NEWSHUB TV3: Celebrating World Maritime Day. Mercy Ships has been quietly changing the world for 40 years, and NewsHub’s Duncan Garner finds out how we do it
QUIZ NIGHT: 27th Sept. Are you a general knowledge nut? Do you love a bit of New Zealand history? Are you ready to gather your crew together? Come ‘aboard’ and test your trivia against your friends in a hump-day quiz night to celebrate World Maritime Day, on the 27th September. With gourmet platters, drinks, prizes, an auction and a special performance by New Zealand’s own singer/songwriter Peter Woolston, this is not a night to be missed!
Kiwis do astounding work aboard ships all around the world, including for charities such as Mercy Ships New Zealand.
In addition to the quiz, come and explore the World War One hospital vessel, the Nautilus. The Nautilus was carried by the hospital ship Marama which transported wounded New Zealand soldiers home during World War One.
With gourmet platters, drinks, prizes, an auction and a special performance by New Zealand’s own Peter Woolston, this is not a night to be missed!
Tickets: are $25 per person. Contact email@example.com or text to 02102984719 to book your tickets by Sunday 24 for you and your mates.
Where: The Dinghy Locker, The Royal New Zealand Yacht Squadron. 181 Westhaven Drive, Westhaven Marina, Auckland, 1011.
When: 7pm to 9pm, Wednesday 27th September
Six years ago, Jaqueline fell in love with a man whose parents didn’t approve of her. “They wanted to choose a bride for him, someone from his own village,” she explains. “His parents told him if he married me, his life would not turn out well.” The two decided to marry anyway.
Not long after, Jacqueline became pregnant. When baby Gladys was born, what should have been a joyous occasion became a horrific shock as they discovered something was wrong. One of Gladys’s feet was facing the wrong direction, a condition known as clubfoot. At the sight of his newborn daughter’s deformity, Gladys’s father believed his parents’ curse was coming to pass. In a panic, he left Jacqueline and his one-month-old baby girl.
“I was the only one fighting for my child,” recalls Jacqueline. Though they were on their own, and Jacqueline was now a single mum, she filled the role of two parents and more. She poured herself into her daughter, making it a priority to find help for Gladys’s foot.
Jacqueline’s search started with a local medical facility, where they agreed to treat the condition for 50,000 CFA (around NZ$120). Jacqueline didn’t have the money, but family members offered to take up a collection. “The doctors put pieces of wood on either side of Gladys’s leg and foot and wrapped it with bandages.” But when the contraption was removed, nothing had changed. Jacqueline continued her mission, next checking in with a local hospital. Their prescribed treatment plan was to put an iron rod through Gladys’s foot and leg. But the hefty price tag of $200,000 CFA (NZ$480) made it an impossible option for a mother with modest means. And, as it turned out, there was a much less invasive option available – one that would require no payment.
“When I heard Mercy Ships was in Cotonou, I literally ran,” Jacqueline remembers. Their journey started with screening in September. There Jacqueline received the news that five-year-old Gladys was approved for free surgery. Her little foot and ankle were placed in a cast each week for two months to help adjust their position before a minor surgery would take place in December to release the problem-causing tendon.
After a few more weeks of casting and several months of rehabilitation, Gladys was making good progress. Then, the day finally came. She slipped her foot into a pink sneaker and tied the laces. For the first time, her foot lay flat and pointed forward – supporting her small frame and letting her take big, bold steps in the right direction.
“Since the surgery, Gladys’s father visited us once. When he saw her foot, he couldn’t believe his eyes. He was terribly ashamed of himself,” Jacqueline recounts. “But he’s not my concern. My concern is Gladys.”
Jacqueline’s fight for her daughter was worth it. The constant concern, the persistence search – it all paid off. What she’d hoped and prayed for has become a reality. “God is great. Seeing Gladys walk has brought me such joy,” she says
Story by Windsor Marchesi
“You have saved my life.” Mabouba’s voice breaks as she expresses her gratitude. After six years, her life-threatening tumour is finally gone. ““It was in 2010 that it started,” the 23-year-old recalls. At the time, Mabouba was finishing up her junior year of high school with plans to become a midwife. The tumour changed all that.
“I have no donation, no gift to give you. But God says when you care for your neighbour, heaven will be guaranteed for you. So I wish you heaven,” she declares.
The award-winning image ‘Searching for Hope’ was taken of Mabouba by Mercy Ships photographer Kat Sotolonga prior to surgery. Kat was awarded by The Lancet – renown UK general medical journal – in their annual medical-related photography competition. Congratulations Kathryn Sotolongo and Mabouba!
After five years as an intensive care nurse at Christchurch Hospital, Jess Doney is used to dealing with crises. Her acquired skills have been put to the test when she recently stepped into a new and extraordinary surgical environment.
The 26-year-old signed on articles for a two-month tour-our-duty in Benin, West Africa, providing care for patients who receive free essential surgery that is inaccessible in their own nation. Jess worked primarily in the ship’s ICU, and one of the five wards where she cared for patients of all ages recovering after the removal of huge, benign yet life-threatening, tumours.
But what Jess says she didn’t expect during her volunteer service was a shift in her own perspective, “Mainly in being thankful for the ‘little things’.
“I visited at the boys’ orphanage here in Cotonou regularly. One week the boys were asked what they were thankful for. Their responses were along the lines of, ‘ I am thankful because I am alive’, and ‘Because I woke up today – lots of people didn’t!’” These comments from little boys have made her think differently about just being grateful for life, and the simple joys that each day brings.”
“Mercy Ships is unique in their work ethic, their willingness to help and serve the people of Benin,” Jess comments in reflection. “I would definitely volunteer again.”
Lack of access to safe surgery results in more deaths worldwide every year than HIV, tuberculosis and malaria combined, according to the World Health Organisation (WHO).
There is growing international acknowledgement of what theatre staffs have long known and advised: accidental trauma, birth complications and the lack of surgical intervention for amenable disease conditions causes millions of people annually life-long disability or death.
Empowered by the rising profile given to the accessibility of surgery in developing nations by the findings of The Lancet Commission on Global Surgery a movement has begun; a new determination to make access to safe and affordable surgery for the poor a reality.
For nearly 40 years Mercy Ships, the hospital-ship charity, has quietly made it a priority to provide safe surgery for people who otherwise would have no options. Mercy Ships joined the newly formed Global Alliance for Surgical, Obstetric, Trauma and Care (G4 Alliance) in 2015. The Lancet Commission’s report was published later that year with a vision to ‘embed surgery within the global health agenda, catalysing political change, and defining scalable solutions for provision of quality surgical and anaesthesia care for all.’ Together these bodies are stimulating a growing recognition that safe surgery must be an integral part of the global health agenda.
During 2014–2016 the Mercy Ship Africa Mercy completed two ten-month tours of duty in the island of Madagascar, off Africa’s eastern coast where 95% of Madagascar’s 23 million people live on less than $1.25 per day to cover all their needs: food, shelter, clothing, education and healthcare. Since much of the population lives in remote villages, it was common for patients on the hospital ship to explain how they had walked for days – sometimes carrying a child – to reach any public transport. From this point, basic healthcare may be accessible, but at a crippling cost. Before any treatment is undertaken, the patient must pay for – and sometimes even source – sutures, IV bags and fluid, dressings, bandages and pharmaceuticals, everything that is needed for treatment. So when free reconstructive or life-saving surgery was offered by Mercy Ships, patients and their families often broke down with tears of relief. Few had any other options, or even hope, for healing.
While in Madagascar, Mercy Ships launched a mobile education team. The ‘Checklist’ team of three to five doctors and nurses travelled a gruelling 16,829 kilometres to every regional hospital, even in the most inaccessible areas. They coached local healthcare professionals in the understanding and use of the WHO Surgical Safety Checklist. This simple tool helps any surgical team to improve safety in surgery. It has been proven that using the checklist has decreased operating room mortality by nearly 50% and significantly decreases surgical complications and infections.
In New Zealand and many parts of the world, this checklist is now mandatory. In Madagascar it was not utilised effectively. Mercy Ships came alongside every region in the country and assisted them in creating their personalised checklist and provided the participating hospitals with pulse oximeters.
Safer surgery is being performed throughout Madagascar as indicated by a follow-up visit after three months which showed a Checklist usage rate of 80%. Further assessment will take place in 2017. The Checklist team collected national healthcare data never previously compiled, and worked with other organisations to support the government in developing a national surgical plan.
In August the Mercy Ship sailed to Cotonou, Benin where the crew have 10 months to engage in medical capacity-building and provide healthcare for thousands more Africans in desperate need of both hope and healing.
Each year dozens of New Zealanders – including theatre nurses, anaesthesia staff, surgeons and other healthcare professionals – volunteer with Mercy Ships. The not-for-profit is Africa-focused, with a mission to provide free surgery for those in greatest need, and to train medical professionals to continue their work long after the ship departs.
Esther Meyer, theatre nurse from Drury volunteered for five months in the on board theatres during 2014, in the Republic of Congo. She found it to be impacting both on a professional and a personal level. Esther explains, “As the Mercy Ship is a floating hospital it is able to move to different locations, while still providing an excellent standard of care. It provides a place where local health professionals can come on board to learn valuable skills, without having to leave their own country.
“The camaraderie between the volunteers is unique. No one gets paid and there is no hierarchy in the operating room. We worked hard as a team with all the same goal in mind. The operating room is a fast paced and fast turnaround of staff. In New Zealand we have a wide range of ethnicities, so it wasn’t hard to feel at home. There is a mixture of British and American terminology inside the operating room, but plenty of understanding and patience. Laughter helps to break down barriers, and friends are made quickly. To be able to serve alongside such knowledgeable people, and to have the opportunity to learn from them, was very exciting.
Posted with permission by The Dissector December 2017
Video link : The Mercy Ships response to Global Surgical Need (3 min)
Starship Health paediatric nurse Vivien Welsh always knew she wanted to work with children. She entertained both teaching and nursing as career options. But time with a Christian missionary organisation based in Brisbane and travelling in India and other parts of Asia convinced her nursing was the right choice. “When I was travelling, I saw just how much need there was for health care.”
Her first paediatric placement as a student and her pre-registration placement on a neurology ward at Starship confirmed she had made the right career decision. She graduated from Auckland University of Technology in 2012 and began her nurse-entry-to-practice placement on the neurology ward where she had worked as a third-year student. Welch loves the work.
“I love working very closely with families. It is different to working with families of adult patients. When a child is in hospital, a family member is there all the time and every shift we discuss with that family member what we hope to achieve. It is a real partnership.”
She has stayed on the neurology ward – “there’s still so much to learn”. But her time there has been punctuated by two stints as a volunteer nurse with Africa Mercy, the world’s largest civilian floating hospital, which was in Madagascar. The Africa Mercy is run by the international non-government organisation Mercy Ships. The first time – from mid October 2014 to mid-January 2015 – she worked on the ship’s paediatric ward. She resigned from her job to do so, but on her return successfully applied for a position on her former ward. Welch knew she wanted to return to Africa Mercy. For her second assignment of 12 weeks with the hospital’s dedicated wound care team, which began in early January this year, the ward accommodated her unpaid leave.
She feels compelled to do this work. “I want to make a practical difference and Mercy Ships provides the structure and support to do that. I also feel a responsibility to do so. I’ve been born in this country but have done nothing to deserve that fate; I could just as easily have been born in a country with nothing. I feel I have a duty to give something back.”
Time with the dedicated wound care team was her way of doing so this year. “Working on the ‘dressings team’ was very different to any nursing I’d ever done before. Previously, I’d worked on the wards where I had a patient load. In the ship’s dressing team we definitely worked as a team, which was great. Five of us rotated, with four nurses on duty each day. We operated in pairs, alternating between performing dressing changes and distracting kids, while getting the instruments and dressings ready for the other nurses.”
There was always music playing, and dancing withher bandaged patients to Taylor Swift’s latest hit was a regular occurrence.
“Despite the seriousness of the conditions being treated, we created a fun environment to work in. There was always music playing. We sang and danced around with our patients – or solo – to entertain them! We always ended the day with our faces covered in stickers from the kids.”
A six-year-old boy, Manantiry, will always remain in Welch’s memory. He had pulled a pot of boiling water onto himself when he was two. His family lived in a remote village, had very little money and poor access to health care. She first met him during his initial dressing change one week after surgery on board. (See box on facing page.)
“He had severe burn contractures and surgery released his scarring and he received multiple skin grafts. Dressings had to be changed on four different sites: his hand, axilla, elbow and the large donor site on his thigh.
“I had the job of distracting Manantiry and holding him still, while his surgeon did the first dressing change. It is something I will never forget. Manantiry screamed and screamed for most of the hour that it took. I spent the entire time wrapping him in a hug and holding his arm or hand still for the surgeon. Manantiry stared directly up at me with his huge brown eyes. I spoke to him gently, reassured him, and sang to him. Through it all, I think Manantiry ended up trusting me more. For weeks afterwards, I was the only one he would allow to perform his dressing change. We formed a really strong bond. It was amazing to watch some of the movement in his hand restored soon after surgery.”
The basics of dressing changes
As her 12-week assignment was coming to an end, Welch was working in the ship’s dockside clinic doing outpatients’ dressing changes. Manantiry’s mother came to the clinic and told her they were going home, as a family member had died. The journey back to their small village took five or six days of difficult travelling. “She said they would return in a month because it would take that long to travel there and back. We quickly taught Mama the basics of changing the dressing and looking after her son’s wound. Before he left, he had 90 degrees of movement at his axilla.”
Welch later heard that Manantiry had returned to the Hospital Outpatient Extension Centre about three weeks after they were scheduled to arrive. His wounds had all healed but he had lost some range of movement because he hadn’t been doing his exercises. The rehabilitation team continued to work with him to regain that lost movement.
While Welch saw “crazy surgical presentations I’d never see in New Zealand”, the actual nursing practice on Mercy Africa was more akin to caring for elective surgery patients. “The nursing is not as acute as my nursing here – you’re not run off your feet so you can get to know the patients and their families really well. We could spend time hanging out with the kids, singing, playing, forming real relationships and seeing how much of a difference we can make. I loved that about it and I certainly got more than I gave.”
Returning to New Zealand and re-entering a high-acuity environment, with acutely unwell children, takes a little adjusting to. But what she finds more of a challenge is some people’s attitudes. “All our patients have really nice single rooms but some people can still find things to complain about. They don’t realise how good we’ve got it here. We have access to free health care. In Madagascar, every intravenous line, bag of fluids, dressing pack etc must be paid for before you get any treatment. If you don’t have money, you don’t get help.”
Welch wants to continue making a practical difference. “I think perhaps it’s time to move on from the neurology ward and get some different experiences, keep challenging myself to learn new things and get new skills I can take overseas. I want to keep finding ways of working overseas, to keep learning and to keep becoming a better nurse.”
Published by Kai Tiaki, Nursing New Zealand December 2016. Posted with permission.