Africa Mercy - Where Are They? One Nurse's Journey

I continue to be impressed with the Africa Mercy team. That screenings of patients can even progress seems a complete, utter miracle to me. About 2000 possible patients came to sign up for surgeries on the first day. Can you imagine? And apparently, there were fewer cataract patients than anticipated. Where are they, she wonders. .........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).

"Where Are They?"
12 November 2014, Madagascar

We've been in country for a little over 2 weeks now, and the activity has been fast and furious, getting ready for surgery. Our first surgeries--orthopedics and general (goiters and tumors)--started today. You could almost hear the collective sigh of "at last, we're doing what we came to do." It's really a red-letter day for us all.

On the eye team, our fortunes have been mixed. We have a wonderful group of day crew, twelve Malagasy men and women. Their collective level of English comprehension is much better than what we usually get at the beginning of field service, and their work ethic is excellent. We have been struggling to find time to teach them all that they need to know, but when we do teach, they seem to learn quickly. They are an educated group, used to learning new things, and they ask good questions.

What pulls the team in multiple directions are the competing demands of various tasks that need to be done ASAP. We needed to
unload the container of supplies, of course, and bring some semblance of order to the peri-op room. We needed to power wash a very dirty room in the warehouse on the dock for future eye team
use. Next week we'll need to haul all our supplies and equipment
to the clinic building that is currently still under renovation, and get that facility set up.

Another thing we needed to accomplish was to get various teaching
materials translated into Malagasy. The day crew translated the
different documents, and I typed them. It took about four revisions to get rid of all the mistakes--it's very interesting to type in a language you don't understand. It made me realize how much I sight read in English, and proofread as I go along.

Apart from training the day crew, the biggest task for the week was
screening for potential patients. Unlike previous years, this year
they decided not to do a "main screening" day in which thousands of people assemble to be screened for surgeries for the entire field
service. Instead, we have established a permanent screening site and we're screening daily for the whole month of November. On the
first day, about 2000 people came. Since then, the crowds have
diminished in size but increased in "quality," meaning that more of
those who come are actually good surgical candidates. They must be reading the posters, or the word is getting out from those who came earlier in the week. For most surgeries, it seems, there are
plenty of people needing the type of help that we can give, and the
daily screening is going well.

That hasn't been the experience of the eye team, however. We've
been screening every day--indeed, one day we were screening at two places simultaneously--but we haven't been finding very many people with cataracts. In fact, the demographics say that there aren't all that many old people around, and for the most part, cataracts are a function of age. Add to that, this town is a third the size of Pointe Noire, which itself was small compared to most of the
ports where we work, and there is a local doctor who has been doing cataract surgeries for the past number of years. Hum...are there patients out there that we just haven't found, or are they really not there? Will we find enough patients to fill the surgery
schedule for the first surgeon, scheduled to come on December 1?
How should we tweak our program to increase our ability to find the patients?

And so, we are underway...and we are not. Have you ever tried to
row a rowboat away from the dock while it is still tied up? That's
a little of what these two weeks have felt like. We're paddling like mad...but are we making progress? When you look at tasks
accomplished, we've done a lot. But when you look at actually lining up surgeries, not so much. And so, for most of the ship, the waiting game is over, but for the eye team, we're still very much in limbo, waiting to see how it all shakes out. If you are the praying type, please pray that we'll find the patients who need cataract surgery, and pray for wisdom for those in authority who are having to make decisions about what to do next.

Don't you love the drama? It's beginning to feel like chasing a mirage. "Normal" surgery schedule is so close...just out of reach...just over the horizon...coming soon, to a port near me--I
hope.
--
Marilyn Neville 

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