Ah, the glamour of being a surgeon on a cruise ship. A leisurely lifestyle, a few cases between shooting skeet and yet another trip to one of several lobster-filled buffets, beautiful sunsets over sparkling, azure water, bikini-clad eye candy on the pool deck and so on. That doesn’t sound much like this ship in any of the mentioned particulars – except that the sun does set every evening. At least we think it does – sometimes the rain clouds hide the event but we assume it occurs based on past experience.
A hospital ship moored to the pier in a third-world port is a slightly different experience than a cruise ship. The heat and the humidity are the same but that is where the resemblance ends. Air-conditioning on this sealed ship is critical for our comfort (especially when swathed in OR gowns and gloves), but requires almost constant effort by those wonderful engineers to keep it running. The city of Freetown is build on the sides of the hills and the torrential downpours of this rainy season wash an amazing amount of trash into the harbor – right next to our ship. The water of the harbor is full of plastic, paper, cloth and other debris. You can find almost anything. One time this week, they counted 15 shoes in the water. Sometimes, it is even worse – one engineer said they saw a dead body in the water recently. Volunteer scuba divers among the crew go down almost daily to keep the intake vents for the cool water clear of plastic. In the bowels of the ship, the engineers are almost constantly going round and round to the big filters which clog in just a few minutes if they are ignored. Without these efforts, no air-conditioning.
The dock itself is also rather primitive. Our security fence consist of containers stacked three and four high. It seems reasonably effective – until we remember all those who cannot get their containers out of port and need the contents therein. With those containers, they have delineated an area a little over the length of a football field and about 60 feet wide. Within that area is a small portable building and two tents that are used for admissions, consultations, limited screenings and so on. All of the vehicles that came on the top deck with the ship, are parked there. It is also here that the crew members who wish to do so, take their daily exercise, walking, running or otherwise gyrating back and forth. Access to the ship is controlled by an electronic swipe card and a dedicated team of Gurkas who appear rather unimpressive in size – but whom no one has the guts to cross.
One of the hardest things for me about serving here is to see diseases that are so advanced that you can do little about them. I saw a man who came in with a non-healing area on the arch of his foot. I was saddened to see that this was a far-advanced melanoma (which commonly occur on the soles and palms on dark-skinned peoples) involving most of the sole of the foot. I was disappointed to find a rock-hard, fixed 6 centimeter lymph node in the groin. There was now nothing I could offer him in terms of surgical or medical treatment, but I could (and did) ask the patient chaplain to talk to him about Jesus Christ. I have not yet heard if he responded to the invitation. I also saw two relatively young women with far-advanced breast-cancer. I am trying to find out what sort of post-operative chemotherapy might be available in-country (which ignores the question whether they can afford it), but a mastectomy to remove the tumor before it rots through the skin is at least an option for them. It is like being back in 1900 in the US. I had one afternoon this week where I screened 30 patients for suitability for possible surgery. Only one could not be helped, so that made me feel better.
This week was Nursing Day internationally and they celebrated by “Crazy Scrubs” day. There wore weird, odd and mismatched outfits. One young woman braided her hair around the wire from a coat hanger so that the braids stood straight out to the sides. The Sierra Leonean day-workers got into the spirit of things as much as possible, but I am quite certain that the patients and their families thought these folks had lost their minds!
There are many tribal languages here but the trade language is a rather unique form of Creole. Like most pidgin English, you understand some of it easily and yet some words and phrases are entirely unintelligible. I am always fascinated when I speak to the patients on rounds. I choose simple words and simple sentence structure – and they look at me as if I was from another planet. The interpreter uses the same words but in a different accent – and they clearly understand. I must confess, however, that sometimes I don’t understand a word they say when they are talking to each other.
Micky and Sean have already settled into a good routine for Sean’s schooling. He loves the classes he takes at the Academy and he is making good academic progress under Micky. He loves the social life here. He has joined the elementary choir, the running club (on the dock once a week) and he and his friends try to get together for DS games and Wii at every opportunity. Last night, they had a Wii party in the cabin of one of the boys. It was rather raucous time when we walked by!
We are looking forward to Sunday when Philadelphia Dembele, Agneta Odera and Arega Fekadu come on board. They are all fourth year PAACS residents. Philadelphia is from Mali and is training in Gabon. Agneta is from Kenya and trains at Tenwek along with Arega Fekadu who is from Ethiopia.
Surgeons OverSeas (SOS) is a secular humanitarian organization who has been working here in Sierra Leone to get the surgical training in-country jumpstarted. Wednesday, the PAACS residents on board and I will be going to the main teaching hospital, Connaught Hospital, to see how we may be able to assist in some way. They are having the same trouble with the West African College of Surgeons as many do – the entrance exam is a killer.
Praise and Prayers:
- Please pray for the adjustment of the PAACS residents to the ship and for me as I establish the right learning environment.
- We are pleased with seems to be a shift in emphasis of on-board life back to one in which Christ is strongly emphasized. This has been something that has been a matter of prayer for us. Please pray with us that evangelism on an individual basis will be emphasized and that those who serve on the ship are open to what God would have them learn.
- Bruce’s Dad has decided to undergo surgery, May 17 (Tuesday). I am very concerned for him, both for the risk of the surgery and that it may not solve his problem. It is in God’s hands. Please pray for safety for him, wisdom for the surgeons and for God’s will.
Yours, for the peoples of Africa and for the Kingdom,
Bruce, Micky and Sean