Mercy Ships Brings Help and Hope to the World's Poor
Article Outline
As part of our international strategy, this year AORN entered into a collaborative relationship with Mercy Ships to bring our member's attention to volunteer opportunities in a part of the world that lacks a health care infrastructure.
Mercy Ships is a global charity that has operated hospital ships in developing nations since 1978. Mercy Ships brings hope and healing to the forgotten poor by mobilizing people and resources worldwide, and serving all people without regard for race, gender, or religion. [The crew] of both professional medical and non-medical volunteers have chosen a very powerful way to share their blessings.1
This year, Mercy Ships' the Africa Mercy is anchored in Cotonou, Benin, West Africa. Benin is a narrow country that runs north to south and is bordered by Nigeria, Togo, and the Atlantic Ocean. Its land area is slightly smaller than that of the state of Pennsylvania. The climate is tropical with two rainy and two dry seasons.2 Benin is a developing nation that ranks 125th among 135 developing countries for which the human poverty index has been calculated.3 There are a limited number of medical facilities,4 with fewer than one health care worker for every 10,000 people.5 Shortages of many medications and supplies exist.4
During the week of June 22, I made a visit to the Africa Mercy to learn more about the ship's mission. Looking at the Africa Mercy, one thinks of a luxury cruise liner sailing off to an exotic location. Although the Africa Mercy is not a luxury cruise liner, it has all the amenities and comforts to make the crew of approximately 450 feel at home. The Africa Mercy only sails about 20 days per year when it is traveling to and from its host city for refurbishing and routine maintenance. Otherwise, the ship remains docked in port to provide surgery and medical treatment to those most in need.
Deck 3 of the Africa Mercy has been converted into a hospital with 65 ward beds, six operating rooms, eight postanesthesia care unit beds, three intensive care unit beds, and two isolation beds. The demands of the local community have led Mercy Ships to set up an additional 48 beds (ie, “Hospitality Center”) off the ship in a converted, air-conditioned warehouse. Because many patients do not have mobile phones and typically travel miles from outlying villages for their surgeries, the Hospitality Center is a place to house and stage patients both preoperatively and postoperatively to ensure they arrive for surgery on the right day and that they are receiving postoperative treatment before being discharged back to their villages. Both on the ship and in the Hospitality Center, a patient's family member or other caregiver is provided with a mattress to sleep under the patient's bed. There is also an eye screening center and a dental clinic off-ship. On a typical ophthalmology screening day for cataract surgery, 1,000 people may come seeking care.
The Africa Mercy under sail.
(Copyright Mercy Ships 2009. Reprinted with permission.)
Benin ranks 125th among 135 developing countries for which the human poverty index has been calculated. Here, local men sell gasoline at a roadside stand.
(Copyright Mercy Ships 2009. Photograph by Jennifer Willis. Reprinted with permission.)
The ship's ORs look like typical ORs in the States—perhaps more compact because of space constraints. The surgical teams have many of the same supplies and equipment found in a US OR. A big difference in practice is that the nurses, surgeons, and anesthesia care providers make a conscious effort to conserve supplies that are so difficult to come by in Africa. No items are opened on the back table unless they are absolutely needed. I could not help but think that if we would practice the same way in the United States, we would probably save our health care system millions of dollars annually. A challenge of the work environment is the constant rocking motion of the ship and making sure the Mayo stand or back table doesn't roll away.
The ship's surgeons and nurses come from all over the world but predominantly from the United States, United Kingdom, Germany, Australia, and New Zealand. English is the language spoken on the ship; however, there are many translators for the patients who speak either French or other local dialects from the villages. At times, there were three-way translations going on, from English to French to a patient's local dialect.
Alison Brieseman, RN, from New Zealand, is the ship's OR manager. She has volunteered on the ship for four years. The OR has positions for approximately 18 RNs, and during my visit, I was delighted to meet four AORN members who are long-term volunteers. A major challenge is finding enough nurses to volunteer in order to keep the rooms running—sound familiar? During my visit, the surgical teams were able to operate four of the six ORs: two for eyes, one for general surgery, and one for vesico-vaginal fistula surgery (VVF). According to Brieseman, the ship follows AORN's standards and recommended practices because they are recognized as the “international standard for excellence” (oral communication; May 2009). The nurses were very excited when I presented them with the 2009 edition of AORN's Perioperative Standards and Recommended Practices6 along with the Fire Safety7 and Medication Safety Tool Kits.9
OR Manager Alison Brieseman and I discuss standards of practice.
(Copyright Mercy Ships 2009. Photograph by Jennifer Willis. Reprinted with permission.)
My day in the OR was spent observing 30 cataract procedures, VVF surgeries, and hernia repairs. The people of West Africa are very prone to hernias, and I have to admit they were some of the largest I have ever seen. In addition to the life-changing cataract surgeries that give sight to people who have been blind for years, I was particularly interested in the VVF surgeries being performed by a Stanford surgeon who was on his honeymoon with his wife, a surgeon from the Cleveland Clinic. Vesico-vaginal fistula occurs because of a pregnant mother's lack of access to proper obstetric care. Women in developing countries may spend days in labor before delivering a stillborn child. Those women who survive the prolonged and difficult labor often develop VVF, a condition in which a fistula develops between the bladder and vagina, causing a constant trickle of urine and sometimes feces. Normal life is virtually impossible for these women, and their husbands and families sometimes abandon them to suffer this humiliating condition alone.9
The surgery gives a woman a new chance at life. The patients are typically hospitalized for two weeks on the ship. I had the opportunity to witness the “new dress day” when the women are discharged home with new dresses and the hope of living a normal life. It is truly a joyous and emotional ceremony of dancing, singing, and praying for the nurses, surgeons, and the patients. Although the people of Benin are poor financially, they are rich in spirit.
The overall experience was one that I will never forget. I admire the volunteers who gave up from two weeks to many years of their lives to provide health care to the world's poorest. When it was time to disembark from the ship, I left with mixed emotions because I could not spend more time and make a difference. I have made the personal resolution that after I complete my term as AORN President, I will go back to volunteer on the ship, which next year will be anchored in Togo, West Africa. It is my strong desire that many of you also will consider the opportunity and experience of a lifetime to volunteer either in Benin this year or Togo in 2010. Let's make a difference together.
References
- Get to know us. Mercy Ships . http://www.mercyships.org/get-to-know-us Accessed July 9, 2009.
- . Benin. US Central Intelligence Agency . https://www.cia.gov/library/publications/the-world-factbook/geos/BN.html Accessed July 9, 2009.
- 2008 Statistical Update: Benin. The Human Development Index—going beyond income. Human Development Reports . http://hdrstats.undp.org/2008/countries/country_fact_sheets/cty_fs_BEN.html Accessed July 10, 2009.
- . Benin: country specific information . http://travel.state.gov/travel/cis_pa_tw/cis/cis_1066.html#medical Accessed July 10, 2009.
- . Core health indicators: Benin . http://apps.who.int/whosis/database/core/core_select_process.cfm?country=ben&indicators=healthpersonnel Accessed July 10, 2009.
- Perioperative Standards and Recommended Practices . Denver, CO: AORN, Inc; 2009;
- . Fire Safety Tool Kit . http://www.aorn.org/PracticeResources/ToolKits/FireSafetyToolKit Accessed July 9, 2009.
- . Women's VVF surgery . http://www.mercyships.ch/e/vvf_e.php Accessed July 9, 2009.
Uncited reference
- Safe Medication Administration Tool Kit . http://www.aorn.org/PracticeResources/ToolKits/SafeMedicationAdministrationToolKit Accessed July 9, 2009.
PII: S0001-2092(09)00472-4
doi:10.1016/j.aorn.2009.07.001
© 2009 AORN, Inc. Published by Elsevier Inc All rights reserved.
