Day -3.
The ride starts here soon, hold on tight, the louder you scream the faster we go!
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Day -2
Almost time to go...
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Ensure the safey bar is fully engaged and keep your arms and legs inside the ride at all times.
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This ride may not be suitable for those with heart, neck or back problems or people of a nervous disposition.
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Day -1
Ready, engage.
The engine roars into life, feel the vibration though the floor. Blip the throttle, slip the clutch. White knuckles at the ready and we’re off…
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Day 1 - November 7th
Departure gate thoughts
I'm sitting in Newcastle airport watching the ground crew trying to de-ice my plane as they announce a 30 minute delay.
A wait at this point doesn't make any difference, it's either wait here or in Brussels so it's not going to matter. But what would matter? What do I want from this trip?
Every time I've set off for Africa I've had a very different set of goals and fears, and this trip is no exception to that. This trip feels more like going on a retreat than before. I'm more confident about what awaits (though of course the accuracy of that confidence remains to be seen!), and my fears and anxieties are based more around a possible sense of complacency and about leaving the ladies at home.
At church yesterday Alex the Muppet Ross, our very bouncy worship band leader was in a deeply gospel music mood. That meant we sang songs full of images of rivers.
I am going, to the river
To a life beyond compare,
I am going, to the river,
I am meeting Jesus there.
In his mind the hymn writer was borrowing from old testament tales of the Children of Israel crossing the River Jordan to describe the journey at the end of life crossing through death into the afterlife.
I however pictured the River Sierra Leone. Crossing the Sierra Leone River is the last leg of my journey back to the ship today. It's done on a rickety boat, in the pitch black,and takes about an hour. Last time I went to Freetown, back in March, this was an unexpected and unwelcome addition. This time I'm looking forward to it. As I cross, I know my Saviour will be waiting. As I arrive on the ship I know my Father will be there to great me. As I tell stories, pull teeth out or play games, I know I'll be in the right place at the right time.
I am going, to the river
I am meeting Jesus there.
Day 1 – later, oh so much later
We had a pretty easy journey this time. No fights with female cabin crew, no long delays. A brief altercation when trying to get on the wrong ferry over the Sierra Leone River, but otherwise simple.
Still it’s always a long and slow process so I’m off to bed now, in my most luxurious cabin yet. Big lounge, double bed, no room mates, spot on!
Night night!
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Day 2 - There's no such thing as a free bunk
Here’s a quick quiz for you…
What’s got a big lounge, a double bed, no room mates and is one thin sheet metal wall away from the noisiest piece of machinery in the western hemisphere?
I’m afraid last night’s delight with my room took a bit of a nose dive at 3.13 this morning when it sounded as though someone started up a pneumatic drill next door. Fortunately I brought my ear plugs with me, unfortunately I didn’t find them until this evening.
Still, that aside has been a great day. I’ve met up with lots of old friends, and sat up on deck to watch the sun go down and the thunder clouds build up. I worked half a day (before wimping out & heading back to the ship to get a lie down) and pulled out more teeth in that morning that I have in all the time I’ve been back in Newcastle since my last trip here.
I’ve just been up watching the film “Pride of Lions” about the war in Sierra Leone. It was an especially nasty war, primarily because of the use of child soldiers and amputation. Some of you will have already read Salamatu’s Story, but if you haven’t yet, although it’s quite harrowing it’s well worth it.
Full time work starts again tomorrow, so I’m off to try to again to get some sleep, but in the meantime don’t forget to check out the special mention page… it could be you!
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Day 3 - Old and new friends
Today has been a day of meeting and making friends. I did do some dentistry, 20ish patients, 100ish teeth extracted, 1 upper jaw bone squelched out and 1 nurse broken, but that was the smaller part of my day today.
Mostly today I have been chin wagging. This is a great environment for that. Lots of people with not much else to do. So far this evening I have discussed the ash cloud, snowvember, facebook, coffee, Yankee slang, miracle healing, beaches, dental school friends, treatment of lipoma, the NHS and iPads.
I've also sorted my weekend plans, visiting a prison on Saturday and going to the beach on Sunday. Hmmmm, I wonder which will be a nicer environment!
Night night - don't forget to look for your special mention!
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Day 4 - Life in the mundane
Life on the ship is getting hum drum.Work, eat, sleep, work, eat, sleep, not much in the way of interesting pathology – though have a look at my new pictures to see a few – only 10 players for The Card Game, and back in my cabin with most of the ship asleep by 10.00pm. (until that 3.00am machinery starts again six inches from my head!)
So how does that make me feel? Well to start with it made me feel cheated,
“Hey, if I come all the way to Africa to do teeth the least Africa could do is to provide me with an adventure”.
But of course that’s not the deal is it? I didn’t come to Africa on some sort of high octane, adrenaline filled, white water dental holiday, I came to serve.
The bible talks a lot about being a servant. Serving the master, the servant king, the good and faithful servant. And I’ve talked a lot about serving in the practice recently. My catch phrase for the autumn has been “At this time and in this place I am proud to say that I serve alongside you at I like my smile dental group”. But I’m not sure exactly what we mean by “servant”.
Teresa (who reads much more than I do) tells me that when the Bible uses “servant” often the most literal translation would be closer to “waiter”. I’m pleased to say that I’ve never had a job waiting tables. I don’t think I’d be very good at it. Standing in the background until someone calls you over, gives you their order and then ignores you again. Hang around whilst everyone else has a good time and then maybe, just maybe get a tip if the people you’re looking after don’t forget and happen to have the right amount of change in their pocket. People I know who’ve had waiting jobs tell me it sucks.
So how do I feel when I know that my job here is waiting on the people of West Africa? Well, it’s certainly less adventurous. It sets the bar lower for my expectations of what I’ll get from the trip. It sets the bar higher for my expectation of what I’ll put into the trip. Maybe it’ll encourage me to be that little bit more patient as I give an injection to someone who flinches at the wrong moment because they’ve never had one before, maybe it’ll help me be a bit more tolerant when the electricity does what it did today and plunges me into suctionless darkness just as I get the lower border of the mandible in sight through a big fat abscess. Maybe I’ll stop feeling hard done by and remember that my lot in life, even on my worst days, is better than most of the people here on their best days.
We sang a song in our ship wide community meeting tonight that expresses the Biblical concept of God supporting those who serve Him.
“Strength will rise as we wait upon the Lord”
Previously this has always conjured up a picture in my mind of me dressed like an extra from Ben Hur, kneeling on the first floor of a two story mud house quietly praying, eyes shut, hands together, that God will magically give me renewed vision, oomph or vigour.
I think now I see it more as me being an attentive waiter at a restaurant where God is sat at a table having a meal with some of His friends. As I notice that they’ve finished a course or their glasses are empty, without being asked I step forward and clear the dishes or pour more wine. I am waiter to the whole table, whatever I do for God, I do for His guests, and whatever I do for His guests I do for Him.
But I know that “strength will rise as we wait upon the Lord”, if I wait on His table He won’t walk off at the end of dinner and leave me without a tip. Far from it, when the time is right He’ll tell me to pull up a chair and sit down. It’ll be like an after hours lock in where the restaurant owner gets up, tucks the tea towel in his belt and cooks up the best food for him and his friends, the food that’s never served to paying customers.
And unlike the first image this picture is easy to translate into real life. There are lots of people around me who have needs, I don’t need to look very far or travel very far. When I’m in Africa the needs are material and dental so I do what I can to help with that. When I’m in Newcastle the issues are more varied; emotional, spiritual, academic, clinical, managerial, to do with debt management or self-esteem and confidence, so I do what I can to help those needs.
I’d love to think of a snappy soundbite ending to these thoughts, but I don’t have one. I’m a work in progress so we’ll just have to see how it pans out but if I get the chance, I’d love to serve God by serving His friends with you alongside me sometime.
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Day 5 – dentistry gets exciting
I had a good dental day today. It started with a guy with severe trismus (an inability to open his mouth). It’s usually caused by an infection around a wisdom tooth or a fractured jaw, and it’s severity is measured by the number of fingers you could fit between your front teeth. If you try it yourself you’ll probably find you can get three in. (hold your hand Karate chop style, point it at yourself and move it forward until your fingers go into your mouth, one on top of the other). This guy’s opening was about half a finger, and has been for 10 days or so.
Normally at home I’d pump him full of antibiotics and send him off to the dental hospital for a team of people way more qualified than me, to take x-rays and treat him under an emergency GA. Here that is not an option. We do have OPG, CT and CBT x-ray machines but because we are leaving soon they are all booked up with other cases. A previous dentist on the ship had given him antibiotics last week, but his symptoms were worsening so it was up to me to do what I can without really knowing what’s wrong. We started by prising his mouth open just a bit with the smallest size mouth prop (think rubber door wedge) that we had and leaving him for five minutes. Every few minutes we’d jack him open another millimetre or two until we could get a look inside to see what was there. Needless to say this was extremely painful, and somewhat risky, for him, especially if he did have a broken jaw.
After 20 mins or so I managed to get a look inside and could see rotten roots along his lower right side along with a heavily infected wisdom tooth at the very back.
Another three or four five minute tweaks of the bite block and he was open enough to try to drain the abscess. There’s a dilemma here. If I give him a local but puncture the abscess with my needle I can spread the infection, if I don’t give him local he will feel everything. I decided that I had to give him something so, more by faith than sight, we gave him an ID block (the normal injection your dentist gives you to fill a lower tooth). He didn’t go very numb but we had to drain the abscess to let some of the pus out, otherwise it could spread down into his neck, round his airway and suffocate him. We made an incision from the very back of his mouth forward to his canine, and pulled the tissue back to expose the jaw bone. This released the pressure in the abscess, but, don’t forget that he’s not numb and has his mouth wedged open (about two fingers worth by now). The poor guy’s in agony and can do little to control where the seemingly gallons of foul fluid goes. But it is imperative that we get the infection out so we leave him like this with a dental nurse trying to suck the worst out of his mouth for 15 minutes.
I tried again to get him a bit more numb but the acidic infection reacts with the alkaline local anaesthetic drug, so that, combined with the immense pain he’s been in already meant that it was pretty ineffective. It’s time to get the teeth now so we go in, starting at the front to make an access route for that wisdom tooth I’m aiming for at the back. The first three teeth 44,45,46 all come out fairly easily, though every time I put pressure on one to take it out it pushes more infection out of the incision we made earlier. Actually this, whilst unpleasant is a good sign. It means that my diagnosis was correct and he’s not fractured his jaw. 47 proves more difficult, because it’s nearly at the back (teeth are numbered with two numbers, the first denoting the corner of the mouth the tooth is in, the second going from 1 at the front to 8 at the back) and it’s so heavily decayed there’s little for me to get hold of, but it comes out and is kept under control but Sandra my German Zahnartshelfiren (see yesterday’s Special Mention for that translation!). That’s more difficult than it sounds. Remember that he isn’t open very wide and everything is dark, wet and slippery. The patient can’t close his mouth because of the wedge, so if Sandra drops the tooth after I’ve extracted it there’s a high risk that he’ll choke on it. She doesn’t and we’re there all bar the wisdom tooth that was the initial cause of the problem.
Back home I see a lot of people with wisdom tooth pain. It’s a particularly nasty pain, but with the correct treatment it can usually be managed pretty easily. A £4.99 bottle of Corsodyl mouthwash and some salt water will keep 90% of them at bay until proper treatment can be given. Easy wisdom teeth are done in the practice with local, medium ones get some IV sedation and difficult ones go to a specialist. This one was a right bugger!
There were some things in my favour though. What makes a wisdom tooth difficult is when it’s encased in bone, but the infection here had destroyed much of the lower jaw so a luxator (an instrument not unlike a screwdriver to look at) placed down the side of the tooth got it on the move. There was no chance of getting the usual lower molar forceps on to it to get it out, nor extra small ones for roots, or the ones smaller still for taking baby teeth out. In the end it was a pair of upper bayonet forceps used upside down that got it, but they’re not designed for that type of tooth so it slipped out of my grasp and headed for his throat. Sandra’s reactions were way quicker than mine and she got it on the end of her sucker before I’d really seen what was happening. Getting this tooth out released the rest of the pus which welled up in his mouth for the next ten min or so.
That was the cause of the infection removed, but we still need to allow any residual infection to drain. There is a much maligned medical learning technique of “see one, do one, teach one” . It’s been cited as a technique for learning surgery that leads to the propagation of mistakes but it’s all I had to rely on today. The treatment he needed was a Penrose Drain. It’s a 10cm rubber hose that is stitched into the patient’s wound at one end and sticks out of the wound at the other end to deliberately stop the wound from closing and locking the pus in. I’d seen my good friend Bob place one when I was here back in March so with guidance from Sandra I got it in.
Finally we were able to give everything a good wash and take the rubber wedge out of his mouth. By this time about an hour had passed and it took him quite a while to be able to close his mouth again. Unbelievably at the end of this horrendous treatment under minimal anaesthesia and a lot of brute force he shook my hand and thanked me profusely. All I could give him for post op pain was a few over the counter paracetamol.
I don’t yet know how well my drain will work. He’s coming back on Monday to have it taken out, and all being well that should be very simple, a quick snip of the suture and pull. We’ll have to wait and see.
If I were to attempt this treatment back in the practice at home, I would, quite rightly find myself in very hot water with the General Dental Council very quickly. But what else was I to do? This patient’s condition was life threatening, if not from the risk of infection closing his airway then from his inability to eat. I believe I did the right thing by him today, I hope and pray that he comes back on Monday and is feeling better.
Several things strike me about this case, the simplicity of it’s prevention, the excellent support a good team can give, the increasingly litigious nature of the UK, and above all the mixed and apparently contradictory looks of pain and relief on the patient’s face as he left. He was in no doubt as to the seriousness of his predicament when he arrived and definitely in no doubt about the amount of pain I had caused him. He was also in no doubt that I was doing the best job I was able to do and there’s no else in Sierra Leone who could have helped us out.
But he was only patient number one of twenty or so to see today, so until now (late night back on the ship) there’s not been time to process these thoughts.
I said in yesterday’s blog that I didn’t have any right to expect Africa to provide me with a white knuckle dental ride, but today it did! I spent the rest of the day doing what I love, a mixture of treating patients, teaching nurses, helping out Toni the therapist when she got stuck, playing silly games (Snorta) and hanging out with people who make me laugh. I also made a renewed acquaintance with my old African friend Mr Immodium.
But I leave you tonight with a thank you. Thank you to all of you who have enabled this trip to happen. Without you I wouldn’t have been here and my patient wouldn’t have been treated. If he survives then saving his life, is thanks to you. So, on his behalf, I’ll say thank you.
Thank you.
Thank you.
Thank you!
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Day 6 - a new thing
Grrr. I've written a long blog but the computer's crashed and lost it.
Ok here we go again let's hope they don't crash this time.
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Day 6 – a new thing
People tell me that I crave the new. I think it’s true, I get bored easily and I love the excitement of a new experience. When I go to a restaurant I’ll often choose the thing I never heard of, just because it’s new. I’d rather visit a new place than go back to an old one. For me it’s often time to buy a new car, a new bike or start some new project.
Today I did something new.
Today I went to prison. I’ve never been inside a prison before, so when someone came round the ship signing people up to visit Freetown’s maximum security jail I jumped at the chance. My motives were multiple. Partly I wanted to help. I wasn’t sure exactly what we would find, but I guessed that the prisoners wouldn’t be having the best of times and I hoped we’d find a way to cheer them up. Partly I was intrigued. I wanted to experience a new thing, to find out what it would be like, and partly because the Bible tells us to go and visit those who are in prison. If I’m honest I don’t really understand why it selects prisoners and not some other disadvantaged groups but it tells us to go, so I went.
So at 10.30 this morning, me, my new pal Stan and 7 other Mercy Ships guys drove the hour or so it takes to get across town in one of our big white jeeps. Getting through security took another half hour – slowed down by my forgetting that I had my room key on a string round my neck, which activated the metal detectors, which in turn activated the most through frisking I have ever had. I’ll spare you the detail of that, let’s just say it was VERY thorough!
The prison itself was built in around 1900 to hold 300 prisoners. It now holds 1300. It is somewhat colonial in architecture and it’s layout and size reminds me of a roman barracks like Segedunum or Housteads. We passed through the gatehouse into a large open courtyard. This had well-tended gardens, with just one prisoner doing what I assumed to be some weeding or something like that. It reminded me of The Shawshank Redemtion. We crossed the courtyard went over to another fence separating this main courtyard from the next area.
Behind the fence were about 40 prisoners and one or two officers who greeted us with big smiles, waves and calls of “Welcome Mercy Ships”, “You are welcome!”, or “Thank you for coming”. Once a guard had open the gate in the fence people shook our hands, determined that every prisoner would meet every Mercy Shipper. One big fella took me by surprise when he didn’t hold his hand out to shake mine. Rather he put his arms out to hug me. Was that OK? Would he try to hurt me? Most of the guys we’d come with have been to the prison each week during our 10 month stay in Sierra Leone, and they were all hugging, so I did too. It was fine. In fact it was nice.
And then my new experience caught my eye.
There, in the crowd, was a smallish man (5’6”) with a yellow patch on his prison uniform. It was about the size and shape of a name tag, and reminded me of the yellow star that Jews had to wear under Hitler. In plain marker pen, it had just one word written on it. “Condemned”.
As he came through the crowd I found myself paying less attention to what was going on around me staring at it.
According to Wikipaedia Sierra Leone has the death penalty for treason, murder and aggravated burglary. I have met people I knew to be murderers twice before. Once in 1988 when a pair of ex-paramilitaries from Northern Ireland came to give a talk about peace and reconciliation to students in Henderson Hall, and once on a secure ward at a local psychiatric hospital through my work as a community dentist. I found it easy to accept those people. Of course, I hadn’t been affected by their crimes, so that made it easier, but to me they were just people who had done wrong and were sorry about it. They had sinned and repented, just like me.
But this man was different. My natural self was repulsed by him. I did not want to be near him, let alone shake hands with him. Not because of his crime. I don’t know what he had been convicted of, I don’t know if his trail was fair, I don’t know if he was innocent or guilty. It was his sentence that made me feel this way. I felt as though the condemnation that hung over his head might somehow rub off on me. I was afraid. I wanted him to pass by me. I wanted to reject him, to hide from him. I wanted him not to be there.
The Bible uses a phrase “There is no condemnation for those who are in Christ”, and this phrase along with my imagining of the carrying out of his sentence was filling my mind as he held out his hand to me.
I took it.
“Welcome, thank you for coming”, he said. And then the moment was gone. He’d moved on to the next mercy shipper and I moved on to the next prisoner.
It took five mins or so to all greet each other and then we moved inside the chapel and set up the film we brought to show to the prisoners. But as we watched the film I kept thinking of the yellow patch, and the name he had been given, “Condemned”.
The moment had been so short, and so far from my previous experience that, by the end of the film, I began to wonder if I had just imagined it. But there he was, still in the crowd, still wearing his patch. As we started to leave I knew this was an opportunity to grasp, but an opportunity for what? I’m not sure. An opportunity to try to give share some compassion with a man whose predicament I can hardly begin to imagine, or an opportunity for me to do something new? Both I think.
At the end of the film we began to say our goodbyes, “Thank you for coming”, “Thank you for inviting us” was the conversation I heard all in the melee around me. But I sought out the little man with the yellow badge. I pushed my way through the crowd to him. I held out my arms, and to my delight he took them and hugged me. We didn’t exchange any words, and the moment was short. I don’t think it was very significant for him. I was just one of 9 mercy ships guys who come from time to time. But it was significant to me. I hope I gave him a little bit of human contact I suspect he may not get very often, but in his willingness to embrace me, he enabled me to face head on my fear “different” people.
As I encountered him for the second time I was no less astounded by his forthcoming execution. I couldn’t assemble a coherent thought. I couldn’t think of anything to say to him. I don’t know his name and I can’t really picture his face. I just felt accepted by his arms.
What does all this mean? I don’t know. Isn’t it odd that the man who received the greater blessing in this situation was me and not him? Who would believe that the prisoner on death row in Sierra Leone would be the source of blessing to the dentist in the UK? It was certainly not what I was imagining would happen when I wrote my blog about de-icing my plane back in Newcastle, and when I thought about waiting on tables for God and His friends I never thought this man would be in my section. I don’t know what God will do with this experience, I suspect it will be significant in times to come, but I don’t know how. I don’t know if the man will ever remember me, but I suspect and hope that I will always remember him.
Tomorrow I’m going to the beach to eat barbequed fish and lounge about on white sands but tonight I have a request.
If you pray, please pray for me. Pray that God would continue to lead me wherever He chooses and that I would choose to follow.
If you do not pray, please accept my prayer for you. I pray that God would lead you wherever He chooses and that you would choose to follow.
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Day 7 - and on the seventh day he rested
I have rested today. I got up late, just snuck into breakfast, got driven out of Freetown and into the countryside to end up at a beach flanked by palm tree and jungle covered mountains.
Our African host brought us cold beers and coke before cooking the lobsters I helped him catch. I was invited into his house and played on the beach during a torrential tropical rainstorm.
The sea was warm, the sand was white, the lobster was fresh, the was company good and the day was refreshing. Back on board I listened to some inspiring preaching, booked up some time for myself in maxfax theatre, organised an outing to say good bye to Stan, and learned some new games.
Work starts again tomorrow, but for now that’s a world away.
Today was my seventh day.
Today I rested.
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Day 7 - The boy who lived
There’s not much more to say. The patient we saw and I wrote about on Friday came back in today. He’s alive and fit and well. He was unrecognisable from Friday, his face looks as good as new.
We still had to take another 4 or 5 teeth out today, but at least this time he was numb!
Yay! To the mercy ships
Yay! To you
Yay! For his family
Yay! To the One who makes all things new.
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Day 7 - Part 2...pictures of teeth
I've written up a report on a patient we saw today. It has gory pictures but if you like that sort of thing you can see it here
Day 8 - Target setting
Target’s get everywhere. At school it was exam results, at work its UDAs or pounds profit, here it’s patient numbers.
I understand why we need targets. Without clearly defined goals success and failure are indistinguishable. We’d never know how we were doing or we were progressing. But targets can be restrictive. If I set a goal, then I am likely to tailor my efforts to meet that goal.
At work in the practice we have a target number of treatments to provide, and we tailor the way we work to meet that target. Inevitably that means that we put less effort into other parts of our work that do not contribute to meeting that target. The NHS doesn’t recognise differences in the quality of dentistry that can be provided so if we want to increase the quality of our work, we have to pay for that out of our own pockets. The way the system is set up it also means that the patients who most help me reach my targets are healthy. How perverse is it that the NHS has a dental structure that means that healthy patients get better access to treatment than ill ones?
Here at Mercy Ships we count patient encounters. And that seems good, but it still leads to dilemmas. Should I take out all diseased the teeth on fifty patients or half the teeth on a hundred? According to the targets the second option is better, but somehow that seems wrong too.
Those of you who have been to Spring Harvest with me over the years will have heard my occasional moaning about faith not having any targets. How can I tell if I am obeying God better this year than last? How can I be sure I am succeeding in my aim to follow Christ if there are no measurables?
But I am wrong to moan.
Walking with Jesus is all about relationship, not output. How could I tell if I am better friends with you this year than last? I can’t measure that. There are signs of friendship, there is evidence of respect. If I consider your needs before my own there will be ways that that shows. But if we were to measure and quantify friendship like that it wouldn’t be friendship anymore. And if we quantify faith in this way we end up with religion.
Success would be marked by the number of times I carried out a certain action. I’d need to pray a certain number of prayers in a certain time, or go to such and such a number of meetings, or give a specified amount of money away. But I could do all that without caring one jot for the principle behind the action. I could look like I was doing great, and then when I reached my target, I could stop.
My personal opinion is that lots of religions, including Christianity, have done that over the years. They end up with people who carry out a ritual because they think they should. But my faith is not like that.
It’s true that I do some things because I think I should, and that there is a place for discipline. But I follow Jesus because I want to. I do what he asks, not for reward, from him or others, but because he’s my friend and he asked me to. I no more help the people of Africa because I have to than I go to the pub, or climb a hill with my friend Ken because I have to. No, I go because I want to. I enjoy his company. I want to spend time with him.
Could I quantify what I need to do for Ken for him to be my friend? Is there a set amount of money I should, or a fixed number of days a year I should see him? Of course not. He’s my friend. I can spend all the time or none of the time with him. I could buy all the beers or none of the beers. We’d still be friends.
Is there a fixed amount of time I need to spend praying? Or a certain amount of my money I need to give to charity to be Jesus’ friend. Of course not. He’s my friend. I can spend no time or all the time praying. I can give none or my money or all of it. He’ll still be my friend.
But here’s the deal, when you friends with people you want to spend time and money with them. I want to spend my time and money with Ken, I want to spend my time and money with Jesus. There’s no pre-requisite to do so, but beware, if you become friends with Jesus you will want to spend your time and money on Him. And that may bring you into conflict with the people you spend it on now.
Today I met some targets. The Mercy Ships dental team saw our 9000th patient of our Sierra Leone mission. That was our target for the trip, completed three days early. In the practice we passed a very significant mile stone in our output too, and I am proud of my team for their achievement.
I am pleased and proud to have met these achievements, but I am more impacted by the one condemned prisoner than patient number 9000. I am glad that we have our UDAs under control, but even if they weren’t the people in the practice would still be my friends. I am glad that I have done what Jesus asked me to do by coming here, but I am gladder still that I heard his voice in the first place.
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Day 10 – it’s not fair!
When my kids were little I’d often hear the words “it’s not fair!” and I don’t think our family was any different to any other.
In previous blogs I have remarked on the unfairness of the distribution of wealth between the UK and West Africa. I have made comment on the obvious differences between our circumstances and drawn conclusions about how the things we moan about are often small and inconsequential compared to the problems the people here face. I have erroneously talked about just happening to be born in the right or wrong place and how that would have such a huge effect on circumstances.
I say erroneously because the place and time of our birth is no accident. The bible makes it very clear that God places each one of us in the circumstances that He chooses. He picks our families for us, and numbers all our days before we are born.
For a scientifically educated man like me this is hard to accept. I don’t understand how God can, does, or chooses to do this. I don’t understand why he’d choose to place one person in the UK and another in Sierra Leone. I don’t understand why he chooses that one person’s life will be long, but another will die shortly after they are born – or before. I cannot fathom his reasons, I don’t agree with his choices.
For this trip I have had a big, though still noisy, cabin all to myself, while others share with up to 9 other people. On Friday I have been given a day’s holiday, which I didn’t expect. On Sunday I was on a in the middle of a wonderful tropical storm on a palm tree and jungle trimmed beach and tonight I had a great meal with good company and was given a free lift home by some random stranger when our taxi didn’t turn up.
For a long time I found it hard to accept these good things when people around be are in such poverty. I don’t deserve them. “It’s not fair” was my cry. But who am I to question God’s wisdom? I don’t know what it is, but I believe that God has a plan, and I am grateful for that. I am beginning to accept that I have to admit there are many things about God that I don’t understand. There are mysteries about Him that I cannot explain but am learning to embrace. How does a fair God fit in a world with such disparity? Why does He seem to do contradictory things? Why does He set the rules he does, but then stay silent on other issues? How can Jesus be both man and God? Why are some people healed and others not? Why do good people suffer and bad people prosper? How is it that when I pray sometimes God seems close, and other times it’s as though he doesn’t exist?
For the last year or so I have been starting to explore the idea that a master is only really a master when you obey even when you disagree. It’s easy to obey someone you think is giving you good advice, but if we claim to be a disciple we must obey even when we don’t understand or agree.
So this trip I am trying not to say “It’s not fair”, I am trying to say “Thank you.” Thank you to God. I will try to say “Thank you” on days when I wake up and don’t need immodium. I will try to say “thank you”, when I go shopping on Friday instead of working. I will try to say “thank you” when my friend Stan leaves tomorrow. I will try to say “Thank you” when a staff member leaves, or the PCT, the landlord or the bank give me grief.
Today was a good day. It was a gift from God. I will not say “It’s not fair” I will say “Thank you” and accept it with both hands. Tomorrow may be different.
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Day 11 – bitter sweet
Today we finished our Sierra Leone outreach and I got the last tooth out! But it’s a bitter sweet victory. We survived the 10 months we were here. We stayed together as a crew, we saw patients, pulled teeth, repaired clefts, and let the blind see. We liberated people captive to disability, mental illness and poverty. We offered our service to one another and gave people from all over the world the chance to try something new, stretch their wings and grow. Some of them had a faltering first flight, others soared straight away but all encountered a unique place and a unique team.
But we leave behind so much work undone. So many teeth, so many babies with clefts, grandmas with cataracts, mums and dads, brothers and sisters, aunts uncles and friends in pain. We saw 9127 people in the dental clinic this year but the population of the country is 5 million, so most people didn’t get seen. There was a line outside our clinic this morning, none of whom could be seen.
On a happier note the here are the before and after photo’s of Moseray, previously known in this blog as “the boy who lived”.
cool eh?
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Day 12 - holiday
I have done very little today. Wrote a bit of essay, sent a few emails, nattered to friends, went shopping and fell asleep watching Lord of the Rings, even before I got to say "and my axe"!
going to climb a mountain starting at 5.30am tomorrow so off to bed.
night night
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Day 13 There and back again.
6.00am start, 5.00pm finish, 30k, 600m, 30degrees, 4litres of water, 2 cold cokes, 1 swim in the waterfall.
My kind of day, but have sore feet and the internet is off, see you all as soon as I can.
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Day 13(b)
Internet is back up so that’s what I did yesterday. Beach today.
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Day 14 – Out of Africa
It’s time to leave again. I’m off early tomorrow morning, so I don’t think I’ll be able to post again. It would be great to be able to sign off with a pithy ending, something to wrap the story up, a nice “happily ever after”. Or if that wasn’t possible, then maybe a great cliff hanger… “tune in next week for the next episode of Ali’s Adventures in Africa!”.
But life is neither a fairy tale nor a TV series. Life is sometimes just plodding on.
Over the time I have been blogging I have often described my faith as a journey with God, as walking the road with Jesus, and I really like that analogy. In my life as a dentist, and even at home I am a very goal orientated person. I frustrate Teresa when I want to know the end of a story whilst she is trying to relate the journey, “get to the point I say”, interrupting her…er,sorry. I know I have a tendency to tread on people toes when I get an idea for a project in my head. But I like to know the plan, the big picture, the end point. I like to define success before I start. And I don’t think there’s anything wrong with that, I think it's OK, up to a point.
But much of life is just bimbling along, making it up as you go. One of the reasons I enjoy hill walking so much is that I just follow. Plod on and see where the leader takes me. Whether we climb this hill or that hill, I’m not bothered, I’m just out for the ride. And I think much of the time Jesus just wants us to enjoy the ride.
If I had so many goals and achived them all that I had the whole world in my back pocket, but missed out on meeting God, what would I have achieved? What benefit does the rich man, or powerful man, or influential man have or from his wealth, power or politics when he is dead? What good can I do from beyond the grave? None.
Now is my time. Now is my time to help those alongside me. I suspect that where I am makes less difference than what I do. Or that who I do it to is of less consequence that the way that I do it.
I have just been up on deck 8 of the ship watching (and failing to photograph) a great tropical thunder storm. Lightning flashed to the south, lighting up the hills behind Freetown and it reminded me of a song we sing at church to express God’s infinite control
Who has told every lightning bolt where it should go?
Or seen heavenly storehouses laden with snow?
And I think the analogy from the physical world applies to the human. Who has told every baby where it should be born? Who has counted, numbered and agreed all my days? Who knows every decision I will make, and every path I will choose?
But I am no fatalist. I need to take responsibility for my own choices. I need to act on what I have learned, and so do you. And here lies a beautiful contradiction. We live with a God who knows and pre-ordains everything, and at the same time leaves it all up to us.
People often say to me that they want to find God. Maybe they don’t use those words, but they talk about wanting to be fulfilled. To be rounded, whole, complete. My girls at work sometimes tell me they think there is something or someone out there, but they don’t know what. Some say they don’t need to go to church to pray, or that they just need the next material, academic or love life goal to be complete before they’ll be happy. Other friends tell me there is no God and that science is the answer. Others still that it doesn’t matter what you believe and that all paths lead to him. Well, that’s not my experience. In my experience there is a God, and he is full of contradiction. He is both easy and hard to find. He is both gentle and jealous. He both loves and forgives and at the same time as judges with an iron rod against an impossible standard.
In my experience there are many ways to express my love for God. Pulling teeth, walking up hills, playing games, studying books, but at the same time that any of these things could be my acts of worship, I could do all of them and fail to express my love for him even one jot. I can spend all night praying and not meet him, or simply groan an un-articulable desire and find he is there. Living in Sierra Leone (The land of the Mountain Lion) reminds me of one of my favourite names for God. He calls himself The Lion of the Tribe of Judah. He is no saccharin blond haired mummy’s boy with an inane grin and a flowing robe. He is powerful, unpredictable. If you want to find God, maybe you should look for that. Look with fear, look with anticipation. Look beyond what you thought was possible and into the unknown.
Of course the Bible describes Jesus as gentle enough not to break even a broken reed. He took the hands of children and spoke quietly and softly to a woman who was caught red handed in adultery. But is he safe? You might as well ask if a lion is safe?
Majestic? Yes.
Gentle? Sometimes.
Safe? Never.
And that’s what this trip is about for me. Enjoying the contradictions I see in God. Not necessarily trying to understand them, just accepting them.
I said right at the very beginning of this trip that it felt like it was going to be a retreat, a time to get to know God better. And it has been. Not because of any great new teaching I have heard, nor because of any new revelation. Not because of any great change in me, I’m not heading home with 10 resolutions, or a five point plan. I’m just heading home more willing to accept dichotomy.
I’d like to be able to say that I know how to lead people to God, that’s one of the things I’d really like to do. But the evidence for that isn’t there. In my years as an adult very few people I have spoken to have become Christians. Very few have listened to my words and turned to Jesus. I don’t know why that is. It’s not for lack of passion nor hours talking on my part, nor is it for lack of will or desire on God’s. I don’t even think it’s for lack of willingness to try in the other people. Maybe that’s just not my role?
But if it were, I’d say you could do a lot worse than look here.
There are people here, on the ship, who live life like it matters. Here is a place I find it easy to find God.
So what happens now?
Well first I sign of and go to bed, and then I make the long trip home.
I hope to come back next year and tell you all
about it, I hope to bring people with me. Suzi, Kat, Rachel, Kelly, Zoe? Anyone else?
Well, I’m afraid I can’t tell you that, because that’s another story.
THE END