Mercy Ships EYE CLINICS & SCREENING Oct-Nov 2010 South Africa

Almost 23,000 people in South Africa’s Eastern Cape Province are unnecessarily blind; blind because they are not aware that cataract surgery can restore their sight. The 2010 Sabona Sonke Campaign, a three-phase plan of intervention, is in process at three area hospitals to offer a workable system at each site, to increase effective eye care to those with little or no access to medical care.

The Mercy Ships team, headed by Dr. Glenn Strauss, surgeon and lead consultant, is teaming with The Fred Hollows Foundation South Africa, the Eastern Cape Provincial Department of Health and management professionals from each hospital to use the current resources most efficiently. The hospitals involved include the Port Elizabeth Hospital Complex, Nelson Mandela Academic Hospital, and Sabona Eye Centre in Queenstown. The program will be in effect for about three weeks at each hospital.

At a meeting of those involved at the Nelson Mandela Academic Hospital in Mthatha, Dr. Strauss explained the importance of keeping the flow of patients constant. This requires that every part of the process must be working well within the system as well as outside. Outside obstacles include, among others, negative attitudes about eye treatment, and government stipends to the blind, which are often the only source of income.

In addition to Dr. Strauss, the Mercy Ships team includes Kim Strauss, patient coordinator; Dr. Richard Newsom, eye surgeon and consultant; Glenys Gillingham, surgical nurse and head of the surgical team; Woody Hopper, consulting optometrist and head of screening; Robin Hopper, educational team leader, administrator and management coordinator; and Shannon Hickey, team member.

Phase one of the program begins with assessment of the current

system, training of eye teams and an orientation in Mercy Ships Vision Training, and transporting of patients to hospital locations. The second phase calls for the training of ophthalmologists in the Mercy Ships expedited procedure of cataract removal, and the referrals of cataract patients to be received at the hospital sites. The final phase includes the cataract operations, assessment and debriefing of the cataract surgeries, and the continuation of the program at future sites.

Screening sites for the Port Elizabeth program were held at Settlers, Uitenhage and Motherwell. The Queenstown screening sites for the Sabona Eye Centre were held at SS Gida Hospital, Aliwal North, Empilisweni and Cofimvaba. Butterworth, St. Elizabeth, St. Patrick and Madzikane kaZulu were the screening sites for the Program at Nelson Mandela Academic Hospital in Mthatha.

Many cataract patients of Optometrist Tseli Khalatha, and others who gained knowledge of the program by word of mouth, crowded the screening site in Butterworth, hoping to have their sight restored. Mr. Khalatha was in charge of admissions at the screening, doing the initial check for cataracts and moving them onto the next step in the process of tagging appropriate patients for the surgery.

Robin Hopper and Shannon Hickey did biometry testing, checking measurements inside the eye, and Woody Hopper used the slit lamp, a diagnostic tool for cataracts, the final step in the screening process.

Dr. Strauss is working closely with ophthalmologists at each location, and hopes this process will open doors to new strategies for addressing blindness that will

be duplicated easily in other areas.

Phase II - Eye Surgery

The Nelson Mandela Academic Hospital in Mthatha, South Africa, is a fine facility that stands ready to handle the medical needs of the community. However, there are obstacles that prevent the people from utilizing the hospital to full potential. First, there are many who need the medical services but can’t afford them; and second, the prevailing attitude is that the hospital is where one goes to die. This belief brings many to an early death who might otherwise be on the road to healing and good health once again.

Medical professionals in the Eastern Cape region are working to eliminate these obstacles. The 2010 Sabona Sonke Campaign is one of their most successful efforts. This plan of intervention focuses on increasing effective eye care to those with no other medical access. The Mercy Ships team, under the leadership of Dr. Glenn Strauss, eye surgeon and lead consultant, is teaming with The Fred Hollows Foundation South Africa, the Eastern Cape Provincial Department of Health and management professionals from three area hospitals to use available resources to provide cataract surgeries to eliminate blindness among the poorest citizens, without charge.

At the Mandela Hospital, candidates arrived by shuttle from the Butterworth screening site, and were prepared for cataract surgery. Dr. Strauss and Dr. Richard Newsom, eye surgeon and consultant, who have teamed to train surgeons in the Mercy Ships expedited procedure of cataract removal, joined Head Surgeon Dr. Carolina Salazar, Dr. Laveen Naidoo, and Dr. Thabo Matubatuba of the Mandela Hospital.

The surgeries began, as Surgical Nurse Glenys Gillingham, head of the surgical team, started instruction with the hospital’s ophthalmic nurses in their new procedures to better assist the doctors. The expedited cataract surgery training proceeded throughout the day under the expert supervision of Dr. Strauss and Dr. Newsom.

Dr. Salazar, who came from Cuba to work for a year in the South African hospital, is now completing her thirteenth year at the facility. “I love the work that he (Dr. Strauss) is doing,” she said. “It’s nice to have colleagues around. We all have the same purpose; to help patients,”

Mandoyisile Esther Ntanjana, one of the cataract patients, was totally blind. Her neighbor was also blind, but had recovered her sight after a similar surgery. The neighbor encouraged Mandoyisile to have the procedure. Zimasa, Mandoyisile’s daughter-in-law, came to visit her as she recovered in the ward. The brilliant smile that greeted her relayed her great joy after the successful surgery. Zimasa translated her mother-in-law’s excited words after the successful surgery. “I had a dark view before. Now I can see! I am happy!”

MERCY SHIPS DENTAL CLINICS SOUTH AFRICA: Oct – Nov 2010

Rovers on the winding roads to Bambanani to set up a one day clinic

( Me bottom left) Dental Team overlooking vast rolling hills of Bambanani
Arms were raised in jubilation and shouts of joy filled the air in the little Zulu settlement of Bambanini, when the Mercy Ships Dental Team passed through their gates for a day-long clinic. More than 125 people from the surrounding area had assembled, hoping for the opportunity to have a dentist examine their teeth and relieve the nagging pain they had been living with.

                               Bambanani mountain top
.
4) Local store on the mountain tops
Although the Africa Mercy is in dry dock in Durban, the off-ship Dental Program continues around the rural areas of Kwa Zulu Natal, working in cooperation with the Kwa-Zulu Natal Department of Health. The team is bringing dental care and hygiene instruction to local hospitals and many remote Zulu villages that have no access to such care.

(top right) Me taking photos of the dental hygiene being taught to the crowds
Crowds waiting to be seen at the dental clinic in Bambanani

For the duration of the Mercy Ships Dental program in the area, the hospitals have agreed to suspend charge. Hospitals in Appelsbosch, Montebello, Imbahlenhle, and Bethesda are the four area hospitals involved. Nine area clinics will be held before the program is completed.
Ms. NgcoboThokozani, Operational Manager of the Bambanini Clinic, said personal funds were used to buy time to ‘get the word out’ that the dental team was coming. Word of mouth passed quickly throughout the villages in the hills and valleys of Kwa-Zulu Natal. Gwala Zama said she was told of the clinic by a neighbor. “I live a long way away, but I came by the shortcut,” meaning she walked cross country, up and down the deep canyons, instead of by the long roads around them.

(Cntr) Ms. NgcoboThokozani, Operational Manager of the Bambanini Clinic
The Dental Team extracting teeth from patients in Bambanani
“They came at 5 a.m. with the trucks,” said Ms. Thokozani. “Most of them are unemployed and they got here by asking the truck drivers for a lift. It will take time to go back.”

Dr Dag Tvedt-Mercy Ships Chief Dental Officer injects freezing into a patient’s mouth before tooth extraction
Many had teeth that were decayed and rotted, causing constant pain. The Mercy Ships dentists extracted the decayed teeth and gave the grateful patients medication for the pain.
Very often, people aren’t aware that they can have fillings to save teeth. They just wait for them to decay and have them pulled.

(L-R) Dr. Natasha Rampershad and Dr Dag Tvedt-MS Chief Dental Officer, offers support & both exchange different procedures at Appelsbosch Clinic
Dr. Natasha Rampershad, a young dentist from Durban, is volunteering her dental skills for a year with the Department of Health, working at hospitals and clinics to improve dental health in areas where there is little access to dental care. At Appelsbosch Hospital, Dr. Tvedt worked with her, offering support and exchanging different procedures. “We can all learn from each other,” Dr. Rampershad noted.


In a local elementary school built on the edge of a canyon, over 120 students were packed into a classroom to hear Patient Life Coach Comfort Yeboah give dental hygiene instruction.

Many of the children had never even seen a toothbrush. She explained the importance of having healthy teeth, how bacteria can decay them, and how good tooth care can improve overall health. She gave explicit directions for proper tooth brushing, using a model of the human mouth and a giant tooth brush.
When she introduced ‘Lucy’, an animal hand puppet with human teeth, the children broke into gales of laughter. But Lucy helped to drive home the message that teeth must be cared for correctly at least twice a day.


Mercy Ships Dental Team at the top of rural village enroute to Bambanani. (Me 2nd from left)


















“Working with Kwa-Zulu Natal Department of Health has been a privilege,” Dr. Tvedt said. “The province has great challenges, but it seems they do their very best to provide everybody with health services. The officials we worked with made it easy for our dental team to reach out to those in need. I thank them.”
 
Sieh Moore-MS dental team, comforts a patient before extraction.

AFRICA MERCY DRYDOCK, DURBAN, SOUTH AFRICA SEPT-DEC 2010

AFRICA MERCY GENERATOR REMOVAL - SOUTH AFRICA OCTOBER 2010.

Mercy Ships state-of-the-art hospital ship, the Africa Mercy, has recently entered dry-dock in Durban, South Africa. Built in 1980, it had become essential to replace the onboard power generators in order to provide the vessel with a reliable supply of power and enable it to remain in service. The ship is receiving four 5L21/31 type MAN engines, each with an output of 1,000 kW (1,360 hp). The new generators will be mounted in such a way as to cause minimum vibration, as any vibration transmitted to the operating theatres could make the surgeons' task more difficult.
The Africa Mercy entered dry-dock on Saturday, September 25th . Approximately 40 shipyard employees are working on the ship.

At this stage in the project, the workers have cut a hole in the side of the ship and removed the old generators: four Frichs diesel generators and two B&W Alpha diesel generators. Currently, the foundations are being prepared before the workers lift the new generators into the ship.

Bottom of ship after
draining water from
drydock bay

Other than the project manager and project supervisors, the Africa Mercy crew is not

working directly on the generator project. They are, however, providing ample support for the ship yard during the project. There are roughly 80 Mercy Ships crew members still living on the ship working simultaneously on other projects. The ship being in the ship yard created an opportunity for the crew to repair areas that cannot normally be worked on when the hospital is in use. Projects include replacing the Main Engine Control System, doing a Main engine overhaul and painting in the dining room. There are also some hospital modifications being done.

South African Shipyard welders cutting
hole on portside of ship to remove
the old generators

Cutaway piece from portside
being hoisted to dockside






Old Harbour Generator took hours to
remove from the engine room

When the project is complete, Mercy Ships will be able to reduce its fuel consumption and CO2 emissions by 20%. It will serve as a substantial cut of annual fuel costs. Founder Don Stephens is pleased with the amount of money that will be saved, and ensures those savings will directly benefit patients onboard the Africa Mercy in the future.


Old Frichs engine hoisted up to dockside by crane

  



Old Harbour generator being lined up on the ramp
before hoisting up to dockside

  

Old Harbour generator being hoisted to dockside


  



 
 
  

Old Frichs engine being taken away to the South African shipyard warehouse

 



New MAN Generator being craned into
engine room









Beginning stages of the new MAN generator in place in
the engine room