Yes's & No's

One of the more difficult things to wrap your head around about the work being done on the Africa Mercy is the "no's."

There are a number of reasons patients would be disqualified from receiving surgery on board. They're all very good reasons, formed over decades of experience.

That doesn't change the fact that it's hard to say no. It often hurts.

The seemingly endless lines are sobering - though I've never seen them in person, I have met many people throughout the country who ask, "I have a hernia, can you help? My uncle is blind, can you help? My mother can't walk, can you help?" I have also had to explain to patients, on occasion, that although we had tried our best, there was nothing more medically that we could do to help.

One of my friends (and current cabinmate) Maddy is part of the screening team - the ones who decide who to say yes to, and who we must turn away. They have, without a doubt, one of the hardest jobs here. There is a lot more involved in the screening process than meets the eye, however, as I've learned from Maddy this year.

The first (and most visible part) of the screening job is to select, from thousands upon thousands of hopefuls, the best candidates for our surgical programs. Here, in Senegal, the Ministry of Health is also involved in this process; local physicians in each region of the country are doing initial assessments before our screening teams arrive. Those who fit certain criteria are then asked to return when our screening team visits that region.

Risk vs Reward

There is a very specific list of surgeries and procedures we can perform on board, and a very specific list of factors that would immediately rule surgery out. It is not easy to rationalize these decisions when staring into the face of someone who is hurting. It's hard to think about the big picture when facing an individual in a difficult moment. The fact of the matter is, however, that charging into any kind of humanitarian work headstrong and reckless often causes more harm than good, despite the best of intentions. I don't think I can say that what we do is the best solution, but it is one carefully thought and developed in collaboration with local professionals, officials, and experts in this field. 

The goal, in essence: provide the greatest possible improvement in quality of life, for the greatest amount of people possible, with as little risk of harm as possible.

Easier said than done.

The most clear-cut factor we consider is a patient's age. Over the age of 70, the risks of most surgeries far outweigh any benefit that might be gained. Recovery tends to take longer, have more complications and setbacks, and (harsh though it may sound), younger patients will have more to gain from their improved quality of life after surgery. More years to make the most of their new mobility, restored dignity, or repaired vision. Life expectancy in Senegal is only 67 years. 

The list of surgeries we can offer our patients is limited, in part, for similar reasons. Some surgeries would be incredibly high-risk, with very poor odds of recovery, and would be genuinely unethical to attempt. Some we simply don't have time or space to fit in, with our limited schedule and resources. Sometimes we don't have a surgeon who is willing to serve with us who has the necessary training and experience for a certain procedure. 

The resources of our host countries are also taken under consideration. With more and more of an emphasis being placed on mentoring and capacity building, we want our surgical programs to mirror those which exist (or are at least feasible) within West Africa. It is no good teaching a surgeon laparoscopic surgical techniques if laparoscopy is (for the foreseeable future) unattainable in most African countries. 

The 'C' Word

Another challenging factor to consider is cancer.

Tumor removals, of various kinds, make up a large part of our surgical programs. We advertise widely about it in our screening announcements. 

Things get complicated if we believe a tumor to be malignant. In most cases, surgery alone is not an effective treatment against cancer. Radiation and/or chemotherapy is usually necessary, and, unfortunately, is hard to come by around these parts. Available - potentially - but expensive. This is a really good article by the BBC about the barriers facing cancer patients here in Senegal.

You'll notice I said 'most' cases. There are a few situations where we do consider surgery for patients with confirmed, cancerous tumors. If our imaging shows no metastases, if the cancer is very localized to one area, if it can be removed intact with wide margins, and if it's believed removing it will provide a reasonable extension of life...then and only then will we consider surgery for them. In almost every other case, as we cannot provide long-term, ongoing oncology care, it would be unethical to operate. We would be causing pain, trauma, and a lot of risk for little to no benefit.

The main case where we would do often go ahead with surgery is breast cancer. It turns out that surgery alone is a reasonably effective treatment for breast cancer, although, most of the data on the subject is decades old. Recruiting research candidates for something potentially life-threatening, when a certain treatment regimen is proven to be quite effective - again, kind of unethical. What research we do have (from the 90's) seems to indicate a 5-10% higher risk of the cancer returning when treated with cancer alone. Not ideal, but if it's the only option you can afford, I daresay it's better than the alternative. We can potentially extend life by 10 years or more with just surgery. Worth it. 

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Next blog I'm going to have my friend and cabinmate Maddy (a screening nurse) answer a few FAQ's. If you've got any questions about the screening team's responsibilities, or the patient selection process, please drop them in the comments below, or on facebook.

À la prochaine,
-D

Pics or It Didn't Happen

It's been a bit. I've been here over two months now, and that means two things:

1. A lot of the nurses I've gotten to work with and love are leaving me now...
2. Photos of said nurses and our wonderful patients are now available!

Really grateful I've been given the opportunity this year to do ward photography, which allows me to give the rest of you a little window into my work environment! I use the term 'work' loosely. As you might have heard me say, and as these pictures show, it often doesn't feel like work. It's a privilege and a joy to spend time caring for and loving on our patients, and often very entertaining!

I've probably said it before, but I think it's worth reiterating that any patients in official photos which are shared outside the organization (including these ones) have signed (or their guardians have signed) a release form permitting us to do so. Time is taken to explain to each one that they will receive the same care whether they agree to promotional photography or not. It is a weird thing for most of us in healthcare, but it is these photos that give supporters like you a way to understand the plight and transformation of those we have come here to help. We are very grateful to those who are willing to share their stories with the world, because they pave the way for us to help others like them. 

This is Aliou, and he is so stinking cute. The past month or so has seen a lot of plastic surgery patients come through our door, and many have burn scar contractures like his. As you can see, the scars prevent him from extending his arm, greatly limiting his functional capability. Contractures like his also often worsen as kids grow - our lead Plastics surgeon, Dr. Tertius Venter, spoke of one young woman he treated in Guinea who was essentially  locked in the fetal position due to her burn injuries.

Osuman here, giving Dakota a lovely braid, had a similar burn to Aliou. As you can see, though, she's had her surgery (which usually involves cutting the scar out, pulling a flap of localized, healthy skin over the joint, then transferring skin grafts from elsewhere to the rest of the arm), and her arm is all bandaged and splinted up. Movement is the numero uno danger to those grafts healing well, so the dressings usually stay intact for at least two weeks. You may have also noticed the little tube in Osuman's nose. Because our patients' diets are often lacking so much of the essential building blocks of the immune system and the healing process (proteins, vitamins, and minerals), we build them up with as much extra nutrition as we can. This includes protein supplements in liquid, powder, and paste form. New this year, we've been trialling adding an extra "meal" in the form of overnight tube feeds - which so far seems to make an incredible difference in the speed of healing.

It takes a lot to grow all that new skin, so we try to give each patient the best chance possible.

These looong extended stays in hospital, waiting for that first dressing change, mean that we get to know these patients very well. They are a family, truly and honestly...and everything that comes with it. Sleepy-head teenagers, teasing and bickering, and covering for each other when one doesn't want to drink their nutrition supplement. There are beautiful moments too, though, like a father ducking out into the hallway to eat so his son (fasting for surgery) doesn't get upset. Comforting another patient who's in pain, or a baby whose caregiver stepped out to make a phone call. Painting each other's nails, and helping each other open containers with their non-bandaged/splinted hands. It really is one big, uniquely beautiful family.

A great group of moms brought together by their children's differences

A Ward evening crew!

Beautiful Mame Diara & Tenin with nurses Amy & Alyssa

TECHNICAL (POSSIBLY ICKY) JARGON BELOW 

Last night we had the privilege of hearing Dr. Tertius speak about the plastics program, and the new procedures that have been pioneered right here on the ship. With each procedure, there is a "design" stage of surgery, where the skin for the graft or flap is selected, and the planned incisions are drawn on. The most remarkable procedure he explained is the Hemi-Scalp Flap or "Africa Flap" - developed by Dr. Parker to treat noma patients. In this procedure, a U-shaped flap of the scalp is taken, rotated down over the face, and the end sutured in over the defect. This leaves a bridge of tissue, including the blood supply, from the origin of the flap to the new site. I've done my best to illustrate this below. The flap stays in place until the blood supply is well established and the flap has begun to heal, then the excess is put back in place. The crazy thing about it, though, is that the direction of blood flow reverses in this flap after it is moved.

It's a rough drawing, but the purple arrows show the usual direction of arterial blood flow up into the scalp. Within 10 seconds of excising the flap, Dr. Tertius said, the blood begins to flow the other direction through the section of flap that is rotated.

Just wild. There's a big document here that goes into quite a lot of detail (and pictures!) about these types of reconstructive procedures, that you can check out HERE.

I have to go, my friend just arrived with scissors to help me try to DIY one of my favourite board games. So with that, I shall leave you.

À la prochaine,
        -D

Where are we?

What country are we in?

The Captain asked that question at the weekly communication meeting.

I'll give you a hint - it's not Senegal.

I may have mentioned it before, but the flag state of the Africa Mercy is Malta. As long as we are aboard the ship, we fall under Maltese and EU law. I've never technically set foot in Malta, nor does my passport carry a Maltese entry stamp, but every time I step down off the gangway - in theory - I'm leaving Malta and entering Senegal. The screening, outpatients & rehab teams down on the dock sure have a heck of a commute if you think about it that way!

Gives a bit of a different meaning to our 12 month, multiple entry, Senegal visas (which we were still waiting on up until the last couple weeks).

The Maltese flag flies from our stern, and the Senegal flag from our foremast. Another example of how this ship feels like being in 50 places at once.

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We've had some challenges with getting our regular supply shipments released from customs (which is usually par for the course). This has made for some creative meal solutions by our galley crew, but we've had an ample supply of beef, in any case. This is in part thanks to the Senegalese President's promise to provide us with a cow every day we are here. He is Fulani, a culture of nomadic herdsmen in West Africa, and so this gift is both practical and meaningful coming from him. Sadly, we have not seen any of these cows walking up the gangway...but they're getting in somehow. Our meals have been evidence of that. He's also providing us with fuel to keep our generators running - keeping the lights on in this place - which is no small contribution either. 

It is a good reminder that we are visitors in this country, here to serve the Senegalese - but at their invitation - and they have graciously welcomed us with love.

Our worship service this Sunday took place up in the open air on deck 8, under a half-moon, and was a beautiful time of old songs & new, from close to home and from afar. It's always encouraging to see the whole crew, from so many different countries and cultures, coming together in song.

Baba Oluwa Oshe - "Thank You Father God" - a Benin classic.

Hospital Update

 The ward I call home (A Ward) is full of 'visitors' at the moment - overflow from the MaxFax and Plastics wards. This is a challenge as one of the people who newer nurses go to for questions! These are not the specialties I have the most experience with, so it has been very much a team effort, with a lot of help and hand-holding from the other wards, to give these folks the best care possible.

I say it a lot, but it never gets old how happy and willing to help everyone is in this hospital. Even when we're dealing with colds (which are rampaging through the crew at the moment), everyone from the bottom of the food chain to the tip-top managers are powering through.

A few days ago we had a bit of a brutal storm rip through very unexpectedly, which caused some damage, mainly to our tents & dockspace. This one you see below, Jane, our gracious Ward Manager - who could have very easily delegated this off to any number of underlings - was right there in the sweltering heat lugging supplies around and re-organizing so we could continue our programs without interruption.

Don't worry, that's not a real patient. ;)

I promised updated photos of Saliou (the very first surgical case this year), so here's some!

I've been granted permission to do ward photography this year, which means I'll actually get to post photos I've taken in the hospital (with - of course - written consent of the patients)! Stay tuned for that. 

Also, you might have seen this photo circulating on social media recently, of all the ward nurses:

I'm there, I swear, but I'm short and hard to see. See?

I had a dear friend depart last week, and it certainly feels a bit different without her around to hang out. She is, however, returning in January, so I'm eagerly looking forward to that!

Last meal out with Suzanne (second from Left) ♥

With that, I shall sign off for now or I will miss lunch. 

À la prochaine,

        -D

A Whole New World

I guess it's been almost 2 weeks since my last post - which, to be fair, is probably the standard I should be setting for myself anyways. Finding time to write every week is challenging!

During those 2 weeks, we've had a very successful run of general surgeries, where we treated many a hernia and lipoma (soft tissue tumor). Our ward has by far been the least busy, with most of our patients going home day after surgery - allowing us to close completely over the weekends.

Things are about to change, however.

For the next 4 weeks we'll be home to the double load of MaxFax (Maxillo-Facial) patients that are about to roll in. Normally these all live on D Ward, but with two ORs and four surgeons rolling, their 15 beds will very quickly be MaxFaxed out (see what I did there...). We will be taking mainly less complex and/or more healed patients, but it will still be quite a different sort of nursing care. I've floated over to D Ward plenty of times, but there's just so many diverse types of MaxFax surgeries that there's still always new and unfamiliar things to learn. Though it does mean dealing with a good deal more saliva/drool than I'm used to...at least it also means I get to love on the little cleft lip kids like Saliou! He was the very first surgery done here in Senegal.

Hopefully soon I'll have more recent (post-op) photos of Saliou. He's cute as a button.

In the meantime, a couple pics from Deck 7 play time!

This cat looks cute but he can be a little bit of a troublemaker...

Bubbles & Jenga & Balloons - the Deck 7 Trifecta! (notice me hiding in the back?)

As we're stepping into this whole new world of MaxFax on A Ward, the Academy teachers shared a relatable rendition of the Disney classic during karaoke night a few days ago:

To adapt to hospital life, substitute "syringes" for "pencils" rolling away,  and "magic stretcher ride" for "magic lifeboat ride."

Also...this happened. 

It is fun to stay/work at the AFM. 

Right now I'm on an extended long weekend, which has been a nice time to unwind after 2 very busy weeks. I'll be starting into night shifts Wednesday to Sunday, though, so if anyone wants to catch up and chat, this is a good week for it! 

Substitute "shift work" for "traveling"

Well, that was a bit of a hodge-podge of a post, but hopefully by next time I'll have more patient pictures and stories to share.

À la prochaine,

-D

Speaking the Same Language

I just happened to start listening to the Come From Away soundtrack the other day. I haven't seen the show - didn't get the chance this past summer - but the soundtrack seems to tell just about the whole story.

If you don't know anything about it, Come From Away tells the story of the 38 aircraft that were diverted to the small town of Gander, NL on this day, 18 years ago. September 11th, 2001. There's some language in the soundtrack (they're Newfies after all), but it sure is powerful.

One of the songs struck a chord with me. Just for context, this is after the passengers were held on the tarmac (some for 28 hours), released (some after questioning), and carted off on busses (many still not knowing the day's events) to various community buildings. This particular moment between a passenger and a bus driver really gave me pause. Have a listen.

"And that's how we started speaking the same language."

Whew. What a little window into the confusion and fear of being in a foreign place surrounded by strange people speaking a strange language. So many of our patients must feel this way when they first come aboard. Fortunately, we have help in speaking the same language.

At Peace

Wolof is the language spoken by about 40% of Senegalese, along with a number of variant dialects, and a couple dozen other languages in various regions inland. In Dakar, an urban dialect of Wolof is spoken - a blend of Wolof, French, and Arabic. Coming from the strong Arabic & Islam influence, "Asalamalekum" is the most common greeting. Much of the language (particularly greetings) revolves around peace, and, as in most "hot cultures," greetings go beyond "Hi" and "how are you" to "how's your family, your home, your health, your journey, etc, etc, etc..."

Thanks to our lovely day crew I've picked up a few key phrases; ready for a survival Wolof primer?

Asalamalakum (Peace be upon you)

     Malekum salam (And you also) 

 Na nga def? (How are you?)

     Mangi fi / Mangi fi rek /Jamm rekk 

     (I'm here / I'm here in peace / I'm at peace) 

Jerrejef (Thank you - literally, "the act was worth it")

     Nyoko bok (No worries)

Baal ma (Excuse me), Massa (Very sorry)

Waaw (Yes), Deedeet (No)

There you go. Now you can survive - or at least bring some peace into the conversation - if you ever visit Dakar.

Be benen yoon ('Till next time),
-D

Bedknobs & Broomsticks

I've been aboard two weeks now, and they've been full of cleaning, organizing, training, and planning.

The dream set-up team!

Cleaning every single duplo block...

Some nefarious person put 2 VERY similar looking syringes all together in a bag that I had to sort through...

Deep-cleaning everything, even the shower drains!

Week one there was a fairly small group of us (around 20 nurses); mostly alumni with a few first-timers; working to unpack, clean, and set-up the wards. Those who had sailed in from the Canaries were astounded as we were getting as much done in one day as they had managed the entire week before! With many hands, we had floors scrubbed & buffed, beds up, shelves stocked, and the hospital looking like an actual hospital, in no time.

Terrible photo of me, but the ward is looking great!

Of course, we had to keep ourselves entertained in the process. The antiseptic fumes may have contributed a bit too...

Towards the end of the week we got to meet our Ward Day Crew (the local staff who are hired to work as aides and translators) in a whirlwind of an afternoon. Small groups ran through our 11 stations learning about various duties, precautions, and protocols they would need to know to support our patients. We only had them for about 15 minutes (of mostly us talking), so it was a very brief introduction, but still exciting to meet them all. 

After a relaxing weekend, Monday morning brought the start of MASS NURSING ORIENTATION. About 30 more had arrived, some alum but mostly newbies, and they received a week of in-depth training to give them a good, solid start into the year. Nurses arrive & depart nearly every weekend throughout the field service, and most only get a day of in-class orientation, but this cohort will be setting the standard and orientating new arrivals themselves in the months ahead. I had a mixed bag of tasks in the meantime, attending and helping with some of the training sessions, while also helping to finish up the odds & ends still unfinished on the wards. 

Jenny & I repairing torn mattresses! They'll be used in the HOPE Center.

Delicious brunch put on by the hospital ward leadership

We also had some interesting events throughout the week, including a Hospital evacuation drill! This isn't something we would really be able to practice once there's real patients in the hospital, so the new nurses played patients and the rest of us assisted in their safe journey out onto the dock. Walking up 2 flights of stairs then down the steep gangway is not exactly easy for most post-op patients, so we use the pilot's entrance right in the middle of the hospital on Deck 3. I got to watch first hand from the eye room with my "cataract patients" as one of the deck crew opened the double-doors up and set out the narrow emergency gangway. Sietske (pictured below) and I then guided our patients across to safety on the dock. This was a full-ship drill, and screening was in full-swing on the dock, so there was quite an audience as the whole ship emptied out - some "patients" being carried out on stretchers, others with bandages and slings. 

Our patient & brave "eye patients"

Also last week was the Hospital Open House. This is a chance for the ~150 non-medical crew members on board, plus some of their children, to see what it's like to work in the hospital. Even the operating rooms were open to visitors (getting a thorough scrub-down after, of course). We had all kinds of activities for visitors to try out, including "eye surgery," injections, naso-gastric feeds, plaster casting, and emptying catheters. I had the role of a patient caregiver, which meant I was "sleeping" under the bed where the catheter needed to be emptied, and popped my head out every now and then to say hello. 

The Ponsetti method of progressive casting to correct clubfoot

Suzanne & Nicole - the "Women's Health patients" whose beds I was hiding under (it's apple juice)

Me and my "caregiver baby" - if a patient is breastfeeding, a family member needs to come with her to help care for baby

Visitors had to track down the right patient and medication record to give them their "pills"

Rahel being a *very* good sport to demonstrate a realistic ICU patient!

We spend the whole morning yesterday with our A Ward nurses & day crew yesterday, getting to know each other much better. The day crew are all lovely, and SUPER SMART (some of them have master's degrees!), a few are real jokesters, and I'm really looking forward to working with all of them. We have one gal, the rest are men - and she was a last-minute addition that we weren't expecting, so it was a nice surprise. They taught us lots of helpful Wolof phrases, which I'll share in another post.

Just as orientation wrapped up yesterday, I sat in on the chaplaincy presentation for the new nurses. While the chaplaincy team does, on the one hand, run the "church" on board, they are also here to support the crew emotionally, socially, and practically. They gave a lot of helpful tips on getting by in such a tight-knit community; there are also a couple of counselors available to support the crew. It's easy to feel both lonely and socially exhausted at the same time - which sounds counter-intuitive, but is very true. I'll end with a very insightful thought from that presentation:

"If you have to chose between being kind, and being right - chose kind. Then you'll always be right."                                                                                                                                                                         - Tammy Dunne, AFM Chaplain

I'll not be able to take near as many pictures of my day-to-day after this weekend, as patients will be filling our beds starting Monday. I will, though, do my best to keep you all up to date as the Field Service switches in to high-gear! Surgery starts Tuesday, Sept 10th.

That's all for now,
À la prochaine,
-D

Our Boat

My journey was safe, I'm settling in, and I have been back on board our lovely AFM (Africa Mercy) for a week now. This weekend I finally have some down time to catch up on this post (which I started a while back).

It was pretty neat flying in and being able to see the line where the Sahara ends and the Sahel (transition) region begins.

^ Sub-Sahara                                                 Sahara ^

Any of you readers out there who have been following me for a while will remember that I try to do a bit of a primer on countries I'm about to visit. I've found it to be quite valuable for my own preparation - it helps me to be familiar with the culture, history, and geography of the place before I arrive. Many folks show up (especially their first time) with little to know real knowledge of the place they're in! Perhaps they prefer to learn by first-hand experience, but I've found that having a bit of awareness of the heritage and current affairs gives you a little more credibility in certain situations.

On my first visit to the AFM, in Madagascar, I had a daily fact for the entire MONTH leading up to my departure. I obviously missed the boat, *cough* so to speak, *cough* this time, but I will sprinkle some knowledge in this post.

History & Legends

There are several possible explanations as to where the name of the Senegal River, for which the country is named, originated. My favourite theory, however, is that it came from the Wolof phrase "our boat," or "Sunu Gaal." Seems rather fitting.

*breaks into song*

♪ Our ship, in the middle of our port... ♫

Speaking of Wolof... The descendants of the Wolof (or Jolof) Empire, and later Kingdom, are one of the main people groups still inhabiting the region. The founder of this empire, Ndiadiane Ndiaye, is said to have mysteriously appeared out of a lake in the midst of a fierce dispute between two rulers. Ndiadiane equitably divided the wood they were arguing over, then disappeared back into the waters. When Ndiadiane returned to settle another dispute (this time a ruse), the rulers captured him and offered him leadership of all their lands. Oh. And a hot wife. Ndiadiane took the offer, forfeiting his immortality, and all the nearby rulers gladly joined in to his new empire.

The region changed hands several times in the following centuries - during which time the trade of captured enemies as slaves became commonplace - before French colonialism took hold.

Eventually, in 1960, the Republic of Senegal became a fully independent nation, and held their first democratic election in 1963 (although there was only one presidential candidate). The nation has had a relatively peaceful and stable government since then, certainly compared to many of its neighbours.

Speaking of Neighbours...

Within Senegal's borders is a most unusual country: The Gambia. This little country is a small swath of land, no more than 50 km across, which follows the Gambia river from the Atlantic coast about 300 km inland. Because it has some coast line to itself, it is considered a semi-enclave (a country contained entirely within another country). There's your fun geography fact for the day.

The Gambia holds the interesting distinction of being one of only four countries to denounce and leave the British Commonwealth, only to rejoin it later.

It's also the reason the map of Senegal reminds me of a heraldic lion.

See the resemblance?

Dakar Life

The capital of Senegal, where we are docked right now, certainly feels very different from other African cities I've visited. Sure, there are the usual wandering fruit vendors, the smell of open-air meat markets, and the lack of traffic rules. The overall vibe, however, is more touristy. There are more Europeans around, more wealthy locals, and a LOT of people jogging and working out. Not exactly something you see unless people can afford to work off extra calories. Senegal is certainly better off than most countries in West Africa - it's a tiny bit higher up the Human Development Index (164/189), and has made substantial gains in urban quality of life over the last few decades.



As you can see, they're making progress in some areas, but about 39% of the population still makes less than $2 a day.* Rural regions have fewer resources and social supports available to them, and this is why our screening teams are focusing on these remote areas. 75% of our patients will come from upcountry - these are our priority - while any referrals from here in Dakar will be put on a waiting list.
* Source: UN SDG Country Database

Our Bowl

The other day I learned about Thieboudienne or "Chebu Jen," a traditional Senegalese dish that I look forward to trying. The appeal of this dish comes not from the ingredients (it sounds like pretty standard fare - rice, fish & veg), but the way that it is served and eaten.

The large bowl is placed on the floor, where the meal is shared by all. Each person gets a wedge of the bowl, and the host divvies up the fish and veggies in the center as you go along. If that isn't the most profound metaphor for the beautiful, community-oriented culture I've come to love in Africa, I don't know what is.

Speaking of profound food....there's a pile of pulled pork calling my name right now, so I'd better sign off.

À la prochaine,
-D

Countdown

Well.
Now that another successful Brunch for a Cause is in the bag (huge thanks to all who attended and made it happen), I'm suddenly faced with the reality that I leave in less than a month! I had been focusing all my energies into preparing for last weekend's fundraiser, and that was my excuse for putting off other things.

I no longer have an excuse!

So, now, I'm looking around my apartment thinking about everything that needs to be packed up and stored, how I am going to decide what to take and what to leave, and thinking that packing for 9 months is going to be a bit different than packing for 2 or 3! I may not really be able to bring more things along, as my storage space on board will be the same tiny closet + 2 shelves as always. I am working on a list to ship some essentials (toiletries mainly) a few months in so I don't run out, but also don't take up too much room in the cabin.

Meanwhile, I keep tabs when I can on the current goings on aboard the ship, and with the Advance team preparing the way for us in Senegal. Here's a couple updates I thought worth sharing!

From the Advance Team

In Senegal, as we speak, and for the last few months, a team of experienced Mercy Ships volunteers has been scouting locations, shaking hands, and making all the necessary arrangements for a smooth arrival and field service. This is, as I've mentioned, the first time Mercy Ships has visited Senegal*, so it is a lot of new ground to break. We have to have written agreements covering immigration/visas, healthcare provision, local employment, transportation, and more. Speaking of employment, the HR side of things just shared that they have received a whopping 2,100 applications for day crew positions. They are currently in the middle of the interview process, and I am excited to meet the Ward Day Crew team they will end up hiring!

*Correction: The first time the Africa Mercy has visited. The first Mercy Ship, the Anastasis, carried out a 4-month field service in Senegal back in 1993.

From Shipyard

The Africa Mercy has spent the past couple months getting sanded, blasted, upgraded, repaired, parts replaced, old carpet torn out and new hardwood put down, and a shiny new paint job to boot. It has just gotten out of dry dock and back into the water, and will be very soon departing the Canary Islands to set sail down the coast to Dakar! 

10 months of wear & tear

2 months of R&R (repairs & restoration)!

I suppose this has been enough procrastination now, and I must get some things done around here!
Thank you all for standing along side me in this journey.

À la prochaine,
-D

Every Sound of the Drum

Just came across this incredible music video that summarizes the history of both West African music in general, and Senegal itself. It's dated, and cheesy, and there's reggae-style rap - and I love it a lot. Stick around 'till the last minute for the history lesson. It does a far better job than I would likely have done in my not-yet-written post about the country.



I really can't top that.

Now watch this - and hope to see you on Saturday!


-D

Art Attack

Life always seems to get ahead of me when I'm at home, and it's harder to find time to sit down and write. I actually started this post back in May, and I'm only just getting around to finishing it. Sorry.
So I guess that means it's time for:

A quick update!

Mercy Ships Canada has changed their donation system, meaning my donation page has changed.
It can now be found HERE, or tinyurl.com/crewmate2 also works if you'd like something short and easy to share.

A few items of thanks

I'm fortunate enough to have very flexible landlords who have arranged a short-term sublet of my furnished apartment while I am away, meaning I only have to pack and store my personal items. Most of my larger belongings can hang tight right where they are.

I had a little money that carried over from last year's fundraising, and a few new donations came in; just enough to book my flights to Senegal. I now need only cover my costs for monthly crew fees.

My wonderful parents, and good friends Rob & Sue are already getting the ball rolling on our (now) traditional brunch fundraiser. I'm so grateful for their eagerness to support me, and seemingly boundless energy! PS IT'LL BE JULY 27TH SO BE THERE AND GET FED.

Now that that's over with...

On with the post!

The Africa Mercy is a pretty neat ship - granted, I haven't been on that many ships - but I suspect it has a fairly unique list of ports of call compared to your average passenger liner. In its journeys, from its time as a Danish train ferry to its current life as a hospital ship, it has visited a good chunk of the world. Serving in this particular part of the world, where culture is as deep and rich as the red sands of the roads, that culture has rubbed off on the AFM (and I don't just mean the harmattan dust).

There is a veritable smorgasbord of (mostly) West African art adorning the walls and corridors, many of them gifts of gratitude, from the nations where the ship has served. Since I'm currently just hanging out at home with not much news to share, I thought this would be a fun little filler post to bide us over. Therefore, I shall now shut up and let the art (and a few quotes from everyone's favourite painter) take over from here. Click on any pic to embiggen.

“You have to allow the paint to break to make it beautiful.” ― Bob Ross

 “We don’t laugh because we feel good, we feel good because we laugh.” ― Bob Ross

“It’s hard to see things when you are too close. Take a step back and look.” ― Bob Ross

Whoops! How did that get in there...hardly fair comparing this to canvas and paint.

“You can do anything here — the only prerequisite is that it makes you happy.” ― Bob Ross

“Go out on limb. That’s where the fruit is.” ― Bob Ross

Left: plaque showing the outreach locations teams reached from the ship's location in Tamatave, Madagascar.

Right: One of several statues gifted by the leadership of Benin. Its attire was not exactly..."family friendly." Thus the addition of a little tube top.

 

Well, that's about all I was able to capture back in March. Hope it gave you an idea what it's like to stroll around the AFM, and the rich and vibrant places it has visited. À la prochaine...

- D