Here vs Home (A Helpful Guide)

So. You're thinking about working in a developing country. Maybe even, perhaps, with Mercy Ships.
But you're wondering how different it will be, how things are done here vs how things are done there.

The answer: A LOT. So, I have compiled them into this handy list so if you ever decide, "hey! I could do that," you'll have a little help getting started. And for the rest of you, hopefully it's still mildly intriguing?

Number One: Reuse, reuse, reuse.

With limited funds, limited resupply shipments, and little to no reliable local resources for medical supplies, everything that CAN be MUST be reused! This means kidney basins, medicine cups, thermometer covers, ice packs, water bottles . . . I could go on, but I think you get the point. Unless it's irrevocably contaminated, it is washed and disinfected, or saved for the same patient to use again.

Number Two: Destroy, destroy, destroy.

An unfortunate fact in developing countries is that if something can be reused, it will be. This is fine in the above scenario, as long as it's done appropriately, and within reason. When empty medication vials, syringes, IV tubing or bags is scavenged, refilled and sold for cheaper than at a legitimate pharmacy, however, you have a problem. You have a black market. One that is very enticing to people who can barely afford to eat, let alone pay medical bills. People WILL buy their own medication or syringes for cheap on the street, and bring it to the hospital for the staff to use. Yikes.

While I'm all for value, catching HIV, malaria or hepatitis is (by Grabthar's hammer) not worth the extra savings. Therefore, we must destroy anything and everything that could be reused. Lines and bags get cut apart, holes poked in bottles or vials, and labels removed. Any contaminated waste (except glass) is incinerated on the ship.

Number Three: Magnets are your best friend.

Ships are made of steel.
Magnets, therefore, stick to almost every surface on the ship.

We, therefore, use magnets in lieu of nails, screws, and other such fasteners, for just about everything.

Need to hang curtains? Here, use a magnet.

Need a clothesline? Here, tie it to this magnet.
Need to stick your water bottle somewhere? Here, hang it on a magnet.

I  bet you think I exaggerate. 

We have monster magnets.

Number Four: World's shortest commute.

If you're tired of driving 1-2 hours to work every day, as so many in southern Ontario do, then this is the place for you. My commute consists of this: 

• Step out my door.
• Walk 50 meters aft.*
• Enter B Ward.

Awesome.

Number Five: Improvise.

As mentioned, sometimes adequate supplies can be hard to come by. In addition to reusing as much as we can, we also repurpose a lot of things. 

Take this empty medication bottle for example. Garbage, right? WRONG! Cut a hole in the base, and you've got yourself a spacer (aka aerochamber) for an inhaler. A spacer makes it easier for the medication to be fully inhaled, by allowing it to mix with the air. Like so:

Or, say a doctor asks you to check your patient's height, because she looks much taller to him than 169 cm. Just grab a measuring tape, right? WRONG. We don't have those. Of course not, why would we have those? So, we grab some yarn from the knitting supplies (because yes, we have knitting supplies but not measuring tapes), measure the patient with the yarn, then measure the yarn with a 6 inch ruler. Oh look. 169 cm.

Number Six: Your paycheck comes every day.

This is probably the best difference between here and at home. My paycheck here doesn't come with taxes, union dues, and a night shift premium. It doesn't even come with a dollar sign. It comes with ear-to-ear grins and giggles, subtle nods, high-fives, and hugs. And it comes every day, not just every two weeks. It is the best paycheck ever.

Number Seven: All the Nautical Terms!

As this hospital is a ship, not a building, you have to get used to translating things. Not just into Malagasy, or French, or whatever your colleagues' first languages are, but also into nautical terms. The front of the boat is the Bow, or Fore. *The back is the Stern, or Aft. The middle is "midships." Left is port. Right is starboard. Standard stuff. The hallways aren't hallways, they're corridors. The doors aren't doors, they're watertight death traps that will crush you if you get in their way once they start closing (but don't worry, there's lights and sirens to scare you off if that happens). The staff are actually "crew." The kitchen is the "galley." And don't you ever. Ever. EVER call this a "boat." That's like telling a pilot he flies a "plane." Just don't do it.

Number Eight: Be flexible.

You never know what the day is going to hold. You might be working with fistula patients, or you might be working with babies. OR, you might be working with other nurses who got injured while spending time off ashore. You might be staying in Tamatave, or you might be setting sail to escape a tropical storm. OR, you might be STAYING in Tamatave during said tropical storm, to care for our patients who will get moved to the Hope Centre (which is, supposedly, hurricane proof). You might be sleeping for your night shift, or you might be woken up by the BLAZINGLY loud fire alarm: "BWAAAAAAAAAAAAAAAAAAAAA - THIS IS A DRILL, THIS IS A DRILL, THIS IS A DRILL." You might have a hot shower, or you might have no water at all in your cabin. Or in the other 8 bathrooms you try. There's always the pool, right?

Number Nine: "Time off."

So you have a day off. You're bored. You've gone for a swim, done your laundry, done some reading. Now what. Why, visit your patients, of course!

This sounds crazy, and back home the last thing in the world I would want to do is go into work on a day off. But here, it's as simple as popping down the hall, saying, "SALAMA!" (hello), and plopping yourself down next to a patient with some crayons. Or get a group together, spontaneously dress up in wacky clothes, and storm the wards singing "Dimy bey!" in Malagasy (gimme five!). Or run up to deck 7 in the afternoon and tow a giggling bambino around in a wagon (I may have taken a break from blogging to do just that today).

Number Ten: Everyone loves being at work.

This is probably the single, greatest difference between working here, and working at home. Now, don't get me wrong, my co-workers at home are amazing, the great majority of them are AMAZING nurses, and they genuinely love providing good care to their patients. 

Something changes, however, when money exits the equation. When your patients aren't just being treated for an illness, but life-long debilitation. Senority, overtime, scheduling disagreements, grievances, lay-offs, corporate politics. . . these don't exist here. So much stress just vanishes when the job is purely about giving your best for your patients, and getting nothing in return but this: