Hernias, an Emergency, and My Last Day in the OR

Last Day in the OR

Today is my last day in the operating room aboard the Global Mercy.

Tomorrow is a “ship holiday,” which means the ORs are closed—and, for the most part, so is everything else on the ship. After a busy month, I’m not going to complain about having a day to slow down a little! (Although I have signed up for a tour of the capital Accra so I am not sure how relaxing of a day it will be!)

This past week has been especially fun because we had a general surgery resident join us. He is part of the Pan-African Academy of Christian Surgeons (PAACS) program in Gabon and is in his third year of a five-year general surgery training program. He is originally from the Central African Republic.

It has been great having a resident around. It has been nice to teach a little and give him some surgical pearls I have learned over the years.  Dr. Joseph and I have been alternating cases with him, which has meant that I’ve actually had a little more time during the day to enjoy some of the ship. I’ve managed to actually get to the walking track, stop by the café, and even browse the ship shop—things that I normally didn't have much opportunity to do.

The general surgery team this week.  A very internation team with members from England, Zambia, Ghana, Gabon, Netherlands, Jamacia, Canada, Cameroon, and of course the US.

Hernias, Hernias, and more Hernias

Over the course of the month, we have now completed 77 of the 1,002 surgeries general surgery cases scheduled for this field service! And technically, many of these patients had bilateral inguinal hernias, so we’ve been joking that perhaps the number should actually be a little higher—or maybe we should be counting hernias repaired rather than patients going to surgery!  There is still a lot of work to be done, but I’m proud that we’ve made the first dent in that number!

The scrub sinks outside OR 1

General surgery was in OR 1 at the end of this hall.  There are 6 ORs all together on the ship.

The portholes across from my OR.  I spent a lot of time looking out of these between cases!  Sometimes the school kids would be outside for recess.  Often patients would be sitting being processed to be brought onto the ship for their surgeries.

We’ve had a few hydroceles and lipomas mixed in just to keep things interesting and keep us on our toes. But last week, we got a little variety.

And by “variety,” I mean an emergency.

A patient came to the ship for her pre-operative screening for a very large mandibular tumor. During her evaluation, she mentioned that she had been vomiting that day and was having abdominal pain. Further evaluation revealed that she had an incarcerated incisional hernia.

Initially, there was some discussion about sending her to the local Tema Hospital for treatment. Dr. Joseph and I felt pretty strongly that this was probably not the best plan. After all, if we have a patient who needs urgent abdominal surgery and we happen to be standing on a state-of-the-art hospital ship with an operating room, anesthesia team, ICU, and surgical team, why would we send her somewhere else?

Thankfully, everyone agreed.

She underwent surgery for the incarcerated hernia and did very well. But that was only the beginning of her story.  Yesterday, she underwent her first maxillofacial surgery for her mandibular tumor.

Last night, we went to visit her in the ICU.  She looked like a completely different person with her tumor removed.

She was sitting up in bed, awake and seemed genuinely happy that her first facial surgery was behind her. She has other surgeries in front of her to reconstruct her jaw and months of healing, but it was great to see her starting that journey.  

There are a lot of numbers associated with a field service like this—how many patients screened, how many surgeries performed, how many people seen, how many cases completed. But every once in a while, you get to see the person behind the numbers.  And last night, I got to see one of those people.

The recovery room.

On to the Next Adventure

Saturday, I’ll leave the ship and traveling north to the Baptist Medical Centre, where I’ll spend another two weeks doing surgery.

I’m looking forward to "going home," seeing everyone there, and getting back into the BMC theatre.  And, if I’m being completely honest, I can't wait for the variety of cases that I know awaits me there.  I will be happy to take a break from inguinal hernias for a while!

Two more weeks of surgery. Two more weeks of new patients, new challenges, for sure a slower pace of life and hopefully a lot of fun at the BMC.

I’ll keep you posted.

The Fish Market

 Last Sunday, I had the chance to visit the local fish market, and it was such a fun experience!

The boats come right into the wharf, and you can watch the fishermen unloading their catch. As soon as the fish are brought in, the women are there ready to sell them. There was so much activity going on, and I loved watching the whole process.

I was especially amazed by the variety of seafood they had for sale. I’m used to the markets up in the north of Ghana, where most of the fish you see are dried tilapia caught in Lake Volta and sardines. So, seeing all of this fresh fish was quite a contrast!

And when I say fresh, I mean fresh. The fish had literally just come off the boats. And there was such a wonderful variety that we were sorry we couldn’t buy anything. Of course, we once again had to explain that, while we would love to take some home, we don’t actually have a kitchen on the ship in which to cook it!

It was such a simple outing, but I really enjoyed getting to see a little piece of everyday life here and another reminder of how different – and fascinating – life can be just a little farther down the coast.

Taking a yellow yellow home

The Not-So-Glamorous Side of Life on the Global Mercy

Let’s talk about the not-so-glamorous side of living on the Global Mercy.

First of all, this is definitely not a Carnival Cruise!

There is no steward who comes into my room every day to make my bed or tidy things up. I have yet to find the Lido Deck, and despite my best efforts, I have not discovered a 24 hour soft-serve ice cream machine anywhere on board!

In fact, there are very few “services” provided to you while you’re living on the ship. In conversations with other crew members, we all seem to agree on one thing: living on the GLM is a lot like going back to the dorms during university.

The common areas are cleaned, but your cabin is your responsibility. You make your own bed, clean your own bathroom, take out your own garbage (which is a whole process because you have to separate your trash into different bins), and generally try to keep your little corner of the ship presentable.

Every week, there are cabin inspections in a different section of the ship. Thankfully, my cabin has not been inspected during this stay! I will, however, have a final inspection before I leave on Saturday. I’m responsible for cleaning the room before I go, and someone will inspect it the night before I leave to make sure I’ve done a proper job. So apparently, my final exam on the GLM will be cleaning my cabin!

The cleaning caddy I had to pick up to clean my cabin.  I lugged this and a vacuum all the way from deck 9 forward to deck 6 aft . . . only to find out later in the day there is another cleaning cabinet with all the supplies I needed on deck 6!  I am leaving the ship soon but still learning things about it daily!

We don’t move ANYWHERE!

Unlike a cruise, where you wake up each morning to a different tropical paradise, beautiful beach, or fascinating city, I wake up every morning in the port of Tema!

I have actually enjoyed watching the activity in the port while living on the GLM. There is always something happening —from the ship, it’s fascinating to watch all of the activity around us.

But after a month, I have to admit that the dirt and grime of the port have started to get a little old!

Tema is very much an industrial city. There are certainly some nice areas, but overall, it isn’t really a city where you head out the door and enjoy a leisurely walk around town. There isn’t a whole lot to do nearby other than perhaps head somewhere for dinner or make plans to explore farther away.

That can be especially difficult for those of us working in the OR. We’re working all day and then often taking call at night and on weekends, which doesn’t leave a lot of time or energy for getting off the ship and exploring. I’ve noticed that crew members who aren’t working in the OR have been able to get out and see a lot more of Ghana than my colleagues in the OR. By the time we finish a long day in the hospital, sometimes the idea of going anywhere sounds exhausting!

It’s definitely one of the less glamorous parts of life on the GLM — we may be in Ghana, but that doesn’t necessarily mean we have a lot of time to experience Ghana outside the hospital and the ship.

The Two-Minute Shower

But perhaps one of the hardest adjustments to ship life is the two-minute shower.

Water is a precious resource on the ship. The GLM can make its own water when it is out at sea, but while we are in port, we rely on receiving water from Ghana.

Fortunately, it is currently the end of the rainy season, so water is plentiful. Apparently, however, there have been some much leaner times on the ship.

Whenever I ask long-term crew members about those times, I get essentially the same response:

“It was really bad.”

And then they refuse to give me any more details.  Honestly, I’m not sure I want to know.

So, I have learned to appreciate my two-minute shower. You turn the water on, get wet, turn it off, soap up, turn it back on, rinse, and get out. There is no standing under the warm water contemplating life. You have two minutes, and you’d better make them count!  

Thursday Drill Day

Another part of life on the GLM that you quickly get used to is the weekly emergency drill.

Because there is a constant turnover of crew, with new people arriving every week, drills are held regularly to make sure everyone knows what to do in an emergency.

On Thursday afternoons, the alarms sound and the drills begin.

Most of the time, it’s a simulated fire somewhere on the ship. Everyone reports to their assigned muster station. For me, that happens to be in the operating room, so most of the time I simply continue working while someone comes by, counts me, and moves on.

Occasionally, the drill progresses to an abandon-ship drill. Then things get a little more interesting. Announcements come over the loudspeaker telling everyone that certain stairways are unusable, and everyone has to follow the designated emergency procedures.

Again, my experience is a little different because I work in the hospital. While the rest of the crew leaves the ship and gathers in designated areas on the dock, I remain in the hospital.

If there were a real emergency and I wasn’t working, I would report to the hospital. If an abandon-ship order were actually given, I would be part of the crew responsible for helping get patients safely out of the hospital.  The hospital even has its own gangway, separate from the rest of the crew, which would make that process easier.

It’s one of those things you don’t really think about until you’re here. You go about your day, hear the alarms, listen to the announcements, and practice what you would do if something went wrong.

Hopefully, all of these drills will remain just that — drills.

Definitely Not a Cruise

So, no, life on the Global Mercy isn't exactly luxurious.  But I would call it comfortable. 

There’s no room service. No one makes your bed.  No soft-serve ice cream machine and definitely no relaxing in a long, hot shower.

Instead, there are cabin inspections, two-minute showers, weekly drills, shared responsibilities, an industrial port outside your window, and PLENTY of rules.

And somehow, I’ve come to really enjoy it.

Maybe that’s because living on the GLM isn’t about being pampered. It’s about being part of a community where everyone has a job to do, everyone contributes, and everyone learns to live with a little less so that we can serve the people of Ghana.

Right now, everyone who has served on the GLM is being asked to fill out a survey about their experience here. Since they’re asking for feedback, I think I’m going to make one small suggestion: install a soft-serve ice cream machine! I think everyone deserves dessert and a little luxury!!

Anyone up for dinner at 4:30!

Mealtimes on the ship are as regimented as everything else. Breakfast is served for an hour in the morning and then lunch and dinner are each two hours. Dinner is from 4:30–6:30, which has been one of the harder things for me to adjust to. Apparently, my body has not yet accepted that 4:30 is a perfectly reasonable time for dinner. At home, that is when I am still trying to decide what I might eventually want to eat!

On the weekends, there is no lunch, but they put out extra food at breakfast, and you can fill a container to save for later. So, basically, Saturday breakfast is part meal, part strategic food acquisition.

There are all kinds of protocols around meals—who eats when (although as someone working in the OR I get to skip to the head of the line if it is long at any time), how you get your food and how much of certain items you can take, how you clean up your plate and table afterward, etc. The idea is that if everyone does their part, there isn’t much for the galley staff to do once service is over. It really is a “many hands make light work” kind of system. And, honestly, it works.

Mealtime has gotten easier the longer I have been here. I have gotten to know more people, so it feels much easier to just sit down at a random table. I have also come to realize that is pretty much what everyone expects you to do. There is no need to coordinate dinner plans. You just show up, find a seat, and see who you end up eating with. 

Believe it or not, the food we eat was brought on board when the ship was getting repaired in the Canary Islands before deployment to Ghana and fresher items are shipped to us from the Netherlands. One of the first days I was here, they had fresh pears, and I was shocked! I had never seen a pear in Ghana before. They also served roasted potatoes, and knowing how expensive potatoes are in Ghana, I remember thinking, “Wow. This is an expensive dinner!”

Later that week, there was an ice cream social.  There were four different flavors, chocolate sauce, sprinkles, and other toppings. That is when I started asking questions and learned that our food is shipped to us. I guess it does make sense. Logistically, trying to feed this many people every single day would be quite a challenge if they had to source everything in-country. Apparently, the answer is simply: put it on a ship and bring it from Europe.

Since our food is coming from Europe, the meals are not all that different from what you might expect to eat at home. I have been told there is a six-week rotation for the meals, although I have only been here for three weeks and have already had some repeats. So, either the six-week rotation is more of a suggestion, or I am already getting the greatest hits.

This was kind of a weird cultural mash-up for dinner.  There was a turkey sausage with sauerkraut, green beans and mashed potatoes.  The next day, the leftover sausage was cut up and found on the salad bar! And then, just to add another country into the mix, there was French bread.

There is always white rice and some sort of local food available for the Ghanaian day crew, along with a more Western-style meal. Sometimes, however, things are not quite served the way you might expect. For example, I would probably have beef stroganoff with egg noodles at home. Here, it was served over white rice.

Because apparently white rice is the universal adapter of international cuisine.  Beef stroganoff? Put it on rice.  Something else that doesn’t quite seem to have a natural side dish? Put it on rice.

Irish Stew on white rice.  Cooked carrots,
green peppers and of course cucumbers

Turkey with white rice and green beans

There must have been some kind of incredible cucumber deal happening in Europe because everyone has been commenting on the fact that they have never eaten so many cucumbers in their lives.  At this point, if someone tells me tomorrow that we are having cucumber soup, cucumber casserole, and cucumber ice cream, I will probably just nod and say, “Makes sense.”

If you miss a meal, there is always bread, sandwich meat, and cheese available. Peanut butter and jelly are also available all the time. So, there is really no excuse for starving. You might not get exactly what you were hoping for, but you will eat.

If all else fails, there is a crew galley that you are allowed to use to make your own meals.  You can go out buy groceries and cook there.

Crew Galley - it is surprisingly well outfitted. 
 Most often, I see people baking cakes and various other treats here.

Overall, I really can’t complain about the food. I don’t think you could possibly go hungry on the ship. In fact, I am trying to remind myself that at home I typically would not eat both a hot lunch AND a hot dinner.

There have been some issues getting things through customs in Ghana, so unfortunately, some things have started to run out! I am not sure about everything that is missing, but I have noticed there is no ketchup, mustard, or honey.  But the biggest tragedy of all is that the Saturday morning croissants are finished! I’m only here for another week, but there may soon be a mutiny on board if those croissants aren’t delivered soon!

Usually, when I come to Ghana, I lose weight. I’m not so sure that is going to happen this trip!

Life on the Global Mercy: There’s Always Something to Do!

I don’t think you could ever be bored while living on board the Global Mercy. There always seems to be something happening, somewhere to go, or someone to spend time with. Life on the ship has a rhythm of its own, and I’m finding that there are plenty of ways to stay busy—or simply enjoy being part of this unique community.

Exploring Ghana

On the weekends, crew members have been heading out to explore Tema and Accra. Some have ventured even farther on organized tours. It has been fun hearing about everyone’s adventures and experiences.

For the most part, it seems like people are having wonderful experiences and really enjoying Ghanaian hospitality. There is always a story to hear when someone returns from an outing, whether it is about a new restaurant, a market, a sightseeing adventure, or simply something unexpected that happened along the way.

At the local fish market

Even during the week, crew members who are off duty will often head into town for dinner. In some ways, it isn’t all that different from being at home—you just have a few more steps to go through before you can get there!

First, you go through ship security. Then you put on your reflective gear and navigate your way through the port. Next comes port security, and finally you are free to hop into your Uber and head wherever you want to go.

Of course, there is one important rule: Be back by curfew!  If you are late, you get to take a mandatory breathalyzer test on your way back onto the ship. 

Evenings on the Ship

You don’t necessarily have to leave the ship to have something to do. There are plenty of activities happening in the evenings right here on board.

The dining room is often a gathering place, with people sitting around playing cards and visiting. Up on Deck 9, there are games available in the lounge, and there are usually several puzzles spread out on tables with people working on them.

The café is another popular spot. When it is open in the evenings, people gather there to grab something to drink, catch up with friends, and simply socialize.

It’s interesting how quickly these casual gatherings become part of daily life. You might sit down for a few minutes and end up talking with someone you barely knew before for several hours. With people from so many different countries and backgrounds on board, there is always someone new to meet.

Finding Your People

Small-group activities are also just beginning to get established. There are Bible studies and prayer groups, but there are plenty of options that are simply social.

There is a creative art group, a Great British Bake Off group, a Chosen watch night, and movie nights. There seems to be a little something for everyone.

These groups are another good way to meet people outside of your normal work routine. When you live and work in the same place, it can be easy to fall into a familiar routine with the same people you work with every day. These activities give you a chance to branch out and get to know people you might not otherwise encounter.

Community on the Ship

There are also larger community events from time to time.

A few weeks ago, a Scottish ceilidh was organized to celebrate Captain Perez’s retirement.  The Scottish contingency on the ship is small but proud! It was a lot of fun and definitely not something you experience every day!

Every Thursday night, we have a Community Meeting. The format has changed each week since I arrived.  Last week, for example, we had a meeting with the entire organization. We were connected with leadership in the Netherlands and Texas, as well as the Africa Mercy in Madagascar. Everyone gave a quick report on the past month and shared some of the new and exciting things that are coming up.

Another week, the meeting was held in the café. We divided into smaller groups and discussed different topics.  I have generally enjoyed these meetings; I have found them a good way to meet different people.

Learning After Hours

As if we don’t get enough medicine during the day, there is also a medical in-service one evening each week, and an anesthesia in-service one morning each week!

I have actually found these sessions very interesting. They are a great opportunity to learn about some of the different medical work happening on the ship and to hear from people working in areas outside of my day-to-day.

One of the sessions was given by the plaster technician who works with the orthopedic surgeons. It was fascinating to learn more about what they do and, in particular, how they treat children with orthopedic deformities.

Sundays

Sunday nights are a little different. There is a worship service, and while it isn’t necessarily the type of service I am accustomed to, it is still a nice time for everyone to gather.

We sing worship songs, listen to a message, and simply have some time together as a community.  With so many people from different cultures and church backgrounds, it is interesting to experience a different style of worship. It is another reminder that even though we may do things differently, there are many things that bring us together.

I have also been attending Mass at a local Catholic church. There is a small group of Catholics on board the Global Mercy, and it has been nice to connect with them and go to Mass together on Sunday mornings.

You cannot see from this picture, but the walls of the church are just big doors that they open wide.  Let's in a great breeze.

Mass here in Ghana is definitely an experience! The basics are the same, of course, but there are some wonderful differences. The music is much more lively, and the readings and Gospel are translated into the local languages. There is a wonderful energy and enthusiasm throughout the service.

The congregation has also been very welcoming to the Global Mercy crew, which has been really nice. It is special to walk into a church in a new country and immediately feel welcomed.  There are also some long-term volunteers living on board the ship, and it has been wonderful to see them becoming part of the local church community. They are getting to know the people, becoming familiar faces, and finding their own place within the congregation.

Life Outside on the Dock

One of the things we are particularly fortunate to have here in Tema is an area on the dock that the port has allowed us to use for outdoor activities.

Apparently, that hasn’t always been possible at the different ports where the Global Mercy has docked. Here, the area is surrounded by a wall of shipping containers, which makes it a secure place for crew to spend time outside.

Returning from an outing.  The soccer "field" is on the right of the photo.  You can see in the background the tent with ship security.

Most evenings, something is happening there.

There might be a game of football—what we Americans call soccer—or a game of ultimate frisbee. Volleyball is also popular.  During the weekdays I have noticed the kids out there for recess.  It’s a great way to get some exercise, get off the ship for a while, and spend time with other crew members.  

Now, the real question is: Have I actually participated in any of these activities?

Well… I’ll let you guess!  Watching from the sidelines is also a perfectly legitimate form of participation, right? 😉

Never a Dull Moment

One thing I am discovering about life on the Global Mercy is that you really can make it whatever you want it to be.  There is always something going on—and if there isn’t, there is usually someone around you can strike up a conversation with.  So, no, I don’t think it is possible to be bored on the Global Mercy. There are too many people to meet, places to explore, activities to try, and stories to share.

A Walk Around the Ship

 I wanted to share this video I found on YouTube because, honestly, I figured I couldn’t do much better myself—and, more importantly, I don’t really have the time or desire to try! 😂

A Ten Minute Tour of the Global Mercy (almost) -- My Mercy Ships Adventure #89

I think they do a really good job of showing off the ship and covering most of the high points. It’s always interesting to see a ship through someone else’s eyes, especially when you’re actually living on it and still discovering things yourself.

In fact, at the very end of the video they go into the VIP lounge—which I haven’t even ventured into yet on this trip! I’m still learning my way around the ship.

I no longer get lost trying to find my way from the dining hall back to my room or from my room to the hospital decks, so I consider that a pretty significant accomplishment. 😂 But there are so many decks, doors, hallways and staircases that it’s surprisingly easy to get turned around. You can be absolutely convinced you know where you are going, make one wrong turn, and suddenly find yourself somewhere you’ve never seen before.

And then, just yesterday, I was shown a route that may revolutionize my life for the final week on board.

I learned about a shortcut staircase that takes you from the café area they show on Deck 9 all the way down to the ORs on Deck 3.

Who knew?  I only wish I had been told about it sooner! It’s amazing how something as simple as finding a staircase can suddenly make you feel like you’ve unlocked a secret passage on the ship. 😂

There are a few areas they missed, of course. Most of those are the “working” parts of the ship rather than the glamorous community areas. For example, there’s the crew galley, where you can actually go and make your own meals, and the crew laundry room. I’m not sure how exciting either of those would be in a video, but they are part of life here on the ship.

Doing laundry brings me back to my ND days!  There's something about hauling your clothes to a shared laundry room that never really changes - shout out to Cecilia and her foldable hamper she let me borrow!  The good news is we do not have to pay for laundry, and they even provided soap.  The only catch is that you have to sign up for a time slot.  And on the high-volume laudry days, getting a good time slot can become surprisingly competitive!

And, of course, the dreaded missing sock happens here too.  Where do they go? It's one of life's great mysteries!

There are also a few places they pass by that happen to be closed when they filmed, such as the ship shop and crew back. I may have to wander around myself and take a few photos of those areas so you can get a look at the bits they missed.

I also got a laugh out of some of the comments in the video because there are little details that probably mean much more to someone who has actually worked on the ship.

One is about the carpet in the International Lounge. I’ve been part of putting the chairs back into rows after an event, and the first thing they yelled out was about how the back legs of the chairs have to line up with the lines in the carpet.  I had honestly not noticed the carpet’s design before while attending meetings in the room but while putting the chairs back I was thinking, “Wow, that was some great designing!”

And then there are the elevators.

The ship is lucky enough to have three elevators, which sounds pretty convenient—until you actually use one! You will wait forever for one to come and then on this ship, if you take the elevator when you could possibly walk the stairs, you’re likely to get a few comments about it. 😂

Most people simply use the staircases. After a while, you get used to it and probably don’t even think twice about climbing several flights of stairs. The elevators are there, of course, but somehow using them feels like admitting defeat!

So, while this video gives you a great overview of the ship, there are still plenty of little corners and behind-the-scenes areas that weren’t included. One of those places is the Academy.

I’m hoping I might be able to get the inside scoop from some of the kids on board about what it’s really like to live and go to school on the Global Mercy. So, stay tuned—you may get a glimpse of shipboard life from a completely different perspective!

A VIP Visit, New Sheriff in Town, Neon Glasses, and an Overall Exciting Week on the Global Mercy

It has been another eventful week aboard the Global Mercy, and I’m beginning to think that “eventful” may actually be the standard around here.

Captain Handover

The week started off with a bang at our All Hands Meeting! All the crew meets Monday mornings at 7:45 for important ship updates and messages from the captain. This week was especially meaningful because Captain Perez was officially handing the ship over to our new captain for the last time and signing off.

Facebook

Captain Perez is retiring after serving with Mercy Ships for more than 30 years. It was really neat to watch the handover and see the outpouring of gratitude for all the years he has dedicated to serving on the ship. What an incredible legacy to leave behind!

Instagram

I’ve heard through the grapevine that our new captain is much stricter, so I guess we’d better all be on our best behavior from here on out! 😅

New Surgery Service Line Started!

Of course, the most important thing happening on the ship continues to be the life-changing surgeries. This week, the pediatric ophthalmology service was started and has been keeping everyone busy, with children coming in for surgery to correct congenital cataracts.

These are children who have basically never seen before.  Think about that for a minute.

They have spent their entire lives experiencing the world without sight, and then they have surgery and suddenly they can see. It is pretty amazing to watch.

I really wish I could take pictures of some of these kids to share because they are absolutely adorable in their new neon-colored glasses. Seriously, if there were ever a competition for cutest patients, these kids would be difficult to beat.

Meanwhile, in the general surgery world, somehow a few hydroceles managed to slip through the screening process.  And then there was a patient who came to screening for a mandibular tumor. While the team was talking with her, she happened to mention that she was having some abdominal pain. Lo and behold, she had an acutely incarcerated incisional hernia!

And honestly, I'm not complaining.

After doing weeks of inguinal hernias, it has been fun to do something a little different. Apparently even surgery on a hospital ship needs some variety.

Lights, Camera, Mercy Ships!

As if the surgery wasn't enough excitement, filming for Season Three of the riveting reality TV show Mercy Ships began on board this week.

Yes, you read that correctly.

There are now cameras following people around the ship, in public places, and events.

I have absolutely no idea what this means for my future career, but I'm choosing to believe this is the beginning of my reality television era.

Maybe I'll become famous. Maybe I'll get a dramatic storyline. More likely, I'll be edited out completely—or never be seen by the cameras at all, because again the one place they do not want to go is into the general surgery OR, where we are transforming one groin at a time!

And Then Things Got Very VIP

On Monday, the CEO of Mercy Ships and several other executives arrived in Ghana. It was the first time they had visited the ship during this field service, so naturally we assumed they were here to check on how things were going.

But there was a little more to their visit.  They were actually here to prepare for a very special VIP guest.

Because of security concerns, we were all instructed to keep the visit top secret until it had actually happened.

And today, Global Mercy welcomed the President of the Republic of Ghana, John Mahama!

He toured the hospital, met patients in the wards, and got to see firsthand some of the work being done on board. He also had private meetings with Mercy Ships executives to talk about the mission and some of the challenges and obstacles the Global Mercy has faced during its time in Ghana.

Afterward, he gave a speech to the crew.

I assumed I wouldn't actually get to see him and figured I would just hear about the visit afterward. But as luck would have it, his visit happened to land right when we were between surgeries, so we were all able to sneak away from the hospital for a few minutes and see what was happening.

And I'm glad I did.

I got to be with the crew and listen to the president speak.

President Mahama's Speech as he visits Mercy Ships

It was one of those moments where I found myself thinking, Well, this certainly isn't something I expected to be doing when I signed up to come work on a hospital ship in Ghana.

President Mahama comes from the northern part of Ghana, which has historically faced more poverty and fewer resources than some other parts of the country. Because of that, I think he has an interesting perspective on Ghana and the different challenges facing people throughout the country.

Of course, no politician is universally loved, but from what I've experienced and heard while being here, he seems to be well regarded by many Ghanaians.  Regardless of politics, though, it was a pretty amazing experience.

Below is a long video of his visit, but if you want to skip ahead to about the 3:50 mark, that’s when he visits the pediatric orthopedic ward. You’ll get a chance to see the ward, see some of the kids in their colorful casts, and get a little glimpse of what things look like in the hospital.

President Mahama's Arrival as he visits Mercy Ships - YouTube

After the speech, I had to run back to the OR for our last case of the day. But while the patient was being prepared, we happened to catch a glimpse of the president disembarking from the ship through our OR portholes. It was a pretty surreal way to wrap up the day—watching the president of Ghana leave the ship while we were getting ready to operate!

Anesthesiologist Dr. Micheal from Northen Ireland, General Surgeon Dr. Joseph from Zambia, and I waiting for the present to disembark. Not exactly your typical OR break!

In the video below, you can see the portholes that everyone in the OR was looking out of, hoping to catch a glimpse of the president as he disembarked.  Don’t know if you are able to see us in the windows!

| President of Ghana, H.E. John DramaniMahama, departs the Mercy Ship, the world's largest civilian

The International Guest List Keeps Growing

The presidential visit also capped off a couple of weeks of some pretty impressive visitors.

We've had visits from ambassadors representing Switzerland, Canada, and France, all coming to learn more about the work happening aboard the Global Mercy.

Not exactly your typical hospital visitor list.  Most hospitals probably don't have an international diplomatic guest list.  But then again, most hospitals don't float.

The president's visit definitely took the cake, though.

It has been such a unique experience to be here in Ghana at this particular time. Between children seeing for the first time, unexpected surgeries, reality TV filming, international ambassadors, and a visit from the president himself, there certainly hasn't been a dull moment aboard the Global Mercy.

I feel very lucky to be here to witness it all.

Life In Port

Tema, Ghana on VesselFinder with all of the ships in port and waiting to come to port

Living in a port is a pretty crazy experience, and I find the whole thing completely fascinating.  The Port of Tema is Ghana's largest seaport.  It is located to the east of the capital of Accra.  It has 22 berths and handles roughly 80-85% of Ghana's import and export trade (most notably coca beans).  

Looking out the windows of the ship is never boring.  The port operates 24/7 so there always seems to be something happening—a new ship coming in to dock, another being unloaded, or trucks moving seemingly endless amounts of cargo around the port.

I wish I could share pictures and videos from the Global Mercy, but the Ghanaian government has strict rules about taking pictures of the port from the ship because of privacy and security concerns. So unfortunately, you'll just have to use your imagination!

The number of shipping containers here is unbelievable. As far as you can see, there are stacks and stacks of containers, sometimes piled six high. I'm sure there is a method to the madness, but to me it just looks completely chaotic. Somehow, though, I assume they manage to keep track of everything and get all those containers where they are supposed to go.

Back in 2013, my folks sent me a package that arrived about five months later.  The Twizzlers they had sent had melted into a solid block!  Now that I've seen the port firsthand, I have a much better understanding of why that might have taken so long.

Even walking from the ship out through the port is an experience. We all have to wear reflective vests, and then we walk between these enormous stacks of containers while dodging trucks, forklifts, and other vehicles. It feels a little like playing a real-life version of Frogger, except the cars are giant shipping trucks and there are several thousand tons of cargo involved.

And because I am apparently incapable of seeing something interesting without immediately needing to know everything about it, I have now learned about all the different types of cargo ships out there. There are standard container ships, Ro-Ro vessels (roll-on/roll-off ships), chemical tankers, crude oil tankers, liquid natural gas tankers, general cargo ships, and bulk carriers.

I honestly never knew there were so many different kinds of ships—or that I would become the kind of person who could actually identify them!

My newest obsession is looking up our current neighbors on VesselFinder to see what kind of ship has pulled into port, where it came from, and where it is headed next.

The container ship, Kota Odyssey joined us in Tema Port today.  It left Singapore 30 days ago!

Grande Dakar was a recent neighbor; huge mining trucks came off the vessel as well as caterpillar backhoes

I have to wonder if our neighbors are just as curious about us as we are about them.

I mean, we're a giant hospital ship sitting in the middle of the port. Surely, we're at least a little interesting to watch!

Maybe they're looking out their windows thinking, I wonder what those crazy people on the Global Mercy are doing over there.

Meanwhile, I'm looking out my window thinking, I wonder what that ship is carrying.

Apparently, this is my life now.

Port of Tema 

I believe the Global Mercy received a prime parking space in port!!  11 months in port would have racked up a 500K parking fee, which the government has been generous to waive.  

From Student to Teacher - An INMED Reflection

The week before I left for Mercy Ships, INMED—the Institute for International Medicine—asked me to write a reflection about my experiences in celebration of their 25 years of educational programs.

As a fourth-year medical student, I wanted to do a rotation abroad, but finding an organization willing to take a medical student was surprisingly difficult. Most organizations were understandably looking for fully trained, experienced volunteers who could immediately contribute. INMED was the only organization I could find at the time willing to take a chance on a medical student.

That opportunity ended up having a profound impact on the course of my career.  I thought I would share the reflection I wrote for INMED with you all here on the blog.

In 2007, as a fourth-year medical student, I was given an opportunity to study at Banso Baptist Hospital in Kumbo, Cameroon. That experience opened my eyes to a world of medicine I could only have imagined and set me on the path toward a career in international medical work.

It was also where I performed my first solo surgical procedure.

With two surgical ward nurses in Cameroon

The patient had a large thigh abscess, and I was tasked with performing the incision and drainage. I made the rookie mistake of making the incision too small. Almost immediately, an impressive four liters of pressurized purulent fluid shot out in an arc across the room, drenching me from head to toe.

My response was to grab a bucket, step about four feet away from the patient, and hold it out to catch the stream. I screamed for help, which came in the form of the two attending surgeons—who were, of course, dying of laughter. They opened the incision wider, bringing the drainage down to a much more manageable flow.

It was messy, humbling, and unforgettable. It was also the beginning of a journey I could never have imagined at the time.

After completing my surgical residency in 2013, I was fortunate to have another opportunity through INMED to complete a Fellowship in International Medicine. I spent a year at Baptist Medical Centre (BMC) in Nalerigu, Ghana, and that year of learning and growth helped shape the surgeon—and person—I am today.

Learning how to do ultrasounds during my year in Ghana

Operating with my sister Megan in Ghana.  She was able to come and do a rotation with me during her fourth year of medical school.

Since then, I have returned to BMC almost every year on short-term trips. Over time, Nalerigu and the BMC community have become a second home and family. I have had the privilege of watching the hospital and village grow, while also building relationships that have lasted far beyond any individual trip.

One of those relationships is with John.

When I first met him, John was a lanky twelve-year-old who would hang out on my porch, ask me endless questions, and help me navigate the market when I needed groceries. Years later, he became a physician assistant. He has told me that watching the volunteers who came to BMC inspired him to pursue medicine and, ultimately, to serve his own community.

John and me

Last year, watching John make his first incision while helping me with a hernia repair felt like a true full-circle moment.

From student to teacher, INMED gave me my first opportunity to experience international medicine, opened the door to a career I had only imagined, and introduced me to people and places that have become an important part of my life.  I will forever be grateful that they were willing to take a chance on a fourth-year medical student all those years ago.

Reflection on my second Week: The people behind the surgery

It has not been lost on me how many people are here volunteering their time so that I can do my job.

Currently, there are two general surgeons, three orthopedic surgeons, and an ophthalmologist on board. I feel like we are the tip of the spear, with an enormous pyramid of people behind us who make it possible for us to ultimately do what we came here to do: provide surgery to people who otherwise would not have access to it.

The hospital occupies only two decks of this eleven-deck ship. Of course, there are all the typical hospital jobs. We have everyone working in the OR—the nurses, anesthesia team, post-anesthesia nurses, and floor nurses. There are the people in sterile processing who clean and sterilize our instruments. There is a radiology tech running the CT scanner and X-rays, laboratory techs, biomedical techs whose job is to keep our equipment working, pharmacists, and, of course, our translators.

There is an entire team working on the outpatient side of the hospital, screening patients before surgery, arranging their testing, and ultimately clearing them for surgery. And you cannot forget the hospital administrators.

Those jobs make sense to me. I understand why people with these skills come and volunteer here. They have a direct connection to patient care.

But then there are another 250–300 volunteers who have no direct patient care responsibilities at all. They are here simply to make life on the Global Mercy possible.

And honestly, this is the part that has really struck me.

At the Aburi Botanical Gardens, only 10 of the 22 people in this group work within the hospital.

These people have stepped away from their homes, their families, their jobs, and their normal lives to come here. Most are here on three- to six-month contracts. Some commit to one, two, or even three years.

The hospitality team were the ones who welcomed me when I first arrived, showed me around the ship, and made sure I had a cabin ready. They make sure cabins are cleaned and turned over for new crew members.

There are people in IT, HR, and the chaplaincy. There are people who run the Ship Shop, our little convenience store onboard, and the Café. One of the largest departments is Food Services, preparing over 3000 meals every day for both crew and patients.

There are six teachers onboard teaching the 40+ kids who currently call this ship home.  There is an entire logistics team whose job is to make sure containers of food, water, medical supplies, and everything else we need actually make it to Tema and ultimately onto the ship.

There are deckhands, engineers, and countless others whose work keeps this enormous ship functioning.

And then there are all the people whose work I probably never even see.

That is what has been humbling for me.

Every morning when I walk into the OR, I see the patient in front of me. I see the problem that needs to be fixed. I see the operation that needs to be done. But behind that one operation is an enormous network of people who have each played a part in getting that patient to the operating room.

This past week, 21 men received surgery.

I was certainly the one directly doing the surgery. I held the instruments, made the decisions, and performed the operations. But the more I think about it, the more I realize that I am only one small piece of something much bigger.

There is an enormous machine—and more importantly, an enormous group of people—behind every patient we care for.

People from all over the world have chosen to come here and serve. Some are providing direct medical care. Others are cooking meals, fixing computers, teaching children, cleaning rooms, moving supplies, maintaining the engines, translating, managing schedules, processing instruments, or simply making sure the ship keeps moving forward.

They will never stand in an operating room. Many will actually never meet the patients whose live they helped change. But without them, I couldn't do what I came here to do. I find myself thinking about that more and more.

I may be the one holding the scalpel, but I am standing on the shoulders of hundreds of people who have chosen to serve. And for that, I am incredibly grateful.

I am thankful for the privilege of doing this work—but I am just as thankful for the people who make it possible.