Four-year-old Gamai has spent most of her life in the small courtyard of her family’s home in Conakry, Guinea, bouncing a ball around and talking to imaginary friends.
Until recently, the world outside was simply too cruel for her. Some people thought she was cursed. Other children refused to come near her, and her own relatives were reluctant to visit her. Last year, on a rare trip outside to a local market, a stranger looked at her and immediately screamed.
The little girl became an untouchable in a country already fraught with difficulties.
On average, 55% of the Guinean population lives below the poverty line. On the Human Development Index—which rates life expectancy, education and per capita income—Guinea ranks 175th out of 189 countries and territories. The average life expectancy in the country is 52.2 years old.
When Gamai was only 1 year old, she was severely burned while tripping over a pot of boiling water in her family’s small kitchen.
“After the accident, people laughed at her, and joked she was a monster. Some people actually believed it,” explains her mother, Confort, while gently rubbing her daughter’s back. “Ever since, she hasn’t wanted to go outside. It’s no way to live.”
Gamai’s parents had rushed her to the hospital, but doctors said there wasn’t anything they could do, because they didn’t have a proper burn unit. They gave her parents some salve for her skin and said that unless Gamai traveled outside of the country for a complicated skin graft procedure, she would likely spend her life immobile. Since then, Gamai has barely been able to make use of her arms and upper torso.
“We gave up,” Confort says. “We thought she would always be like this, that because we’re Guineans—forgotten people—we would have to accept this fate. Then we heard about the ship.”
Delivering critical surgical care by sea
Since 1978, Mercy Ships, which owns and operates the largest nongovernmental fleet of hospital ships in the world, has delivered services to more than 2.71 million direct beneficiaries, valued at more than $1.53 billion.
The Africa Mercy, which began operations in 2007 and can accommodate a crew of 450, is the ship currently in service. It features five operating rooms, as well as recovery, intensive care and additional patient quarters. Also on board the more than 16,000-ton vessel: capabilities for CT scans, X-rays and laboratory services, as well as a satellite communication system that transmits patient data to dry land.
During the Africa Mercy’s 10-month stay in the port of Conakry, which commenced in August 2018, the plan is to provide up to 2,500 free, life-changing surgeries on the ship, which is staffed with volunteer healthcare providers from around the world, like surgeons and nurses, who have signed up for stints ranging from a few weeks to a few years.
For the past 25 years, Johnson & Johnson has partnered with Mercy Ships to help support this great work by providing hygiene kits and surgical products, like Ethicon sutures, needed to perform post-burn care and dental services, maxillofacial operations to remove tumors, surgeries to repair cleft lips and palates, reconstructive surgeries for congenital abnormalities and women’s health operations. The partnership ties into the company’s United Nations Sustainable Development Goals commitment to Essential Surgery, which aims to make timely surgical care accessible to all.
The work Mercy Ships does goes beyond just helping patients—the organization also supports local healthcare providers with essential skills training so they’re able to transform lives on the ground.
Improving surgical care and training throughout the world should be a key priority of the global health community. We’re making sure of it.
“Mercy Ships is unique in that their focus is on healthcare system strengthening,” says Kimberlin Keller, Senior Manager, Disaster Response, Resilience and Product Donations, Global Community Impact, Johnson & Johnson. “They don’t just dock the ship, operate and then leave the country. They spend more than a year preparing for the docking, and involve the entire healthcare system in that prep—doctors, nurses, administrators, technicians and management. And after the ship leaves, they spend between 12 and 18 months providing ongoing support to ensure the lessons are put in place and maintained.”
To that end, in November 2013, Mercy Ships launched its first-ever Basic Surgical Skills Course (now called the Essential Surgical Skills Course) in partnership with Johnson & Johnson; the Medical & Surgical Skills Institute in Ghana, West Africa; and the West African College of Surgeons. To date, Mercy Ships has provided the two-day course on safe surgical techniques—like properly handling sutures and repairing tendons—to 175 surgeons and trainees in five countries.
“Five billion people have no access to safe, affordable surgery,” says Dr. Gary Parker, chief medical officer and maxillofacial surgeon on the Africa Mercy. Dr. Parker was eager to make a difference in the world early in his career, so he joined a Mercy Ships team in Mexico as a young physician—and has now lived aboard the fleet for 32 years. He met his wife on the ship, and the couple has raised their two children on board. (Mercy Ships provides accredited schooling for the children of volunteers.)
Despite growing interest in global surgery in the last decade, says Dr. Parker, funding opportunities for surgical research have been limited. But he believes that, while expensive, surgeries ultimately benefit economies. For instance, he has repaired countless cleft palates that have prevented speech problems and social stigmas, which can weigh down not only an individual, but a family and even a community.
“Essential surgical procedures can actually be the most cost-effective of all health interventions,” Dr. Parker adds. “Improving surgical care and training throughout the world should be a key priority of the global health community. We’re making sure of it.”
“It was like magic": changing lives, one patient at a time
The bus ride from Freetown, Sierra Leone, to Conakry takes about seven hours, without traffic. When 26-year-old Salamatu hopped on the rickety bus on a scorching morning in late September to get to where the Africa Mercy was docked, it took around 12 hours.
“I just kept praying the whole time. I kept singing to myself: Just get me on that ship!” she says, laughing. “Please, make me normal again!”
It’s been awhile since Salamatu has laughed. Two years ago, her husband died unexpectedly of a disease she doesn’t know much about. She took on a handful of jobs—as a cleaner, a cook, a nanny—to care for her two daughters, Taisha, 7, and Ramatulay, 2. She entered nursing school, determined to make enough money to support her family.
“It felt like it was me against the world,” she says. “I didn’t know things could get worse, but they did.”
Shortly before her husband died, a tooth in her upper jaw began to hurt. She went to a few doctors who told her it would eventually get better. Within a year, the infection grew into a tumor that consumed the left side of her face. Doctors told her they didn’t have the skills or the capacity to extract it.
“My girls could barely look at me,” she says. She soon dropped out of nursing school and began worrying about who would take care of her daughters if she died.
“Here I was, trying to help people, and then I was helpless,” she says. “I had nothing to do but watch it grow. People looked at me like I was a beast. For a while, I actually thought I was one.”
I don’t have a phone, so I can’t send photos to my girls, but when they see me, they’ll be proud of me again. All we ever want is our children to be proud of us.
A few months ago, her uncle called. While listening to the radio that morning, he had heard about a crew of volunteers from Mercy Ships who were holding screenings for patients in Conakry.
Salamatu had never left Sierra Leone before, let alone her village, but figured this could be her only chance to get help. So she hugged her daughters tightly, and walked to the bus stop.
When she arrived in Conakry, she didn’t know what to expect. She thought that maybe the ship was a scam, that they’d insist upon charging her money that she simply didn’t have. When doctors screened her and told her she would have an operation the next day, she was speechless.
“It was like magic,” she says. “I couldn’t believe it. Just like that they could remove this and make me a woman again? A person?”
Dr. Parker successfully removed the tumor. When Salamatu woke up and looked in the mirror, she began crying.
“I don’t have a phone, so I can’t send photos to my girls, but when they see me, they’ll be proud of me again,” she says while recovering at the Hope Center, a clinic operated by Mercy Ships not far from the ship.
“All we ever want is our children to be proud of us,” Salamatu says, crying.
Paying it forward by passing on surgical expertise
When Dr. Ibrahim Diallo was growing up in Guinea, he was confused by why there was so much sickness and death. When his father died young from a treatable disease, he vowed to become a doctor. But medical training is limited in Guinea, and the country suffers from a critical shortage of health workers. By some estimates, there is only one physician for every 10,000 people, compared to about 25 physicians for the same number of people in the U.S.
“Sometimes you feel overwhelmed by the amount of people you have to help and simply can’t,” says Dr. Diallo, who works at a hospital in Conakry and manages a private clinic. He recalls that during one of his recent surgeries at a local hospital, the electricity cut and he had to use his cellphone for light.
When Dr. Diallo heard that Mercy Ships was docking in Conakry for a year and training some 1,200 medical professionals through its Capacity Building program, he saw it as a chance of a lifetime.
“We have few opportunities here to learn more and improve our techniques,” he notes. “And it’s not like we can just travel to conferences around the world.”
Every child deserves an opportunity at life. That’s why I have chosen this path. We’re all here to improve futures.
During the program, Dr. Diallo learned maxillofacial and reconstructive techniques from Dr. Parker, including repairing cleft palates, which can make it impossible for babies to nurse or drink from a bottle.
And these trainings have proven to have a lasting impact.
During the Africa Mercy‘s last visit to Guinea in 2012 prior to the Ebola outbreak, Dr. Parker trained a Guinean colleague of Dr. Diallo’s on cleft lip procedures. This time around, the ship has noted far fewer cleft lip cases because that doctor has been able to perform hundreds of surgeries since the ship’s last trip.
“What if we can do that with every type of procedure? I think we can,” Dr. Diallo says. “There are too many people in my country that deserve a chance to truly live. As a doctor, it’s my responsibility to help them.”
Building friendships, building futures
After a complex operation aboard the Africa Mercy, Gamai now has hope. Doctors worked to release burn contractures (the tightening of skin after a severe burn) on both of her elbows, wrists and her fingers, as well as performed extensive skin grafts. She can now move comfortably.
And there’s another first: She’s found a best friend.
Five-year-old M-ma Bendessa had developed a neurofibroma, a noncancerous benign tumor. Doctors in her village said that if they removed it, she would likely lose her left eye and much of her face.
So she and her mother, Camara, traveled to the Africa Mercy, and Dr. Parker and Dr. Diallo successfully removed the tumor.
The two girls met a few days before their respective operations and have been nearly inseparable since.
“Gamai isn’t used to seeing someone else who looks different,” Confort says. “When she met M-ma, they instantly bonded.”
Their mothers talked to each other about their plans for their daughters, including the hope that Gamai and M-ma will start school next spring. Both children have already said they want to be doctors when they grow up.
“Every child deserves an opportunity at life,” Dr. Diallo says, while watching them play. “That’s why I have chosen this path. We’re all here to improve futures. We’re all here to make sure that tomorrow is better.”
