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

An Easter Mosaic

The picture shown here is a beautiful mosaic created by Catherine Schwebel. Catherine is one of the chaplains serving on board the Africa Mercy with her husband and three children. She is an incredible artist. Many times I have bought cards with images of her paintings on them. Now she has created this beautiful mosaic picture. It has truly been a labour of love undertaken during lent. She carefully chose the image and outlined the picture. She designed the contents of the picture. The hills, the garden, the two figures, perhaps one is Mary, kneeling. The empty tomb, the angel of the Lord appearing. Catherine had in her mind’s eye the finished product. She knew what it would look like before it came into being. I didn’t. All I could see was a blank white canvass. If I looked closely I could see a faint outline of an angel, a kneeling figure. But I didn’t know the intimate details, the colours, the beauty. But week by week the mosaic took shape. One by one, Catherine selected scraps of paper. Each carefully chosen. The right colour. Actually it was more than just colour, shades and tones mattered. Then each piece was cut. Precisely. Lovingly. And finally glued in place. Not any place, but the exact place Catherine had prepared for it long ago. Long ago when she designed the mosaic.

This mosaic is a reminder of you and me. Each one of us carefully chosen and formed by God. Each piece in the mosaic is different but each is carefully chosen, designed, and set in place. Not any old place, but a specific place. And together all the pieces make up a beautiful picture. If one was missing the picture would be incomplete. So it is with us. Each of us is set in place by God and if one of us was missing, our world would be incomplete. My world is, here on the Africa Mercy. Your world is wherever you are….your workplace, your family, your church. Each one of us is significant, made in the image of God, chosen to reflect Gods beauty. Individually we reflect in part, together we reflect the whole. God knew what he was doing when he made you. Before the full picture was finished , he chose you and made you specifically, lovingly, uniquely. No one else can replace you. He set you in place. You are valuable to him. You are valuable to your world. To the people around you.

This Easter, do you know your significance and your worth before God, the God that died for you and rose again to give you new life? If you don’t believe what I say, ponder the following statements from the bible:

Acts 17 verses 26 & 27 says God

…determined the times set for them and the exact places where they should live

Psalm 139  verse 13 – 16 says about God

For you created my inmost being; you knit me together in my mother’s womb.

…I am fearfully and wonderfully made

My frame was not hidden from you when I was made in the secret place.

When I was woven together….your eyes saw my unformed body.

All the days ordained for me were written in your book before one of them came to be

Esther 4 verse 14 tells us

And who knows that you have come to royal position for such a time as this.

Civil unrest

I am meant to leave the ship this evening to do an airport run. The Africa Mercy has a constant turnover of volunteer staff. Over 1000 people will arrive and depart in a 40 week filed service. That’s a lot of people to take and fetch from the airport. Each department is responsible for picking up its own volunteer’s. The hospital makes up almost half the crew so we have a lot of airport runs to do ! Actually they are quite fun and not really a chore. Sometimes the drive is fun…a chance to feel free and independent, other times you are picking up friends and welcoming them back to the ship; and other times you get the pleasure of picking up new volunteers and welcoming them to the ship. They have a mixtue of nervous anticipation and excitement. I like airport runs.

However, sometimes airport runs are not so much fun. Tonight might be one of those times. There has been political unrest in Guinea for several days now. Ever since we arrived 8 months ago there have been occasional political demonstrations. Most of these do not affect our ship activities, patients can still reach us and we can move around freely in town. Only on rare occasions has our personal or business activities been affected. This week has been different. Yesterday (Saturday) we went on a boat trip to the beautiful islands just off the coast here. It was an outing for all Operating  Room staff including our local workers. However, due to recent violent protests some of the local workers didn’t want to leave home, especially the women. We live in troubled times.

The political unrest here has deteriorated into ethnic violence in some areas. It hasn’t reached main stream news but you can read reports on Reuters News Agency network. The following is a brief summary of what has been happening this month, taken from the news articles on the web.

Guinea is a former French colony, and when President Alpha Conde narrowly won the presidential election in 2010, the election was billed as the first free poll since the 1958 independence. Although the election was marred by deadly riots and opposition allegations of fraud. There had previously been a military coup in 2008, and the transition back to civilian rule is still not complete. The final step is legislative elections, which after much delay have finally been scheduled for May 12^th. These elections are a prerequisite to unlock millions of dollars of frozen foreign aid, and were originally scheduled for 2011 and have been delayed many times already.

Preparations for the elections are being hampered by opposition claims the government is seeking to rig the outcome in advance. The opposition, has called for a number of protests. But meanwhile, the head of the Guinean armed forces, General Diallo, was killed in a plane crash in Liberia on Feb 11^th. He was one of the main architects of the reform of Guinea's powerful military, which seized power in the military coup of 2008. Diallo was a strong supporter of the Conde government, but Diallo's predecessor, Nouhou Thiam, is in prison facing trial for his alleged role in a gun and rocket attack on President Conde's home by soldiers in 2011. During the period of mourning for General Diallo the protests were called off but restarted this week on wednesday Feb 27^th.

In 2010, President Conde promised to unite Guinea in the same way Nelson Mandela did after apartheid in South Africa. But many of his compatriots say he has failed. The opposition protest on Wednesday turned violent and some 130 people were injured. The violence continued and Guinean President Alpha Conde appealed for calm on Friday after rival ethnic gangs fought with knives and truncheons. Reuters reported ‘Security forces in full anti-riot gear took to the streets of the crumbling seaside capital Conakry to try to stem violence in which at least 65 people were injured, according to a statement from the presidency.’ And that ‘Residents of Conakry fled in panic as the gangs from rival ethnic groups roamed the streets. Shops and business were looted in many parts of the city.’

I feel safe on the ship, and we are monitoring the situation closely. Most of the violence is further outside the city than where we are in the port. Guinea is the world's top supplier of bauxite, the raw material in aluminium. However, the economy produces only about $1.50 per person per day despite a wealth of natural resources, including the world's largest untapped iron ore deposit.

Politics are mainly drawn along ethnic lines. The opposition coalition is broadly supported by members of the Peul ethnicity - the country's biggest ethnic group - and the government by the Malinke. Sadly, the political protests now appear to have degenerated into inter-ethnic violence between the Peuls and Malinkes. The US government and UN Secretary-General Ban Ki-moon have called for calm.

To reach the airport, we drive past the Grande Marche area of Madina. This is where there were running street battles between the Malinke and the Puel.

I will await further instructions from the captain and managing director as to who is going to the airport and how we get there. They are very experienced and have all the information they need from a variety of sources. I am confident wise decisions are always made here as Mercy Ships takes crew safety very seriously. So those of you reading this needn’t worry. Reminds me of trusting the Lord. We don’t need to know everything or know the outcome, but what a relief when I have confidence in the authority over me. Knowing they are there to protect, to lead and to guide. I thank God for Captain Tim and Donavan, and pray for them for wisdom, strength and energy as they steer the ship and crew through troubled times. I also pray for the people of Guinea, for peace and reconciliation. For good men and women, people of integrity and courage to lead this nation. The last women in government who stood against corruption was assassinated a few months ago. Guinea needs our prayers.