surgery and had a surgical problem we can operate on, and then passed them to me, with a "yes" or a "no" for the screening with the surgeon in a couple of weeks.
The "no"'s were sent here.  To the prayer tree.  We offered every person who came through at least the first set of gates (1609) the opportunity to be prayed over if they could not otherwise be helped by us.  I am told the number of people who showed up here seemed endless. 
There were many, many heartbreaking stories that day.  But in the end, those we could help was what we focused on.  In the end there were smiles, laughter (hopefully not just the over-tired-giggles), and the belief that we are making a difference.

This beautiful girl is on the ship right now.  On her first night I got into a game of "toss the balloon" with her that had her in fits of giggles.  After surgery it took her a couple of days to get her energy back.  Yesterday I tried waving her over to me and she smiled, shrieked and ran.  So I chased her down and when she ran to her mother's lap... her mother handed her over to me. hehehe!  I carried her for a little while, talking to her and goofing around a bit, then put her down by her mom when she was seeming really quiet/tired.  She followed me back to the nursing desk and put up her arms.  The universal "pick me up please."  After that she was my closest friend and wouldn't leave my side.  LOVE IT!!!

This beautiful girl captured everyone's hearts the moment they met her.  6 months old and full of belly laughs.  Mom dotes on her.  So did we.  She's already had her surgery and gone home.

 The help we provide may only be a drop in the bucket.  But to these two girls and many like them, their world has changed.  And I got to be a part of it.  I feel sooo blessed!

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