Mercy Africa in Congo

We arrived in the Congolese port city of Pointe Noire early in the afternoon on a Friday and managed three adventures before bedtime at our beach hotel, The Twiga. We had lunch on the beach, visited the Mercy Africa ship, and dined on grilled lobster at The Sea Club without a reservation and ten minutes ahead of a house packed full of ex-pat dinner parties, en plein air.

Our first aim was the stretch of beach populated by a series of umbrella'ed restaurants, distinguishable by the brand of beer they advertised or the color of the umbrellas. A tasty start to the weekend involved a lunch of chicken brochettes, l'oiselle (fabulous cooked sorrel), and bananes frites with Ngoki ("elephant" in Lingala) beer. Food was handled by one vendor, beer by another. People watching was thrown in for free. My favorite sight was the guy selling hard-boiled brown eggs from a stack of 4-5 cartons atop his head. Not carton as in one dozen. Carton as in flats of 30, piled atop one another.

The surf here and all along the coast is pretty rough, the waves just big enough this day to attract several surfers as well as swimmers. The swimmers close to us simply removed their outer layer of clothing, e.g., top and pants, and went in the water in their underwear. They would come and go like this from their beachside tables under the umbrellas without benefit of towels. Walking along the beach seemed to be purposeful, not idle recreation. It was a route from one place to another. This is after all, a port city full of purpose, where anything that is shipped into Congo enters the country and where petroleum rules and ex-pats with money inspire relatively high end retail activity.

Some of you know that mostly for sentimental reasons I love a big port. So our next destination was the Port of Pointe Noire, where there are bulk, container, and pipeline shipping operations going. It is not Rotterdam or Long Beach or even Houston, but it is very active and the line of vehicles to get out of the port on a Friday afternoon was long. Our specific destination was Mercy Africa, a huge hospital ship that after ten months was about to embark for repairs in the Canary Islands and then move on to Benin by August. Our guide on the Mercy tour was Brenda, a Capetown native who has been with Mercy for 17 years and was about to go on a year's sabbatical home.

The ship itself was created from a former train ferry and on the lowest deck you can still see the ridges where tracks once held train cars. Eight decks in all, of which we saw the better parts of six, the ship boasts the only Starbucks in Congo. In fact the Starbucks is the centerpiece of a very comfortable lounge on a deck that also holds the gift shop and the bank. I can attest to the fact that the decaf latte was right up to SB standards. Our timing was such that we had an half hour of bling-shopping in the camp store-style gift shop, where the cashier was a woman from Wheelock, Vermont near Lyndonville in the Northeast Kingdom. This was not her first volunteer tour. She comes for three months at a time when she can afford it! U.S. dollars cash money, as they used to say in Georgia was required for our purchase of tee shirts and assorted miscellany.

Virtually everyone on board, like my new friend from the NEK, is a volunteer. The distinction among them seems to be how long their tours are. There are long-term volunteers (a year or more) and shorter-term volunteers. They do everything from mopping floors to performing complicated maxillo-facial or orthopedic surgeries. The security crew, led by an American, is otherwise Nepalese. We met a 60-something couple  from Rochester, NY, who were just about to go home from their latest visit, she as a lab tech. Many nationalities and a wide age range are represented.

Mercy collaborates with national governments at the highest levels. In most ports they work directly through and with the national Ministry of Health. In Congo they worked with the Ministry of Social Welfare. The ship provides only surgical care (it is not a general hospital), and then only very specialized surgical care otherwise not available in the country and which is often life-saving. This goes far beyond but does include cleft palate repair. Referrals and any follow-up come from the local systems of care and assistance. There are 8 surgeries and places for 80 recovery beds, including an intensive care unit. The last surgery for this tour had been performed the day before we arrived and all evidence of patients and their families was gone. The suites had been scrubbed and emptied of everything, including beds.

My complete ignorance of large cruise ships meant that I was continually amazed by the resources aboard for crew and families as well as patients. There is a swimming pool, the bank, the coffee shop and store, a video and book library, a computer center, a school for the children of the crew (K-8), a cafeteria where everyone eats all their meals, and a very large multipurpose room used for meetings, movie nights, dance parties, exercise classes, piano lessons, performances, school assemblies, and honoring visiting dignitaries.We were invited to see a large family cabin. The common room was the size of a tiny studio with a small kitchen, a good sized monitor for family pizza and movie night and a desk, with a couch and chairs--crowded. We did not see the sleeping areas. Most volunteers, especially short-termers, share a double cabin. Dozens of bicycles in different sizes are available for crew and they have a fleet of 4 x 4s lined up on the dock.

The magic of the ten-month stint in port is that the period lines up with the school year. School had just ended. One of our tour guides, Patricia, is a chaplain from the UK and the mother of a musically talented son who graduated from the ship's school. She has been on the ship since he was six and he remembers no other life. But his parents are concerned that they may need to leave to get him into a schooling situation that can lead to university in England.


My principal interest in seeing the ship was to learn whether and how social work expertise fits into the model. The short answer is that it does not. As a former medical social worker and an organizer, I was full of ideas about how much social work could contribute and I suspect its absence is due at least in part to a lack of knowledge about the many and varied potential contributions. For example, I could imagine support and educational groups with parents, counseling with patients about how significant surgery might affect  a person's self-image as well as reception in his community and offering coping tools, and networking and organizing resources in the host country for special ongoing support. I also believe social workers would be as willing to volunteer for this work as nurses, lab techs, doctors, and others. But for now the line is bright and the model seems reasonably fixed.

One change they anticipate when they return to Congo (some years away) is to enhance their capacity to train locals--a focus on sustainability. Brenda noted they would have to recruit differently; for example they will need nurses with training experience, not just clinical experience. So changes in the model are possible. I am not giving up on this yet.

But for the afternoon I was willing to move on to dinner at The Sea Club. Our late night bonus was being able to join the Heineken-sponsored party at our hotel to watch (huge outdoor screen on the beach) Real Madrid beat Athletico Madrid for the Championship League finals 4-1.