"Bringing hope and healing the poor." Doctors on board the Anastasis operate on people who need it most. Abi Boys spent a year away from her medical degree to help out

Heat and humidity hung in the air; about 2000 hopeful people filled the dusty street outside the national stadium in Freetown, Sierra Leone. The people were hoping for life changing surgery from the doctors onboard the mercy ship. As the largest non-governmental hospital ship in the world, the Anastasis is the flagship of Mercy Ships, a Christian organisation devoted to "bringing hope and healing to the poor" of all faiths.

The organisation, which is funded by private donations, was founded 25 years ago with the vision of using ships to access countries where healthcare services are primitive. There are three vessels; the Caribbean Mercy serves South America, the Africa Mercy is currently in the ship yard but will soon join the Anastasis in serving Africa. The Anastasis, which means resurrection in Greek, has helped 10 African countries in the past.

Assessing the crowds

The Anastasis had only docked in Sierra Leone one day when the overwhelming screening process began. Vast crowds of people from all over the country arrived with scarves wrapped around their faces to hide their afflictions, hoping they would be suitable for surgery. I measured visual acuity in hundreds of people that day, looking for conditions we could treat--mostly cataracts and strabismus but also trauma from the war. Some patients could not even see my hand waving in front of their face. There were many young people, many old people, and many stories. Other assessment stations were dedicated to orthopaedics, plastic surgery, maxillofacial surgery, gynaecology, and general surgery.

The ruthless and brutal 10 year rebel war in Sierra Leone came to an end in January 2002. Stemming originally from greed and corruption in the diamond industry, the war favoured a few members of the population and deprived the rest of the nation. Thousands of people were murdered or left with horrific injuries or as internal refugees. With a nation functioning purely on survival mode, vital vaccination programmes were neglected resulting in a vicious cycle of disease, poverty, and war. The effects are still starkly visible. Bullets to the face, shrapnel in eyes, and machete scars provide a painful reminder of past atrocities.

Paying to volunteer

Surgeons come from America, England, Germany, New Zealand, and South Africa, some for a few weeks and some for years. All are voluntary, but they pay about £40 (€60 ;$73) a week for the pleasure of helping out. Together they do up to 800 free operations in each country that the ship visits. Gary Parker, chief surgeon, explains: "Representing many nations, we work as a team to serve the poor and to show off God's love in practical and beneficial ways."

People queueing to be seen by surgeons screening
for treatment on the Anastasis are lead in prayer

The Anastasis has three operating rooms, a ward with 50 beds, and an intensive care unit with two beds. Representing 30 different countries, 400 crew live and work on the ship--engineers, deck officers, teachers, plumbers, electricians, housekeepers, and chefs maintain the ship. As well as the onboard medical projects, teams work away from the ship concentrating on long term development programmes which aim to educate and empower local people. Community health teams teach basic health principles such as hand washing, HIV prevention, and how to treat worms. The community development team teaches and facilitates building projects, small business plans, agricultural efficiency, and livestock management. At the dental clinic, 2000 people receive dental care and education.

Inspired by my friend, Jess, who had come back brimming with enthusiasm after spending four months volunteering as a ward nurse on the Anastasis, I took a year out of my medical degree. I downloaded an application form from the website (www.mercyships.org), and a month later I was accepted, but I had to find sponsorship to pay for crew fees to cover cost of living and food. My job was to sterilise the surgical instruments in the operating room--the perfect place for observing life changing surgeries.

Ali was able to go back to the village after
he had corrective surgery on the Anastasis for a cleft lip

The lucky ones

Ali was one of the lucky ones. He was fortunate to have made it past infancy--cleft palates make it difficult for infants to feed adequately. Yet, his life did not seem that lucky--if he strayed too far in his village, people would throw stones at him. People thought he was cursed; he was unable to attend school, and life did not look so hopeful. Surgeons operated on his cleft lip and two hours later he returned to the ward with a gorgeous smile. Inspired by his experience, Ali now dreams of becoming a doctor.

Hawa, in her mid-40s, came to the hospital with a bacterial infection not seen in Europe since the Nazi concentration camps. Noma (Cancrum oris), eats away the face around the mouth and nose impairing eating, talking, and breathing and often causing death. It is all too common among malnourished, impoverished African children. Those who survive, like Hawa, are not only left severely disfigured, but are also labelled as cursed and so rejected by their village. Hawa, lived with this most of her life. But after four facial reconstruction surgeries onboard the Anastasis, her previous injury is barely noticeable.

Hawa: before and after surgery treating the effects
of Noma, an infection not seen in Europe since Nazi Germany

Caesarean sections are not easy to come by in Africa--there are few doctors, fewer hospitals, and the surgery will cost about a year's salary. Labours that do not progress normally put the woman's life in great danger. She may be in labour for 4 to 5 days. The child is lost, and if the woman survives she may well be damaged. Obstructed labour can tear, making a connection between the vagina and bladder (vesicovaginal fistula), causing women to constantly leak urine. The implications of this are rejection by her husband and community and, often, total ostracism from the village. The result, however, is usually death, either by dehydration, because the less she drinks the less she leaks, or suicide. Surgery to repair the vesicovaginal fistula is life saving. Each woman is given a brand new dress and head scarf after their surgery. They now have a future. Once a patient is discharged, they often return to their village with a crew member. Awaiting them is not just a joyous family but an entire village celebrating the undoing of a condition they had perceived to be a curse.

After treatment for obstetric fistulas women are given
new clothes. They are then able to go back to their villages to celebrate

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