Member Update: Marris Smith and the Mercy Ship

For those of you who are unaware, one of our members, Marris Smith, is currently spending two months in Africa with an organization known as the Mercy Ships. While she is away she is sending us updates about her time aboard the “Africa Mercy.” Because of the length of her first update, we will be dividing it up into two parts. The first part will be posted today and the second part will be posted next week. Please take some time to pray for Marris as you read through this update. And take some time to thank God for his graciousness in using our people in mighty ways all around the world.



Photo Credit Ruben Plomp, Marris SMITH (USA), Nurse

Hi everyone!

I am aboard the Africa Mercy in Pointe-Noire, Republic of Congo! When I first started making plans to come (which was a LONG time ago!) people told me that I should start a blog…but the thought of that just stressed me out. So, I told myself that I would send two update emails. One for every month that I’m here. But, its already February! Time is flying by. So here goes nothing…
I had no idea who to include on this, so I just went through my conacts and clicked. If you were included and really dont want to read all of this, I am not offended at all! Stop now! This is your warning…its long! And if I forgot someone, please feel free to forward this along.

Where to begin?
I have been onboard the ship for three weeks exactly now and they say that is about the amount of time  it takes to get adjusted. I think I would agree with that…When I first got here, I really had a hard time figuring things out. It was all such a foreign concept! I had flown all the way to Africa, to serve the Congolese people and provide medical care. But, I felt very seperated from all of Africa! It is about a 20 to 30 minute walk to get out of the port and into the city (its rather civilized too. You have to drive a little to see the Africa you typically think of. Not the safari kind of Africa though!). On the ship there are three meals: buffet style in a cafeteria, some serious air-conditioning (it’s so cold on board!), a small gym, laundy room, crew galley, computer station, pool, a midship lounge and snack bar, and a “starbucks” (fun fact: the owner of Starbuck’s is on the Mercy Ships board and donates all the coffee! It is the only Starbuck’s that has a different logo because the mermaid in West Africa is typically associated with demons/evil spirits). It seemed to me  you could spend your entire time here hiding away from the culture and the people! Over the past few years I have grown to love the model of serving by being in the community you are serving by seeing it demonstrated in Nicaragua- Pinas de Paz, through Parker Street Ministries in Lakeland, and through so many other examples. But this seemed to be the opposite! It was at this time that I had to accepet something that was kind of hard to swallow: Even if this trip was a total bust…even if I left here at the end of eight weeks and said “I will NEVER go back there”…it was okay! I learned to trust God a little bit more and accept the fact that His plan is good and he wanted me to be here for a reason!

So, that was my mindset the first week….UNTIL I was off orientation and on my own in the hospital. THIS is what I came for! And then I realized, THIS is why all these other people are here serving too!

Photo Credit: Peter McMahon, Mercy Ships
Almost the entire “deck 3” of the ship is the hospital (with the exception of a few cabins … mine included. I could literally roll out of bed and be at work in 2 minutes). There are 5 operating rooms, (they are tiny from what I hear!), a radiology department, pharmacy, lab, PACU, eye clinic, ICU and currently 3 active wards for patients. We are about to open C ward Tuesday! (the Christmas “slow down” is officially over.) The D ward is the maxillofacial (MaxFax) ward. This holds the patients that Mercy Ships is often known for- the ones that have facial tumors, etc. B ward is the plastics ward. Different than plastics back home (or in “the states” as it is referred to here), these surgeries often include burn contracture releases, skin grafts, and reconstruction of certain birth defects. A ward (the one I am on… the best, of course!) is the general surgery ward,  meaning we get a little of everything (kinda like Moffitt’s 5 North!). This includes plastics, max fax, as well as hernia repairs, orthopedic follow up patients, thyroidectomies (also not like the states…they are HUGE goiters often!), and anything else. There are 20 beds in the current units (in one large room with a 1/2 wall in the center). The beds are maybe two feet apart, with adults, kids, male, and female all two feet apart! If the patient is under 18, they have a caregiver with them on the ship. They sleep on mattresses under the patient’s bed. I can’t tell you how many times I have accidently stepped on a hand early in the morning!

Photo Credit Ruben Plomp

Congolese people speak a few different languages: French, Kituba, and Lingala to name a few. Often the kids don’t speak French until they go to school. Thankfully we have translators in the wards with us! They are our “day workers”- Congolese men and women who speak all three of those lanuages as well as English. They are HARD workers, who translate, clean, entertain, and often do more nursing than we can! It has been fun to get to know them while I have been here. They tell me that this kind of expereince looks great on their resume, and really helps their English. I am trying to learn French! While I am here I can use Rosetta Stone for free, which has been a nice resource. But, I have to say, in the heat of the moment, Spanish often comes out of my mouth! The other day I just started teaching one of the patients Spanish because I wasn’t getting anywhere with French!

The types of patients depends on the surgeons on the ship. There are a few “long-term” surgeons, a few that have committed to a few months/the whole field service, but often they come for 2 weeks and the patients for their speciality are scheduled to return to the ship accordinly. It is a very detailed and well thought out process. From screening, to follow-up appointments, it is very organized. (yet there is a little room for flexibility…It has to be in West Africa!) From what I have gathered, Mercy Ships has had to alter their care a little bit for Congo. Because it is a more developed country, the need hasn’t been as great for surgical care closer to the port city. Therefore, the government has requested that we reach out to “upcountry.” Mutliple screenings have been done in Brazzaville and other “up country” cities. Because of this, the government has converted a portion of the local hospital into a dorm for a lot of pre op patients that have to travel far to get to the ship. Also, our “Hospital Out Patient Extension” (HOPE) Center which typically houses long term recovery patients, has been expanded to house patients that live too far to travel for post-op appointments.

[Side note: Some of you may know I was looking forward to getting involved with the Palliative Care department while I was here. However, there is almost no need for this during this field service because of the development of the country!]

Details about the hospital: 

  • The crew is the hospitals blood bank! If your blood type matches a patient’s, they contact you and you are “on call” during that patients surgery!
  • My shifts are 8 hours. I typically work 5-6 days a week, rotating between days, evenings, and nights. The day shift and evening shifts overlap an hour and a half so that the stable patients can sit up on “deck 7” for some fresh (and REALLY hot and sweaty) air.

Photo Credit Ruben Plomp

  • I monitor post-op patients for complications- Lots of vital signs, and neurovascular checks on plastics patients. I also turn into the bad guy when I make them walk or do exercises. Bed rest is also REALLY hard to enforce here. They hate it!
  • Discharges occur in the afternoon, and admissions typically happen in the evening. They are usually so happy to have a bed on the ship! They have been waiting a long time for this. There is something that we call “white boat syndrome”. Instead of the “white coat syndrome” where you have anxiety when medical personnel are in front of you, some of these people tend to get a little anxious (making high blood pressure even higher!)
  • Meds. This is so interesting (for all my nursing friends!) The MARs are paper, and the medications are in a cabinet. The narcotics are locked in a box on the wall, while the key is kept in the med cabinet. We have to cosign all peds meds and narcotics on the MAR, and for narcs we have to cosign in a book how much we take out and how much we use. I am still learning how to get kiddos to take meds! I think I might like to be a peds nurse eventually…
  • Since the nurses are from all over the world there leaves room for some interesting practices and terms. For example, to “cannulate” someone means to start an IV. 😉
  • We have a charge nurse on every shift. This is great! They cosign all new orders, call Docs (so they dont get paged ALL the time), round with the surgeons, and answer all my questions (I’m good at questions).
  • I get time for a coffee and lunch break….WHAT!?
  • I am a nurse, respiratory therapist (I did my first nebulizer my first day!), physical therapist (doing and encouraging patients to do exercises), and play-mate. I get to make glasses out of pipe cleaners, cuddle with patients on the floor (NEVER would THAT happen back home), color, and so much more.
  • Supplies. I have learned that “containers” are like Christmas presents. The whole ship waits on the arrival of  containers like it contains gold. It may hold chocolate (that tends to run out here), or hospital supplies!! Currently we are running low on S or M gloves (so we have to use large ones. But I must confess that I use gloves WAY less than I would back home surprisingly), protein and electrolyte powder for our plastics patients (which is a big deal! we are hoping that this arrives Sunday. I am told that last field service we ran out of tube feeding and had to make their own with peanut butter and other things. This worked well until all that they could find was chunky peanut butter! I think some NG tubes were clogged that week!!) We have to be very careful of what we dispose of where. If it is a bottle of anything-medicine, IV fluids, etc, we have to destroy it before we throw it in the normal trash (that way people cant reuse things and sell it on the side of the road!)
  • It’s a totally different work environment. Everyone is PAYING to be there and WORK! No one minds when their pager goes off, or if you need a question answered. It can be a little weird because you practically live with the person you just asked a stupid question to, and you WILL see them at dinner! haha!



Thanks for reading. Check back next week for Part 2 of our first update from Marris.

Posted on: February 11, 2014 - 10:00AM

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