What seemed like hours of flying over the deserts of Mauritania, the green tropical forests appeared below out of my window as the plane started its descent into Republic of Guinea. You know you have arrived safely in West Africa when the passengers on the plane burst into a raucous applause on arrival at the international airport of Conakry. As the doors of the plane unlock you suddenly feel the loss of the cool air-conditioned air suck out and replaced by the hot sticky climate of Guinea. Instantly I feel my back drip with sweat as I step into the airport lounge and follow the line to Immigration. For an instant I panic as the immigration personnel whisks my passport away, and disappears into a back room….agghhh the travellers nightmare…losing my passport in the first ten minutes! I suddenly look around me and see about 10 other westerners in the same predicament.  After a blank stare we suddenly realise we are all heading to the Africa Mercy and the immigration personnel comes back and whisks us through the long line. We are huddled into a couple of white land cruisers which seems to be the car of choice for all NGOs travelling the rough roads of West Africa and head to the port. After a 45-minute drive through Conakry we reach the port and there in front of us is the 499-foot-long hospital ship Africa Mercy.

Acquired in 1999, Africa Mercy used to be a Danish roll-on roll-off train ferry that has been converted into a state-of-the-art surgical ship. Africa Mercy is the fourth ship run by the international charity Mercy Ships. Mercy Ships' main headquarters is in Texas, USA but has many branches around the world including the UK. The main mission of the charity is to provide surgeries to the poorest countries of the world.  The first ships were based over in Central America and the Caribbean before they moved over to West Africa. The basic model they work on is that the ship is based in one country for 10 months then after a short haul out and restocking they move onto another country. The amazing feat of this charity is that the whole crew of about 400 is made up of almost all volunteers. During the day time the crew can swell up to about 600 as local Guineans are offered jobs to help with deck crew, kitchen and translators.  

After many years of working as a nurse in Eastern Washington State, USA I was starting to feel a little jaded and burnt out. I had received a letter from one of my nursing organisations advertising that they were looking for volunteer nurses for a hospital ship in West Africa. As soon as I had opened that letter, I had a gut feeling that this was meant to be. It actually took me a couple of years to finally get all the paperwork in and get accepted.  

Walking up the gang plank of Africa Mercy you suddenly leave the hot West African climate and enter the air-conditioned mini global community. Over 40 countries were represented while I was there, and it got very entertaining translating all the different ways of running a hospital. I was shown my room which was shared with 7 others. Living with 7 people in a space not much bigger than a hallway was going to be a challenge but I counted myself lucky that at least I got a bottom bunk. The bunk mate age-range in my room varied from 18-60 and comprised of American, English, Swiss and Canadian. The charity is very good at organising many volunteers and getting people trained quickly and to work as soon as possible. After a couple of days training, I started my shift on one of the 5 wards. Not only does Africa Mercy provide 5 surgical suits, it also provides an onshore dental clinic, an eye clinic and a halfway home for people who have to travel far and still need outpatient services before and after surgery.  Another part of their mission is ongoing training for the local staff to improve the services they have. During the 6 weeks, I mentored a local Guinean nurse. She had been a midwife for most of her life but never gone to any formal nursing school. It was fascinating to learn so much from her but also to share some of our western standards. While I was there a crew from the UK was visiting and they came to run a training session at the hospital in Conakry on how to sterilise medical equipment.  

Africa Mercy is not only a hospital ship, it is also a home and community, where almost everyone is a volunteer. What you find on the ship is that there are short-term volunteers like me which is considered anyone under 6 months and then there are long-term volunteers where people stay for many years. There is a school which had 40 students, a Starbucks café, launderette, shop and hairdressers to name but a few. Some people come for 2-5 years and some people have met, married and lived on the ship for 35 years. You’ll find these people are often sponsored by a church or charity to stay there for that length of time.

The surgeries each week depend upon which surgeon is volunteering at that time.  Some surgeons just come for a week - one surgeon has been there for 35 years!  The patients had been preselected before the ship even arrived. An Advance Team arrive sometimes 6 – 8 months before the arrival of the ship. They tour the country and set up mobile clinics. Posters are displayed around the country offering free surgeries to those that meet criteria. The charity knows that the ship will only be in the country for 10 months so will only provide surgeries to those that can be treated and healed before the ship leaves. Talking to some of the volunteers who run these mobile clinics they say that often queues can sometimes be miles long with hopeful people praying that they will receive the ‘yellow card’ meaning they have been cleared for surgery.  

While I was there, we had an orthopedic surgeon, a general surgeon, an obstetric surgeon, a maxillary facial surgeon and a plastic surgeon.  A common injury you see in young children in Guinea are skin contractures due to children falling onto open fires, which is the main energy source for cooking. As there is no affordable health care, or no health care in many parts of the country, these children grow up with burnt skin that has lost its flexibility; contractures emerge and prevent normal development. These can be debilitating as a burn on the hand can mean contractures that prevent a child holding utensils or writing. A burn on the legs or feet can prevent a child even walking properly or affect their balance. The hardest to see were children who had fallen face first into a fire where they had lost their lips, eyelids or cheeks. The resulting plastic surgery was long and painful and often these kids were with us for weeks on end. It amazed me how resilient the young kids were and soon were bouncing off the walls of the ship, playing with balls and all the fun western toys they have never seen in their lives.

On my days off I would get off the ship and wander around the streets of Conakry. Walking the city was not always a relaxing endeavour but living on a ship with 400 people there were times I felt I needed to get away. Obstacles such as man-sized pot holes, scooters driving in and out of traffic, cars going down the wrong side of the street, made you keep on your toes. My first day out I remember feeling nervous and shocked at the crazy scene in front of my eyes,  but slowly I got to feel the pulse of this amazing city where people were so warm and waved at you as you passed by.  

Back on the ship I was glad for our little island of western relief of air conditioners and running clean water. Towards the end of my stay I got to work on the women’s ward and the vesico vaginal fistulas (VVF) surgery. Rarely seen in the western world due to good obstetric care, VVF is caused by prolonged childbirth where the fetus is pushed up against tissues in the birth canal for too long.  This can cause tissue damage that leads to an abnormal tract between the bladder and the vagina or rectum causing incontinence. The sad fact about these cases is that not only do the women usually lose their babies, they are often ostracised for leaking urine or faeces and cast out of their village. These women were so grateful for the surgery and care we gave them. Even though the success rate of the surgeries were about 80%, they gained so much strength from being around other women who were facing the same problems as them.  As these women were with us for a couple of weeks for bladder training, great friendships were formed. When it was time for discharge, Mercy Ships bought all these women brand new dresses and we would have an amazing ‘dress ceremony’ where dancing, singing and celebrations could be heard from all over the ship!

When you first arrive, 6 weeks seems like a long time to be away from loved ones and living in tight quarters. Soon the rhythm of the ship and life in the hospital consumes you and each day brings some amazing experiences or life lessons. Then suddenly your time is up. It’s a bitter-sweet feeling.  All the friendships you made, the special patients that touched your soul…My husband asked me a good question of why was I doing this? Why was I paying all this money to take time off work, buy a ticket, pay crew fees then work hard as a nurse with heart-breaking patients? Many people working on this ship get asked the same question. Anyone who has volunteered in difficult circumstances will probably end up saying the same thing…. you get so much more out of it than what you put in. As one volunteer commented, ‘I came here with this expectation that I was the one to give. But after a while, I realised that I am actually the one who is receiving - all the time’.