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Medical-LiveIamA Nurse who just spent 3 months aboard the world's largest civilian hospital ship... AMA!

May 22nd 2017 by StarGateGeek • 26 Questions • 711 Points

I'm a 27 yo RN from Canada, and just returned from my 2nd tour volunteering aboard the M/V Africa Mercy in the West African country of Benin. The AFM as we call her is the largest ship of her kind outside of military hospital vessels, and is operated by Mercy Ships, an international NGO focused on providing free, safe, high quality healthcare to some of the poorest countries in the world. All of the 400+ volunteers from around the world are paying their own way to be there.

During this past field service in Benin, over 1700 patients received surgery on board, 1800 local professionals received training and mentoring, and over 6000 dental patients were seen.

My job on the patient wards involved prepping our patients for surgery (including a lot of teaching about how things will be done and what to expect), and caring for them after they've recovered from anaesthesia, until they're well enough to return home. I mainly worked with hernia and soft-tissue tumor patients, but my MVP's (most valued patients) were women we treated for Obstetric Fistula. This condition is relatively unheard of in western countries, but affects millions of women worldwide. Lengthy, obstructed labor often leads to a still birth, and on top of that chronic incontinence, which in turn leads to a cycle of shame, ostracism, and emotional pain. I've never met more brave, beautiful, and inspiring women than in my time working with fistula patients.

Ask me anything!

My Proof: http://i.imgur.com/1Wi6B7s.jpg

EDIT: Hey folks! Thanks for all the great questions!

I'm going to take a little break for lunch, and try to get some unpacking done. :/

I'll be back around 1PM EDT.

In the meantime, check out endfistula.org. Tomorrow, May 23rd, is the International Day to End Fistula. Please spread the word about this devastating but relatively unknown condition!

Edit 2: Forgot my disclaimer.

Although I am currently serving with Mercy Ships, everything communicated here strictly reflects my personal opinions and is neither reviewed nor endorsed by Mercy Ships. Opinions, conclusions and other information expressed here do not necessarily reflect the views of Mercy Ships.

Edit 3: Thanks everyone for all the interest and fantastic questions!

I'll continue to answer questions if more come in, but before it gets too late I want to remind people about the Day to End Fistula tomorrow. Spread the word!

Also, keep an eye out on the NatGeo Channel for their documentary filmed last fall, The Surgery Ship. It's out in Australia, and some parts of Europe...no word yet on when it will air in North America.

Cheers!

Q:

You're a wonderful person for doing this ! How were you recruited for this and how was your employer during your absence ?

A:

I feel lucky for the chance! It's the most positive and patient-focused work environment I've ever been in. It really doesn't feel like work at all.

My employer has been, fortunately, very flexible and willing to give me a leave of absence when I've requested it.

EDIT: Ah, and as for recruiting, my dad actually saw a documentary about Mercy Ships back when I was in University still...sent me a message saying, "Hey, so, you need to do this."

I looked into it, and ever since then had been working towards having the experience and financial stability to pull it off.

Double edit: Just noticed my blatant missed opportunity for a Benin pun.


Q:

1800 local professionals received training and mentoring

Can you elaborate on this a little bit? Was this training related to the healthcare, or was it more specific to the professions of the locals?

A:

Yes and yes.

We had surgeons, dentists, and nurses mentored by our volunteers, we had OR checklist safety, neonatal resuscitation, instrument sterilization, to name a few of the workshops we put on.

There's also some other forms of capacity building we're involved in, like agriculture training, and refurbishing and better equipping local hospitals and clinics.

Our aim is to work ourselves out of a job. If we can improve the infrastructure and make it easier for people to access quality healthcare, someday we hope our work will no longer be necessary.

Edit: Whoa!!! Thank you, mysterious stranger.


Q:

How did the general population of the places you visited view your presence? Did you have to do a lot of outreach? Were most people welcoming or skeptical?

A:

There's definitely a mixed response. Most people, when you're walking around, will say, "Yovo! (white person) Mercy Ships? Ahhh! Mercy Ships!" Definitely widely recognized, in part because we're usually the biggest group of yovos/foreigners in the city in which we're docked.

Screening teams travel far inland to reach some of the more remote and isolated places, and as well print, radio, and TV ads air throughout the country to encourage people with the kinds of problems we can treat to seek out a screening event.

Most people are very grateful for the help. Mercy Ships has visited most countries in West Africa multiple times, so there is definitely a reputation by word of mouth from previous patients. Vodun (the origin of Voodoo) is widely practiced in the region, so some people tell us stories that they were warned against coming to us for help. People say that we cut off tumors and then use them for some kind of evil practice. The overlying attitude, though, is very grateful and appreciative.


Q:

thanks!

A:

Thanks for the question!


Q:

I've never heard of Mercy Ships before, so thanks for spreading the word! How long do you stay in port? Was it difficult leaving everything behind to do this?

A:

My pleasure! I take every opportunity I can to share about it.

The ship spends about 10 months every year in one country. It is currently wrapping up its field service in Benin, and in a couple weeks will head to the Canary Islands for some repairs and maintenance. At the end of the summer it will be heading to Cameroon for another 10 month field service.

The first time was harder than the second time, for sure, because I knew what I was getting myself into the second time! Being away from family is not as hard as it was a decade or two ago. You can stay in touch so easily, and we are fortunate to have pretty decent wi-fi on the ship. Leaving the ship behind and coming back to "real life" tends to be harder.


Q:

I've never heard of Mercy Ships before, so thanks for spreading the word! How long do you stay in port? Was it difficult leaving everything behind to do this?

A:

It's not the sketchy that stops you from going out so much as the incredible heat/humidity, the inconvenience of getting the shuttle out of the port then walking or finding a taxi in the incredible heat/humidity, and the fact that you aren't exactly raking in the dough.


Q:

Do you find yourself more willing to try different foods knowing your going home to a hospital?

A:

Ha, it's nice having that reassurance, but I am still always super careful about foods. Local food isn't usually an issue so long as it's well cooked and doesn't involve raw fruit or veg.


Q:

You mention that all the volunteers on board pay their own way. If you don't mind me asking, what if any financial costs are there to consider for this type of thing? Also were there ever times where you or the ship were in possible danger?

A:

Sure! If you're from a "western country," you pay $700 USD for crew fees each month you're there. You do get a bit of a discount for longer service, and if you're alumni. Volunteers from developing countries pay 1/2 the usual fee.

Flights are also a big expense, and often cost as much or more than your crew fees.

I've never felt at risk on the ship. Ashore, your safety is almost always up to your common sense and making sure you take reasonable precautions.

Travel in groups. Wear a helmet if you're going to take a zemidjan (motorbike taxi). Dress modestly, especially at night. Keep your valuables out of sight or leave them on the ship.

The only time people have been injured or threatened was when they didn't follow these precautions.


Q:

You mention that all the volunteers on board pay their own way. If you don't mind me asking, what if any financial costs are there to consider for this type of thing? Also were there ever times where you or the ship were in possible danger?

A:

And you're welcome! If you do make the leap, feel free to PM me with any other questions you have. :)


Q:

Do you have a weird fascination with veins like my RN girlfriend does?

A:

Baahahah I definitely do.


Q:

ugh. gross. she just likes to touch them and poke them and constantly ask if she can put an IV in me or whatever. NO. you guys need to cut the shit.

A:

They're just...so pretty!


Q:

I'm currently working as an EMT, do you know if there are any BLS positions on the ship?

A:

Strictly speaking, no. Our focus is mainly on chronic conditions, not acute. However, there are plenty of positions that any lay-person can fill (like food services, reception, deck hand, or housekeeping), and you could still be involved in patient care in other ways. Or on the ship's fire team if you have experience there!


Q:

Thanks for the response, I will definitely look into it!

A:

Ah, I should also mention the heightened precautions we took being in West Africa since the Ebola outbreak, and recent outbreaks of Lassa Fever and other highly infectious viruses.

Every person entering our berth space in the port had a temp check, and handwashing was mandatory before coming aboard.

Patients are screened for malaria, and for a history of travel in high-risk areas.


Q:

Wow, you are just as inspirational as those women you helped. What is one great thing you learned from these women, and how do you look at life differently after this experience?

A:

I learned the power of community. Most of our patients come to the ship looking apprehensive, quiet, and ashamed. Within minutes of arriving, though, the patient on the next bed over will be sharing their story, explaining what all the weird gizmos on the wall do, and how to use the toilet. The camaraderie that develops between our patients is incredible, and that accepting, supportive community around them does more to heal them than the physical repair ever could.


Q:

Does the ship jump from dock to dock in Benin and send out dinghies to get the patients, or do most patients come to the ship in their own vessels?

Also, what advertisements do you use, or is it more word of mouth?

A:

The ship is docked in a port where you can walk on via a gangway. We do help cover transportation costs for patients who live far out of town, and sometimes drive them ourselves if need be.

TV, radio, and print ads are used, but word of mouth is definitely still the most effective at reaching very remote areas.


Q:

But this doesn't make sense? I thought they needed staff to work the ship?

A:

All the crew are volunteers, and we all pay crew fees to cover the costs of our accommodation and food.


Q:

I had thought it would be cool to do for a bit. I could take a month and paying my travel and stuff...but I'm in IT and the current position I'm qualified for they want 2 years. I most definitely cannot afford to take 2 years off!

A:

You could certainly try to apply or email one of the crew coordinators to discuss it. If the need is urgent, they would be more likely to take any time you can give.


Q:

what made to you decide to do this?

A:

I knew I wanted to do some sort of relief or humanitarian aid work eventually. That's why I became a nurse.

I ended up liking surgical nursing, got my first job there, and it all just seemed to line up really well with the work done by Mercy Ships.


Q:

How do patients find out about the ship or do you find them somehow?

A:

We do send teams out to major towns inland, but we also use TV, radio, print ads, and word of mouth.

The ads explain the types of problems the ship is equipped to fix.


Q:

[deleted]

A:

There are precautions, screening, and protocols in place to protect the ship from infectious diseases, absolutely. The last two field services were in Madagascar because the risk of Ebola was too high in the countries in West Africa, and a ship is like a little powder keg of infection waiting to explode if anything got on board.

There are also reasonable precautions you can take to keep yourself safe. Wear modest clothes, avoid certain areas, never go out alone, don't go out at night often, and if you do only in large groups. I can't speak to Liberia specifically as I've not been there, but these are generally good rules of thumb to follow.


Q:

[deleted]

A:

I did have some fairly burly deck crew with me most of the time. ;)


Q:

A family member works there atm, but he tells me there are some strange things going on like patients will only be treated if they are Christians, Muslims are turned away. That's a bit odd isn't? He also tells me drinking alcohol is forbidden, but of course it still happens. What do you think about the strict rules?

A:

Well, I think they're exaggerating. We've had many muslim patients on board, even setting up a prayer room in an empty ward for them.

The ship is dry, but it's not a problem to have a drink with dinner off the ship.

The rules are a bit strict, but this is because Mercy Ships holds its crew to a high standard, and wants to maintain a reputation of integrity among the host countries.


Q:

Ah yes they told me they heard it from someone in Benin, I think there's more to the Muslim story than my family member knows. I understand they want to maintain there image, still it sounds a bit strict to me, especially when you are months on end aboard and are not allowed to receive visitors of the other sex in your room or have a fun night out with plenty of drinking. But maybe it's because there are a lot of young people working there and they want to keep them in check. Still I find the stories about the ship quite outlandish, because of Christianity being so overly present, mandatory church/prayers in the morning etc. But good work, lots of good stories too.

A:

Church also isn't mandatory...there's only one mandatory meeting and it is purely informational updates for the week. There is usually one worship song and a prayer at that meeting, but the church services aren't mandatory.

That said, faith is a huge part of how and why the ship works. I can understand it being challenging for someone with different beliefs. From my point of view, though, there's a very open and accepting atmosphere among the majority of the crew, regardless of your beliefs.


Q:

Think about going to Columbia or Venezuela?

A:

Me personally, or the ship?


Q:

To work for

A:

The point of working for a charity is not generally to make big bucks.


Q:

Are you planning on volunteering in the US next, since they are cutting back on healthcare coverage?

A:

The situation in the US is not quite as desperate as that of most of Sub-Saharan Africa.