Recently as I tried to eloquently describe what compassion really means for a talk I was doing, I realised that compassion is a feeling and an action. Compassion doesn’t simply stop with a vibe. That would be empathy or sympathy.
“Amy, you are invited to my orange party, will you come?”
“yes of course”
You don’t always know what you are letting yourself in for and the beauty is that you learn not to care. Just to embrace all that comes along and dive into the fun that awaits you. So when asked if I wanted to go to an orange party that I had no details for whatsoever, then of course the answer is yes. I wear as much orange as I can find….
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….
Photo Credit Deb Louden, Caryle Apendi EPOPO (COG) Local Congolese Nurse, works with Amy JONES (GBR) Ward Nurse, learning nursing skills in D ward.
Photo Credit Katie Keegan – Amy Jones (GBR) and Mioty (MGB14013) color in the wards
Photo Credit Suzanne Scheumann; nurse Agnes PEN (NLD) with a VVF patient
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 ….
This man has made me cry on two occasions. In a good way. All he did was share some of his story and some of his wisdom. That was enough to make me scrunch up my face in that awkward and uncomfortable way that leaves you in longing. Longing that no one turns around to see your tears, longing that you had picked up your sunglasses that morning and longing that you don’t sneeze and ruin the powerful and goose bump filled moment.
The last time he made me cry was in the Hospital Conference room. A dark and dingy room with no desire to hide the fact it lies in the hull of an old ship. It’s nothing fancy. It was 4 o’clock in the afternoon and we were celebrating. It was the last day of work for our Day Workers, the Congolese people that had given their time to work alongside us for 10 months. Some were translators, some were cleaners, some were sterilizers and some physiotherapy assistants. That day was their day. The day where we all took time to celebrate them. They cheered and whooped as they saw their own faces on a rickety projector screen. There were drums and certificates all over the place. Big smiles, big laughs and a room full of love and gratitude. This was a deserving occasion for those Sapuers to get their best suits out of the box and shine.
Although the event was an exciting and fitting tribute, there was an air of sadness. The party was clouded by an unspoken inevitability. Their big white ship was leaving. Their home and friends and jobs were being uprooted and relocated all at once. The beginning of the field service was tricky and the relationship between Mercy Ships and its Congolese day workers was definitely not love at first sight. But the love came, sometimes in unexpected places, in the form of tears as we left, from some of the biggest and strongest men.
As I sat and watched the presentation unfold, the woops and cheers and the certificates circulate, a man came to address the crowd. He came to deliver a speech. A word of hope.
They, like me, sat mesmerised; but this speech wasn’t for me. He addressed this group of men and women as if they were his own brothers and sisters. He told them some of his story…
Papanie is from Sierra Leone, he grew up in a war torn country and describes him self as coming from the streets. His father died when he was young and two of his brothers died in childhood. Because of this people said his mother was cursed and she belived it too, she thought she would kill her son if he stayed with her. So Papanie was taken in by his aunt and started to work at the age of 5. He says the work was hard and at the age of 15 he decided being on the streets was better. So he started to make a new life for him self. As my friend sits and explains his story, the word he uses many times is ‘abandoned’. Papanie had a turbulent start to life and knows hardship. He has also known discrimination and humiliation. During his early teenage years he developed a limp due to a damaged leg and hip after years of intensive labour. Whist on the streets Papanie was helped out by an organisation called Word made flesh they helped him to go to school and showed him kindness and love. In 2011 Mercyships docked in freetown and Papanie got a job as a day worker. He cleaned the wards and took care of the laundry and loved every second of it. In 2012 Panpanie came to live on this ship as long term crew. This was made possible through the contacts he made at Word Made Flesh. He is now head of hospital house keeping on the Africa Mercy.
As he addressed his audience he told them how he grew up on the street, how he worked for Mercy Ships, and how he felt hopeless when they left. He talked about how he prayed and how God answered his prayers as he became a Crew member of the Africa Mercy. His dreams and prayers came true. He didn’t share this to boast but to encourage our Congolese friends that they were not being left behind. God was with them and would hear their prayers too.
“God has a plan for you, just like he had a plan for me, it may not be the same and your dream might not be to be a crew mate on the Africa mercy but God knows your heart and he hears your prayers whatever they are”
“If he can do it for me then he can do it for you”
And then there was hope…
Followed by tears…
From a man that once had nothing but has found everything in God.
The cloud of uncertainty and sadness wasn’t completely gone but this group of people were encouraged and strengthened by this man. And so was I.
We have arrived in Teneriffe safe and sound after a few delays due to some technical problems. But now we are here and ready and one step closer to Benin. The Canary Islands have been a nice break, I think. There are definitely things that I would like to leave here and never see again. Like the flocks of people in their speedos. Speedos never have and never will be attractive. Or like British people at the Airport that are far too ignorant to attempt to speak Spanish and when questioned can’t even tell you which airport they are at, and definitely can’t do so without swearing. Or like sitting on the beach and being surrounded by topless obese women in thongs. I have embraced it because it’s necessary but I would much rather be in Africa or many other places come to think of it. But here we are and the food is good and the red wine is good and I am grateful for that.
So the main thing is that the ship is fixed and sea worthy. We will be docked in Teneriffe for just under two weeks before sailing to Benin on the 14th of August. And now I think it’s time to start getting excited about Benin. About my new job. About the people i’ll meet. The patients i’ll treat and the nurses i’ll teach.