Sinclair Carter, Second Engineer on the 16,000 tonne Africa Mercy, says his days were busy and never boring. They wouldn’t be. After a career at sea, Carter has recently returned from volunteering his maritime skills with Mercy Ships, the hospital ship charity dedicated to providing desperately needed surgical services and medical capacity building to the under-served in Sub-Saharan Africa.

Published by Professional Skipper Magazine (Jan/Feb 2021 edition) 

‘The scale of the ship’s operations is massive,’ explains Carter. ‘The Africa Mercy is self-sufficient, with its own generators, firefighting, fuel and oil systems, sewage treatment plants and heating, ventilation and air conditioning systems – all of which must function to support a crew of over 400. The ship also needs to power hospital facilities such as X-ray machines, CT scanners, and for the five operating theatres, five wards and axillary hospital services onboard. The free operations provided onboard for the poor include burns reconstructive surgery, cleft lip and palate reconstruction, benign tumour removal, paediatric orthopaedic corrections, womens’ health and cataract surgeries.
The technical crew makes up roughly 30 % of the volunteer crew onboard the Africa Mercy, which includes a large contingent of medics as well as operational crew. The engineering team plays a vital part in maintaining the operating platform so that surgical treatment can be carried out for people in the region without access to essential surgery.

‘With four main B & W engines along with the 4 MAN 21/31 generators, each of 3120kW, the engineering team maintains the constant power supply necessary to supply the operating theatres, air conditioning units are needed to keep the ambient temperature and electrical systems have to be maintained to all other areas of the Mercy Ship. There is an interdependency within the Africa Mercy, and the engineering team ensures the power to run the medical and other facilities onboard is always available.

‘As an engineer used to working in a commercial environment, one of the big differences on the Africa Mercy was the higher number of passengers – which includes medical and operational crew, and the 25 families of long term crew members who live onboard. This necessitates additional resources to manage the electrical, HVACR and sewage requirements. This means the engineering team includes electricians, plumbers and HVACR technicians. The hospital ship has its own medical waste incinerator and medical waste convertor which also require regular maintenance.’

Acquired by Mercy Ships in 1999, the Africa Mercy is almost 40 years old. The vessel was retrofitted from a Danish inter-island rail ferry to hospital ships. As a result, there are a few idiosyncrasies to contend with. Now carrying up to 400 passengers who live onboard, the need for air conditioning, sewage and water increased exponentially. Additional air conditioning units were placed throughout the ship which makes the maintenance of these units challenging due to their decentralised location.

‘Because a rail ferry doesn’t have large fuel requirements, when the ship was refitted, ballast tanks and dry tanks were used to hold the additional fuel required to operate a hospital ship. As fuel in Africa is not always readily available, the Africa Mercy tends to carry more fuel in the event of needing to sail urgently, explains Carter. ‘Using ballast and dry tanks, there would be a higher risk of contaminants and water ingress from wear and tear of pipes so extra maintenance was necessary to keep everything in good working order.

‘Direct access to the engine room was cut off when the operating theatres and hospital wards were built the same level as the rail ferry entrance and exits, creating a challenge to move materials and goods in and out of the engine room, now needing to be moved through the hospital area.’

Typically, Carter checked in with his team first thing in the morning and allocated work accordingly, knowing that generally within the first hour all planning would go out the window as more urgent work was needed first.

One aspect of the role he says loved most was training the team and watching them learn. For many of the African volunteers this was the first opportunity to gain their certificates and to progress up through the ranks to the next stage of their career. Carter would often run evening training sessions for his ‘guys’ and there was always a roomful of attendees.

When doing his last round in the evening, he would often find one of the team studying, sometimes with one of their team mates who wasn’t even on duty. ‘Togetherness reigns; if one succeeds, they all succeed! No tall poppy syndrome there!’ he affirms.

Carter’s wife Kathy also volunteered onboard; as Deck and Engineering administrator. Originally their service was to be for three months, but they extended it – twice. Her role was to keep both technical teams running smoothly. She found it interesting and varied.

‘There were monthly rosters and changes to rosters as crews changed, and engineering reports which had to be provided on a weekly and monthly basis,’ Kathy explains. ‘Mercy Ships is registered under the Malta flag so any officer that starts has to have their credentials submitted to Malta for approval. It is also important that any information relayed at the meetings was passed on to the teams so I would attend the morning catch-ups with each team and pass on any information deemed necessary.’ Kathy says her work was very crew-orientated, with a lot of data entry and report writing – but also there was a bit of ‘camp Mother’ in looking out for the team. ‘The crew were all special and would come to ask for help for a variety of reasons. Of course, the Captain and Chief Engineer also had occasional requests that needed to be looked after,’ she adds.

In February 2020, several weeks shy of the Africa Mercy 10-month surgical schedule duration, the Carters arrived to the field service in Senegal, West Africa. ‘Patients were arriving daily for their surgeries, the hospital was full of patients and families and the sound of laughter and singing permeated the ship’s wards,’ recalls Carter.  Then suddenly in March, the unprecedented global spread of COVID19 required immediate contingency, and the NGO paused the field service for the health and wellbeing of crew and patients. Shore leave was cancelled and surgery wound up. The vessel relocated to the Canary Islands, where it remains in an extended period of maintenance, until their return to Senegal in April 2021. The charity quickly refocused their healthcare work for this period into eLearning and online training for their healthcare colleagues in West Africa.

‘Onboard, community life was very important, particularly whilst we were in lockdown,’ explains Carter.  ‘Everyone was very supportive to one another. There were regular activities organised to keep the morale up as many crew returned home. Life onboard was quite different to when we were in field service. Sad to leave, we finally departed the Africa Mercy in August after serving a total of six months.’

Deployment of the world’s largest civilian hospital ship – Global Mercy™

In February 2021 Carter steps into the volunteer role of Second Engineer aboard the new Mercy Ship; 37,000 ton Global Mercy™, soon to undergo sea trials. Once again Kathy will also join the vessel’s crew as Technical Administrator.

The Global Mercy™ is scheduled to begin the journey to Africa in 2021 and will also operate in the sub-Saharan region, complementing the work of the Africa Mercy. The ships will operate on a staggered cycle of six months, ensuring there is always one vessel in service. The first field service location will be in West Africa, providing desperately needed operations for people who have no other access to the healthcare they need.

The global backlog of surgery means there has never been a more urgent time for Mercy Ships to increase healthcare services. The deployment of the Global Mercy ™ will more than double the surgical care and medical training Mercy Ships can provide for people who live in low-income countries in Africa.

The Global Mercy ™  will be crewed by 600 international volunteers in medical, maritime and operational roles. The 174-metre vessel has two hospital decks and includes six operating theatres, six wards, isolation, auxiliary services – and an ICU suite sponsored by private donations from New Zealand.

In addition to providing six surgical specialties onboard, the medical capacity build teams will serve alongside their local colleagues, multiplying the impact of mentoring programmes. To enhance this capability the Global Mercy ™ will be outfitted with state-of-the-art training spaces featuring a simulation lab with virtual and augmented reality, mannequins and other surgical training tools. Significantly, a simulated post-op care space will allow trainers to reproduce local operating conditions and limitations in order to teach best practices in low-resource environments.

Mercy Ships has volunteer opportunities for maritime, medical and operational crew in 2021 and beyond to help the charity double their impact for the under-served poor in Africa. For further information visit www.mercyships.org.nz/volunteer

Download the print article Professional Skipper Jan-Feb 2021

Take a tour of the Global Mercy™ as the vessel is prepared for sea trials