It was time for a new professional challenge and a different kind of experience. As Robyn Ferguson searched for a volunteer nursing opportunity to ‘give back’ using the skills gained over her extensive nursing career, she found Mercy Ships – the hospital ship charity providing surgical care in Africa for patients who would otherwise have little access to essential services.

The Wellingtonian was inspired by her three-month tour-of-duty in 2010; now she is a familiar face among the 450-strong international crew. The most recent field service in Senegal, West Africa – paused due to COVID-19 – was Robyn’s ninth time volunteering on board the Africa Mercy.

The hospital ship has five operating theatres, 80 ward beds, intensive care, and all the required auxiliary services to treat patients in the specialities provided; ophthalmic, maxillofacial, paediatric orthopaedic, women’s health, burns and plastic reconstruction, and paediatric general surgery. Other services include mental health, oral health, palliative care, and Ponseti treatment for babies born with clubfoot.

For ten months at a time, the self-contained floating hospital provides free care in low-income countries where healthcare resources are usually inaccessible and unaffordable. ‘The long queues of people at the Mercy Ships screenings show how desperate people are for treatment; many have walked for days to get there,’ explains Robyn.

One of the unique aspects of the Mercy Ships wards is the level of interaction between the patients; people who were strangers before admission.  Robyn clarifies, ‘Patients support each other and follow cues from others who have been in the ward longer. It is very community-based. In western countries, people want privacy from others and would not think of asking another patient what to do, or they would not want to be seen to interfere.

‘As patients don’t speak English we have ward translators, but they are not medically trained. I have be known to resort to making up my own sign language to show patients what needs to be done. When caring for obstetric fistula patients who needed perineal/catheter care, I had the habit of indicating time for this treatment by saying and acting ‘Wash.’ One day a patient asked for Mama WashWash, which apparently was me!’

The Mercy Ships hospital processes were familiar to Robyn from the beginning. ‘There are nurses from across the globe with different nursing backgrounds and styles, so on board care pathways guide our day-to-day care for different specialities, similar to pathways used at home. There are policies and procedures to follow such as hand hygiene, infection control, IV therapy, all in line with my nursing experience.’

‘The equipment is similar. I was surprised to see more BP machines on the ward of 20 patients than that on the ward of 30 that I had left in New Zealand.

When asked about what was most surprising aspect of nursing on board, Robyn was quick to reply, ‘How easily the patients accept us. They come into an unfamiliar environment, not speaking or understanding the language, and not knowing what the outcome of their surgery will be. After seeing other patients’ reactions, they are encouraged. They relax and settle in, letting us hold their hands and accepting hugs. They sing and dance and laugh. One day I gave a hug to a lady who was crying. When she settled, the patient in the next bed put her arms out for a hug too. Then I had to give a hug to all the ladies in the ward. This became a part of my working day.’

Mentoring and teaching

With an emphasis on mentoring and teaching, Mercy Ships leans on the experience of professionals like Robyn to strengthen the healthcare capacity of the host nation. She explains, ‘If we were doing surgery without mentoring, teaching and training, then change won’t occur. We help nurses, doctors and technicians learn new skills. We provide protocols like the WHO Safe Surgery Checklist, the importance of hand hygiene and specific surgical techniques. Local colleagues teach this to others, improving on what they are already doing.’

While patients experience physical healing through the surgeries they receive, they often find much more. For many, access to surgery means finding hope again. Patients frequently report that the level of personal and unconditional care provided by the Mercy Ships nurses is a deeply meaningful boost to their holistic recovery. Mothers and fathers are able to return work and provide for their families. Children can go to school. Community relationships are restored.

‘I love Africa,’ Robyn declares, ‘… the people, community spirit, the sights and sounds, the chaos and the acceptance. I make friends in each of these countries, and they stay with me always.’

Published with permission of Kai Tiaki, NZNO, December 2020