Monday, September 9, 2013

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)

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,


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



  1. Hi Sherry. I'm still wrapping my head around the numbers and the desperation everyone must feel. We have it so good here!


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