Ann's-Mercy-Africa-Service-Trip

So I’ve been here for 2 weeks now. I am getting the idea of how to navigate the ship, places to go and how to get there off the ship, etc. I’ve had one group of friends who left yesterday and I’m working on making some new friends to hang out with. There are ALWAYS people coming on board and people leaving. Today I made some new friends. 4 young men all from Ghana originally who are working on the ship. One works in engineering (electricty, plumbing, air conditioning, one in IT, one on the deck, and one who works on ship logistics). You just have to be friendly and reach out and people are generally very nice.

The actual physical therapy to be done is a combination of things. We see 4 groups of patients. One group is people who are seen in PT 1-2 days before their surgery. We take measurements of their motion and strength and pictures of them before surgery (how high they can lift their arm, how they walk, etc). I am not allowed to show you any actual pictures of patients here, but i’m going to show you some pictures from the internet of similar things. Right now we have plastic and maxillo-facial surgeons on board so the surgeries involve cleft palates, or facial/head tumors, extra toes and fingers, or burns. Many children get burned in Madagascar, and Africa in general, because cooking happens on an open fire where there are big pots of things cooking. Kids pull the pots down on them selves and get bad burns which limit their mobility because of the formation of thick scar tissue

The next group we see are people in the hospital on the ship a couple of days after surgery. We get people out of bed the first time, get them moving their joints and activating their muscles. We have a hand therapist on board who is making a lot of splints to keep things still as they are healing. Once patients are mobile enough to do stairs, they go up 4 flights to go outside on one of the decks once a day. The kids can ride on scoot along toys or be pulled in wagons. They can play with balls and games. The adults enjoy the warm air, and sit and relax, or talk with other patients, or play cards. The ship is air conditioned 24/7. Patients are not used to this and often feel cold. (as I do). Everyone looks forward to “deck 7 time”.

Most patients stay in the hospital for around a week. (more complex patients longer, less complex shorter). Once they are well enough to leave the hospital they go to the Hope Center. It is like a step down unit where there is some help but not the intensity of the hospital help. Patients have to be able to go up and down a full flight of steps in order to be able to go to the Hope Center. Then there is a bus that comes to the ship 3 times/day and takes them to the outpatient nursing clinic where they have dressing changes and to outpatient Rehab with both PT and OT. We work on moving the joints by stretching and manually mobilizing the scar tissue. This promotes it to remodel and be more flexible to allow more motion. Patients stay at the Hope Center from a few days to months at a time, depending on the amount of rehab they need.

The last group of people that we see are folks who are being screened to have surgery for the next time the ship is here. Patients are prescreened by people who go out into the countryside. Word is put out in the community that this is happening and many patients come in hopes of being chosen for surgery. These decisions are made based on who can be helped the most, and whether or not their problem can be fixed surgically, and how many surgeries are being done that session. Once patients are identified in the community, they come to the ship and are screened by MD’s and nurses and PT and OT. In Rehab our job is to make sure that they will not LOSE function due to the surgery. (sometimes things help cosmetically but can make function worse).

Again, these are NOT patients that I have seen. Just images from the internet.

Ater a couple of weeks of ramping up, we are seeing all of these patients in our outpatient clinic which is on the dock. It is a very sturdy “Tent” which is air conditioned and set up as an outpatient clinic. I will take a picture of it tomorrow and post it.

For now here is are some pictures taken from the ship.