My last blogpost was written halfway our field service. I finished with a recap of 2023, and some surgical numbers. An explanation of the transformation we have in patient lives, physical and spiritual healing. Not only for the patient him/herself but also the impact it has on their families. Helping one patient at the time, working with an international team, often past official working hours…but with a smile.
GLM stuff
Another 3.5 month has passed. We’ve been able to help many more patients and transformed many more lives.
As the MaxilloFacial Team Leader in the Operating Room I get to work with a new team of surgeons every other week. Each 2 week block usually starts with a surgeon consultation day.
On a surgeon consultation day, we will assess a selected number of patients for the coming 2 weeks. The team doing the assessments are the surgeon(s), a pre-op nurse and myself. Pre-op assessments are already done by pre-op nurses and their documentation is available to the surgeons. They will assess the patient, ask follow up questions, decide on the need for extra diagnostics (radiology, lab work). Once all information is available a surgical plan will be discussed and after seeing all patients for that consultation day, a surgical schedule for the 2 weeks is made.
My job is usually asking multiple questions, referring to protocols and procedures, checking paperwork (and handwriting). When it comes to scheduling, it’s important to create a balanced schedule. Keeping track of limitations of any kind, such as available instruments, implants, equipment, workload for OR and ward, surgical hours, patient factors. Patient factors we keep an eye on are travel time from the ship, need for follow up surgery with a certain time frame, underlying medical conditions, pre-operative health assessment and the need for pre-op treatment.
Once the surgical schedule is put together (which is written with a pencil) it usually changes a couple times. There are (almost) always good reasons for changes. We’re in Africa and Malaria is common. In case a patient shows up with Malaria, we’ll treat the Malaria and wait for a certain amount of time before we move forward with surgery. In case we cancel a patient, we try to use that time for another patient, so we don’t “waste” surgical time.
On average, for MaxilloFacial surgeries, we operate on about 12 patients a week, depending on the complexity of surgery.
The first 2 weeks of April, I got to work with 2 very experienced surgeons, who also operate very fast.
In these 2 weeks, which turned out being 8-and-a-half day of surgery, we operated on 30 patients and didn’t have to change our surgical schedule once. Which is
very unique.
The days were quite busy, but it’s been a pleasure working with these surgeons.
AFM - Madagascar
At the end of their first week I had a video call with one of my co-workers on our sister ship the Africa Mercy, AFM (my former home). The AFM is in Madagascar and preparing the hospital for their field service, working on the set up of the hospital after a one year maintenance period. During our call it became clear that there was extra help needed on the AFM, as it wasn’t a normal set up but more an equipping phase without having OR personnel onboard that had dealt with it before.
After talking to Eric, the best way to support them during their set up/ equipping, would be going over myself and help as I’ve worked on the AFM for many years and know what items (consumables/ furniture/ equipment/ instruments etc.) are needed, what lives where and how should the OR department look like before surgeries start.
After my phone call with Eric, I went to my manager in the OR to discuss the possibility for me to go to Madagascar at short notice. Just to put it in perspective, it’s Friday afternoon, 17.15hr, workday is over, Madagascar is 3 hours ahead of Sierra Leone.
Looking at the staffing plan and the incoming surgeons, I could be released from the OR department on the GLM.
After talking to our Hospital Director, I messaged the Hospital Director on the AFM, had a phone call with her the next day, and fast forward, I flew out of Sierra Leone a week later.
Travel to Madagascar wasn’t easy. I was blessed with a travel buddy who also left the ship to go to Madagascar as part of the patient selection team.
We had an overnight flight to Nairobi, Kenya, landed in Antananarivo, Madagascar on Saturday afternoon. I was picked up from the airport, brought to a hotel where I had a meal, shower and bed. Sunday morning at 5.30hr my luggage needed to be in the reception area of the hotel to be loaded on the roof of our bus. You would think that I wouldn’t need much luggage for 3 weeks. Which is absolutely true. But once people find out that you’re travelling to our sistership, many people ask you to bring something to give to someone. So I became a courier for many crew members. The bus would drive us all the way to Toamasina. A 12 hour bus ride. The distance is less than 400k, but the roads aren’t in the best condition. We made it safely to the AFM by 6.15pm, where I was welcomed by many old friends who were very excited to see me.
I’ve spend 3 weeks on the AFM, working long hours to get the OR department in shape. I’ve sorted through implants, located furniture and put it in the correct rooms. Together with my wonderful co-workers we sorted our supply storage room (OR pharmacy). We identified missing items and sorted out when and where they were coming from. Created an overview of our instruments, consumables. Searched for missing items and brought them “home” from interesting places.
It were 3 weeks of hard, intense work. Frustrations. Concerns. Headaches. Stress. Search parties. But also friendship. Coffee breaks (with apple pie). Dinner out with friends. Kingsday celebrations. Laughter. Cleaning. Teamwork.
The travel back to the GLM was worse than the travel to the AFM. It felt like the roads got worse in the three weeks I’ve spend on the AFM. The bus ride took as 13.5hrs, I had only 2.5hrs at the hotel, before I needed to go to the airport. Quick shower and dinner, more goodbyes and continue the travel.
I left the AFM, Saturday morning at 6am and made it back to the GLM at 10pm, which was 3hrs back in time. A total of 43 hours of travel. I won’t recommend this to anyone. And of course, Monday morning back in the OR for a full day of work.
Social activities
Although most of my workdays are long, there is some time for fun. Time to relax and hangout with friends. Leaving the ship to walk to the market. Go out for dinner with (part of) the team.
Enjoy the beach for a couple hours.
And I even got to do a pottery workshop, with a few friends. This pottery place has been set up to teach people a trade. It has an ongoing training program for new staff. The pottery that they make is shipped to and sold in the Netherlands. Haven’t find out where exactly. They also organize workshops for visitors. We got a tour of the facility and got some hands-on experience.
Future plans
As our field service in Sierra Leone finishes in June, I’ll be helping with the pack up of the OR department and will fly from Freetown to Brussels, mid June.
I’ll be in the Netherlands to get much needed rest, time with family and friends before I’ll fly back to the GLM. The plan is to be back on the GLM by the end of July. We’ll be sailing back to Sierra Leone for another field service there, somewhere beginning of August.
We have to set up the OR department again, which means lots of cleaning and re-organizing.
Hopefully the organization has found a replacement as by the end of November I’m planning to move back to the Netherlands. What that’s going to look like, I don’t know at this point. The goal is to rest, find a place to live, do a debrief to process all I’ve been through in the past couple of years and after that, I need to find a job and settle in to “normal” life.
As much as I love my job onboard, it is time for a good break and to come to a complete stop and necessary to take care of me.
What that exactly is going to look like I don’t know. I don’t know what the future holds, but I do know who holds the future.
Prayer points
- Finishing well of our current field service in Sierra Leone
- For a good start of the field service on the AFM in Madagascar
- A time of rest for the crew that is taking PTO
- Maintenance on the ship that needs to happen during our time in Tenerife
- My upcoming transition to “home”. That I will find a place to call home, to re-connect with family and friends, to find a good organization/ place for a debrief
- Find and follow God’s direction for the near future.