10 months of iPhone pics....

We are really nearing the end of our time here in Madagascar, I actually need to leave early monday morning to begin the trip to Australia...more on that later but it's to take a course related to my nursing registration, which has been very difficult to get. Nick will stay for a few more weeks and leave in early June as planned.

We've been in clean up/pack/finish projects/handover to the local clinic mode for the past weeks- it's been intense but very rewarding. The clinic staff are very well prepared to continue this work on their own.

I looked back at some of these old snapshots on my phone, and wanted to share some of them.  Just bits and pieces of life from the past 10 months, not great quality pictures but they still remind me of how much has happened since August!

August, 2015 - First views of Madagascar 

August 2015 - First visit to Antananarivo, meeting with the Ministry of Health

August 2015 - Market in downtown Tana

August 2015 - Market in downtown Tana

August 2015 - The food is good in Mada

September 2015 -  peaceful evenings

September 2015 - Intensive week of training (practice casting on models)

September 2015 - thank you to these brave gentlemen for making the outside of the ship shine!

October 2015 - Sunset out our cabin window

November 2015- testing out the sewing machine in the rehab tent

November 2015 - colorful streets 

November 2015 - Dr. Linds teaching in the clinic

December 2015 - Blue ship, blue sky, blue sea

December 2015 - soon-to-be brace shoes, local materials

December 2015 - lychees in the market 

December 2015 - the fruit section in Bazar Be

December 2015 - Tuk-tuk in front of the flower ladies' stalls

December 2015 - Nick giving a hospital inservice about Ponseti

December 2015 - the local port security got new shirts...we questioned the decision for the design

December 2015 - Christmas in cabin 4428

December 2015 - perfect place to welcome the new year

December 2015 - Kinda scary santa claus..not sure what the story is (was just next to the side of the road) 

January 2016 - hot hot days at the clinic...tiles are cool.  Also, the kid in the background was not appreciating the bath he just had.

March 2016 - Happy Birthday Nick (and thanks Krystal for making that cake happen)

April 2016 - 8 months later I still can't figure out the bus schedule, took the photo to help me remember

April 2016 - new hair selfie

April 2016 - Dr. Linds teaching Dr. Edouard suturing techniques

April 2016 - Dr. Edouard and patient orange

April 2016 - this is a drill, this is a drill...at sea muster stations.  Andrea and Harmen never actually sail with the ship though...they are too busy leading the advance team and making preparations in the next country!

April 2016 - Finished, locally made braces on a patient.

April 2016 - Last day of French class at Alliance Francaise de Tamatave.  Class was every tuesday and thursday.

April 2016 - Last day of class with Mme. Ginette.  She was a high school french teacher in Tamatave for 20+ years (with class sizes of 75 students!), now she is semi-retired and teaches evening classes to adults.

May 2016 - Containers in the port

May 2016 - sparkly ship in the evening

May 2016 - the rain has come

May 2016 - one more fire drill before I head to Australia.  Thankful for great friends like these two!

May 2016 - took a snapshot of the miraclefeet website to show the clinicians.  This organization will continue to support the clinic after our departure, so that clubfoot treatment is accessible for as many families as possible.

Click here to check out the Madagascar partnership page!  

May 2016 - The walls in the clinic have filled up with memories. It's going to be hard to say goodbye.

May 2016 - this funny floating village, full of people and a hospital that we love! :)

Meet baby Serah

Once again, I need to apologize for the long silence on our blog!  I always struggle with keeping up during the second half of the outreach.  The weeks tick past at a scary-fast pace, and the end of our time in Mada is rapidly approaching.  More updates are coming very soon, but for now I want to share a the story of one of our patients! 

Serah was 7 months old when her mama brought her to the Mercy Ships screening. She was selected as one of the patients that we would treat together with the clinicians at CHUT (Centre Hospitalier Universitaire de Toamasina). Her feet have now been fully corrected with the ponseti method, and her treatment was provided at the local clinic by local clinicians! 

Here's the story from the fantastic communications team here on board (with photo captions from me):

Sandrine’s elation turned to shock when her longed-for daughter was born. The baby’s tiny feet were twisted at severe right angles, facing inward. The heartbroken mother tearfully wrapped Serah’s disfigured feet and could not find the courage to look at them again for three days.

Sarah's feet before treatment

Sandrine’s husband had been delighted about his daughter’s birth, but he felt ill when he learned about her clubfeet. He feared her options for the future in Madagascar would be limited. He thought the disability would prevent Serah from marrying and establishing a family support network of her own.

Sandrine shares, “I was embarrassed about my baby. People were looking at her – everyone’s eyes were on her.” And Serah’s grandmother cried with despair.

The midwife was able to help the family understand there was hope for Serah because Mercy Ships was returning to Madagascar. She assured them the hospital ship’s Ponseti program had corrected many babies’ clubfeet in the past year. They could help Serah too.

Sandrine took her baby to a screening day after the Mercy Ship docked. When she received an appointment card for treatment, she held Serah close and danced for joy around her garden. Hope had finally arrived!

Back in September, in the early days of Serah's treatment, Nick demonstrated how to put the casts on and correctly manipulate the foot.

When Serah was seven months old, they began weekly visits to the Mercy Ships Ponseti clinic. The treatment protocol, developed by Dr. Ignacio V. Ponseti, corrects congenital clubfoot without invasive surgery. According to lead orthopedic surgeon Dr Frank Haydon (USA), this method of reversing clubfoot conditions needs minimal specialized equipment, which makes it ideal for developing nations. The key is local adoption of the program. “It can’t be guaranteed by a charity or by government. It must be sustained by the culture,” he explains.

Dr. Edouard and Nick assess Serah's feet together. In the background are Tiana, Olivier and Josiane who are physical therapists.  Since september, they have all been developing their skills in the Ponseti method, and are now very proficient.

Ponseti team crewmembers Nick (AUS) and Suzanne Veltjens (USA) collaborated with several Malagasy physiotherapists led by Dr Razafindravoanjo. He comments, “We have treated 15 children with perfect results (100% correction). Now we can treat children up to three years old. Maybe in the future there will be no older people with clubfeet in Madagascar because now we have three years in which to treat children with this condition!”

Each week’s therapy began with Serah and the other babies happily playing in water tubs while their mothers soaked off the previous week’s plaster casts and chatted.

Bathtime/cast removal for baby Serah and her clubfoot buddy, Francia.  We have the cutest patients!

Serah grew used to the physio team “playing” with her bent feet – gently stretching and manipulating – focusing one week on one degree and direction of foot flexion and then focusing the next week on a different direction. After each session, Serah’s feet were held in the newly attained position by fresh plaster casts on her wriggling and kicking legs.

Serah had a total of six little casts consecutively on both legs before her tenotomy procedure. This snip of her Achilles tendons allowed her feet to fully pop into the final corrected position. To maintain this ultimate degree of foot flexion, she wore miniature foot braces for three months.

Serah sporting her foot abduction braces.  After three months of wearing them all day, she needs to only wear them at night to keep her feet from relapsing.  (Kinda like wearing a retainer after having braces for the teeth.)  She will need to wear braces until about age 4, then the correction is permanent. 

Over months of therapy, the Ponseti team helped Sandrine understand how vital her commitment to Serah’s ongoing treatment is. In the final stage (the longest of the treatment), Sandrine must ensure Serah wears the supplied foot braces every single night until she is four or five years old.  Only then will Serah’s clubfeet be permanently corrected.

Sandrine says, “I was so sad, but now I am overjoyed. Now we’re going to show Serah off, saying, ‘Here we are! Come and see my baby!’ I am very happy now she has 'real' feet.”

When Serah takes her first steps, she will be just like all her little toddler friends. No one will be able to tell she was born with a disability.

Serah will never remember living with the burden of bilateral clubfeet, but Sandrine will never forget the life-sentence of disability her daughter was saved from.  “My mother cried before. We won’t cry now – we will dance!”

Serah being a little Ponseti method model for the camera and showing off her new feet! :)

Story by Sharon Walls

Edited by Nancy Predaina

Photos by Katie Keegan, Justine Forrest and Ruben Plomp

Bonus pictures: The communications team recently visited Serah's family in their home to interview them...here are a few snapshots:

I'm hoping that we get to see Serah take her first steps before we leave Madagascar, she turned one year old in February.  She wasn't quite walking at her last appointment, but maybe she will at the next one.  I'll try to snap a picture if she does :)