Screening Day #1 in Tangier Morocco

I slept really well last night...just not long enough....that 6 am alarm was a challenge! Breakfast was interesting but hard boiled eggs & toast are always safe :) The hospital is only about 15 min away which is nice - it's older & a little worn down but I've seen worse...
I SERIOUSLY under estimated the weather. I have had Tangier on my weather feed for about a month & it was always between 60-70 degrees & my sister told me it's near the equator so it should be mild....not really. it is FREEZING & I have no long sleeve shirts & one light jacket. I clearly did not take into account that it is a coastal town with wind & moisture coming off the ocean. All of the locals, patients & parents are bundled up & it is wet & drizzly - I am wishing I hadn't taken out that sweatshirt in my "packing light" but oh well.
We arrived at the hospital at 7 am & there were over 100 people already waiting outside the gate of the hospital plus people inside on the hospital grounds under the tents that were set up - I have no idea when they arrived but this is often the scene that greets us & it is ALWAYS humbling. Morocco has actually done 106 Operation Smile Missions about 1.2 to 3/4 local (with just Moroccan volunteers) & the rest international. The in country team has this set up like a well oiled machine!!!
The people here speak a mixture of French, Arabic & a bit of Spanish (since we are only 35 miles across the Atlantic from Spain). It can be a little complicated communicating. The Pre-Op & Post Op Nurses were asked to do the Nursing history, vital signs & height/weight & the Recovery Room nurses like me were asked to do all the lab draws - basically making every child cry. Fortunately about 1/3-1/2 of the patients were seen in local clinics in the past week & had labs already done so we only drew about 140 labs today....which was a TON. Fortunately 3 of the PACU RN's LOVE to do blood draws so I helped with holding the kiddos (yes as they cried) and keeping us well supplied with everything we needed & got out labs to the courier routinely because the hospital we are at didn't have a lab???
Like other areas in Africa the moms all carry their babies on their backs - swaddled in a blanket around the 2 of them watching them get them out then back on their backs is pretty sweet. There are 4 Nurses here from Australia one of whom is Natalie in the PICU with me - she is 72 & still works 3 shifts in a "fortnight" - I had no idea what that was but it's 2 weeks - she said only Yankees don't know that - I guess that's me. She has been on 15 missions & is a spitfire but she does like an arm when she goes up or down stairs. The other nurse is Ida from Sweden, plus 3 Moroccan nurses who are great & a Moroccan nurse "Observer" or trainee. Rainia who si from Morocco came from 12 hours away past Fes so local just means they live in Morocco. I think we will have a great team we did good work together today! Plus while I will be missing my friend Gayle who was to be the intensivist Chris who is from Alabama is great - he was a navy guy & is super friendly & checked on us a few times today.
It stayed rainy & cold until 1:30 & then the sun finally came out :) When it cleared up we had an ocean view from our screening room & could see Spain across the water.
We screened 258 patients today - that may be the most I have ever screened in one day & definitely the most I have ever screened in 11 hours!!! Just for perspective the CHOC ED is busy with about 220 patients in 24 hours & these patients all have to be processed thru 9 stations....registration, nursing assessment, surgeons, anesthesia, pediatricians, labwork (that was us), dentist, speech & processed out by a large trilingual Gatekeeper team. You should be impressed I was! They also do it so that all Priority #1 patients (cleft lips/palates under 1 year that have never been treated) were screened first, them priority 2 & 3. That way the little babies don't have to wait all day - it is brilliant. Typically people line up & are brought in simply by where they were in line. So we didn't start seeing toddlers & older kids this after 1 pm or so.   Some of these sweet tender hearted moms got very teary as their babies screamed & cried with the labs so we were comforting the moms & the babies. I always knew the lab station was tough but didn't fully appreciate it til today! There was a set of 2 year old twin boys both with cleft palates that I totally was smitten with.
There was also a beautiful 14 year old girl with a cleft palate who had come with her mom from Senegal in West Africa - 1600 Km & 24 hours of travel. They made tremendous sacrifices to get here. They arrived towards the end of the day at a time when we were slower in the lab area but they had to wait for the line of people to see the dentist after us so I sat & talked to them for awhile. The mom spoke some English & was so sweet. She took a picture of me & her daughter on her flip phone (& I took one on mine but it was a little blurry) & she took a picture of my nametag. I asked the local coordinator if I could possibly help them with transportation back & a few other things (assuming she is cleared for surgery) SO I am excited to be able to help them because of generous friends. There is a mission shelter here that can house 50 patients with 1 parent so they will stay there - the criteria is that they traveled > 12 hours to get here. So I am excited they I have found one of "my people I was sent her to lift & light their way a little brighter :)
So for having so many missions here I am blown away by the number of patients we screened. On local mission they are sometimes only 2 days of surgery & maybe 20 patients (because the people who live here & support local missions also have to work to support themselves & cant take off a week of work to volunteer without a big financial impact. So they really rely on these big missions & I guess that is why we are having 8 OR tables. Many of these families found out about the mission thru the OSI Morocco Foundation & thru social media - Facebook is alive & doing good things her in Morocco.
I had a reality moment when I went to use the bathroom for the first time at 2 pm (clearly I was not hydrating properly) anyways one of the local volunteers told me to go use the bathroom in the surgery areas as it was cleaner & "the best". If that was the clean one I am in big trouble & may not want to hydrate...nothing like a trip to the bathroom to remind you that you are on a mission trip in a 3rd world area. That reality came back real quick :)
A few groups were getting dinner after we got back at 7:15 but I opted to stay in & shower & get a little more settled. That lasted about 30 minutes until our toilet overflowed & we had to move rooms...it's all good though. Somehow also in my "light packing" I did bring shampoo & conditioner but forgot my hair mousse, hair spray & dry shampoo...but I decided - "Mission Hair Don't Care" - it works are the beach it can work in Morocco cause I am by a beach! We have a team dinner tomorrow night & a pre surgery meeting on Sunday night so this is really my only night to not be exhausted & to relax and recharge a little.
We got so many patients screened today that we get to sleep in a little & breakfast is at 7 not 6 tomorrow YAY!!! It's already 10:15 so I am hoping to be in bed by 11. I am so grateful to be here & to be meeting some wonderful people on the team & some precious children & families bringing them life changing surgeries...Tomorrow is the world service day for my church (The Church of Jesus Christ of Latter Day Saints) kicking off the Light The World Campaign for December and I will be doing my global service & #lighting the world here in my little piece of Tangier Morocco with some of Gods precious children & for that I am abundantly honored. Good Night from Tangier!

Travel Tales, Arrived in Tangier, 3 Hour City Tour & Team Mtg...I'm a little tired!

This post will not be all that exciting but remember that this is also my travel =journal so some of these details are just for my memories :)
Last night as I was finishing getting ready my goal was to be in bed at midnight. I was in bed at 12:41 so I call that a success!!! It wasn't just about packing - my 50.6 lb bag was downstairs at 10 pm full of 15 CHOC Walk t-shirts, 12 donated dollies, a small quilt, about 15 pairs of socks/slippers, 20 onesies, 24 pair of bandage scissors for the nurses here, & 4 ear/temporal digital thermometers - much of which I have been madly ordering on Amazon the past week - thanks to the generosity or sweet friends! And yes there were also 5 pairs of scrubs, pj's, a pair of jeans a pair of joggers & about 5 shirts - this was a big change in my personal packing - in the past I brought clothes for every day but I know now that I will leave the hotel at 6 am in joggers & a shirt I will wear for an hour, change into scrubs at the hospital, get back to the hotel at 8 pm on a good night or often 10 pm, shower & put pj's on...so recycling my 1 hour outfits in the morning is my plan! Since my suitcase hit 50 lbs fast I moved all my food to a canvas carryon & I am pretty sure it was about 30 lbs, in addition to my backpack with my computer, camera, headphones, magazines, journal, flight snacks etc (sort of like carrying a 2 year old on your back!) It's a little crazy to look at all the food & think that is my primary diet for the next 12 days - peanut butter, tuna, bagel thins (they travel well), crackers, trail mix, protein bars, crystal light & dark chocolate almonds - sounds like a balanced diet to me??? I know they will feed us breakfast & lunch but sometimes it's questionable so I find it easier to to just pack food!
So if I finished that at 10 why wasn't I in bed earlier...well Doug is out of town, home for the weekend then gone again, so an extensive "honey do list" was needed with about 8 piles on the kitchen table!
Kristen took me to the airport & it was so nice to fly out of SNA & have my luggage sent all the way thru to Tangier. The 1st leg to Dallas was easy - one Christmas movie & I was there it seemed. Fortunately my Dallas to Madrid flight was 30 min delayed as I only had a 40 min connection time & had to take the train to another terminal. I had just enough time to buy a salad for the long flight - I viewed it as my last fresh vegetables & the cute girl at that restaurant asked if I was going to Madrid & I said yes I was on that flight but I was going to Tangier & she said "I'm from there but moved to Texas 5 years ago" I explained why I was going & she said - thank you for helping and loving my people" What a great unexpected connection. At that same foo stand I met Brittany a girl who is on the mission & it's her 1st OSI mission as a Pre/Post Nurse. I was so excited for her & it was nice to travel together.
The Dallas Madrid flight was NOT AT ALL FULL :) except for 1st & Business class where everyone was upgraded to...I ended up with great travel karma & had a full row of 3 seats to myself so I knew there was great potential for sleep!
There was a cute older lady who walked past me 3 times & I asked if I could help her - she spoke no English, had 3 boarding passes & was looking for row 42 which didn't exist on this plan - she was on the right flight but that was her last seat assignment so I helped her to row 31 - in retirement maybe I can be a flight attendant & get some travel perks??? Ya  probably not...
I stayed up for the first 2 hours of the flight then settled to sleep - I did sleep most of the rest of the flight - obviously not ideal & I repositioned myself often but it was definitely sleep! In Madrid Brittany & I got a drink at Starbucks & chatted - she is 30, recently broke off an engagement, has done some travel nursing & works in Colorado right now. She is the oldest of 8 children, was homeschooled & is so sweet! We met about 5 other OSI team members as we waited for our flight to Tangier plus 2 students & their sponsor That flight was < 2 hours & we arrived, got thru customs, exchanged money, went thru security & loaded lots of luggage in a van like a tetris game & came to the hotel. It is nice enough - $39 a night I think is the rate so you get the idea we are not at a 3 star place but it's clean, there is a decent bathroom (although you almost need to hurdle into the bathtub/shower) AND.... guess who was assigned to be my roommate??? Cute Brittany :) We were both SO SO TIRED but knew we needed to push thru to get on a Morocco time schedule so after we unpacked we decided to try to go to a market. The person at the desk told us it would be better with a guide so she called someone who spoke English & he came & got us 15 min later. What was going to be a trip to the market turned into an AMAZING 3 hour city tour. Said was our driver-  her was born & raised here but lived in London for 12 years working for Holiday inn & returned to care for aging parents as he is an only child. In 3 hours we saw 2 lighthouses & marina areas, a super cool cave, took a camel ride, saw lots of palaces, some pretty look out spots - he was our personal hop on hop off tour guide, photographer & Wikipedia on Tangier...all for $40 for both of us. What a great surprise afternoon we had.
We finished in time for our 7 pm team mtg that went for 3 hours!!! We have a GIANT team - over 60 people for sure - lots of Moroccans, only 5 from the USA, some from Sweden, Australia, Russia & a few other countries. This is going to be an 8 operating table mission (usually its 5 & sometimes only 4) so that is part of why we have so many people - 9 plastic surgeons, 9 OR nurses, 7 of us in recovery, 8 in Pre/Post & 2 in all the specialties instead of 1 (pediatrician, intensivist, speech, dental etc) plus 8 guests from Stryker, the students etc. It's probably the largest team I have been on. What that means is we have ALOT of work to do 0 the goal is 160surgers & probably 350 patients to screen in the next 2 days. We start every day with breakfast at 6:15 - I am a quick morning girl - no fluff so I will get up at 6. As the local coordinator thanked everyone for coming to Morocco to help their children my heart was immediately full. It will definitely be a long, tiring & challenging week but we are in the business of changing lives & if it was easy people would be doing it everywhere all the time - but it takes a group of people who don't know each other but have a common goal of working together to change children's lives for these 12 days! I am up for the task & the immense blessings that come with it. Now I need to get to bed it's almost midnite!
LOVE & HUGS from Tangier!
 

Headed to North Africa - Tangier, Morocco on Operation Smile Mission #14

Typically I start my blog for a new mission trip at about 2 am the night before my flight. I decided to blog tonight one night early in hopes I can be in bed before 2 am tomorrow night!!! That being said the only thing in my suitcase right now are 5 pair of scrubs, some food, 4 new digital forehead/ear thermometers (thanks to generous friends) and 12 dollies from another friend. So while I may not be blogging tomorrow night I definitely need to be packing!
So about this mission....I was supposed to be on a mission to Malawi last spring but the dates were changed and I couldn't go, then the dates were changed to summer & I couldn't go again...but I was a little busy at CHOC so that was all fine. BUT..I was anxious to get on another mission as my last one was 8 months ago. So on Oct. 11th I got an email at 12:26 & "Invitation to Volunteer" in Tangier Morocco. I immediately called Doug & my CNO at CHOC talking about the dates & where I would need coverage & they both said...."YES GO! & I replied at 12:51 & signed on for this mission. Fast forward 5 weeks & here I am today.
A little bit about Morocco...it is in the Northern region of Africa - the same area as Egypt, Libya, Tunisia, Algeria & Western Sahara. Tangier is a port city & nearly the northernmost city in all of Africa. It is on the Strait of Gibraltar near the Mediterranean Sea. I really don't know much else or what to expect there....
The majority of the team on this mission is actually from Morocco - they have alot of local volunteers but there are a few volunteers from Sweden & the US. I found out after I said YES that a dear Op Smile friend of mine was going to be the Pediatric Intensivist on this mission & my roomate - I was SO EXCITED!!! Sadly she lives in Malibu & while her house is fine several of her neighbors lost their homes in the recent Southern California fires & are staying with her now so with all of that going on this was not the time for her to leave the country for 2 weeks. So while I am sad she won't be with me I totally understand but if really would have been nice to know someone going into the mission. Instead I will be meeting lots of new friends :)
I have to be really honest this week I have been a little stressed & anxious about going on this mission...wondering "what was I thinking leaving for 2 weeks between Thanksgiving & Christmas" with all the kids coming home, some needs my mom has, alot going on at work etc. BUT...I have told my kids "Kraus' can do hard things" and I needed to tell that to myself & have faith it would all work out. Yesterday at church I was introduced to the 2018 Light the World Service Program. It is divided into 4 weeks of service and week #1 Dec 2-8 is "Light the World" focusing everyone on Global needs. I immediately felt a flood of peace wash over my anxious self realizing that I was going to be exactly where I needed to be doing exactly what I was supposed to be doing by going on this mission to Morocco and serving the people there - especially the children whose lives will be changed "One Smile at a Time".  Doug also gave me a blessing last night and that also gave me even more peace.
My flights are Orange County to Dallas, Dallas to Madrid then Madrid to Tangier...it's about 24 hours of flying which I am not super excited about but it's all part of mission work & getting to where you need to be to help the people who need this team. I will be 9 hours ahead of Calif which really isn't too bad so at the end of my day I will be able to catch up with family & life at home. 
I am now starting to get just a lil excited for this mission...for the dear people I will meet, the sweet children & parents and the wonderful team who will all have "servant hearts". I really can't think of a better way to start the month of December; when we celebrate the birth of Christ than with these 12 days of service. I am confident that all the "things" I have been concerned about will all work out at home, at work, with family, friends & even Christmas.
I am so humbled to have these opportunities. I know the days will be long, the work difficult, the circumstances and Recovery Room setting unpredictable and I will be far from home & all things familiar....but off I go because I know that the skills I have are meant to be used to help others & there are people in Morocco that I don't know but I do know they need the help I can offer. Times like these are at the core of who I am and really are the reason I became a nurse to serve others with love and compassion and follow the example that was set by my Savior. Please keep me & our team in your thoughts and prayers these next 2 weeks. They are truly felt and carry me thru my tough mission times.