Africa Mercy - Christmas and Cataracts: One Nurse's Journey

Still aboard the Africa Mercy in the Congo, Marilyn talks about Christmas in Africa and on the ship. As the crew members come from nearly 30 different nations, you can just imagine the variation in customs. Meanwhile, the eye surgeries continue . . . and she shares a typical day. ---Sharon

(This is a running email post written by a volunteer nurse serving on the Africa Mercy, a hospital ship that travels the African coast. In your charitable donations please remember this worthy organization).

Dec 7, 2013

Christmas greetings, my friends

Christmas in Africa.  What is that like?  From outward appearances, it seems like it isn't a public event here, despite the fact that this nation is overwhelmingly Christian. There are no decorations around the town. There is no Christmas music playing in stores (they're just stalls, without electricity, not proper stores). There is no blitz of advertising, urging me to shop 'til I drop. In fact, I see no evidence of preparation at all. When we ask the Congolese day crew about their plans, it sounds like most of them plan to go to church that morning and then spend the rest of the day with family, maybe have a nice meal together.

Christmas on the African Mercy. What is that like? For a while, I thought maybe it was going to be a low key event. Then, a week ago, the ship suddenly blossomed with decorations--artificial trees (we have room to store those all year???), door decorations, cloth wreaths, trimmings everywhere you look. No candles and no live evergreens--it is a ship with maritime regulations, after all, and we are in Africa. The crew comes from about 30 different nations, and it seems we've all brought our cultures and traditions with us. The Dutchies had their version of Santa Claus last night--all the children had to do a trick for Santa, and then they got treats. Other nations will have events on other nights. This evening they  had a Winter Bazaar--it seems that quite a few crew members make craft items to sell, and tonight was the carnival to show their wares. I'm told we'll have a very nice brunch on Christmas morning, and of course we have our religious celebrations throughout Advent. I even hear rumors of a candlelight service Christmas eve--on the dock, of course, fire regulations being what they are. What is pleasantly missing, however, is the constant advertising, the obsessive shopping, the obligatory parties, the secular songs that celebrate everything but Jesus, and the frantic pace that so often blurs the holiday at home. I think that I'll enjoy Christmas quite a bit this year.

 Also missing is winter weather, something that is strongly

associated with Christmas in my head.  Just after the decorations went up, a friend exclaimed, "it's snowing!" She meant it was snowing at home, of course, but for just a moment, I really expected frosty air and snow flurries outside. I was almost ready to go see for myself--and then I remembered, I'm in Africa. It is hot even when it rains, and I doubt they've ever seen frost or snow here. It's just not Christmas weather, to me.

Meanwhile, we have started cataract surgeries in earnest. This year was slow starting because we lacked surgeons for several weeks, but now we have surgeons coming nonstop through the end of field service next May.  Each surgeon comes for two or three weeks, and then we get another one.  Each surgeon has their own specifications and quirks, so it seems like we are always on a learning curve, changing things to suit them. Never a dull moment! But it is certainly rewarding work.  Each day brings 12-20 people with dense cataracts to receive life-transforming, sight-restoring  surgery. It still thrills me to think that I can play a small part in this great blessing.

Every day is different, but let me describe a "typical" day. I usually wake up before the alarm rings, which is good, because my bunkmate doesn't need to get up as early as I do. I get dressed in the dark, having carefully laid out everything I need the night before. Breakfast starts at 06:00 so I grab a quick bite, because I need to begin the work day by 06:45. Fortunately, the "commute" to work only takes a minute or two (and no scraping my windshield or shoveling my driveway...) After a quick prayer, the team goes out to the dock to fetch our patients on board.  That's no easy task! They are blind and usually old. Walking is difficult, and they need to walk up the gangway (42 steps), into an unfamiliar  environment, down two flights of stairs, and down the hall to the peri-op room. Some of them are really, really slow and need lots of help.  Once the first batch of patients arrives in the room, we get their name bands on, their eyes checked, their vital signs done, their dilating drops administered, the pre-op teaching done, and take the first three to the bathroom--all before the surgeon comes to examine patients around 0745 or 0800. It takes all five of us working at top speed to get the first patients ready for surgery on time.  I feel like I've done a day's work by 0830 or 0900, when the pace finally slows down a little.

After the initial surge, I have time to deal with the little problems that come along--the diabetic with a blood sugar of 400, the three or four people who have blood pressures of 230/120 or thereabouts, the one with a fever, the patient or two who are missing vital measurements of their eye that the surgeon uses to choose a lens. Often, it seems, there's a media team from somewhere who just have to have a story by following one or more of our patients through the whole process. They bring their big cameras and microphones and generally get in the way and slow things down. But, telling the world about what we do brings in the finances so that we can keep on doing it.

Eventually, we hit a steady state--taking patients down the hall to     the bathroom, taking them to surgery, and receiving patients back from surgery about every twenty minutes or so. Naturally, when they come out of surgery, we need to check them over, give them meds and instructions, and walk them back out to the dock, which is just as difficult as bringing them into the ship initially. Once we reach steady state, we have a little time to spare. Often, we engage the patients in singing worship songs.  The whole mood of the room mellows out. Most of the patients smile and sing along readily. You should see their delight when I get them up to dance with me while we sing!

The surgical team breaks for lunch at some point, which interrupts the steady state flow. We don't get a break, of course, because we still have a room full of patients to tend to. We need to finish with the last of the morning patients and escort them off the ship, and we need to begin the prep for the afternoon patients, to have them ready for when the surgery team gets back. We do get to eat lunch, of course, by taking turns, but it is eat and run so that the next person can go to lunch, too.   

Somewhere between 2:00 and 4:30, we get the last patients off the ship, and we're done for the day--except to prepare for tomorrow. We get the room cleaned and ready, supplies restocked, and charts checked.  Statistics, ordering more supplies, dealing with emails...all the usual stuff. I'm seriously dragging by suppertime. I tend to work to exhaustion, not realizing how tired I am until I stop moving for a moment--and then it's too late. I am trying to learn to pace myself, take proper breaks, delegate tasks appropriately, and be less of a perfectionist. I need to think like a marathon runner, not a sprinter. Well, that's the goal,    anyway.

One of the really good Christmas traditions we have, in my opinion, is the annual "Christmas letter." I look forward to hearing from many of you about your fortunes in the year gone by and your dreams for the year to come. I wish you all good health and peace as you pace yourselves through this holiday season. 

Blessings, Marilyn

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