case therefore has to be reviewed by a hospital board
to decide whether to take it on. The main concerns are
whether this procedure can be done safely and whether
the child has a high chance of disabilities that will be
unmanageable after the ship’s departure. I point out
that this child has already proven her desire to live.
She was delivered vaginally without rupture or hemorrhage from the tumor and has thrived and grown
despite it. A decision is made to proceed. Together with
anesthesia and nursing, we plan every step.
On the day of the operation, I start by placing a
subclavian central venous line for access. We proceed
slowly and deliberately, one small step at a time. Three
hours later, the tumor is out, and Polly has been stable
the entire time. We extubate her and send her to the
recovery room, where Polly’s mother will see her for
the first time without the deformity.
That night, as I head to dinner, I experience the
power of the Africa Mercy community. The food servers
and cooks, who have nothing to do with the OR, ask
me how the operation went. In response to my puzzled
look, they tell me that their entire team prayed for her
as she was heading into the OR. This experience is
repeated throughout the evening as many residents of
the Africa Mercy with whom I do not work and had not
yet met approach me to ask about Polly and to reassure
me that they will continue to pray for her recovery.
In the ensuing days, their prayers are answered.
Polly is in a ward of 12 patients sharing a single, large
room. The other patients and families rally around
her. The nurses take impeccable care of her, attending to her almost hourly to keep the wound clean and
dry. On the second day, the drain in Polly’s buttocks
is removed. On the third day, her bladder catheter is
removed, and her bladder starts to function normally.
Today, her biggest challenge is to satisfy the wishes of
all the nurses who want to cuddle her.
What does it take to see hundreds of patients like
Polly safely through deforming diseases and severe
anomalies? A case like Polly’s requires the following:
screening throughout the host country, linking the
patient with the appropriate surgeon, transporting
the patient and mother to the port city, performing
the necessary imaging, hosting the patient in the
port city for several weeks pending the surgeon’s
arrival, planning responsibly to perform the case
safely, providing excellent nursing care, and having
an entire community of 420 crew from 40 countries
support the mission in faith and prayer. It takes a
Dispatch 6: Jane
I sit at breakfast about to try a new fruit. I am not
exactly sure what it is—maybe a Malagasy pear or
apple. But my teeth hit solid rock. Jane White, RN, sitting across from me, shows me a sharp knife and tells
me with a gentle smile, “That’s what these are for.” She
splits the fruit into two and gives me a spoon. Sweet
and sour all at once—passion fruit! Despite coming to
Africa for medical missions since 1999, I obviously still
have a lot to learn about this continent.
Jane has been my shadow since my arrival. A nurse
from Northern Ireland, she is serving her second long
haul on the ship. After the first stretch, she returned
home. When she wanted to return to the ship and her
hospital refused to grant her the leave she needed, she
resigned and came back to the Africa Mercy. “This is
Dr. Emil with Ms. White and Dr. Elliott
V101 No 9 BULLETIN American College of Surgeons