Sierra Leone (English)

My last update (April-May 2023) I finished with my plans for the summer of 2023.
I spend about a week in the UK with great friends. Enjoyed good conversations, nice walks, beautiful nature. Arrived in the Netherlands the beginning of July. Had a good time with family and friends. Tried to get as much rest as possible, maybe not as much as needed…

The beginning of August I returned to the Global Mercy, in Tenerife.
We set sail for Sierra Leone and arrived there August 22nd, around dinner.

During the sail we spend most of our working hours in the office. The four of us come from different corners of the world, Hong Kong, Australia, United States, and the Netherlands. We all have a different role within our department.We had a great time working together, sharing ideas, preparing for the field service ahead of us. For the patient we get to serve, the team members we get to work with for the next weeks/ months. Getting excited by names on a staffing plan that we connect to the people we’ve worked with before.After our arrival we had to get one of the operating rooms ready for official tours for the following morning. Which meant unstrapping, unpacking, cleaning, and re-organizing one of our Operating Rooms. It involved laughter, unexpected guests, water leaks. But we were content with the result.

The next morning was the official arrival ceremony. Lots of guests were invited to come to the ship. The ceremony had different speeches. As the president was part of the ceremony, it involved a lot of security as well. We tried to continue our work, as unpacking the department without being visible for the tours that were held. We had interesting conversations with the people that we did get to see during the whole ceremony. Learned about official protocols, dos, and don’ts regarding presidential visits and because we have portholes in the outside corridor of the Operating Rooms, we got to watch some interesting arrivals. Part of getting the Operating Rooms ready to be used means cleaning, cleaning, and more cleaning. Organizing the OR’s and setting them up for different specialties.
Packing the pack-up boxes, organizing the packing material and ratchet straps. The better you organize the pack-up stuff after unpacking, the easier the next pack-up will be. And as space on a ship is limited, there aren’t always multiple ways of doing things. So, we spend hours of packing up packing stuff and rolling up ratchet straps.

When the hospital is ready to get started and receive patients there are a couple of important activities that take place before the official opening. We will organize a hospital open house. One last opportunity for the non-hospital crew onboard to walk through the hospital, to hear and see what we do. There are fun activities to participate in throughout the hospital.
As Operating Room Department we hosted 3 stations in 3 different rooms in our department. The sterilizing department explained what happens with surgical instruments, and how cleaning, organizing, packing, and sterilizing takes place, and what the key point in this process is. Crew got to race each other in packing an instrument tray correctly. Our anesthesia team showed the crew how to intubate patients (don’t worry, we have mannequins for demonstrations), how ultrasound works and what we use it for.
And lastly, we have crew dress up as surgeons and had them operate on a patient.

My job for the evening was to help everyone dress as a surgeon, wearing a scrub hat, surgical gown, and gloves. We had many surgeons, different nationalities, ages, heights. The patient needed to have foreign bodies (gummy bears) removed from her abdomen, preferable without blood loss (juice), which wasn’t easy for most surgeons, therefore we didn’t hire anyone. At the end of the evening, we weren’t sure who had the most fun, all the crew that got to participate in the open house or the crew that organized it. Next activity on our start up calendar was the Hospital Evacuation Drill. We have regular fire drills throughout the field service. But at the start of the field service, before we have patients onboard, we practice, especially for the hospital team, how we would safely get patients out of the hospital, including surgical patients in the middle of surgery, in case of a catastrophic emergency. We have procedures in place, that we regularly talk through, but now had to put into action. We started with our team to talk through the procedure, discussed the different rolls, options for how to get out of our department, as we have to go upstairs, not being able to use elevators. Things we need to take with us, what are the different responsibilities?

And we got to re-do this during the Christmas break, the beginning of January as the OR didn’t have scheduled patients and with new staff that had just arrived, we used the opportunity of the regular fire drill to practice our evacuation of a patient. The official evacuation drill was followed by an all crew and all hospital crew photo.

The last official part of our start-up procedure is the prayer walk. The Sunday night before we open the hospital to admit patients to the wards, we invite the entire crew to walk through the various places of the hospital and pray. Pray for the patients and their caregivers that will come to the hospital. To pray for the ones that we can help with surgical care, but also for the ones that we interact with and are not able to help. Praying for the day crew that is helping us with many jobs, and one of the important tasks they have is translating for our patients. Although Sierra Leone is an English-speaking country, it doesn’t mean that all our patients speak English and are able to understand our English language. Pray for incoming crew, as we have ever changing staff in all the different departments of the hospital. Strength and energy for especially our long-term hospital crew and the ones with leadership responsibilities. It’s such a powerful time as the whole crew comes together and we are once more reminded of why we do what we do and that we can’t do anything without God’s help. I won’t share any photo’s as they don’t do justice to what we experience. While I walked through the hospital I was also reminded of patients that we journeyed with through our Senegal Field Service, early 2023. The struggles, challenges, and sad moments. But also, the joys when patients get to leave the hospital, free from the burdens they carried. To celebrate the wonderful teamwork as we try our best to help our patients and going the extra mile. Every time I think about what I do here onboard, the way we work in the OR, even after all these years, it still amazes me how this somehow does work. Taking 7 or 8 people from all over the world. Put them together in an Operating Room, where they don’t know each other, don’t know the way this hospital works and in what way each of us is trained and what to expect of one another. To give an example. I got to work with 2 surgeons from the US, a surgeon from Switzerland, OR nurse from Australia, one from Hong Kong, anesthetist from the UK, anesthetic assistant from New Zealand and myself from the Netherlands. When you read this, you might think, that sounds dangerous and shouldn’t work. And I agree. But I can tell you that it does work. And we have great teamwork here. And not because of what we do, but because of God who gives us the ability to do this in his strength.

While I’m writing this blogpost, we’re halfway our Field Service in Sierra Leone. A lot has happened in the past months. I got to work with wonderful surgeons, anesthetists and nurses from all over the world. I made new friends, had to say goodbye to some special friends, who have been my family for the past months to years. Hard goodbyes that make me feel sad and happy at the same time. Sad because for now are paths are leading in a different direction and we’re not able to work and/or live together anymore. Friends that move back to the Africa Mercy but also friends that move back to their “own” country. Friends that I definitely miss being around daily. At the same time thankful for the time we got to spend together and the friendship that has been build. And there are always friends that come for a few weeks or months and leave again, but you know that they will return. As a recap of 2023, we did 1540 surgeries, for 1437 patients. 795 surgeries (728 patients) were performed during the Field Service in Senegal. So far in Sierra Leone we operated on 709 patients, performing 745 surgeries. With 5 more months to go. If you look at 709 patients, that means 709 patients that had surgeries, which transforms their lives. But not only their lives are transformed, but it also changes the lives of their families, their communities. Their ability to go back to work, to care for their children, their families. Not only physical healing but sometimes even more important, their spiritual healing. When patients share with us how they experience their time in the hospital. Where they’re seen as human beings with a name. Not someone with a medical condition. Where people look them in the eye, and really see them. Where they all are treated equally, receive care, food, encouragement. They’re looked after 24/7.  And yes, there is more work than we can do while we’re here. There are patients we can’t help as their condition is not something we can treat on the ship, or their condition is malignant. I sometimes feel disappointed that there is only so much I can do, not enough time to help more patients. Frustrated that we have so much in our home countries, and we lack so much here in Sierra Leone. Feelings of sadness that life is unfair, and the need is bigger than we can carry. But we can only do so much, and each day gives us the opportunity to help the patient in front of us in the best way possible. One at a time. One patient that we want to give our best. One patient that we want to care for in the way that we want our loved ones to be treated. We often work past “official” working hours as surgical times are hard to predict with some different and ever changing factors. But sometimes we have to go back to work after hours because of complications that occur. Not something we prefer to do, but if we have to, we’ll make the best out of it and there is always time for a smile. You might recognize the faces below. We don’t often get to work together as we all have our different roles within the Operating Room department, but somehow, we ended up back in the OR after hours together. And no, this is not after lunch, this was past midnight. And we still managed to smile.

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