Africa Mercy - We're here! One Nurse's Journey

Madagascar at last! You can really sense Marilyn's excitement as she shares her impressions. A very interesting post. 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).

"We're here!"
26 Oct 2014

At long last, we have arrived to the port city of Tamatave, Madagascar (also known as Toamasina...). The sail from Cape Town was rougher than the previous sail. We never did hit a storm, but some of the rolls reached a tilt of more than 30 degrees, and seas were rough pretty much the whole trip. Restraining straps broke, food splattered, the ship creaked and groaned, and 20 barrels of paint got loose in the paint locker (I hear it was quite a mess in there--very colorful). Fortunately, none of the medical equipment seems damaged, and the crew escaped major injury. We were glad enough to arrive after eight days of "fun" on the high seas.

The captain knows "tricks and shortcuts," and he got us here at
exactly the time we were supposed to arrive. He made up more than 18 hours of delay somehow. The presidential celebration happened pretty much on schedule, and I think it was a good success.

Certainly, we got a lot of publicity out of it, with live TV
coverage as well as news media reports. Hopefully, his "Year of
the Volunteer" received the spark that it needed, too. I saw the
president and prime minister as they came onto the ship for their
tour, but of course, security dictated that most of us had to stay
away from their path.

Today (Sunday), the deck crew are unloading the vehicles, but most of the crew have the day off. Many have walked to town to explore our new surroundings. I got as far as the port gate but turned around and came back. It is HOT and HUMID out there! Next time, I'll set out in the early morning if I want to walk. First
impressions from yesterday and today, though, are of a friendly,
hospitable people who are glad to have us here. Perhaps they won't be as reluctant to come to an unknown ship as they were in Congo when we first arrived.

This first week, we will all be busily working to get things set up
as much as possible. Day crew begin with a general orientation on Friday and will be available to us after that, so we'll spend our second week training our eye team day crew in all the things they need to know. Screening for patients starts November 8, not quite two weeks from now, and the eye program will be underway. Our eye clinic won't be ready for occupancy for at least three weeks, so we have some puzzles to solve on how to get things done. I think that life will remain unsettled and full of surprises and adaptations for yet a little while. But at least, we begin!

Have the last 2 1/2 months been "wasted," since we couldn't begin field service in Benin as planned? Not at all. In waiting and planning, we've developed some new strategies for screening that should serve us well in the future. The era of a big screening
day, involving hundreds of crew and thousands of potential
patients, is past. This year, we will have a screening clinic,
screening about 300 potential patients each day for a month. The
clinic will then relocate to the capital city and screen for a
period of time. After that, we'll see. If the model works well,
they may screen in other cities as well.

Moreover, we heard multiple times yesterday that although the
government and people of Madagascar are delighted that we are here, if we had asked even a couple of months earlier, the answer would have been "It's not the right time." The political situation here is pretty unstable. The current president has been in office for only a few months, and the former president is apparently trying to get back into power. I'm sure there's more to the story, but the point is, thanks to all the twists and turns in our journey, we are here at "just the right time."

I am attempting to learn a few words of Malagasy. Manahoana touku (sp?) means hello to folks in the capital, but manakouri touku (sp?) means hello here in the port city. If you pass in front of someone, especially an older person, you are expected to be polite by saying azafady touku (sp?) while bowing slightly and extending your right hand in the direction you wish to go. Malagasy uses a lot of vowels, and a lot of syllables. The capital city is Antananariva, at least one syllable longer than I seem to be able to pronounce (people call it Tana for short). The president's last name has 19 letters. I'm not even going to try! Patient names are likely to be a challenge, don't you think?

The Madagascar adventure has begun!

Marilyn Neville


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

Africa Mercy - Madagascar Here We Come, Part 2: One Nurse's Journey

They are off again! This time the destination is finally Madagascar. I hope they make it in time for the "Year of the Volunteer" celebration. 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).


Madagascar, here we come, part 2
21 Oct 2014

We are now underway, sailing toward Madagascar. Ah, but will we arrive in time? We need to arrive by Saturday morning because the president of Madagascar has planned a gala celebration to kick off his "Year of the Volunteer" campaign, using us as his "poster child." The president, prime minister, all the cabinet members, and many of the ambassadors are coming to the ship Saturday afternoon for a tour and for the event. It wouldn't due to be late!

The captain planned to leave Cape Town last Thursday, sailing for nine days to reach Madagascar early on Saturday morning, leaving us a few hours to get the ship ready for display after the rocky sail. Alas, once again we encountered obstacles. First, it was immigration. They required that we change docks in Cape Town (again) and then bring every one of us individually to their office to be stamped out of the country.

That took hours. During that short sail to change docks, we discovered a new hole in the exhaust of one engine. That had to be repaired before we could leave. (The ship is 35 years old...). Before immigration and repairs were finished, the weather deteriorated. High winds closed the port, and we couldn't leave.

And so, we finally did leave on Friday morning. The captain has been calculating the fastest path, using the currents to his advantage when possible, trying to make up for lost time. Fortunately, we haven't had to contend with any storms. The seas are rougher than they were on the previous sail, but not unmanageable. It's starting to seem normal to hear silverware sliding off the tables and see oranges rolling across the floor. Couches slide, chairs tip over, people fall. Thank goodness the tables are anchored--something to hang onto. A fair number of people are seasick, but so far, I've been OK, thanks to regular medication and occasional trips to deck seven to gaze at the horizon.

As an eye team, we have been meeting to hear the latest updates on the ever-changing plans for field service, and we are beginning to prepare materials for training the day crew once we get there. It looks like it will be a rocky beginning because the advance team simply hasn't had enough time to get everything in order. The eye clinic building, for instance, needs a fair amount of renovation before we can set up our expensive equipment, and they are just now hiring people to do that. It won't be ready as soon as we need it...so Plan B is...and so it goes, every day bringing new information and new difficulties to be solved.

It certainly keeps life interesting.

Eleven weeks ago we were set to sail for Benin. 

It has been a long process of transition as we developed new plans and worked on ironing out the wrinkles. Really, when you look at it, it is extraordinary how things have come together so quickly to go to Madagascar. It usually takes months to work out the protocols with governments; it took five days. Our advance team usually works for 3-6 months getting ready for the ship to arrive; they've accomplished a tremendous amount in 6 weeks, thanks in part to the excellent cooperation of officials at every level. It certainly seems that the Lord has opened doors for us, and we are getting pretty excited to see what lies ahead. Anticipation is becoming electrified in these last days of sailing.

Perhaps next time, I can tell you new things about the wondrous land of Madagascar.

Marilyn
 

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

Africa Mercy - Cape Town: One Nurse's Journey

What a breath of fresh air Cape Town appears to be. Marilyn's observations about the end of apartheid in the area are really encouraging. 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).

Cape Town
4 Oct 2014 Saturday

The rolling seas of my last email are now an ancient memory. We arrived in Cape Town last Monday; it was exciting to see land again...but tantalizing, at first. Due to immigration issues, we weren't allowed off the ship for almost 24 hours after arrival. I heard a rumor--I think it's probably true--that at one point they threatened to put all 350 of us in jail because we moved the ship from the immigration dock to our appointed berth when they quit work for the day on Monday, even though we were all still quarantined on board awaiting their pleasure.

Ah, well, that would have made a news splash, wouldn't it?

On the other hand, the government and the port authorities are certainly rolling out the red carpet for us. The berth they gave us is right on the waterfront, the tourist center of the town. A huge shopping mall, as nice as any mall I've ever seen, is practically on our doorstep.

Outside, there is a beautiful, clean, well-lit promenade all along the waterfront, with little shops and restaurants, street musicians, a ferrous wheel, and crowds of tourists just strolling along. It feels like a carnival, and it's safe enough to wander at will, day or evening.

Plenty of pickpockets, of course, so normal prudence is required. I can certainly see why this is a favored vacation spot for the rich and famous...and for much of Europe, too.

It feels like we are on vacation, but in fact, we are still working as much as ever. I did my last two days in the dining room on Wednesday and Thursday--exhausting, as always. I have the weekend off, and then rejoin the eye team on Monday. I'm not sure what all we will find to do, but I have a feeling that we will stay busy planning the details of the impending outreach in Madagascar and developing the training program for the day crew. At least it will be sit-down work for a while.

Meanwhile, folks higher up in administration have done a terrific job in organizing a whole bevy of tours to increase our footprint in South Africa. For the first several days, we have had invitational tours--one for 150 local pastors, one for Mercy Ship alumni, one for donors who attended a $1000/plate fundraiser luncheon, one for government officials, and some for groups I don't know who they were. Next weekend we will have three days of public tours on a first come, first served basis. They expect a crowd of thousands. There is a lot of publicity and a lot of interest. Everywhere we go, people stop us to ask about Mercy Ships. Is this what it's like to be famous???

Yesterday I had a real vacation day. A friend and I took a bus tour of Cape Town and the surrounding countryside. The buses run on a regular schedule, and you can hop off at any stop, look around, and hop back on the next bus. We spent a couple of hours in the botanical garden, one of the more magnificent gardens of the world. This region has had its own indigenous ecosystem, plants not found anywhere else in the world.

Much of it has been lost through lumbering, but now they are making a concerted effort to preserve and restore. At another stop, we watched seals swimming in the harbor. The bus drove quite a distance along the coast--spectacular beaches and ocean views. The rich and famous live there...

The most interesting and heart-warming stop, though, was to take a walking tour through the Township of Imizamo Yethu, one of the slum settlements that sprang up during apartheid as black people tried to live as close as possible to their jobs in the white community. I think the guide said that 20,000 people live there now. In some ways, it is like West African slums, with crowded ramshackle dwellings, high unemployment, and little material wealth. What is exciting, though, is what has been happening over the last twenty years, since the end of apartheid. This community, made up of multiple tribes, has learned to pull together to improve their lot. The streets are free of rubbish and of the smell of urine. Many houses have running water and electricity, even if the whole house is about the size of a large bathroom at home.

One house he showed us was a very nice home built by a volunteer group from Ireland, I think it was, in 2005. It had tile floors, a refrigerator, it's own bathroom, a TV, a kitchen. What stunned me was this: It had been nine years, and it hadn't been trashed. The guide showed us a school built by some German volunteers. The playground was clean, the equipment was functional. We saw a small library with clean floors, books carefully cataloged and available, children reading.

Again and again, I saw evidence that the people were taking good care of what they had been given. The churches in the community had banded together to build a community center. All sorts of ministry went on there: counseling, drug rehab, sewing projects, micro-business enterprises, job training. In the hour or so of walking through the community, not one person approached us to beg (unless you count the wee girl who asked for a sweetie...). People smiled and met our gaze. You could feel the sense of pride they had in their community--and well they should be proud of the progress they've made!

There is still a huge gap between the very wealthy and the extremely poor people, and their neighborhoods are in close proximity. Of course there are problems with crime. We are advised not to travel anywhere in Cape Town outside the tourist waterfront, except in groups. What is so encouraging, though, is that the country seems to be making a frontal assault on corruption. There are signs everywhere asking people to report it when they see it, and officials aren't asking us for bribes.

It seems to me that if a country can keep from civil war, have their tribes learn to live together in peace (which takes even-handed justice), and stamp out corruption, progress like I saw in Imizamo Yethu can happen, and the nation will be transformed. (There, that's my philosophy for today.)

Time for dinner. More another day.

Blessings, Marilyn

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

Africa Mercy - Catch That Plate: One Nurse's Journey

Marilyn's incredible journey continues as they travel to west Africa. The ship is at sea, bound for Cape Town, but the seas are challenging. 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).


"Catch That Plate"
27 Sept. 2014

We are nearing the end of the sail to Cape Town. We have had
smooth sailing and mostly clear weather until two days ago, making it quite an enjoyable interlude despite the long, exhausting days in the dining room. We have a lot of community activities during sails--you'd almost think we were a cruise ship (except, of course, we all work our shifts...). Normally the bow is closed--it's a work space and full of hazards for us non-sailor types--but on the sail, weather permitting, the bow is open for ocean-gazing. One can spend many hours watching for dolphins and enjoying the endless variety of colors in the ocean. On Sunday evenings, we hold our worship service on the bow, weather permitting--a treat that reminds me once again how special this community is, and how blessed I am to be a part of it.

Two days ago, the seas got rougher, as predicted. There is a strong head wind against us, which slows us down some and makes choppy white-capped waves. As I understand it , though, the source of the rough ride has to do with the currents and cross-currents below, and those are a factor of the geography of the ocean floor.

That's why it's always rough around Cape Town, and even worse between Cape Town and Madagascar. In the melodramatic stories of sailing ships rounding the cape, it's always storms that provide the crisis. It's rough enough without a storm...I can only imagine what a storm would be like.

As we go rocking along, we are mostly tilting ten to fifteen degrees, then the same amount the other way. That's enough to cause me to reel in a zig-zag fashion and stop abruptly when I meet the wall. Occasionally, though, we get a more dramatic roll.

Yesterday, at least one registered at twenty-one degrees tilt. Dressers fell over, cabinet doors flew open, and we quickly found out what had been adequately secured for the sail and what had not!

In the galley, food pans slid off their shelves more than once, despite all their precautions. Occasionally all the chairs in the dining room start sliding, occupied or not, not to mention the
plates and cutlery that aren't actively restrained. A few people
have fallen, but no major injuries. Sleep is difficult, with the uneven rocking, and listening to the banging and creaking of the ship. A couple of people are seasick enough to require injections, even IV fluids. I feel fortunate to have had only minor amounts of seasickness, curable with medications and gazing at the horizon for a while to give my inner ears a break. On the other hand, working in the dining room under these conditions is quite a challenge. If this were an airplane, we would be told to sit down and fasten our seat belts, and no dinner would be served...

We will reach Cape Town two days from now, assuming all goes as planned. We never did find an available berth in a dry dock, and I guess they decided that we could live with it until next summer's scheduled repair time. The current plan is to spend about two weeks in Cape Town, mostly doing promotional tours, while we wait for the advance team to work in Madagascar. I hear that Cape Town is a lovely place to visit, so it should be a lot of fun, even while we prepare for field service. Kathryn, the Eye Team Leader, has been planning several scenarios, but of course, everything is still pretty tentative, and will be, until we get there.

Well, I'm having to hang on to the desk occasionally as I type , and I hear something crashing around nearby that should be
investigated. So, enough for now. 

Blessings for all of you. Wish you were here...it's quite an adventure!

Marilyn

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

Africa Mercy - Madagascar, Here We Come! One Nurse's Journey

Finally up to date on Marilyn's emails. The Africa Mercy is Madagascar bound and likely in rough seas. Pray for the crew's safety and that Marilyn can handle the sea sickness! 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).

15 September 2014--Monday

"Madagascar, Here We Come!"

We are at sea--literally, instead of figuratively, which is a
pleasant change. We left Las Palmas Saturday evening, headed for Cape Town. The sail should take about 18 days, more or less,
depending on sea conditions. So far, we've had excellent sailing.
We got out of the Canaries ahead of a storm, and we have both sea current and wind pushing us along faster than we could otherwise go. They say the calm waters should continue for at least another day...but they predict rough seas further south.

I, for one, am easily troubled with seasickness. I'm faithfully
taking medication, yet I was borderline queasy yesterday morning, on these almost glassy seas. Oh, boy. What have I gotten into?

I'm going around the notorious cape in a boat? Me? This ship used to be a railroad ferry, traveling in protected waters. It has a shallow keel, so it bobs and rolls more than a ship designed for
open seas... Well, it will be "interesting."

We still do not have a dry dock birth in Cape Town, and we need
one. It seems that every "motel" is booked already--no place for
us to stay. We are praying that something will open up by the time we get there. And, I assume, the leadership is working on yet another "Plan B" in case there are no cancellations. So, any and all plans for what we do in Cape Town are still very much in the "fluid" stage.

On the other hand, plans for the field service are beginning to
solidify. We're going to Madagascar. Madagascar is a big country: 250,000 square miles, larger than California, almost as large as Texas. It once was reasonably developed, but not any more. I hear that even the main "highways" are often dirt roads. The people are extremely poor; health care is as scanty as in West Africa. There are 18 tribes, with racial origins as diverse as Polynesian, Indonesian, Arabian, Moor, and sub-Saharan African, but Madagascar is no "melting pot." Tribal rivalries and prejudices make governing very difficult. As elsewhere in Africa, corruption is rampant, making economic development difficult. In other words, its "our kind of place," a place that needs a lot of assistance.

Toamasina, where we'll be, is a small port city on the eastern side of the island. Open to the Indian Ocean, it experiences cyclones with some regularity. The rainy season starts about the time we get there, and lasts until about the time we leave. Sigh. That always makes things complicated--dirt roads, travel difficulties, people not coming for appointments. The city itself is quite small, which means that most of our patients will probably be found in the surrounding rural areas. Travel is likely to be one of the major hurdles we face, both for ourselves and for our patients.

We have an advance team in country already, working to gather
information and to set as many things in place as possible before
we arrive. I hear that they are doing very well--lots of meetings
with all levels of government officials, and the meetings have been quite productive. Information that the eye team needs is on the list of things to be done when time allows, but we don't have much feedback yet.

Meanwhile, work in the dining room continues. We've switched to an every other day schedule during the sail, which I think I will like even better than the two on, two off, and work every other weekend schedule that is the normal one. Yesterday was a work day for me, and apart from some seasickness in the morning, it went smoothly.

I tend to sleep for an hour or two between meals; it is enough to restore my energy for working the next meal. Today, I'll probably spend the afternoon on the deck, just watching the ocean. It is such an odd sensation not to be able to see land anywhere. We are a very small cork, bobbing alone in a very large bathtub. Of course, in this day and age, we are still connected to the world electronically. What must it have been like to be a small ship with no engine, no maps to guide, no information about "country next," no connection to the known world, and no rescue possible? Now that was adventurous!

Marilyn Neville

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

Africa Mercy - We Have a Plan...Fluidly Speaking: One Nurse's Journey

This from Marilyn on the Africa Mercy, the first week in September, the week of her 70th birthday! And here she goes again, off on another adventure in a very "far-away land." 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).

8 Sept 2014
"We have a plan...fluidly speaking"

It seems odd that I've been here for only a month--so much waiting and wondering, so many plans changed, and changed again.

Let's see...Since I last wrote, our leadership finalized their
decision not to go to Benin at this time. The situation was just
too precarious, and there was too much chance that we would make the situation worse by inducing people to travel and congregate.

Next, we considered returning to the Congo, where we had our last field service. Unfortunately, the situation in neighboring DRC was also precarious--sources told us that it was much worse than was being reported. The government of Congo preferred that we not come into their port at this time, for the same reason--we are a magnet, and people will travel to get to us.

So, where are we going? The latest plan is...________(I'm not
allowed to say just yet). I must admit, this country wasn't even
on my short list of possibilities. Looking at the map, I discover
that it is very far away! The sail will be long indeed--all the
way down the west coast of Africa, a stopover in South Africa to
refuel and replenish our supplies, and then another sail up the
eastern side.

Usually, it takes months to get a protocol signed with a host
country, even a country where we've been before. For last year's
field service, it took a year to hammer out the details of the
protocol with Congo. It took two months to finalize the protocol
with Benin, a country where we've been five times previously.
We've never been to "country next" before, but with them,
negotiations began one weekend and were finalized and signed one week later. Seems like God has opened a door for us, doesn't it?

Dates...are quite tentative at this point. The target date for
arrival in country next is October 25. We will deploy an advance
team to work with the government and with the port authorities so that at least the legal stuff (protocols, visa waivers...) will be
done and essential services (water, sewer, trash...) will be
available. Much of what the advance team traditionally does will
not be done, of course, because they have only 40 days. It means a slower, more gradual start-up for the field service. We probably won't have an eye clinic building waiting for us, or day crew hired, or screening sites located. Other departments will be
similarly impacted. But, I hear that this is the way we used to
operate, so this is a return to old patterns of arrival, not
complete chaos.

Meanwhile, work on the ship continues. The engineers successfully replaced the O-rings in the propeller shaft, but unfortunately, sea trials to test that repair revealed a second problem, something with the side thrusters. I'm not sure what they will do about that. The delay to fix the propeller allowed time for other repairs, too. They've been working on something electrical--we've had several blackout periods while they worked--and other less critical repairs. Other departments are working on special projects of various sorts, too, so the extended shipyard time has not been wasted.

We are also awaiting the arrival of two containers. We shipped
containers to Benin, our usual procedure...but it takes two to
three months to get a container, and we didn't know what country
next would be in time to send containers there. 

When it rains, it pours. Now, our massive freezer went on the
fritz. That repair is likely to cost $100,000 and take eight days.
Even paying the shipyard workers extra to work the holiday
weekend, this will delay our departure for another two days. So,
our proposed departure date is now September 13--if all goes well.

Once repairs to the ship are sufficient for sailing and the
containers arrive, we'll leave the shipyard in Las Palmas to sail
for Cape Town, South Africa. In Cape Town, the plan is to do some PR work--lots of tours of the ship, etc.--while we wait for the advance team to do their thing in country next.

We may also need to go into dry dock for repair of the side
thrusters. That is a bigger deal than just shipyard repair. You
have to lighten the ship of fuel and water and relocate all the
families with children to somewhere off the ship. We can't do it
here because we've already taken on too much fuel. The problem is, we're having trouble finding a dry dock with space for us in Cape Town. So, as you can see, plans and dates are still pretty fluid, developing and changing daily.

Faced with the prolonged sail, many people who came to help with the beginning of field service in Benin are going home early. Lots of goodbyes, and lots of rearrangements of staffing to cover the holes. I expected to work in the dining room for 2 weeks before transferring back to my "real" job on the eye team. I'm still in the dining room, and probably will be until late October. It is hard work, but not as hard as working in the galley or on deck crew. I get exhausted, but it is a good team to work with, and others do the really heavy lifting and mopping so I don't have to.

I appreciate their consideration!

All these details are not as fascinating as patient stories, but
perhaps it paints a picture of just what a complicated operation it
is to deploy the Africa Mercy to do those surgeries. Usually, all
that preparation happens smoothly in the background and doesn't get noticed, even by those of us who serve on the ship. Watching as these changing plans develop has made me appreciate all the more how many issues must be resolved to make a field service possible.

Now, if all goes according to the latest plan...I will celebrate my
70th birthday on the high seas, on my way to South Africa. My
chair might be rocking, but its not a "rocking chair." I'm on my
way to adventure in a far-away land. How crazy is that?

Marilyn Neville

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