More from my good friend Marilyn in Madagascar. She does a bit of touring with the staff in between setting up the clinic and sees the Lemur Zoo and Madagascar's famous rain forest. Would have loved to have seen the cinnamon and clove trees, and vanilla vines, and of course, the lemurs.....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).
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| Lemurs |
"Lemurs"
16 Nov 2014
The rainy season is soon upon us...so any sightseeing is best done now rather than later. They say we get over 3 meters of rain a year--that's a lot of water, and it mostly comes in torrential downpours, with hot, humid sunshine in between. Tropical rain forest weather, yes? I imagine roads suffer a lot of erosion, and travel becomes more difficult.
So, with that in mind, I took an opportunity to visit the Lemur Zoo, located in a rain forest less than an hour from here. I expected a "zoo," meaning a collection of penned-up animals. What a pleasant surprise! Yes, they had several species of lemurs in cages, but the cages were spacious and clean. Moreover, they only keep them there for a couple of years to help them breed and raise some babies, and then they turn them loose into the rain forest again. They put microchips in the lemurs before release so that they can track and study their habits. The whole focus is to preserve and stabilize the endangered lemur populations.
We watched the lemurs in the cages and the free-range lemurs in the trees overhead for a while, and then we took a hike through the rain forest with a guide. Our destination was a lovely waterfall, but all along the way he pointed out the various trees, vines, and other plants of interest. There is such an abundance of vegetation, so
much variety. We saw cinnamon trees, clove trees, vanilla vines, rosewood, ebony, various palm trees, bamboo, and all sorts of plants with medicinal uses. You really can find everything you need in a rain forest if you know what to look for.
The folklore of the Malagasy people is rich with this knowledge. Pam is normally the coordinator for the peri-op room where I work, but her mother needs her to come home for a few weeks. I'll need to learn the ins and outs of what Pam does before she leaves on Thursday, since I'll need to coordinate until her return sometime in January. We begin surgeries in two weeks, and of course, the day crew I'll be working with have never done this before. I think, though, that it will go smoothly. I already know most of what Pam does, and the day crew seem eager and willing to take direction, so supervision shouldn't be too tricky.
Meanwhile, we are searching for other sites for screening in nearby towns, still looking for patients who need cataract surgery. Kathryn will go north tomorrow, and south on Tuesday, searching for possible screening sites, talking to officials, and trying to make arrangements. Then we'll need to publicize, work out the transportation issues, and hope we can find the patients to fill the surgery schedule and keep the surgeons busy.
The next couple of weeks are filled with "secondary screening," meaning a full eye exam for the people found in the field screenings who might qualify for surgery. Oh, and we also need to set up our clinic before we can do the secondary screening...and the clinic isn't quite ready for occupancy yet. We're holding our breath that we can get ready before Friday, the day the first batch of patients are scheduled to come. I expect it will all work out, but not well in advance, with a healthy cushion for unforeseen difficulties. It's part of the ripple effect of having to change our field service at the last minute. I'll update you again once we get closer to starting our eye surgeries. Meanwhile, keep us in your prayers as we travel the "gravel road" (a slightly rough ride, but not too bad) toward that day.
--
Marilyn Neville
[Click here to learn more about the nurses and doctors on board the Africa Mercy.]
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.]
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.]
More from my good friend Marilyn in Madagascar. She does a bit of touring with the staff in between setting up the clinic and sees the Lemur Zoo and Madagascar's famous rain forest. Would have loved to have seen the cinnamon and clove trees, and vanilla vines, and of course, the lemurs.....Sharon
