March 5, 2016 22:30: The only act in life that requires more trust than a patient surrendering himself or herself to a surgeon is a parent surrendering their child to a surgeon. Every time I take a child away from his or her parents, whether it is for a minor procedure, or a major intervention, I am cognizant of the awesome responsibility I am carrying with me, as well as the responsibility of the entire surgical team.  All of us who work in the operating room – surgeons, anesthesiologists, nurses, and respiratory therapists – have pledged to do our best to be worthy of this responsibility. However, it also makes for a stressful environment.  Emotions often run high and the margin of tolerance can be quite narrow. (Photo left: Africa Mercy Operating Room Assignments).

The operating room on the Africa Mercy is not like any operating room I have ever experienced. There is a clear understanding that surgery is at the heart of the Africa Mercy’s mission – the core of its ability to serve the forgotten poor of Africa. A deep sense of camaraderie pervades every moment and every action in the operating room. This is not easy, since new volunteer surgeons, anesthesiologists, and nurses join and leave every week. Monday starts with a “hall meeting” of all OR personnel to welcome new members and Friday starts with the same to bid farewell to those departing.  On Tuesday, a half hour is set aside, before starting, for all those who want to join in devotion, prayer, and reflection. Before we bring in the first patient every morning, we have a group huddle to review all the patients and discuss any anticipated difficulties. (Photo right: Operating room "Hall Meeting" after group devotion and reflection). 

Keeping the same team intact for the entire week on the Ship enhances the camaraderie. My three nurses are from the Netherlands, Germany, and New Zealand. They come from different cultural backgrounds and have different native tongues. But together, they create a wonderful atmosphere in the operating room – an atmosphere not just pervaded by competence, but also pervaded by love and care for the patient and for the team. By the end of my first day, I truly feel like I have worked with them for years, like I am among friends.  Here, at the bottom of the world, on a hospital ship, I feel like I am in a familiar environment.

My last case of the week on Friday was exceptionally challenging, a large lesion called a lymphatico-venous malformation, giving an appearance of a large breast in a pre-teenage boy. He was being ostracized and teased. I proceed with trepidation, knowing it will be difficult and bloody, and it is exactly as I expect. But as I successfully complete the operation and put the last stitch, I look at the team of nurses who have worked so hard, who have skipped their meals and their breaks, who were so profoundly engaged during the most difficult moments of the operation, and simply thank them. I thank them for being who they are, and for leaving the comfort of their home environments and coming to this ship of mercy docked at the end of the world, to take care of patients whose language they do not understand and whose culture they do not share, patients who had no other options. The personnel of the Africa Mercy operating room have taught me many lessons in a single week, the most profound of which is the power of camaraderie. (Photo left: Dr. Emil's nursing and anesthesia team in a group huddle before starting the day).

Dr. Sherif Emil  [1]is a pediatric surgeon and Director of the Division of Pediatric General and Thoracic Surgery at the Montreal Children's Hospital. Over the 2 weeks, he will be part of the volunteer crew of the Africa Mercy, currently docked in Tamatave, Madagascar. The Africa Mercy is the world's largest civilian hospital ship dedicated to bringing hope and healing to tens of thousands of the world's impoverished populations.  

Read more: 

Dispatches from the Africa Mercy # 1: The End of the Earth [2]

Dispatches from the Africa Mercy # 2: Can it get any better? [3]

Dispatches from the Africa Mercy #3: The Heroes of Africa [4]

Dispatches from the Africa Mercy #5: It Takes a Mercy Ship [5]

Dispatches from the Africa Mercy #6: Jane [6]

Dispatches from the Africa Mercy # 7: A Vision of Mercy (Final Dispatch) [7]