Friday, October 20, 2017

Africa Mercy - First Day: One Nurse's Story

My friend Marilyn is in Africa serving as a nurse on the Africa Mercy. She emails me and I share her words with you. For those of you who know nothing of  Marilyn's story, the Africa Mercy is a hospital ship that travels the African coast with a crew of nurses and doctors. They come from all over to give of their time as volunteers.  

"First Day"

I arrived in Cameroon last night, got to my room around midnight, after
about 36 hours of travel without sleep.   I was supposed to arrive
several hours earlier, but my first flight out of Syracuse had
mechanical problems, and so they had to completely reroute me, through
Paris instead of Brussels.  Now that is one intimidating airport!  Huge,
with multiple terminals, a complicated bus system between terminals, and
poor signs.  It took a couple of hours to get from arrival gate to
departure gate.  Luckily, I had six hours to kill, so taking two hours
to find my way wasn't overly stressful.

I was up again at 5:45 AM to start my first day of work.  We have 22 day
workers (the locals that we hire to translate, teach, manage patients,
and do many of the technical tasks), so I have a lot of new names to
learn.  Dr. Glen spent most of the day still teaching the team--he is an
excellent teacher!  The day crew seem like they are all fairly strong in
English.  That will help a lot.  They also seem like cheerful workers,
enthusiastic and involved.  I think we're off to a good start.

Initially the plan was for government workers to screen for cataracts
upcountry before the ship arrived and then send them to us for surgery.
For reasons I don't know, that plan didn't work well.  That meant that
we needed to restructure our team to handle the extra work of doing the
initial screening.  So, now the eye team has been subdivided into task
groups.  One group will be responsible for the initial screening
process.  They will see hundreds of people each day, selecting those
that seem like they'd be good candidates for cataract surgery.  Those
folks will get an appointment for secondary screening at the off-ship
eye clinic.   At this appointment, the second group will test their
visual acuity (we select for the more profoundly blind) and give them a
more thorough eye exam.  If they are still good surgical candidates, we
do a variety of measurements to determine the correct lens.  When we
give them an appointment for surgery, we need to teach them of possible
complications so that they can give informed consent, and we need to
teach them what to do to prepare for surgery.  This last step of
appointments and teaching is where I will be working.

The third task group is the day-of-surgery eye room, where I have worked
in previous times.  They bring the people onto the ship, prepare them
for surgery, and then send them home after surgery with careful
instructions on what to do next.  The fourth stop for the patients is
the surgery itself--but that's the OR crew, not our team.  The next task
group of our team is the post-surgical care group.  They see the
patients the day after surgery, see any patients that need further
follow-up, and see all the patients again at six weeks for a final check
and JAG treatment (a laser treatment that pokes holes in the posterior
capsule behind the new lens, done because about 20% of all cataract
patients develop cloudiness in this membrane after surgery; the JAG
treatment prevents this.)

I think that this new organizational scheme will be an improvement over
what we've done in the past, where one clinical team handled all the
tasks that weren't done on the day of surgery itself.  Divide and
conquer--I think it will reduce the stress and chaos of one team trying
to do too many tasks at once.

We don't have internet at the team house where I live off ship, so my
access to internet may be sporadic--free time on the ship will probably
be random and scarce once we actually get underway with secondary
screening in the clinic.  I'll write when I can.

Keep us in your prayers as we gear up to do 2200 surgeries in the next
six months, nearly double of what we've done in previous field services.



  1. Your friend is doing such valuable work and has shown an insight what she is experiencing. Good luck to her.


    1. I always thought she should write a book someday, but in some ways, she already has!


"Stay" is a charming word in a friend's vocabulary
(A.B. Alcott). Stay and visit awhile. Your comments mean a lot to me.