The heart of the hospital – CSSD

It has been said the central sterile services department is the heart of any hospital. This is true in a New Zealand healthcare context, or on a hospital ship.

Not-for-profit Mercy Ships is staffed by an international volunteer crew dedicated to turning the tide on the lack of safe and timely access to essential surgery in Africa.

For 10 months at a stretch, Mercy Ships is in an African port providing thousands of free services. As well as six surgical specialities, strengthening healthcare systems and building medical capacity with their local colleagues are a priority. These vessels aren’t just floating hospitals, they are also floating training centres.

Louise Hayden was tagged on Facebook by a workmate to an urgent vacancy for a sterilising technician on the Africa Mercy. He jokingly asked, ‘Fancy a cruise, Lou?’ But volunteering had long been on Lou’s radar, so the 50-year-old promptly stepped into a healthcare journey that would impact her both professionally and personally as she volunteered for three weeks in early 2020, aboard the Africa Mercy in Senegal, West Africa.

While on the Mercy Ship Lou maintained some familiar routines like hitting the gym first thing in the morning, while other activities were an interesting mix of life onboard a ship and life at home. Breakfast of a boiled egg and vegemite toast – check. Eating with a hundred others in the dining room before work – not the usual for Lou.

Perfecting the two-minute-shower technique, sharing a living space and bathroom with cabin mates who were also workmates, and learning the ship vocabulary (port is left, right?) required new flexibility, but Lou took it all in her stride as part of her long-awaited volunteer adventure.

The two-minute commute to work (allowing time to stop and chat with a crewmate in the corridor) took Lou to the hospital deck of the Africa Mercy, consisting of five operating theatres, five wards, ICU, auxiliary and technical services. There she joined her CCSD team; ‘Frank, the team leader, is from Sierra Leone, others from Benin and Guinea, and Amadou from Senegal where the ship was docked. He was so friendly and welcoming, and speaks eight languages! Amadou was inexperienced and soaked up everything I taught him about cleaning, disinfecting and sterilising. We have kept in contact and I’m excited to learn he is hoping to sit for the CRCST exam.’

Teamwork is highly valued by Mercy Ships.  The theatre clinical supervisor, theatre team leaders and nurses are in frequent communication with the sterilising team members regarding specific instrumentation needing to be processed for that day’s surgical schedule. The sterilising technicians also interact frequently with the hospital wards and outpatients as all they handle all instruments used there and restock those areas daily.

‘Sometimes stock is held up due to customs issues,’ commented Lou. ‘I learned some valuable tricks for being resourceful without compromising patient safety while remaining compliant with the Standards.

Lou was in a familiar professional environment, as much of the ship’s equipment is similar to that which is used in a New Zealand or Australian CSSD. She explains, ‘In decon there are two pass-through STERIS washer disinfectors, basic ultrasonic, Stella for cleaning and disinfection of intubating bronchoscopes for those difficult airways caused by the unbelievable size of some facial tumours, distilled water line, double sink and a pass-through window.

‘On the clean side there is an air gun, and two STERIS Steam Flush Pressure Pulse sterilisers which were also used as drying cabinets when not in use for sterilising.

‘A ‘terminal’ clean is performed each Friday using Tristel. Everything is wiped down including the ceilings.’

The level of excellence on the hospital ships is often an eye-opener, explains Merry Hoey from Brisbane, the ship’s theatre clinical supervisor. ‘Most volunteers are surprised at the equipment we have on board Mercy Ships; we have the same washer/disinfecting machines and autoclave/sterilisers that are used in western hospitals. We maintain the same standards and keep the same records. PPE is present and used.’

 ‘I want sterile processers to know how vital they are to the provision of surgery; to bringing hope and healing. Their role is key,’ declares Merryl. ‘We have very few wound infections on board the hospital ship – this is due in part to these amazing technicians who volunteer their knowledge and skills.’

Lou says the professional highlights of her service with Mercy Ships were attending the in-service lectures for the crew by volunteer maxilla-facial and reconstructive plastic surgeons, the opportunity to observe a cleft lip surgery, and giving the paediatric patients High Fives as they courageously exercised after their orthopaedic or burns and contracture reconstructive surgeries. Lou is eagerly awaiting the opportunity to volunteer on board again soon.

A new ship – a new hope

In sub-Saharan where Mercy Ships serves, 93% of the population can’t afford surgery, cannot access it, or it is simply not available in their country at any time. In 2020 this need has escalated.

In response to this enormous surgical need, Mercy Ships has launched a second vessel to serve low-income countries in Africa; the Global Mercy ™  is the world’s largest purpose-built NGO hospital ship.

The search is on for the most important part of the ship – and that critical component, that beating heart need to bring the ship to life; you.

There are volunteer positions available for sterile service technicians aboard the Global Mercy ™  for the first surgical field service.

We know that volunteering is a big ask especially in times like these when uncertainties abound, health and economic challenges are constant and the thought of overseas travel seems challenging.  But we know your hearts are big and you’ll give it some thought. We also know that the journey to service with Mercy Ships takes time and serious consideration which is why, if you are interested in exploring what’s involved, this could be the do-good adventure of your career.

Published by SupplyLine, April 2021 – New Zealand Sterile Sciences Assoc

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