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British Journal of Surgery (BJS) has published an important medical paper about the work of Mercy Ships. The paper is an evaluation of our implementation of the WHO’s Surgical Safety Checklist in Benin in 2016/17,  co-authored by Mercy Ships expert Dr Michelle White of Great Ormond Street Hospital, and Dr Nina Capo-Chichi, a surgeon in Benin,

The Checklist is a simple tool that has been repeatedly shown to improve surgical outcomes and reduce mortality and morbidity.

‘One of the greatest challenges we face in tackling this problem is how to take proven interventions, and implement them successfully, at scale in low-income settings.’ Dr Michelle White.

In Benin, Mercy Ships volunteer experts visited 36 hospitals and delivered three days of multidisciplinary checklist training at each site, teaching medical staff how to use the Checklist. The aim was to see how great an effect Mercy Ships could have by running intensive courses in Checklist training across a whole country, rather than spending six to 12 months in a single hospital. Would the healthcare providers still be using the Checklist up to four months later?

‘We found that checklist use increased from 31% pre-training to 89% at four months and this was sustained at 86% 12-18 months later. Also after 12-18 months, there was high fidelity use and high penetration shown by an improvement in hospital safety culture.’ Dr Nina Capo-Chichi.

This evaluation, published in the BJS, forms part of the ongoing assessment of Mercy Ships field services in Benin. Assessing our work in this way enables us to improve the delivery of our projects and connect our work to tangible outcomes and impact subsequent field services; offer better healthcare strategy advice to host nations’ governments, and provide information to other non-governmental organisations working in low and middle-income countries.

The paper also stands with a growing body of work led by female medics and jointly with professionals in both Western and Sub-Saharan Africa – a hallmark of the innovative and collaborative approach Mercy Ships is proud to promote.

See a video summary and read the full paper ‘Implementation and evaluation of nationwide scale-up of the Surgical Safety Checklist’

‘Leaving a legacy of lasting change is crucial, so in addition to providing direct medical care on our hospital ship during a ten-month field service, Mercy Ships implements a programme focused on health system-strengthening and quality improvement across the whole country, with the goal of improving the medical care provided for generations to come,’ stated Dr Peter Linz, International Chief Medical Officer at Mercy Ships.

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Sign up to be the first notified of the broadcast date of TVNZ’s SUNDAY feature, recently filmed onboard the Africa Mercy in Guinea

Watch here for broadcast details of the SUNDAY Mercy Ships feature, due to air early in 2019.

Miriama Kamo and TVNZ’s SUNDAY team present a weekly in-depth current affairs, bringing viewers award-winning investigations into the stories that matter.

They are kicking off 2019 with a special filmed on board the Mercy Ship in Conakry, Guinea. Producer Chris Cooke, reporter Tania Page and videographer Gary Hopper had the experience of a lifetime as they followed the journey of a dozen Kiwis volunteering on the Africa Mercy, and met the courageous patients receiving free essential surgery onboard.

Why not receive a notification of the TVNZ free-to-air programme airdate by joining Mercy Ships NZ’s monthly EDM (you can unsubscribe at any time), and then you can plan to have a few friends over to watch along with you!

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Bill and Lynda Williams, Mechanical Fitter and OR Nurse.

When operating theatre nurse Lynda Williams learned about Mercy Ships providing free essential surgeries provided to Africa’s poor, she was immediately engaged and interested in volunteering. What came as a big surprise was that her husband Bill’s trade skills were also in high demand on the hospital ship and they loved the idea of serving as a husband and wife team.

The Fielding couple has returned this week from a six-week tour-of-duty aboard the 16,000 tonne Africa Mercy currently docked in Conakry, West Africa. Bill sums it up as ‘Hard work that’s great for the inner soul.’

Lynda was rostered on duty in the vessel’s six operating theatres. Her surgical teams performed tumour removal for large benign yet often life-threatening tumours, and more recently ophthalmic surgery for patients of all ages. ‘The last two weeks I contributed to the healing of people of Guinea who are blinded by cataracts by scrubbing every day in the eye theatre. Although the hours are long, and some of the cases are all day long, the crew we work with are great – surgeons and anaesthetic people even helping to mop the floors, take out the rubbish and saying thank you often!

Bill Williams, Mechanic/Fitter.

Bill has a lifetime of trade skills in including industrial refrigeration engineering and plumbing. This experience proved to be invaluable on the Mercy Ship which not only contains a self-sufficient surgical hospital and axillary services, but is also home to  450 crew from more than 40 nations. The Africa mercy is large a town where the main industry is a hospital. Therefore Bill’s work crossed between industrial and jobs that were more domestic in nature. Bills explains, ‘I learned a lot while on board but I also brought a lifetime of engineering skills which became very useful and benefitted the ships engineering department.’

Both Lynda was impacted by the level of need they witnessed ashore Guinea.  ‘There are many people in Guinea who cannot afford safe and timely medical care, as 55% of the population live on less than NZ$2.50 a day. There is a shortage of trained doctors and nurses (less than 1 surgeon per 100,000 people). Many people are malnourished and need to have vitamin supplements before and after surgery. Some children also need special feeding programmes so they are healthy enough to enable a successful surgical outcome. Infections, non-cancerous growths, and deformities, (which are not seen in the western world), can kill and maim people who have no healthcare. Children with deformities and severe burns struggle to lead a normal life and are often shamed into covering up or becoming outcasts.’

OR Nurse, Lynda Williams, leads an eye patient out of the OR.

While Bill was keeping things running behind the scenes, Lynda particularly enjoyed interfacing with the patients before and after surgery. ‘I was most impressed with the very first patient that entered the maxilla-facial theatre on the first day of surgery this year.  I was privileged to be the scrub nurse for her operation to remove a cyst from her jaw. The 14-year-old girl walked into the operating room by herself, turned and gave a smile and a little wave before climbing up onto the operating table for her operation. She displayed a total trust and bravery that we would be unlikely to see in our own country.’

‘All the personnel on board were there to achieve the same goal – and it wasn’t about earning money. The experience made me more humble and thankful as to where I was born and live,’ reflects Bill, who has a challenge for Kiwi tradies. ‘We are short of people in the trades to carry out maintenance work – engineers, plumbers, electricians, refrigeration engineers, welders and more.’

Lynda concludes, Volunteering with Mercy Ships has made me realise how easy it is to become comfortable and insular in my lifestyle.  I have much to offer others who have so little. Getting to know faithful people from around the globe has been a highlight of this experience.’

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Mercy Ships recently signed a collaborative agreement with the World Health Organization in the African Region, to improve surgery and anaesthesia services in Africa.

The agreement aims to increase access to surgical care and build capacity of health workers to strengthen surgical care delivery systems.

It was signed in Dakar, Senegal, by WHO Regional Director for Africa Dr Matshidiso Moeti and Dr Peter Linz, International Chief Medical Officer of Mercy Ships.

“This agreement epitomises what the Transformation Agenda in the African Region is all about – joining hands with new partners, working together towards improved, equitable access to healthcare services – to transform people’s lives, bringing hope and healing on the African continent,” said Dr Moeti.

“I hope our partnership will do what you [at Mercy Ships] do so well: provide vitally needed services for those who need it desperately, as well as building up capacity in countries.”

No one left behind

During their bilateral discussion, Mercy Ships and WHO highlighted the gaps in safe, affordable and timely access to essential surgical care, and underscored the need to ultimately work to ensure that no one is left behind.

A report published in The Lancet earlier this year found that there is a severe lack of surgical provision in African countries: the number of operations provided annually was 20 times lower than the crucial surgical volume required to meet a country’s essential surgical needs each year. Furthermore, when African surgical patients can get the surgery they need, they are twice as likely to die after their planned surgery than the global average.

In his remarks, Dr Linz said: “The solution to this daunting and complex problem will require hard work and collaboration from all stakeholders. We are hopeful that our formal collaboration with WHO will be one of those pillars in strengthening access to surgical care across Africa.”

The agreement between Mercy Ships and WHO covers a range of activities including strengthening health systems and building the capacity of health workers, providing technical assistance to the integration of surgical, obstetric and anaesthesia services in National Health Sector Strategies and Plans.

It also includes contributing to health infrastructure development and supplies in partner hospitals and clinics aligned with Mercy Ships programmes and in collaboration with country priorities, as well as documenting and disseminating surgical best practices for improving the quality of care.

Dr Linz was accompanied by Mercy Ships Ambassador for Africa – Dr Pierre M’Pele.

Pictured (l-r): Dr M’Pele, Dr Linz and Dr Moeti.

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Motorcycle courier, bookbinder, English as a second language teacher, telephonist, wife and mother – Heather Provan calls herself a ‘Jill of all trades’.  Shipmate is the latest role the ‘70-plus’ year-old with a thirst for adventure has added to her repertoire of experiences.  Not satisfied with anything dull and routine, Mrs Provan’s most recent undertaking sees her volunteering on the crew of the world’s largest civilian hospital ship – the 16,000 tonne Africa Mercy.

This is the second tour-of-duty for Mrs Provan on the Mercy Ship which provides free essential surgery to people in poverty on Africa’s West Coast. She is aboard for three months working in the hospital ship’s laundry. ‘I am a very small cog in a huge organisation, but without the small cogs working efficiently the hospital wouldn’t be possible,’ she explains.

This is the second time Mrs Provan has volunteered on board – last year she served in the dining room team 6 weeks. This year her voluntary work saw her fly into Cameroon, West Africa towards the end of the vessel’s field service.

During that 10 months in Cameroon, the Mercy Ship had provided 2,746 essential surgeries with rehabilitation services, treated more than 10,000 dental patients, and invested in the local health care structure with 1,475 local people attending Medical Capacity Building courses participants.

‘The ship is completely run on donations and by volunteer workers,’ she describes. ‘I work with people from many nations, different cultures and languages – all working in harmony,’

As the Mercy Ship was due to enter a maintenance period in the Canary Islands during her service period Mrs Provan was also able to enjoy time at sea. She had the unusual nautical experience of sailing through the Prime Meridian, crossing the Equator at 0,0. ‘Not just any old bit of the Equator,’ she states, now able to claim the title of Royal Diamond Shellback for the rare feat, with a certificate to prove it.

With support from Mahurangi Presbyterian Church, Mrs Provan will continue her volunteer work through the maintenance period in The Canary Islands, the return sea voyage to Africa, and conclude after the vessel has arrived in the new field service location of Guinea.

‘This experience satisfies my desire to help others and has given me amazing experiences and adventures,’ she reflects. ‘I feel each day is a gift from God and I must make the most of it. God is still teaching me. He has given me such blessings during my lifetime; I want to be a blessing to others who are less fortunate.’

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Marthe takes a bow for the nurses after recovering from her life-transforming surgery

 

Hannah Peters’ huge heart took her to Benin, Madagascar and Cameroon caring for people with devastating conditions. She shares the remarkable transformation that occurs on the inside and outside of her patients, and Marthe in particular. Read Hannah’s story in That’s Life magazine here

 

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Victoria was on her own in the world

Victoria never lost hope. Not after her parents died when she was a girl, not after she was forced to start begging in the streets, and not even when she began developing a massive facial tumour when she was only 18 years old.

Now, the resilient 23-year-old sat on the deck of the Africa Mercy, one hand holding a blue cloth to her bandaged face. Above the white bandages, her eyes sparkled when they caught the sunlight. It was difficult for her to speak after her tumour removal surgery, but warmth radiated from her smile. Her story was begging to spill out.

Her journey, like that of many of the patients who come to the ship, was marked by courage. It was not a short one … nor was it easy. Her travels took her from the far north, beyond Cameroon’s borders, on an arduous three-day journey to the port city where the Africa Mercy is docked.

Orphaned from an early age, the brave young woman made the trip alone. She was accustomed to facing obstacles. She had spent her adolescence fending for herself – living on the streets and sometimes forced to beg for money. Then the tumour appeared, slowly expanding over her face, affecting her in ways that stretched beyond the physical. It was difficult to eat or speak clearly. People avoided looking at her, and it became more challenging to find work to earn a living.

Victoria could have easily given in to the bitterness of a hardened heart. But, even in these difficult circumstances, her love for Jesus remained. It shone brilliantly in her eyes and was evident in her gentle spirit.

After hearing about Mercy Ships, Victoria bravely left the familiar behind for a chance at a brighter future — one without the weight of the tumour that had burdened her for five years.

“Victoria was all joy the night she came to the ship. The surgery took some of her energy and spark. Yet, through moments on the ward and dances down the hall, Victoria recovered

Victoria’s eyes tell the story of her healing

well both in heart and health,” said Kayla Bissonette, a volunteer ward nurse. “What was once work and exercises changed to laughs and friendships during her stay … the smile that reaches her eyes is how I’ll remember her!”

Victoria’s time on the ship gave her plenty of opportunities to exercise her engaging smile. While recovering from surgery, she celebrated her 24th birthday on the Africa Mercy, surrounded by fellow patients and caring crew members.

Before long, Victoria’s bandages were removed, and she saw herself tumour-free for the first time in years! “Thank you for making me beautiful,” she said to a nurse.

“You’ve always been beautiful,” the nurse replied.

Victoria’s first surgery left her free to eat, speak, and move with much more ease than before, but her journey to a full recovery was not yet complete. A routine second surgery awaited her to tighten the stretched skin on her chin.

But as she sat on the deck in the warm sunshine, Victoria’s journey to healing had already begun. By bravely telling her story, Victoria shared the hope she received, and her powerful transformation is evident in her beautiful smile and sparkling eyes.

‘Thanks for making me beautiful,’ Victoria told a nurse after the surgery to remove her tumour. ‘You’ve always been beautiful,’ the nurse replied.

Story by Rose Talbot

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