Nate Claus

Chicago // Illinois // USA

Interior Screening


Last Wednesday we returned from our Interior Screening Trip.  It was an incredible trip and a perfect way to end my time with Mercy Ships.

The following is a transcript of what I said about the trip during our Programs Reporting Time on the ship last Friday.


Good morning and thank you for joining us today.   My name is Nate Claus and my role on-board is Screening Coordinator.  My job so far this field service has largely been centered around the interior screenings in Oyo, Ouesso, and Impfondo that we are here this morning to tell you about.  Before we really get in to all the details I’d like to invite Mirjam up to share some thoughts that many of us on the team had in regards to what we would share with you today.

(read by Mirjam)

We’ve been asking ourselves how we should measure the success of a patient screening trip.  Is it purely statistics?  Or surgery slots filled?

The numbers are important, but they don’t tell the whole story.  Every number has a name, and every name is a life, individuals with their own story to tell.  When we talk numbers, we must not forget about the one.

So rather than focusing on numbers we want to present to you the people for whom this whole trip was about.  We want you to be as excited as we are about the people whose lives have strategically intersected with ours over this past weeks.  People like Simon, who despite the large Neurofibroma on his face, couldn’t stop smiling after he received his patient card. Or Benjamine who sustained serious burns to both her arms and neck 6 years ago. Or Siara, born with a cleft lip and palate, she and her mom are living in Impfondo as refugees from the Central African Republic.  Or Chadley, Annie, Brunelle, Emanuel and Esperance.  People who now have the opportunity to have the surgery they never thought would happen, and ultimately dignity restored & hope renewed.

With the Oyo, Ouesso and Impfondo screenings complete and hundreds of kilometres travelled by car and plane, we are looking forward to receiving all these patients in Pointe Noire.



(back to Nate)

I’d like to start by introducing the rest of the incredible team I had the pleasure of journeying into the interior with the past two weeks.  For some strange reason I was deemed suitable to be the leader of this pact and entrusted with the responsibility of organizing and heading up this trip but I could not have been even remotely successful for it not with the efforts of these people standing up here with me.  This was a team in every sense of the word and I never doubted once that this group could accomplish what we set out to do.  So my first of many thanks goes to each one of you.  Thank you.


Let me introduce them.

Matt Tveite is programs security officer on the ship.  Matt was in charge of security for the screenings and transportation logistics.  He worked tirelessly to get our lassez passiers from the government so we could freely travel all the routes we needed to.  He was on duty 24/7 for the last two weeks and we knew he had our backs.

Steven is the 4th Engineer on the Africa Mercy.  His role during the trip was a part of Matt’s security team.  He was also our car mechanic, comic relief, and token cowboy.  And, after two weeks on the Congolese roads we can all say that he now is able to drive stick.

Krystal Remers is a ward admin assistant and on the trip was also part of Matt’s security team.  She was the gentle rose between the two thorns of the security team.  She was always willing to help with whatever needed to be done and was a great addition to the team.

Mirjam Plomp is a nurse in the screening team and was my right hand woman during the trip.  I was thinking back to September when she was a last minute addition to the assessment trip we took, asking to come along to learn the ropes.  Now, a few months later, she is all set to take over for me as screening coordinator come Monday.  She is well-prepared and I have no doubt she will do an incredible job.

Jasmin Biddell is a new addition to the screening team and was along as a screening nurse.  She brought her taste for good coffee, enthusiasm and adventurous spirit to the team.  Mirjam also wants me to say that she was the perfect replacement for her husband.

Missy Brown is Assistant OR supervisor and an expert Mercy Ship’s nurse.  She acted both as a screening nurse and the OR scheduler for the trip.  She was essentially our expert consult for all things surgical and she happened to turn the big four “O” on the trip this past Tuesday while we screened in Impfondo.

Keith Brinkman serves as Programs Administrator on the Africa Mercy and joined us for the last screening in Impfondo.  He is an expert gate person having stood his post at the gate for 5 total Mercy Ships screenings.  It was a pleasure to have his enthusiasm with us for the last portion of our trip.  I’m pretty sure he already has dibs on certain patients we saw during the screening as his “befriend a patient” so if you can’t find Keith around the ship look for him down in the wards.


So, why do we screen in the interior?  If you’ve been around Mercy Ships for a little while, then you’ve probably heard more and more talk of forging into the interior to find our patients.  It goes without saying that a large portion of our patients will always come from the port city.  However, to truly reach the people of Congo, we must look further than the city we are docked in.  Beyond Pointe-Noire and Brazzaville there are Congolese people that desperately need the surgical services that we can provide.  Generalizations can be dangerous, but it is probably fair to say that most people living outside the main cities have little to no access to healthcare.  It either doesn’t exist, especially in the case of specialized surgical treatment, or they simply cannot afford what is available.  Consider a poor farmer in a small village with minimal income.  He has to decide whether he will spend his money on food, or his children’s education, or for travel expenses all the way to Pointe-Noire hoping for healthcare on a big white ship.  And all of this travel and expense is without any guarantee that he will even be selected for surgery.  That may not be a gamble he is willing or even able to make.  These are the very people we have come to serve.  Since they cannot reach us, we travelled across this country for 12 days looking for them.   It truly is an honor to serve these people and we are grateful for the opportunity to do so.

So the beginnings of the interior screening actually happened several months ago in September when five of us from the ship traveled to the screening sites on an assessment trip.  Our goals were to assess the sites for patient flow and security; establish contacts and build relationships with the Hospital Directors and our partners; rendezvous with selected orthopedic patients; determine transportation logistics for future selected patients; and to have trainings with representatives from the Ministry of Social Affairs.


Screening Assessment Team in Ollombo, Congo


As I mentioned, we held trainings with representatives from the ministry of social affairs.  The purpose was so that they could help identify appropriate surgical candidates for us and direct them to the screenings.

Andrea and Sophie provide training in Oyo, Congo

Andrea and Sophie provide training in Oyo, Congo

Partners: For the last several months we have been working with Felbo, a Congolese NGO, to help us advertise for the screenings.  Of course a big partner in our work has been the Congolese government, who have been providing free transportation to and from the ship for the patients that we have selected.

So where did we screen?  Oyo, Ouesso and Impfondo

Oyo is a town straddling the plateau and cuvette regions. It is about a 450 kilometer drive from Brazzaville.  I never managed to find statistics on the size but Wikipedia tells me the neighboring city of Owando, which is a bit larger than Oyo, has a population of around 26,000. Ouesso is another almost 500 km drive further north from Oyo.  It is a town of around 20,000 people in the Sangha province.  The Sangha province has somewhere between 200,000 and 300,000 inhabitants.   Impfondo is almost directly East of Ouesso by a few hundred kilometers but it is only reachable by plane or river barge from Brazzaville.  Impfondo is also a city of around 20,000 people.

While I am talking geography I’ll just mention that it was very encouraging to us as we registered patients when we realized how far they came to get to the screenings.  Several came from distances over 300 kilometers away.  This was encouraging because the word had indeed gotten out about our screening plans.

How did we get there?  Getting to the places we needed to screen was a mission unto itself.  You may think I am kidding when I say this but transporting our vehicles on the train from Pointe-Noire to Brazzaville in time to drive to Oyo for our first screening ranks as one of the greatest accomplishments of my life.  Steven and Courtney, who worked for an entire day in Brazzaville this past Monday to get the vehicles back to us in Pointe-Noire probably know that I definitely am not kidding.  It was one of those experiences that I’ll remember forever, don’t ever want to repeat, and finally am able to laugh about….at least a little.


To get up to Impfondo we had the great experience of getting to fly up to Impfondo on a Mission Aviation Fellowship 10-seater Cessna.



In my notes I have written “Find more patients!”  Our goal was as simple as that.

 During the ten month field service in Congo we aim to do approximately 1600 surgeries in Max Fax, Plastics, VVF, Ortho, and General specialties.  Six hundred spots have been reserved for patients outside of Pointe-Noire.  In November we had our screening Brazzaville which yielded almost all of the 300 patients we planned for from that city.  That left almost 300 open spots for the interior screening trip to fill.

 Statistics:  We promised numbers so I’ll move on to statistics now….

The totals are for all three sites combined.  554 total potential patients came to the screenings.  We scheduled 172 and had 291 spots available.  The breakdown by specialty is as follows:

Max Fax: 55 out of 129 spots available

Plastics: 18 out of 35 spots available.

General: 87 out of 87 spots available.  15 patients put on wait list.

Vesico Vaginal Fistula (VVF): 12 out of 40 spots available.


With that, I’m going to invite Missy up to share.

(Missy shares personal reflections, as the OR scheduler, getting to interact with every single patient that we selected to come to the ship for further screenings.)

 (Photo slide show)


On behalf of the whole team, it has been an honor and a privilege to represent Mercy Ships as we searched for patients across Congo.  Thanks especially to Gerrit and Esther for entrusting us with this responsibility, and to Laura and Amy for keeping the screening team afloat while we were away.  Thank you to the entire crew for all of the prayers and encouraging notes we have received.  It was comforting to know that we had hundreds of people on the Africa Mercy and all over the world standing behind us.  It is a pleasure to serve the poor alongside you.

Nate Claus, 13 December 2013 // Pointe-Noire, Republic of Congo

End of the screening day in Ouesso, Congo

End of the screening day in Ouesso, Congo

Fun times at the president's ranch on our day off in Oyo
Fun times at the president’s ranch on our day off in Oyo

Oyo Hospital on screening day
Oyo Hospital on screening day



The Vernel Effect

I love this post by a friend of mine on the ship.  Really, really good.

Brazzaville Screening


The screening in Brazzaville was a success.  We scheduled 296 patients for further screening back on the ship in Pointe-Noire.

Screening Team


The Screening Team at the end of the Brazzaville Screening Day // Brazzaville, Republic of Congo

Brazzaville Bound

In a few hours I will board a plane bound for this nation’s capital, Brazzaville.  Tomorrow at this time we will be in the thick of our screening there.  It has been a busy, challenging, and tense last few weeks organizing for this screening.  It has taken nearly the same energy and effort that we put into our “main” screenings except that this one is happening over 1000 km from the ship.  Roughly 60 of us from Mercy Ships will be there to screen around 1000 patients that have been pre-registered by the government (with our guidance).  It turns out we are struggling to find enough patients in some specialties so far so everyone’s hope is that the right patients enter through the gate tomorrow morning.  We will see…



Live music  at Le Losange // Pointe-Noire, Congo


Vote Against Germs

Germs are bad (most of the time).

I want to tell you about my friend Christina Fast and the work she has been doing here in Congo and West Africa for the past few years.  Christina is a sterile processing technician from Calgary, Alberta who is passionately working to improve sterilizing conditions in hospitals and clinics in Africa.  Some of the surgical departments she has visited have post-operative infection rates as high as 90%.  A lot of these infections are due to improper sterilizing techniques and procedures.  She provides these departments customized training that is adaptable to their low resource setting in order to help bring them up to international standards.

I first met Christina in Guinea and it has been a great pleasure having her back on-board again in Congo.  I am amazed and inspired by the work that she is doing.  She has started an NGO called Sterile Processing Education Charitable Trust.  Currently she is in the running for a $100,000 grant from Grand Challenges Canada.  Please check out this video and vote for her organization so she wins!  The grant money will go a long way towards interventions that literally save lives.


Interior Photos

Our team stopped to take a photo at the equator // Makoua, Congo

Our team stopped to take a photo at the equator // Makoua, Congo

Trying to capture the sunset // near Ngo, Congo

Trying to capture the sunset // near Ngo, Congo

Meeting our first orthopedic patient // Nkayi, Congo

Meeting our first orthopedic patient // Nkayi, Congo

Pirogues on the Sangha river // Ouesso, Congo

Pirogues on the Sangha river // Ouesso, Congo

Team photo // near Etsouali, Congo

Team photo // near Etsouali, Congo



Exploring the Ngoko river between Congo and Cameroon on a day off in Ouesso // 27 September 2013


Assessment Trip Report

I thought I would copy and paste a brief update about my last trip that I was asked to write for the news page on our intranet.


A team of five from Mercy Ships along with one government partner returned this week from a nine day trip throughout the Republic of Congo.  The trip had four main objectives that were all met in full:

  • Visited the sites in Oyo, Ouesso, and Brazzaville where Mercy Ships will have patient selection days in November and December (the site in Impfondo was visited the week prior).  Met with hospital directors and local government officials.  Established patient flow and security plans.
  • Provided training to representatives from the Ministry of Social Affairs so that they can help direct the proper type of patients to the selections.
  • Selected 27 orthopaedic patients from various towns in the interior.  Gave these patients their yellow appointment card to come for a surgeon screening on the ship in October.
  • Alongside our government partner, determined assembly point and logistics for the transport of selected patients from the interior to the Africa Mercy.

The team had a great time exploring the beauty of Congo and navigating the long drives between the selection cities.  The support we received from Africa Mercy community when we hit a few ‘bumps in the road’ was greatly appreciated.  We eagerly await the arrival of the selected orthopedic patients and look forward to working out the final details of the upcoming selection days.

Screening Assessment Team in Ollombo, Congo

Screening Assessment Team in Ollombo, Congo


Taking a break to take in the scenery on the road between Brazzaville and Oyo

Taking a break to take in the scenery on the road between Brazzaville and Oyo

Andrea and Sophie provide training to the Ministry of Social Affairs in Oyo.

Andrea and Sophie provide training to the Ministry of Social Affairs in Oyo.

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