(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,
That's a lot of people to screen!
ReplyDeleteHi 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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