Spurred on by Connection

This is a copy and paste of an entry that I posted on the Mercy Ships intranet site:

In the Madagascar 2015/2016 Field Service, 85% of the patients that we encountered during our 11 field screenings had problems that are not captured within the surgical scope of practice on the ship.  This is a significant statistic because it represents thousands of patients to whom we have had to say, “No”.

Most people that understand the screening process within Mercy Ships get this.  We’ve been given several wonderful opportunities over the years to share this difficult part of our jobs –  from programs reporting time to community gatherings.  Our closest confidants know how much this part of the job eats away at our spirits.  We caution our applicants about this fundamental aspect when they apply for a position on the team.

For me, one of the most beautiful parts of the Mercy Ships community is how incredibly it supports our team throughout this difficult task.  Extra portions of grace are extended to our team especially in our busiest of seasons.  We truly do feel loved and supported.  With this post, I wish to express our sincerest gratitude and appreciation to you all.

We are in the midst of one of the busiest prep and planning periods that we will do for the upcoming field service.  It seems as if a constant stream of numbers run through my tired brain.  How many patients for this specialty?  How many surgical slots do we save for patients from the interior? We can gain an increase in surgeries here but how does that affect rehab?  Or the wound care team? Or outpatients?   How do we adjust for “no shows” and patients that ultimately will not be surgical candidates?

For our surgeon screenings we always bring in extra patients as a buffer in case some simply do not show up for their appointment, are sick or have a medical problem that delays their surgery, or are ultimately not a surgical candidate according to our scope of practice and the skills of the surgical team.  We do our very best to calculate this as precisely as possible but inevitably we end up with an excess of patients and therefore must triage them, something most medical people are unfortunately all too familiar with.

This evening as I went over some numbers on how many neglected clubfoot patients we would bring in to screen in September, I paused at a thought that I surprisingly have never had before:

 

I am knowingly bringing in more patients than we can help.

 

I am planning on saying “No” to a certain number of patients during every screening.

 

In this particular case, it was just a mere 3 extra patients that I would bring in for this buffer for “no shows” and “no candidates”.  For most surgeon screenings it is usually 10-15.   Is that not such a dismal thought?  Planning to give bad news?

My shoulders slumped and my face fell into my hands as that thought registered with me. I find it difficult to find a silver lining that comes with delivering bad news.  It is simply no fun and each “no” weighs heavily on me.  But that doesn’t mean I still don’t view this job – this work we do as an organization – as the greatest privilege I have ever had.  Because for me, it truly is.  We have the privilege of walking with others through this harrowing process of life and experiencing the vast spectrum of the human experience.  The pain, joy, sorrow, laughter, anxiety, freedom, and adventure.  These dynamic emotions and experiences remind me that we are all connected.

That deep connection that we all share ultimately makes me want to work harder.  I want to strive to improve our procedures and processes in order that they reflect the patient’s best interest.  I want to pursue clinical excellence so that our medical assessments result in fewer patients being canceled for surgery and therefore fewer OR tables empty.  I want to stay up late at night dreaming of creative ways we can improve the efficiency and safety in how we reach out to find and select patients.

What a privilege this truly is.  Again, my sincerest thanks to the entire organization for the love and support that is poured out onto this team.

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Nathan Claus, Screening Supervisor 

Durban

It’s time to play a little catch up.  I arrived back on our ship, the Africa Mercy, on July 29 after a little over three months in the US.  The ship spent most of June and July in Durban undergoing it’s annual maintenance phase.  We typically do this in either Durban or in the Canary Islands depending on the previous and the next country of service.  I arrived in Durban with just two days left in the city before we sailed on to Cape Town (post coming soon about that) and then on to Benin.  It was great to reconnect with friends and explore a new city.

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Afros Chicken Shack on the promenade in Durban. Made for a delicious lunch.

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A beautiful sunrise on deck 8 of the ship on my first morning back on board.

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The pilot leaving our ship on our way out of Durban.

The ship departing Durban.

The ship departing Durban.

 

A mid sailing view from my cabin window.  That's right, after many years with Mercy Ships I now have a cabin with a window.  And even better, it's a single berth!

A mid sailing view from my cabin window. That’s right, after many years with Mercy Ships I now have a cabin with a window. And even better, it’s a single berth!

 

Madagascar 2014 – 2016

 

MadasurgicalpatientsThere is a lot of sentimentality floating around in the organization these days.  After two back-to-back field services in Madagascar, the Africa Mercy has departed the shores of the beautiful island nation we called home for nearly two years.

On Friday, 20 May the last surgery took place on board.  A week later the hospital closed and was packed up for the sail.  Just yesterday the gangway was raised, the moor lines taken up, and the Africa Mercy set sail for shipyard in Durban, South Africa.

It has been an amazing privilege to serve the people of Madagascar.  During my time there I met and developed some of the deepest friendships with people than any other country that I’ve been to with Mercy Ships.  Most guide books will describe the unique beauty of the country.  I can attest to that and will add that it’s all the more rich because that same beauty is found in the gracious and welcoming hearts of its people.

Thanks for your support, which allows me to have such extraordinary opportunities.  Thank you for the part you played in the 2581 patients that received surgery on the ship in Madagascar.

 

Field Service

I’ve been wanting to do something for awhile now and I still haven’t found the time, but I thought it would be helpful to make a glossary somewhere on this website.  There are some terms that we use within Mercy Ships that are quite specific and may need some defining.  So for today’s post I want to start off with a pretty foundational term for us.

Field Service is the period of time that the ship serves in a country.  It roughly follows the North American school calendar, usually starting in mid August and going until the beginning of June (about 10 months).  Madagascar has been unique in that we are nearing the end of back to back field services there.  The few field services prior to Madagascar were in Republic of Congo, Guinea, and Togo.

Due to maritime law and general upkeep of the vessel, the months the ship is not in a field service (June, July, and part of August) we go into a maintenance period.  The ship goes into shipyard and maintenance and upgrades are done.  Usually every second year, the ship must come completely out of water and goes into something called Dry Dock.  The upcoming maintenance period will be in Durban, South Africa.  Most of the hospital crew take PTO and return home during the maintenance period.

At the end of July I will meet the ship in Durban and we will sail to our next country of service which is Benin in West Africa.

Dental Team

Did you know we have a dental team? There is much more to Mercy Ships than the surgical programs that we run on board and one example of this is our Dental Program. Monday through Friday our dental team treats patients at the university hospital in Toamasina. Like our surgical programs, dentists and dental assistants come periodically and volunteer their skills to serve the people of Madagascar. Just last month the dental team treated their 6000th patient since September 2015.

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Cabin

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This is my cabin.  I am in a 3-berth and my space shown here is about 6.5 x 6.5 feet.  It’s cozy but certainly luxurious compared to the 4 and 6-berth cabins I have been in before and that many of the crew are housed in.  I am in cabin 4326, which is located is on deck 4 and about mid ship between the bow and stern.

Fire Teams

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That’s right, we have Fire Teams.  Three, in fact.  Not something you may have thought about but we potentially could have fires on board and if one were to happen it could be pretty bad.

The men and women on these teams work hard to keep us safe.  We also have fire drills every two weeks.  That sometimes gets old for those of us not involved in the action…

All Smiles

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Our orthopedic program has been finished since December but there are some kids still in casts waiting for their bones to fully heal and strengthen.  I remember the first time I met this patient way back in July in Tana.  It was winter then and she finally came to me at the front of the line all bundled up in several layers and wearing a knitted winter cap.

She has had a long period of recovery with some ups and downs along the way, but she exudes such joy every time I see her.

Antsirabe Screening

The posts I make here aren’t always chronological.  Mostly it is because I come across some photos that I realized I haven’t shared.  That is the case again this time.  Scrolling through the archives today I found some photos that were taken at our screening in Antsirabe in December.  It was a really great screening.  We partnered with a company called Socota Group.  They are a fabric and textile company and the largest employer in all of Madagascar.  They have been a wonderful partner to work with.  Instead of using a clinic or hospital like we usually do, we held the screening in a very large, old house that was the former office for the region.  Here are some photos taken by Ruben Plomp.

Patients wait to be pre-screened inside the old house

A patient and caregiver during a consultation with a screening nurse

Patients wait to be pre-screened

This was one of largest screenings and the line of patients waiting to be seen by us stretched far down the street.

Pre-screening a patient with Wenceslas

Our screening and security team plus members of the region and the ministry of communications

Midi Madagasikara Article

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This is an article about our latest field screening in Morondava that appeared in a local newspaper on Monday.  It’s in French but google translate does an okay job…

The man in the photo comes to the ship tomorrow!