The huge ships that stop in Senegal’s bustling port of Dakar normally carry goods bound for Europe or China, but inside the Global Mercy’s warren of corridors, medics are preparing for a very different task.
Built for $200 million, the giant vessel is the world’s largest civilian floating hospital. Spread across several decks is a maze of brightly lit, sanitised wards with 100 acute care beds, six operating theatres, testing labs and x-ray rooms, all bustling with activity after the ship’s maiden voyage.
The Global Mercy arrived in West Africa earlier this month from the Netherlands, in a bid to plug the gaps in African healthcare. It boasts state-of-the art facilities like CT scanners, isolation beds and top-notch surgical suites which are in short supply in Africa.
Around 650 volunteers from across the globe – including the UK, Netherlands and Benin – live onboard the ship, including nurses and doctors who are ready to perform complicated procedures like tumour removals and obstetric fistula repair.
Mercy Ships, the charity which built the boat, expects the Global Mercy to treat more than 150,000 people in its lifespan as it moves around Africa and further afield.
While it is docked in Senegal, its main purpose is to train hundreds of local doctors and nurses from across Africa in uncommon practices like plastic surgery and anaesthetics. It will also operate a basic walk-in service for daytime patients.
In one of the wards, Fifonsi Odry Agbessi, Benin’s first female plastic surgeon, is teaching a group of young Senegalese doctors and nurses about the critical lack of plastic surgery in Africa.
“When most people think about plastic surgery in developing countries, they think about cosmetic surgery,” she said. “But if you have a tumour, cleft lip and palate, disfiguration – that requires plastic surgery.”
‘Safe surgery for every African’
Dr Agbessi was just 12 when she decided she wanted to become a plastic surgeon, after watching a documentary about a woman who suffered horrendous acid burns after an attack by her husband. The only problem was that there was nowhere to train in Benin. In fact, the tiny West African country only has around 0.16 doctors per 1,000 inhabitants – well below the global standard of 1.5.
Instead, she studied first in Morocco, before shadowing a reconstructive surgeon on board a separate floating hospital, the Africa Mercy, while it was docked in Benin. Since then, Dr Agbessi has returned every year to help Mercy Ships train African doctors in plastic surgery.
“My dream is that each African has access to safe surgery,” she said. “I feel I am making a difference by training other doctors.”
The Global Mercy hopes to replicate the success of the Africa Mercy, which was converted into a hospital ship from an old Danish ferry over three decades ago. It has administered healthcare in 11 African countries including Guinea-Bissau, Madagascar and the Republic of Congo – some of the world's least developed countries in terms of healthcare.
The organisation estimates that it has carried out more than 100,000 procedures in 30 years of service – roughly 3,000 a year – and trained more than 8,000 healthcare professionals.
In Senegal, Dr Agbessi said that they are hoping to train at least 260 health professionals while the latest ship is docked in the harbour.The Global Mercy offers a range of courses including biomedical training, nurse training, anaesthetics, essential pain management, safe obstetric and childbirth practices and paediatric resuscitation.
Dr Miriam John, a British doctor working as international chief medical officer at Mercy Ships, said that training is incredibly important, because small gaps in certain practices have a big impact on the overall quality of care.
“There’s no point training only surgeons if you don’t have any anaesthetists,” she said. “And there’s no point training anaesthetists or surgeons if you don’t have any nurses to look after patients who have undergone surgery. You really have to invest in the whole surgical ecosystem”.
Just across the corridor, Alhassan Datti, a doctor who trained with Mercy Ships, is teaching a class on anaesthetics to an eager bunch of Senegalese students.
He told The Telegraph that before 2018 there were no physician anaesthetists in Liberia which had a devastating effect on the local healthcare system. Nurses were trained in basic anaesthetics but there were no medical staff able to carry out invasive procedures that require a high-level of training, sometimes lasting years.
Complicated procedures like heart surgery were impossible and there was no intensive care unit – which requires a trained anaesthetist – for a population of around six million people. Instead Liberians who needed major surgery were forced to go to neighbouring Cote d’Ivoire or Ghana, if they could afford it.
Dr Datti came to Mercy Ships to train in anaesthetics and, like Dr Agbessi, he now returns each year to provide training.
“We teach trainees key skills so that they can be safer anaesthetists and they can go on to teach their colleagues tomorrow, to train trainers,” he said.
Since 2018, Liberia has had three physician anaesthetists – all of them trained onboard the Africa Mercy when it docked in the West African country in 2019.
Although Liberia remains without an ICU, the trained anaesthetists offer hope that Liberians will soon be able to undergo complicated procedures without having to leave the country.
The challenge is not unique – a Lancet Commission Report found that five billion people around the world do not have access to “safe, affordable surgical and anaesthesia care when needed”.
“The main snag there is that there are no qualified physician anaesthetists to allow safe surgery to take place,” said Dr Datti.
The Global Mercy will leave Dakar’s hot and dusty port at the end of June, moving to the Canary Islands for further outfitting, before returning to Senegal next year to train more doctors and perform surgeries. Then it will continue to travel between Africa’s many ports, attempting to help plug the gaps in local health systems.
Dr Agbessi said that she will return to the ship each year to train others in critical medical skills.
“I don’t have money but at least I can dedicate my time to share with people what I know.”
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