And so here we are in our 3rd field service with Mercy Ships. The ship looks the same, but a lot has changed. I walk around my floating home and see new shoes and new trousers I have never seen before, leading me to the realisation that my living room is again full of people that are new members of an ever growing family.
This field service is our second in Madagascar and has big dreams and high expectations that are both daunting and attractive. My role has developed and changed slightly. In my first field service in the Republic of Congo I was a ward nurse in the Maxilla facial ward and intensive care nurse with an interest in training and mentoring. In my second field service I carried on being a ward nurse and intensive care nurse but dropped some hours and took up the local education position. Certificates, teaching sessions, frustrations, defeats, victories and many stories later, here we are in our third field service praying in our first day of surgery.
As I started to plan the year ahead and looked at the challenge, it seemed and continues to seem unachievable and impossible. From 800 collective hours of training and mentoring to nearly 5000, from teaching nurses just to strive for clinical excellence to equipping 15 nurses to competently run an entirely new ward.
Then in meetings with managers where important decisions were made it seemed only right that I drop my hours on the ward to accommodate the hours that will be necessary for this big project .
And so we broke up
My relationship with the hospital, my ward, my patients with deformed faces and beautiful hearts is over. Of course the door is open to old friends but that is not the same as being their nurse. It’s a pretty hard thing to think about. It’s the centre of what we do, it’s the glamorous role of headbands and bubbles where patients call out your name and hug the tears out of you.
But as I leave those beautiful memories behind I force my self to focus on their real nurses. Not the mercy shipers who come for a few months but the Malagasy nurses who will always be here and will care for these patients in the future with better clinical skills, deeper medical knowledge whilst being drenched in compassion all because of what they will be taught.
Medical capacity building is not sexy, it won’t make headlines and it won’t make us money but it will transform the nations. It will improve the standard of health care in this country. The ward is an unreal place of great life satisfaction. We treat people with minimal co-morbidities who receive good outcomes, their lives are transformed and the cupboards are always full. Resources are limited but flow continuously and we can provide first class and safe health care. That is not the case in the community, satisfaction, resources and safety all look a little different. You could say that the ward is my safe place and comfort zone.
And so this field service I will be stepping out of that safe place, there’ll be no colouring with Mioty and no laughing with Angelique. Instead I will be helping to staff a brand new clinic for women with obstetric fistula. The training course starts in 5 weeks time and the 15 nurses will go through an intense program that will equip them with the knowledge and clinical skills they need to manage these women after this ship leaves. They will directly brighten the future of Madagascar and work towards the eradication of obstetric fistula in their country.
And so for this field service I am no longer a ward nurse. I am a member of the medical capacity building team and am in the business of transformation, not patients directly but health care professionals that will be empowered to care for their own people. It will not be easy but then the best things in life never are….
Other medical capacity building team plans for this year…….
From 4 courses last year to 18 this year
Set up a Ponseti clinic – training in ponseti method
Set up a Fistula centre – training of 15 nurses, surgeons and anaesthetists
(both of the above are permeant buildings that will stay operational after we leave)
WHO Surgical Safety check lists – OR training throughout the country
Trauma course- training doctors in urgent trauma treatment
Basic Surgical Skills – training doctors and surgeons essential surgical techniques
and more ….