“No.” A simple word, yet it carries so much weight. As a nurse mentor in Sierra Leone, I have learned that “no” is often the hardest part of the job. In a place where medical resources are scarce, where suffering is woven into the fabric of daily life, and where hope flickers like a candle in the wind, saying “no” is a burden that never gets lighter.

No to patients begging for money, their eyes filled with desperation and silent pleas, hands outstretched in a final act of hope. No to nurses pleading for the equipment they so desperately need to save a life, their frustration and exhaustion mirroring my own. No, the ship doesn’t do that surgery. No, the ship can’t help you. Each “no” is a small heartbreak, a tiny fracture in the foundation of my spirit. But then, every now and again, God provides a yes.

The past few weeks have been relentless. Focusing on the paediatric ward, the place that usually fills my cup, has been nothing less that heart breaking. Witnessing emergency after emergency. The haunting cries of grieving mothers. The unbearable weight of tiny, lifeless bodies. Children dying from things that should never take a life—things that, in another place, with better resources, would have been treated in time.

On Thursday, just a day after losing a young patient, I met another—a boy, fragile and struggling for every breath, his eyes wide with fear, searching the faces around him for comfort, for hope, for someone to make it all okay. I did what I could, but deep down, I knew it wasn’t enough. I didn’t have what I needed to help him. As I left the hospital, my stomach twisted with dread. Would he make it until morning? Would I come back to find his bed empty, another loss, another name added to the ever-growing list in my heart?

The next day, against all odds, he was still alive. But barely. He needed surgery, and he needed it immediately. I met with the surgeon, whose face told me what I already knew—this was impossible. The hospital wasn’t equipped for a procedure this risky. “Is there any way the ship can help?” he asked. I swallowed hard, already tasting the bitterness of another “no.” “I’ll try,” I said, but hope felt distant, a cruel mirage.

I left Freetown for the weekend, trying to disconnect, trying to let go of the things I couldn’t change. But I couldn’t. Every twenty minutes, I woke up, whispering the same desperate prayer: “God, protect him. God, keep him safe. God, be with him.” His tiny face haunted me. The thought of his mother, of how she would hold his lifeless body if he didn’t make it, broke me over and over again.

Then, returning to Freetown yesterday evening I started preparing myself to return to the hospital in the morning. Hoping for the best, expecting the worst.

But then my phone buzzed. A message from a friend on the ship: “I think your patient is here.”

I froze. My hands trembled as I read the words again and again. And then I wept—deep, soul-wrenching sobs. Relief. Gratitude. Hope. I tried not to get too excited, tried to brace myself in case it wasn’t him. But when the confirmation came, I ran. I didn’t care how late it was, how busy the roads were or how much a keke would cost. I needed to see him with my own eyes.

Walking into the ICU, I saw him. The familiarity of the ICU feeling like home. Tubes, machines, beeping monitors. And there he was. Alive. Fighting. A miracle in the making.

Today, I have spent every moment thanking everyone who had anything to do with his surgery. They don’t seem to understand why I’m so overwhelmed with gratitude. But they don’t know the weight of the no I had prepared myself to carry. They don’t know how much this yes meant—not just to me, but to him and his family.

This was the yes that changed everything. This was the yes that only God could give.