Perspectives

The past week and a bit has given me quite a lot to think about - my brain might be a bit mushy but I always appreciate the chance to see things from a new point of view. 

The most EXCITING thing to see last week was seeing people seeing! That, uh, sounds strange - but it's really the best way to describe it. Adult cataract surgery continues all year, but the last two weeks were exclusively for kids, who have to be put under for the procedure. The buzz around the hospital seemed to grow and spread throughout the ship, because by the last day there were so many people coming to watch the eye patches come off, they filled the hospital ward! Some kids were slow to adjust, having a hard time with the bright lights and the pain, some were looking all around straight away, and some were just plain stubborn:

Mama: "Ouvrez les yeux."
Kid: "Non."
Mama: "OUVREZ LES YEUX POUR LE DOCTEUR!"
Kid: "NON!"
Doctor:

I also had the opportunity last week to learn some of the ropes in sterile processing - the place where surgical instruments are cleaned, sanitized, packed, and sterilized! Here I am (all PPE'd up) with Roximo, a crew member from Sierra Leone who has worked in the department for a few years. 

Every instrument is re-counted here once brought from the OR, to ensure nothing was left behind (or accidentally thrown out)! Each one is then scrubbed by hand, before being sanitized: either in one of the high-powered washers you see above, or an ultrasonic cleaning thingamajig for the more delicate instruments. THEN, moving to the non-contaminated side of the room, everything is dried and counted into individual, surgery-specific trays, packed, labeled, sealed, registered, and fired up in the autoclave. Whew. I'm tired just writing that. Every step of the surgical process, including all supplies that might be brought in, is meticulously structured and documented to cut down any potential risk of infection or misplaced items. Nobody wants something like this to happen:

This is also why our Medical Capacity Building program has a strong focus on safe surgery mentoring, utilizing the WHO's checklist program as the ideal standard. 

It was pretty cool to see things from the other side of the hospital (literally - the ORs & Sterile Processing are on the starboard side of the ship, and the wards are on the port side). Typically, not just anyone can wander down that corridor - but I was able to poke my head in the window of OR 5 to watch one of the last pediatric cataract cases for a minute! If you're curious, and not squeamish, here's a decent video of the process.  I also scrubbed, ultrasonically blasted, counted, packed and sterilized some cataract procedure trays from start to finish, which was pretty neat. 

You might have seen on facebook that we're having a bit of an issue with water supply here on board. Ordinarily, at port, a local water supply is piped in to fill our tanks (after being run through our own purification system). Unfortunately, at the moment, there is little to no pressure in our intake, and the local authorities are just as baffled as us. Thus, we have been relying on water tankers (see above) to maintain our supply. 10 trucks a day. Each one taking 1 hour to unload. With over 400 people on board, you can imagine how much water we go through each day. Subsequently, our water usage has been restricted to "at sea" standards. One load of laundry a week, 2 minutes of water use per shower...you get the picture. Nothing gives you a new appreciation for something like not having enough. 

During my down time, trying to avoid needing a shower...I have instead caught up on some reading. I have my sister to thank for this particular book, which gave me some new insight into the impact of the Korean War. I highly recommend it, but WOW some parts were tough to read. The author shares memories of her childhood as a Korean War orphan. Abandoned because of the shame she brought to her family, her father an unknown American serviceman; it is a story of overcoming prejudice, and surviving the worst of what nature and mankind could throw at her.

To end the week, I had the chance to see the city and the ship from a different vantage point, which is always a cool experience. The ship seems massive while walking the decks or standing beside it on the dock, but from out in the harbour, it is dwarfed by the surrounding cargo ships.

Can you spot it? (Click to embiggen)

It's easy to get into a mentality where we assume our presence is widely known within the country, and that surely everyone knows about the work we're doing on board. While it's true that many people in the street recognize us as "Mercy Sheeps!" people, seeing our little tin can compared to the expanse of Conakry around us is a good reality check. We are barely making a dent in the needs of this country. It is so important that we do the very best job we can to maximize our impact, and leave behind people who can continue the work.

Speaking of which...

Fun fact: the number of cleft lip cases we've seen this year has dropped by 80% compared to the last time the ship visited Guinea (2012-2013)! Guinean surgeons who received training through our mentorship & training programs are effectively tackling the problem on their own. How cool is that. 

Here's a little callback to my last post (though I'm not sure how clear it is in this picture), HARMATTAN!! You can kind of see the cloud of dust obscuring the view towards the left. And you can really see the dust built up on the stern (below), where it hasn't been washed in a while. 

So when you're shovelling the mountains of snow this week, just be glad you aren't inhaling the Sahara with every breath.

That's all for now. I hope to have some pictures of our cataract patients by next week.

À la prochaine.

-D

What's Harmattan With You?

This is my first time in West Africa during Harmattan season.

You're probably thinking, "What's this 'Hardly-a-tan?' I thought there were only 2 seasons in Africa: hot & dry, and hot & rainy." Well, surprise, surprise. Here in the Sahel region - the transition zone between the arid deserts of North Africa and the tropical forests of the south - there is an extra season. HARMATTAN.

During Harmattan, powerful winds blow across the region, bringing dusty, sand-filled air from the Sahara down into the Gulf of Guinea. The dust settles on everything and everyone, and hangs in the air like smog. In short, this:

...is Harmattan.

There are obviously many downsides to all that particulate in the air (just great on the lungs), but the one plus is that the sun doesn't beat down quite so hard as it otherwise would.

I think being right on the water helps a bit with the dryness, too.

Other than enjoying the (sometimes) cool mornings and brushing off the sand, I've had a pretty low-key week to settle in here. Due to the large cohort of new nurses, and the slow ramp-up of surgery after the Christmas break, I was kind of put on the back burner to give newer nurses a chance to learn the ropes. This meant office work and more free time than expected. Despite this, I've managed to keep myself on a half-decent sleep schedule (which, if you've ever seen me in the morning, you'll know is a minor miracle).

Now that things are back in full-swing, we've got a variety of patients filling up the wards. Kids with cataracts, adults with goiters, and both with hernias. Last week there was also another screening day up-country, where hundreds more patients were given appointments to see a surgeon.

My evening shift is starting soon, so I'd better sign off for now.

À la prochaine,

-D

Fresh Blood

Greetings from the shores of Guinea!

My trip here was relatively uneventful, though, as usual, I barely slept during the ~27 hours in airplanes and terminals. Weary-eyed as I was, seeing the gangway and the familiar blue lettering of the Africa Mercy was a welcome sight. The thought of lugging my duffel up said gangway was less exciting, but many hands make light work, and soon myself and the other new crew on my flight were aboard.

I am quite fortunate this year to have been placed in a two-berth cabin; most of these are reserved for couples, but there are a handful down on deck 2 with bunk-beds for singles. Deck 2 has a few drawbacks: there is a LOT of noise and heat from the engine room that it's nestled right up against, and the cabins are some of the oldest on board. There's a water pipe running from our floor to our ceiling. It's also the longest commute - a whole extra flight of stairs.

There are a lot more pros than cons, however, in my opinion. For starters, deck 2 is essentially ladies only. The ship's small gym and second-hand boutique are at the bottom of the stairs, but other than these rooms men don't really come down here. There are 2 women's washrooms with 3 bathroom and 3 shower stalls each - which are cleaned and stocked daily by housekeepers. Most of the short-term crew cabins are 6 berth, with all 6 people sharing one small bathroom/shower. As far as the noise goes, I would far rather hear the constant rumbling purr of the generators than the intermittent whoosh and clunk of the vacuum plumbing system.

All in all, I'm obviously quite lucky and pleased to have snagged this cabin. Considering how jet-lagged I was the last 2 days, I'm very, VERY glad to have such a restful space to acclimatize in. Today is the first day I haven't felt fog-brained, although I still keep waking up at 3 AM for some reason.

Terrible board game selfie with friends old and new.

It has been lovely to catch up with some old friends, but there is also a LARGE group of us nurses who just arrived - some new, some alumni - that are gearing up for another round of surgeries in the new year. The hospital was mostly shut-down over Christmas & New Years, with just 2 patients remaining with (unfortunately) infected wounds. This week is the beginning of General and Maxillo-Facial surgery, and Plastics will be starting soon after. 70 crew arrived this past weekend, about 30 of them nurses. We've had a full day of orientation, but I got to opt out of day 2 as it's been less than a year since my last service.

One of the nurse educators mentioned how the influx of such a large group of new crew is a huge asset to the work being done. We are bringing new energy and enthusiasm, hopefully boosting the spirits of all who have been here since September, or longer! As a returning crew, it is always refreshing myself to see the genuine wonder on the faces of new nurses seeing for the first time how lives are transformed here.

Looking forward to my first shift when I be a fly on the wall during some of those transformations.

À la prochaine,

-D