Lessons from the swimming pool

I am sitting watching my niece in her swimming class. She is fascinated by all that is going on. She is a beautifully inquisitive and engaging 10month old. She has a gentle and calm disposition. But according to my sister-in-law, my niece doesn't like the bit when they go under the water. Suddenly when the water hits her face she changes. She squeals at the shock. It is as if she is saying 'Mummy what on earth just happened?' It shouldn't have been a shock, she was warned. Mummy told her several times what was about to happen, and so did the teacher, but it was as if she either didn't listen or was simply too fascinated by everything else that was going on to register the instructions. Now her eyes are fixed on mummy, but she doesn't want to have another go at going under the water. Fear of being shocked again has robbed her of the joy she had a few moments ago. But she needn't fear. Her mummy is there, it is totally safe. Mummy loves her. Parents are to protect us and empower us. Empower us in the sense of releasing us to be all we were created to be, releasing us to reach our full potential. Releasing us to be greater than they were. That's why mummy is taking my niece swimming, to enable her to swim so she will be safe around water. Protecting and empowering.

Parenting is a good model of what leadership and authority looks like. Parents have authority over their children. Team leaders in the work place have authority over their teams. Bosses have authority over their employees. However, today we seem to struggle with the concept of 'authority'. The very word provokes strong reactions. And add in the concept of 'submitting to authority' and it sometimes unzips people, rather like opening the lid on a can of cockroaches. This doesn't totally surprise me because when I look around, sometimes I struggle to see good role models of authority. Instead I see leaders (or parents) controlling or holding someone back out of their own insecurity, not releasing others to be greater. Or, at the other end of the spectrum, I see parents pushing children to be something they're not, simply because the parents wished they had been or done that one thing. I see bosses crushing the creativity and suggestions of those below them simply because they are insecure, or trying to build their own empire. I see bosses taking the credit for ideas that are not their own, or blaming employees for something that went wrong instead of owning the responsibility as the leader.

Yes, authority has been abused, in the home, in the workplace and in the government of our land. But just because it has been abused does not mean it is an outdated concept. Quite the contrary. It is a beautiful thing to be under authority that protects and empowers, training you to be greater, releasing you to be more than you are already. This type of leadership is known as servant-hearted leadership. Servant-hearted because it seeks to protect and defend, and ultimately the leader would give up their own life to save the life of another. To protect them. Servant-hearted because the leader lays down their rights to their own desires and pride and serves another, pouring out and investing for the other to become greater.

Sounds like being a parent doesn't it? As a doctor on a children's intensive care unit I  looked after some of the sickest children in England. Many a parent said to me they would do anything to save/help their child. They would literally give up their life it they thought it would help. That is protecting, defending, fighting for those under your care. And in the same way, what mother at home with small children denies that looking after them is a sacrifice? A laying down of her rights to her own time, her own desires etc etc. It truly is a servant-hearted job especially when the children are small. I wonder what your workplace would look like if these concepts were applied there? I wonder what my workplace would look like, if I led like that and embodied this principle?

And now my niece's swimming lesson has finished. Today, she actually went under the water. She didn't squeal, she loved it. I could see the grin of delight on her face as I watched from the seating area. She knows she has a mummy who protects and empowers. And I pray she grows up to be the same. A servant-hearted leader. Someone who protects and empowers.

By the way, Jesus is the greatest role model of this type of leadership. Servant-hearted leadership. So if you want to know more about how this concept works, read his book.

Mohammed's story

I write this having just arrived in the Canary Islands. Our 10 month Fields Service in the Muslim nation of Guinea has finished. I have many memories. My friends favourite story is described by her in the video above (click on the arrow to play). But one of my favorite stories comes from a Muslim man named Mohammed. I first met him in the middle of the night when the emergency alarm went off because his neck had started bleeding. A true life-threatening emergency needing immediate surgery. But that is not the only reason I remember him so vividly. It is because of what he said. Mohammed said, about us “They actually pay to come here so that people they don’t even know can be healed. Who else but God sends people like that?”  . Mohammed's story is told here by one of the ship writers, and his pictures are shown in the right hand column:

Dr. Mark Shrime, a Mercy Ships volunteer surgeon, was recently serving onboard the Africa Mercy hospital ship in Guinea.  One of Dr. Mark’s patients, Mohamed, had such a large growth on his neck that, at first glance, it seemed like a goiter. To determine the exact nature of Mohamed’s condition and to plan treatment, Dr. Mark used the diagnostic information provided by a computerized tomography (CT) scan.

Mohamed had fallen into deep despair. He explains, “As my condition worsened, the growth increased to such a size that I had difficulty eating and sleeping. My voice also became hoarse. My wife worried constantly that this condition would cause me to die.”

Another of Mohamed’s fears had already come to pass, causing the family extreme hardship. He recounts, “The lump on my neck started growing when I was in my mid-twenties. I had worked very hard to complete University studies in law, planning to have a good career in the justice department of the Guinean government. But when I could no longer hide the growth, my career stopped. I had the education and trust needed to take on significant roles, even as a Minister, but my appearance prevented any chance of promotion.” Mohamed was transferred to a local police detachment, with no contact other than the criminals he interviewed.

When Dr. Mark received the results of Mohamed’s CT scan, he was taken aback. According to Dr. Mark, “As it turned out, Mohamed’s problem was not a goiter but a cyst. The condition begins even before birth, when the thyroid gland descends from the base of the tongue through a canal called the thyroglossal duct to the neck. Usually the duct disappears after the gland descends, but sometimes small pockets, called cysts, remain. For Mohamed, and others with this condition, fluid collects in the duct cyst. The result is a visible lump.”  

Dr. Mark had never seen a cyst as large as Mohamed’s, noting that, “This condition is normal, but the growth generally remains golf ball size. Where there is access to surgery, the cysts are usually removed once they become noticeable. But for Mohamed, whose cyst was untreated for almost thirty years, it grew to an enormous size.”

Mohamed learned through bitter experience that he had no access to the treatment he needed. “I spent almost $10,000 (enough to put ten children through University) in Guinea, and other nearby countries, looking for a cure. My family and I did without many things. When I found out that I could get surgery in France, I even entered a competition to be sent to police training school there.” While Mohamed obtained the top score on the selection test, another person was awarded the scholarship to travel to France. After years of unfair treatment in the workplace and ridicule from his colleagues, this final injustice crushed Mohamed’s remaining morale. He left his job, shuttering himself inside his home.

Unemployed and feeling hopeless, Mohamed began a personal prayer vigil. Daily at 2:00 a.m., often with his wife at his side, he prayed for healing and to have his livelihood and life back.  

Mohamed believes that God answered his prayer by bringing Mercy Ships to Guinea. He recalls his remarkable experience as a patient. “Mercy Ships saved me and renewed my life. While I was waiting to hear about my surgery date, a Mercy Ships day-worker who I met at the screening continued to check on me and assured me that I would be called.  All of the volunteers for Mercy Ships were so helpful and kind. When I had my first test, the nurse was careful and made sure I was comfortable. After my surgery, I had some unexpected bleeding in the middle of the night. Within minutes, I was immediately surrounded by nurses and taken to the operating room where many doctors were waiting to fix the problem. I was back in bed sleeping within an hour!” (technically this is true as the bleeding was fixed quickly in theatre but we actually ventilated him on ICU for the next few hours and woke him up in the morning !)

Following his successful surgery, Mohamed returned home a renewed man. He was so impressed by the quality of care he received from Mercy Ships that he wrote a personal account of his entire experience to share with his friends and family. The part that still surprises him is what he learned about Mercy Ships volunteers: “They actually pay to come here so that people they don’t even know can be healed. Who else but God sends people like that?”

Written by Joanne Thibault

Edited by Nancy Predaina

Photographs by Debra Bell, Michelle Murrey, Bright Effowe

Always Learning

I love learning new things. I love new experiences. Maybe that’s why I love being a doctor because one is always learning.  No two patients are ever the same.  Science progresses and we learn new techniques for treating patients, new ways of making surgery safer. Sometimes these things are not huge technological advances but simple things such as using a Checklist to make surgery safer.

At the end of April I spent a week driving through the interior of Guinea visiting 3 different hospitals. (Click on the Page tabs above to view some pictures of the Hospitals and the scenery). I learnt a lot. Each hospital was a 2 day journey along difficult potholed roads, or dirt roads with huge craters. We were fortunate it was the end of dry season. In rainy season some of the roads become impassable, and when the large pothols are full of mud and water it is easy to become stuck! Even in a landrover. Back in November when another Mercy Ships team went this way in two landrovers, one of the landrovers actually became stuck. Thankfully the other one had a winch so could rescue the first vehicle. Driving here is not for the faint-hearted. But when you learn how to drive these roads it is actually quite fun. Oscar, our Hospital Projects Manager had spent two years living in Liberia so he knew these road conditions well. I learnt a lot by watching him.

The aim of our trip was to visit Kissidougou, Kankan and Labe hospitals to follow-up on the training we had given to Obstetric Fistula Surgeons and in two cases their anesthetists and nursing staff as well. We were not so much interested in what particular surgical techniques they had learnt but rather what principles of safe surgery (such as the Safe Surgery Checklist), whole person care and empathy they had learnt through our methods of modelling and discussing these concepts. I was humbled and amazed how much they had learnt and how diligent they had been trying to put it into practice various actions and attitudes. The culture here is described as an ‘honour / shame culture’.  So I knew our visit to their hospitals would honour them. Back home visitors to a hospital can be viewed as a burden - a ‘oh gosh who is going to look after them’ type-attitude. Not in West Africa. Visiting the surgeons honoured them to their Hospital Director, and honoured them in their community and family. But I also learnt that driving two days to visit them showed we cared. It added credibility to our training program. The training program aims to model ‘whole person care’, ‘servant-hearted leadership’ and  to instil ‘individual value and worth even for those with disfigurement or disability’. I learnt that we can model these concepts not simply by the way we treat patients and each other our ship hospital, but also by visiting the trainees in their own environment. These follow-up visits showed we don’t just teach healthcare professionals, we also care about them as individuals.

Medicine treats and cares, Education teaches and cares.

I still have much to learn about teaching medical knowledge, skills and attitudes cross-culturally in West Africa but I learnt an important lesson this week and I am very thankful.

I love the fact that life is one long learning process. It keeps me humble