Africa Mercy - Stories and Screenings: One Nurse's Journey

Another post from the Africa Mercy in the Congo. Marilyn shares a touching story of a young boy's life-changing treatment, and the difficulty dealing with the anger of those turned away......Sharon


(This is a running post about a nurse's journey on the Africa Mercy, a hospital ship that travels up and down the coast of Africa)

9/12/13

Stories and screenings

Evangeline is a little 2 1/2 year old boy with a story.  It started

almost a year ago with difficulty breathing.  It was diagnosed as

malaria, but it didn't respond to the usual treatments. His parents

took him to a large hospital for further evaluation. They said     maybe he had malaria and maybe not, but he definitely had a tumor

in his mouth which would grow and eventually suffocate him.

Indeed, as the months passed, his breathing was progressively  compromised, to the point where he would pass out several times a day. 

The local hospital had nothing further to offer, so the parents eventually quit taking him to the doctors and awaited his approaching death.  The father, however, works in the shipyard.

When the Africa Mercy arrived and he heard that we were a hospital ship, he bought a calendar and marked the days until our main screening day. The parents just hoped he could last that long   (only two weeks!).  Indeed, Evangeline had trouble during the      screening--they had to call the emergency medical team for him. He had surgery early this week.  They removed a tumor from his soft palate the size of a man's fist.  No wonder he couldn't breathe! He spent a couple of days in intensive care, but he recovered well. He went home today to live a normal life, rescued just in the nick of time. 

A little girl wasn't so lucky.  She was brought to us from a mission hospital upcountry, hoping that we could help.  Alas, she had advanced cancer, far beyond anything we could treat.  One of the nurses was carrying her on her back, African style, when she died. The nurses often do that with the young ones--they are greatly comforted by being carried in that familiar way.  I'm glad the little girl was being held close and feeling loved for her final moments on earth.
    
Our screening day on Tuesday went very well.  The church hadn't   closed the gates, but the people were lined up outside as they were   supposed to be, and the crowd stayed manageable.  We were even able to screen everyone in the line.  Wednesday, however, was a      different story.  That church is in one of the poorest, most crowded districts, and they didn't shut the gates either.

Consequently, there were roughly 400-500 people already inside the compound when our security team arrived at 5:00, and the crowd outside was growing quite rapidly.  The church refused to shut the gates because they wanted their congregation to be able to come to morning mass.  The security team tried to admit only those who said they were going to mass...but once inside, they almost all  immediately tried to get into the eye screening crowd instead. People were starting to push and shove, and tempers were rising. It soon became clear that we were not going to be able to establish order, so we had to pull out and cancel screening altogether that day.

Of course, every screening that doesn't happen or doesn't go well only increases the potential for problems at future screenings by swelling the crowd size and by frustrating and angering the people who have been waiting in line for hours.  It seems to me that there is a level of expectation here in Congo that we haven't encountered elsewhere. Or maybe it is a cultural difference in how they handle disappointment. In Guinea, people seemed so very grateful for anything we could do for them.  If we couldn't help, they seemed to take it in stride and remained grateful that we tried.  Here, there is a lot more evidence of anger. 

One man told me that he was angry because he had to get in line while we were still sleeping--never mind that his mother actually did get an appointment, unlike many who were shut outside the gates.  Another man was angry because a local doctor was trying to help us with screening," You never helped us before, so why are you here now?" 

A day crew member from  another department had brought her mother to the screening that was canceled.  She was angry. Even after 15 minutes of explanation, her anger didn't often.  Our eye team day crew have reported to us that people approach them to say that they are angry to have been unsuccessful in being seen at various eye screenings. Some people even seem angry when we have to tell them that we can't help their particular problem. 

I get the feeling that the general expectation is that Mercy Ships is supposed to see everyone who wants to be seen and to fix every problem that they bring to us. Being confronted with the perception that many of the people we are trying to help are angry instead of grateful brought me to a moment of truth. Was I going to get on my high horse, as if we deserved their gratitude?  Was I doing this for the sake of getting pats on the back for being here? Or was I working to please an audience of  One, a God of compassion who cares about these people no matter what their emotional response to disappointment might be. It was a good reminder to keep my focus where it belongs!

Marilyn


Click here to learn more about the nurses and doctors on board the Africa Mercy.

Africa Mercy - First Week of Field Screening: One Nurse's Journey

More from Marilyn on board the Africa Mercy. The crew is overwhelmed by the number of people still seeking a medical screening--an impossible task it seems. I feel for the Africans living there. How frustrating it must be to live in a country where your only medical resource is a hospital ship. Sharon

(This is a running post about a nurse's journey on the Africa Mercy, a hospital ship that travels up and down the coast of Africa)

9/7/13

First week of field screening

 

We have begun our twice weekly field screenings, looking for more cataract patients.  These screenings are being held at five different locations in various churches around the city.  Tuesday we went to St. Marie's Cathedral, a huge compound not too far from the ship.  More than a thousand people came--too many for us to see them all.  Screening was scheduled to begin at 9:00,but many people had already arrived when our security people got there at 5:00 AM.  We got them into lines and got started about 7:30, but they came faster than we could see them, so the lines kept growing.  Finally, we had to close the lines and send the rest away.  Matt, the head of security, tried to hand out flyers with information about the next screening dates and nearly had a riot on his hands. I think they thought it was a ticket to get into the next screening, not just information, so they pushed and shoved to get one. 

Fortunately, all the churches where we will be screening have high walls and gates.  We were able to get our people inside and get the gates closed without injuries to anyone.  We stayed until we'd screened everyone inside the gates, but many unhappy people were left outside.

Wednesday's screening was even worse!  There were already more than 300 people inside the gates when the security team arrived at 5:00 AM, and the crowd was growing rapidly.  Matt just shut the gates at that point.

The crowd outside continued to pound on the gates and to climb the walls, but the security team was able to keep it under control inside the compound, so the screening process proceeded in an orderly fashion for those 300 people already inside.  Unfortunately, there was no safe way to bring any more people in once the gates had been closed, so we saw somewhat fewer people than we might have with better crowd control.

By now, I'm sure the word is out that you'd better get there the night before and camp in the courtyard if you want to be seen, so I expect that the problem is going to get worse.  Matt is talking about having the gates to the church compound locked the evening before a screening so that at least the crowd is outside and won't overrun the screening stations.  One problem, though, is that each church has daily early morning church services.  How does one admit the congregation but not our patients?  I would suppose that the pastors will have to agree to cancel church on screening days, at least until the crowd size diminishes to manageable levels.  Hopefully, with continued screenings, we'll eventually get the crowd processed and/or enough people will get discouraged and stay home.

Our problems with crowd control certainly underscore the desperate need for cataract surgery and eye care in this city, so I am glad that Mercy Ships can begin to meet that need.  I wish we had the resources to at least screen and interact with everyone who comes--but we don't.  Angry, disappointed, disgruntled crowds are inevitable at this point--but it's heartbreaking.  There is no Plan B, both for the people we have to turn away and for the people we cannot even find time to screen.

On Friday we held a bit of a debriefing for the eye team.  One person after another talked about the heartbreak of having to turn people away--and then we started remembering the people for whom we had been able to say yes, the people who will eventually have their sight restored through surgery. We remembered several who came to screening with vision-threatening infections whose eyes we were able to save.  An eye drop in time saves sight!  Anyway, as a team, we seemed to get our emotional balance back, ready to face another week of screening days.

If a potential patient makes it past the first cut on screening day, they are given an appointment date to be seen at the eye clinic for a more thorough eye exam.  At this clinic exam, we will make a final decision on whether they are a candidate for surgery or not, and if so, they will be given an appointment date for coming to the ship for surgery.  These clinic exams will begin next Monday.  So, beginning next week, we will be screening for two days a week and running clinic for two days a week.  I'm not sure what will happen on Fridays--but I'm sure something is scheduled, and I'll find out eventually.

Meanwhile, we have been using every spare minute to train ourselves and our day crew in all the things we need to know and do for clinic appointments.  There is a lot to learn!  Language barriers make everything more difficult, and medical terminology can present problems even if English is your first language.  But, our day crew are now trained in such things as using charts for visual acuity tests, using tonopens to check for glaucoma, using auto-refractors to measure refraction and corneal curvature, and A scans to get the measurements for the intra-ocular lens to be implanted during surgery, not to mention all the vocabulary that needs to be translated in taking medical histories and in explaining everything to the patients.  Are you impressed?  I am!  Perhaps I should mention that I didn't know all these machines a week ago either--I'm learning right alongside the day crew.

I would like to end with a story. "E". traveled from Nigeria to Guinea last spring, hoping for surgery on his large facial tumor.  Alas, the surgery schedule was already full, and there was no room for him. Undeterred, he arrived here in Congo just about the time the ship came into port, with little money and no place to stay, but full of hope that this time we would help him.  Perhaps by divine appointment, he encountered some incoming Mercy Ship people in the airport, and they could tell that he would be a likely surgical candidate for us.  He became our first customer at the Hope Center (normally used for post-surgical patients needing ongoing therapy) as he waited for us to get the hospital up and running.  I met him in the hall a few days ago--he was on board for surgery the following day.  I hear it went very well. I expect he's a handsome fellow now--I hope I get to see him again before he leaves.

 

Blessings to you all,

Marilyn

Click here to learn more about the nurses and doctors on board the Africa Mercy.

 

Africa Mercy - Selection Day: One Nurse's Journey

More from Marilyn on the Africa Mercy. It's hard to imagine, but 7000 came for the screening in Pointe Noire, more than 4000 of which received doctor's appointments! 


I am thankful for people who give of their lives and time to help those in need in such a far away place. It is humbling to say the very least. Not that all of us have opportunities to help in this way, but it does give perspective. I guess it comes down to this: we can all do something to help others where ever we are......a neighbor, a friend, a family member or even a stranger. One person at a time. It all adds up, no matter how small our contribution may seem. Anyway......this and the last post sure got me to thinking. Sharon


(This is a running post about a nurse's journey on the Africa Mercy, a hospital ship that travels up and down the coast of Africa)

8/31/ 13

Selection Day

Last Wednesday was the day of our big screening, the day we selected patients for the various types of surgeries in the coming months.  By government request, our advertising poster depicting the types of surgeries available did not have a date or place for the main screening event, so I wondered if the people would know to come.  They came--more than 7000 of them.  I've attached a picture which suggests the size of the crowd, but one picture doesn't really capture it.  The line of people wound all around the wall of the selection site, doubled back, down a second street and back.  It made the longest Disneyland lines look short!  

I've heard that we had about 350 crew members plus 100+ day crew translators working on site that day.  We needed every one of them, both to manage the crowd and to do the actual screening procedures. We screened for more than twelve hours, from dawn until after dark, to see as many people as possible. More than 4000 people got appointments, either for further medical testing or for the surgery itself. 

Altogether, it was a very successful screening day.

The hardest part of screening is having to turn people away.  They come so full of hope.  They wait patiently in line for many, many hours to be seen.  Then, some of them have to be told that we cannot help their particular problem.  More than half of the people in line for eye problems didn't have cataracts, or their cataracts were not sufficiently ripened so that our procedure would help, and they had to be turned away.  Some had corneal scars--a corneal transplant would restore their sight, but that is not possible to do here.  Some were blinded from untreated glaucoma--irreversible damage was already done. Some were blind from injury that couldn't be fixed.  So many reasons to say no...and every "no" hurts.

 We saw a fair number of children with evidence of Vitamin A deficiency. The poorest people eat mostly white starchy food because it is  cheapest, so even though they get the calories, they lack the vitamins  they need.  Vitamin A deficiency in children can lead to blindness, but  it is preventable.  One thing we try to do is to educate parents about  Vitamin A and where to get it.

 Because cataract surgery is quick and patients are released the same day, we can do a lot of eye surgeries.  So, we will continue to hold field screening to gather more patients throughout the months that we are here.  Our next eye screening is scheduled for next Tuesday.  There will be hundreds of people there, but not the thousands that gathered for the main screening, because only one type of surgery is being offered.  Still, it is likely to be another emotional day.

Let me end with a couple of stories from previous years.  Many of our cataract patients are old, of course.  One year a man a wife both received cataract surgery the same day.  When the eye patches came off the next day, the grandpa turned to his wife and said, "you are as beautiful as I remembered you to be."  They were very much in love.
 

Next year, another old couple had surgery the same day.  When the eye patches came off, the old fellow turned to one of our day crew people and asked her to marry him!  Needless to say, grandma was having second thoughts about having his sight restored!  People are people, the world over, aren't they?  Well, we screened an old couple this year and scheduled both of them for surgery...

More another day...

Oops..."They" won't let me send such a big file, with the picture attached.  So here's the email, and I'll work on how to send the picture separately.

Marilyn




Click here to learn more about the nurses and doctors on board the Africa Mercy.

Africa Mercy - The Big Day: One Nurse's Journey

Another email post from the Africa Mercy in the Congo. What do you do when you can only admit so many patients? The 'big day' is here and maybe over (but unlikely; it's 7pm in the Congo). The excitement prior as the crew prepares for a 'massive screening' of potential patients is described in this post. Marilyn gives a detailed account of what to expect during the screening, when thousands of potential patients line-up and Mercy personnel are given the daunting task of deciding who can be admitted. She has asked for prayers. They can only help so many . . . Sharon 

 

(This is a running post about a nurse's journey on the Africa Mercy)

 

Our heroes, the Africa Mercy crew. Doesn't it just make you want to
shout "Hurray!?"

The Big Day

 

8/27/13

Tomorrow is a big event for us, the biggest event of the year.  For weeks or months, we have been advertising about Mercy Ships and the types of surgeries that we can do, inviting people to come for screening to see if they can be helped.  Tomorrow is the day of that massive screening.  Thousands of people will come.  Some will camp in line overnight to be sure of their place.  If it is like other years, they will wait patiently for hours to spend a few minutes with our doctors, hoping fervently that we can transform their lives.  Some, we can help.

Many, we can not.  It can be a heartbreaking day, having to turn away people who have nowhere else to go for help. But it is also a joyous day, seeing so many people for whom we can make a difference--a huge difference.

Why must we turn people away?  We try to advertise the types of surgeries we do, but many people come with other health problems, hoping that we can help anyway, or they have a problem that looks like the posters but is not the same, or they have additional health problems that make surgery not an option...or...sometimes we just don't have enough time and surgeons to handle all that could be done if we had those resources.  You've heard the story of the boy on the beach tossing stranded starfish back into the ocean...we can't save them all, but we do what we can.

Screening day is a massive logistical operation.  Think of a football stadium, and thousands of people all trying to get in through the gate in time for the game.  Consider--all they need is a ticket, and their place is assured.  All they have to do to qualify for that ticket is to pay money, which they have.  And if per chance the game is sold out, they can go home, none the worse for wear--probably even to watch that same game on TV!  The stakes are pretty low, really.  But you've been there, felt the crush of people pushing to get in the gate, heard the noise and felt the energy of so many people in one place.

Now think of those thousands of people vying for a once-in-a-lifetime chance to get a desperately needed surgery.  So many hopes and fears, so much at stake for each of them.  Try as I might, I cannot really put myself in their shoes to understand the depth of this experience for them.  For those of you who pray, please pray for our prospective patients tomorrow--especially those whose hopes are dashed as we sadly send them away.

On the ship, we have six operating rooms.  They will be in constant use, beginning next Monday. There will be a whole parade of surgeons coming and going throughout the 10 months of field service.  Most can only break away from their practices for 2-4 weeks at a time.  We have a stream of eye surgeons doing cataracts, plastic surgeons doing burn contracture repairs, orthopedic surgeons fixing dysfunctional limbs, general surgeons doing thyroids, tumors and hernias, surgeons who do vaginal fistula repairs, maxiofacial surgeons working on cleft palates and facial problems of all sorts, and so on.  So, in screening, we need to look for patients whose needs match the specialties of our surgeons, and we need to schedule them for surgery at the right time for the right surgeon!

A little bit about the flow of screening day:  We have the use of a large school compound with walls and gates.  That's important for crowd control.  Security people establish the lines and keep people in order.

Pre-pre-screeners walk up and down the line, eliminating those who are obviously not candidates for the surgeries we offer.  Eventually, the people get through the gate to the pre-screeners.  Those folks gather enough information to send the person to the correct station for further assessment, or out a different gate, if we can't help.  Eventually, after a medical history and basic nursing evaluaton, surgical candidates are seen by a doctor.  If he approves for surgery, the patient gets an appointment card to come to the ship at the proper time.  There's a prayer tent for those who would like prayer.  There are translators working with each medical person, of course.  There are people passing out water and bread for these people who have been waiting for hours.

There are escorts to lead people from one station to the next throughout the whole process.  We have hundreds of crew members on the ship, and we all have a specific job to do tomorrow.  Hopefully, it will be like a well-oiled machine!  We expect to process thousands of people in one day--it had better run smoothly!

Many, many of these hopeful people have eye problems.  Those are sent into a separate line to come to the eye team for evaluation.  We expect to process thousands of people just in our area, and hope to select about 500 of them to come to the clinic on other days for a more complete eye examination, with the hope of cataract surgery for many of them.  I filled out 520 appointment cards to give out tomorrow, for clinic days from now until mid-October.  It took several hours to fill out the cards--and each card represents several people who will need to be seen tomorrow, since there are probably more rejects than acceptances.  Obviously, our optometrist is going to have to work fast tomorrow!  In fact, we all will have a very long, very busy day.

I've attached a picture that they took today of the Africa Mercy crew. If you are looking for me, I am about half way back in the crowd directly under the "r" of ".org" painted on the ship.  White hair, green shirt... All these people, plus about a hundred more Congolese day crew (translators, etc.) will be working tomorrow.  If I can, I'll send pictures of screening day a little later this week.  Meanwhile, appreciate your prayers that it will go well tomorrow, and that we will select the right people for surgery to do the most good possible while we're in Congo.  Thanks.

Blessings,

Marilyn

Click here to learn more about the nurses and doctors on board the Africa Mercy.
 

Africa Mercy - In the Land of Congo: One Nurse's Journey

Long awaited news from my dear friend in Africa! She has finally arrived in the land of Congo and has yet another interesting tale to tell. This is a running post about her journey as a nurse on the Africa Mercy, a fully staffed hospital ship that travels up and down the coast of Africa. Learn with her as she discovers and relates  to life in Congo and the people firsthand.

Online image of Pointe Noire market

 8/19/13

In the Land of Congo

We arrived in Pointe Noire, Congo a little over a week ago now, although it seems much longer ago that that.  As expected, we spent last week in a flurry of cleaning and unpacking.  The job is not done yet, but it's beginning to look like a hospital again, and it is certainly much cleaner than it was before.  We'll be ready in time for our first patients on September 2nd.

This week, we are beginning to train our day workers.  We have eleven day workers assigned to the Eye Team.  They are all Congolese who speak English, and usually four to seven other languages.  They are not medical personnel, however, so we begin at the beginning. Today I taught basics like handwashing, use of gloves, body mechanics, and waste disposal.  Tomorrow we'll teach about blood pressures and administering eye drops, and then move into basic eye anatomy and eye diseases. I do wonder how much of this they are understanding--but we do a lot of show and tell and we give them written material so that they can read what they miss.  And I'm sure we'll be re-teaching the material individually in the coming weeks, but at least we've laid some groundwork.

Probably the most interesting exercise we did today was to blindfold half the class and have their partners lead them up the gangway and down two flights of steps into the hospital eye room.  I participated, and it was interesting to see how frightening it was to make that journey blindfolded, and how much difference it made when my partner led me by the hands and gave me verbal cues.  That's what our patients will experience, only more so, since they are not familiar with our ship, have probably never been in a hospital, and don't get to take off the blindfold at the end of the journey.  Most of them have been blind for a long time and depend on family members to guide them.  Now they have to leave that caregiver outside the ship (we don't have room for them inside) and go in alone to face surgery among strangers.  It makes you appreciate their courage and their desperation, to entrust themselves into our care that way.  Well, hopefully today's exercise will make our day workers both sensitive to the patients' situation and skillful in guiding them along.

First impressions of Congo: 

1.  Weather:  Right now is their winter season, very pleasant, usually sunny, but not too hot.  I hear that the rainy season lasts from October to May, and it gets hot and humid then.  So, I'm enjoying this good weather while it lasts!

2.  Plastic:  Congo outlawed plastic bags a couple of years ago.  You can get quite a fine if you put a WalMart bag in the garbage.  We didn't know that when we arrived--a lot of plastic went out with the trash that accumulated during the two weeks of sail  Oops!  Well, someone is figuring out what we need to use to collect our trash in--it'll all get clear sooner or later.  Meanwhile, I can certainly see the wisdom of such a law.  Pointe Noire is not buried in plastic like the places I've been before.

3.  Market:  Pointe Noire has a very large open air market downtown.  It is organized and relatively tidy. Here there is a whole row of little stalls with traders selling shoes.  Next is a whole row of little stalls with bananas.  Fruits and vegetables are in abundance as far as the eye can see.  Some stalls have clothing, or cooking pots, or electronics.

Whatever you want, it is probably there somewhere.  I was struck with the lack of trash piles or garbage underfoot.  I hear that the traders must completely vacate the market two days a week so that the city can clean the area.  It certainly makes the shopping more pleasant.

4.  Traffic:  Unlike Guinea, Congo has traffic laws that are enforced. Policemen in the intersections are not offering suggestions, they are giving orders. There are a few traffic lights in town, and they actually work.  Taxis are abundant and relatively cheap; most people do not own cars.  The roads are crowded, but not like I've seen elsewhere, and traffic goes in the right direction, not every which way.  For the most part, traffic flows without major bottlenecks.

5. Port Security:  Congo takes their port security very seriously. That's good, but it has also been a hassle for us, bumps in the road that haven't been ironed out yet.  It is about a mile from our ship to the port gate.  Our vehicle generally gets stopped about three times in that mile so that they can check our ID badges--very carefully, comparing our pictures to our faces for everyone in the car.  Problems arise when we pick up new crew at the airport and try to get them to the ship, since they don't have a proper ID badge yet.  We've worked out a compromise, giving the port authorities a list of expected arrivals each day.  Then  our new people just need a picture ID of some sort, which is compared to the list.  In theory.  Not every guard seems to know the procedure.  Vehicles get hung up, and Mercy Ships officers have to go out and negotiate again. Soon we'll face the same issues trying to bring patients in to be ship.  Do all of them have a picture ID of some sort?

I doubt it.   We are an odd duck, moored here for ten months, with

patients, caregivers, patient visitors, new crew, and ship guests all coming and going, giving those port guards heartburn, I'm sure.  Well, resolving these issues is above my pay grade...but I'm sure it'll get smoothed out before long.  This is the first time Mercy Ships  has been to Congo, so a lot of little details have to get ironed out as we go.

Blessings on you all.

Marilyn


Click here to learn more about the nurses and doctors on board the Africa Mercy.

Africa Mercy - Sailing the Ocean Grey: One Nurse's Journey

The Africa Mercy has finally left port where it has been undergoing repairs and maintenance for some time. The medical team is on their way to Pointe Noir, Congo now, where once again they will provide critical health care services. This is a running post of my friend's journey on board this amazing hospital ship as a nurse. I love the dolphins she describes in this post. What a blessing she also happens to be an excellent writer!    



"Sailing the Ocean Grey"

7/31/13

We set sail last weekend, headed for Pointe Noir, Congo.  It's an almost two week sail--seems like a long time, in this age of air travel, but since this ship can't fly, we chug along through the waters off the coast of Africa to reach our goal.

The waters are grey, not blue, this trip.  That's because the sky is overcast, dense with sand blowing off the Sahara.  I had trouble sleeping last night, so I went up to deck 8 for a while.  There was not a star in the sky, no horizon to be seen, just a closed-in world of water churned up by the wind.  I held on to the railing, of course, since the ship rocks quite a bit with the wind and waves.  It felt almost greasy, damp with sea spray and covered with fine-grained sand.

You should have seen my hands afterwards!  Who knew I'd find a sandstorm a hundred miles out to sea?  It wasn't like the stinging sandstorms we used to have in El Paso Texas, though, because only the finest grains of sand travel this far.

When the ship rocks gently, it can lull you to sleep.  Last night, however, it felt like my bunkmate was kicking my bunk or stepping on my mattress while climbing into her bunk.  It was rather like someone was shaking me awake--so naturally, I would wake up every time it happened.

My bunkmate was safely tucked into her bunk, not guilty of causing any commotion--it was just the whole ship shuttering under the impact of the wind-blown waves.  I can't imagine what it would be like in an actual storm! I hope I don't have occasion to find out!

A couple of days ago, we suddenly had an escort of a dozen dolphins for about half an hour.  They were amazing to watch as they swam alongside, dived under the bow, and leaped into the air for us.  At dinner, I heard a seaman describe it from the dolphin's point of view.  "Ho hum, another day like other days.  Hark!  I hear the drone of one of those large, boring old fish that just swim in a straight line and sing  one note the whole time.  But often, there are parasites on those fish that can be a lot of fun.  If we jump out of the water, they make the grandest noise, cheering and clapping and talking to one another.  Let's go see if we can make them perform for us."  And indeed, that's just what they did.

Once we arrive in Congo, sometime around August 9, we will be busy cleaning and unpacking the hospital.  It's very dirty from all the construction, and of course, everything is all packed away and tied down for the sail.  We are planning to do our major screening on August 28, and will begin surgeries not too long after that.  Anticipation is running high.  This is what we've all come to do, and it is about to begin, another year of life-transforming surgeries for the world's forgotten poor.

The advance team has been in Congo for several months already, making relationships, finalizing contracts, preparing the sites for the dental clinic, the eye clinic, and the Hope Center. (The Hope Center is basically housing for patients who live far away and need ongoing physical therapy or dressing changes after they are discharged from the hospital.)  Containers of supplies should be waiting for us when we arrive.  Surgeons, nurses, and others are making their final arrangements at home, preparing to come before the big screening event that kicks off our field service for the year.

The advance team has been interviewing and hiring several hundred "day crew", Congolese nationals who live at home but work on the ship as translators, galley crew, deck hands, and other jobs. We couldn't manage without them.  Getting the right mix of job skills into each department and getting translators for multiple languages into all the departments that need translators is quite a project in itself.  Then, all these workers need to be trained, not only for their particular jobs, but into the Mercy Ships culture, expectations, and standards.

When you think about it, it's pretty incredible.  We have to have a full crew with technical skills to sail a large ship, a full crew to provide hotel services for an average of 500 people a day, a full surgical crew to staff several operating rooms, and a full hospital crew to care for the patients.  Then you try to staff that with volunteers from 30-35 different countries, go cross-cultural, deal with language barriers, move the whole operation from place to place every year, stretch your supply lines half-way around the world,  and work with a dozen different host nations.  Somehow, the Lord sustains the whole messy business, and we actually do a fair amount of good wherever we go. I am still thrilled to have a small part to play in this grand scheme.  What a blessing it is to be here.

May the Lord bless each of you in your endeavors, too.

Marilyn


Click here to learn more about the nurses and doctors on board the Africa Mercy.



 

Africa Mercy - Shipyard Renovations: One Nurse's Journey

More from my friend on the Africa Mercy. This is a running post about her work in Africa as a nurse. One more week to go before the repairs are complete, then off to Tenerife for a week and finally, the Congo!


Sun 7/14/2013 2:35 AM

If you missed the segment about Mercy Ships that was aired last February and you would like to see it, you have another opportunity. [click here] They plan to rebroadcast our segment on their program on July 21st--next Sunday evening.  The hour-long program begins at 7 p.m. Eastern & Pacific Time and 6 p.m. Central Time on your local CBS station.  

I personally thought they did a very nice job of representing us to the world; public reaction has been positive, with both financial contributions and volunteer applications increasing immediately after the first showing. Now we get a second exposure--what a blessing, especially considering that Mercy Ships is currently in the process of trying to finance the building of a second ship, and will eventually need to staff it with volunteers.

Meanwhile, the shipyard renovations on this ship continue, pretty much on schedule.  We still hope to be done with this shipyard a week from now.  We will then sail to Tenerife to stay for a week (I still don't know why...) and then we're off to the Congo.  It takes two weeks to get from here to there--seems slow in this age of air travel, doesn't it? But it'll be a pleasant interlude, a time of getting things ready for field service, at least as much as possible while everything is battened down for safety during the sail.

My life is pretty smooth at this point.  I still don't have a bunkmate, and I have been thoroughly enjoying the freedom that that allows, flipping lights on when I can't sleep, getting up and going to bed whenever I please, etc.  I expect I'll get a bunkmate sometime next week.  We anticipate over 150 people embarking between now and then, more than doubling our current occupancy, with every bunk occupied before the sail to Congo.  The times, they are a' changin'.

Yesterday was probably my last day of being able to take some serious time away from the ship.  I am either working or on call as duty nurse every day from now until we sail.  So, to celebrate my freedom, I walked to the shopping mall at the far end of the boardwalk and back--fourteen miles.  Of course, I was too tired to do any shopping, and didn't really want anything anyway.  I could have taken a taxi, but actually, walking was the point.  It was a glorious day, just the right temperature, scads of interesting people to watch all along the boardwalk, occasional music from street musicians or birds, a fellow creating sand sculptures beside the boardwalk, vendors of curios plying their trade, etc.  I noticed a number of relatively young adults wheeling older folks along, lots of families out for a day of adventure, and many older couples strolling along hand in hand.  Some were tourists, of course, but most seemed to be Spanish, and I assume many were locals.  Their beach and boardwalk are a treasure, and they take time to enjoy it.

The shipyard itself is pretty interesting.  The "Catalina" from St. John has been in dry dock next to us for several weeks.  The shipyard men looked so tiny in their perches as they needlegunned and sanded away the rust and then painted the towering ship.  Finally, last Friday, it was ready to launch.  In dry dock, the ship rests on hundreds of wooden supports mounted on wheeled platforms that run along railroad tracks.

The Catalina had five rows of these support gadgets running on ten rails, the equivalent of five lines of railroad flatcars traveling abreast.  To move the ship toward the water, they lined up five large front loaders to push against the central platform--it took that much power, I suppose.  At the end of the line, they pushed the ship onto an elevator platform. Once the ship was in position, about fifty huge motors lowered the platform into the water by unwinding the thick cables, allowing the ship to float.  Alas, the Catalina listed badly, not seaworthy after all.  I suppose that something must have been wrong with the ballast balancing system.  They had to drag the poor baby back into dry dock, where it remains today.  There was lots of activity aboard the ship yesterday, though, so I suppose they'll try again today or tomorrow to launch the ship.

Blessings to you all.  Thank you for walking with me in this Mercy Ship adventure.

--

Marilyn  

Africa Mercy - Life in the Shipyard: One Nurse's Journey

More from my friend on board the Africa Mercy. Read about her life in the Las Palmas, Gran Canaria shipyard . . . on a small island that belongs to Spain.

   

 (Reported images of Las Palmas online)

   

Life in the shipyard

20 June 2013

Greetings from Las Palmas, Gran Canaria (one of the small islands off the coast of northern Africa that belongs to Spain).

Life on board the Africa Mercy in the shipyard is different from life during field service.  There's a completely different feel to it, as you might expect--sort of a combination of "resort vacation", living in a construction site, and working full time at strange new jobs.  There are only about 150 people on board, a mix of long-term crew, temporary volunteers who come for the renovation work, and shipyard workers who speak only Spanish.  Some of our families are still aboard; children in the shipyard freak out the port authorities, so kids have to be driven to the port gate before they can set a foot down.  That's reasonable--most ships in the shipyard are not occupied even by adults, much less children.  We are an "unusual case," so they have to figure out how to make it work for us.

Resort vacation:  This is a gorgeous island, a popular vacation spot for Europeans who want a beach holiday.  A couple of us drove around the northern edge of the island and then through the mountains in the middle of the island.  Fantastic views of the ocean, sheer cliffs of lava rock, and quaint little villages that were all impeccably clean and inviting.

The beach here in Las Palmas is a beautiful expanse of clean sand, bordered by a boardwalk lined with little shops and eating places.  The food is delicious, the fruit is lovely, and the prices are reasonable.

What more could one ask?

Construction site:  Jackhammers batter the eardrums all day long.  They are renovating the floors in the hospital.  This ship used to be a railroad ferry, so the floors have rails embedded in concrete.  Great for trains, but not so great for hospital patients.  It will certainly be an improvement...once they finish hammering.  Then there are occasional blackouts, water turn-offs, and so forth, to accommodate other renovation projects.  One of the trickiest projects has been the replacement of the CT machine. The original machine was installed before they finished building the bulkheads.  Now, how to get the old one out and the new one in?  Limited space in a "floating box" makes it a challenge to replace such a large, heavy piece of equipment.

Strange new jobs:  As I mentioned last time, I was assigned to work in the galley for the summer.  Feeding 150-300 people is a big project, and very hard work.  You are on your feet for nine hours, leaning over a sink or a counter, chopping food or washing dishes.  (I never made it to the "hot side" where the cooking is done...).  Well, by the middle of the second week, I was so exhausted I could hardly put one foot in front of the other, even after a night's rest.  I must have looked as bad as I felt, because my boss decided that maybe I needed a different job. Bless him!

So, now I am working in "sales."  We have a small "ship shop" on board, where we can purchase cleaning products, personal care items, comfort foods, and a few other assorted items.  We also have a Starbuck's cafe where we can purchase coffee and snacks.  (Starbuck's donates the coffee!)  I am learning the language of coffee...frappachino, cappachino, latte...as well as how to make them and how to ring up the sales.  Hey, this job is FUN!  Maybe I've found my next career.

One of my cabinmates has left the ship.  My two remaining cabinmates decided that since I was their mother's age, I should have a bottom bunk despite the fact that normally it would be Maryke's turn to move down, not mine.  That was quite a sacrifice on her part, to spend the next year in a top bunk for my sake.  I must say, I sure do enjoy the new arrangement, the ease of flopping down for a quick rest now and then, or getting up to the bathroom at night without clamoring down a ladder in the dark.  Maryke (South Africa) and Remy (Holland) and I certainly get along well together.  Hopefully, my new bunkmate will be as pleasant as they are, whenever she arrives.  Living in such a small space, it matters a lot how well you relate with your cabinmates, and especially with your bunkmate.  Meanwhile, my two cabinmates are both on vacation, and I have the entire cabin to myself!  How's that for luxury?

Well, time for lunch, and then back to work.

Marilyn

This is a running post about her work in Africa as a nurse. Click here to learn more about the nurses and doctors on board the Africa Mercy.

Africa Mercy - The Sail: One Nurse's Journey

More from my friend on board the Africa Mercy. I love her poetic and detailed description of the sail to La Palmas, where they are docking for repairs and maintenance. Read on . . .



The Sail
06 June 2013

We have just arrived in Las Palmas, Gran Canaria, the shipyard where we will be undergoing repairs, maintenance, and inspections for the next several weeks.  We left Conakry at noon last Saturday and arrived here at noon, five days later.  The sail was very nice--ideal weather, calm seas, and smooth sailing all the way.  It was an odd time, a mixture of work and "cruise ship" atmosphere.

With Mercy Ships, everyone works.  If your regular job is suspended during this shipyard time, you get assigned to a different job for the duration.  I will be the pre- and post- operative nurse for the eye surgeries once we reach Congo, but for now, I work in the galley.  We are making three meals a day for a crew of about 300 people, so it is a big operation.  I find it physically taxing, standing on my feet from 8:00 AM to 7:00 PM, chopping vegetables, washing dishes, washing all the fresh food in bleach water, etc.  We do get breaks and meals, but still...it's a lot of standing and leaning over a sink or counter while I work.  Aleve (naproxyn) is my new best friend!  

Our work is about to get even more complicated, because they plan to do renovations in the regular galley.  We'll have to move our cooking to the crew kitchen, a much smaller space set up for individual and family cooking, not mass production.  Ken, the chief chef, has modified the menu to fit the new circumstances...I'm guessing that it will include a lot of soups and sandwiches.

I've never sailed on a cruise ship, but I've heard it described as one big party.  We also had a lot of fun while sailing.  Someone organized events for every evening, ranging from worship on the bow at sunset, to Open Mike entertainment, to a game of "gotcha".(Each contestant was given a name of another player to "eliminate" by sneaking up on them and squirting them with a syringe of water.  If you got your victim before you were squirted, you inherited your victim's target for your next quary, until everyone was eliminated except the winner.)

For me, the wonderfully refreshing thing about the sail was the ocean. It stretched from horizon to horizon in all directions--endless, vast, gently undulating, sparkling in the sunlight, a whole cacaphony of colors.  If the sun is behind you, the water is emerald blue, except the almost-black water in the shadow of the ship.  If you face into the sun, the water is black at the base of the waves, coffee brown on the sides, and white on the crest.  In the distance, all you see is sparkles dancing.  If you look at the water in our wake, it is a light aquamarine, filled with bubbles.  It gradually smooths out and blends in again, but the surface of the wake remains smoother than the surrounding water for quite a long time, leaving a visible trail.

There is a peacefulness about sailing.  The pace is steady, hour after hour, cruising in a straight line toward your destination, but at such a slow, measured pace.  The scenery doesn't change, except another ship in the distance now and then, so it feels somewhat timeless, like an endless voyage, sailing to the ends of the earth.  We had navigation updates, of course, so we were aware of our progress on the map--but I could imagine what the Pilgrims must have felt crossing the Atlantic for months with nothing but stars to guide them and no feedback on their progress.

Gran Canaria is one of several little islands just off the coast of Africa, but they are part of Spain, both governmentally and culturally. 

Las Palmas is a large city, and a tourist attraction.  It will be interesting to see how it compares to Conakry.  I suspect that it will feel a lot more familiar--European, with a southern Mediterranian flavor,  but far closer to my culture than Guinea was.  I expect that I'll have a good time exploring on my days off.

But for now...it's been a long day in the galley.  Definitely time for bed.

Marilyn 

This is a running post about her work in Africa as a nurse. Click here to learn more about the nurses and doctors on board the Africa Mercy.