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