|Q&A with Mercy Ships Nurse Alison Chandra|
|Alison (Ali) Chandra, RN, BSN, received a BS in nursing from Messiah College in Pennsylvania. She is certified in CPR and PALS. Chandra is currently working as a volunteer nurse for Mercy Ships. For more information about Mercy Ships, visit www.mercyships.org.
Q: What motivated you to become a nurse? How did you decide to work for Mercy Ships?
A: Ever since I was a child, I sat in church listening to missionaries from around the world reporting on the work they were doing. My mother had been a nurse before I was born, and I knew that being a nurse would open the door for me to go out and work somewhere in the third world. I've always felt very strongly that there was a calling on my life to leave the US and work as a nurse in Africa, so as soon as the opportunity presented itself, I took it!
Q: What type of organization is Mercy Ships?
A: [Mercy Ships] is an international, non-governmental, global charity. [My] ship, the Africa Mercy, serves as a floating, specialized surgical center, providing free surgical care to the marginalized poor in West Africa. We focus on providing surgeries to correct conditions that force people to the fringes of society. Tumor removals, cleft lip and palate surgeries, orthopedic surgeries to repair club feet, VVF repairs and cataract removal are some of the main surgeries. Along with providing free surgeries to the forgotten poor on board the ship, we also send teams into the communities to provide health education and community development through agriculture, water and sanitation programs. We partner with local medical professionals (doctors, nurses, biomed technicians) to train them in order to develop the infrastructure of the countries we serve. A typical year on board a Mercy Ship consists of 10 months of field service docked in a West African port, with two months in a first-world port for repairs and maintenance on the ship. But there are also many opportunities for nurses to serve in shorter time slots of several weeks to months.
Q: Typically, what are your day-to-day responsibilities as a nurse on the ship?
A: I work rotating shifts as a pediatric ward nurse and a charge nurse. I also serve in the ICU when needed. The patient population is all surgical, so I care primarily for children pre- and post-operatively. Sometimes there aren't enough [of us] to go around and I help with adult patients.
One of my biggest responsibilities as a ward nurse is education. We care for patients who may have no access to clean water and live without electricity, cooking over open fires. Before I discharge a patient, I need to teach them how to make their own saline to care for their wounds until their follow-up appointment at our outpatient clinic on the ship. I need to teach them about safety, since we see a lot of pediatric patients who have been burned by open fires and have fallen into pots of boiling water or oil. I need to teach them how to recognize an infection, since some may never have heard the word before.
As a charge nurse, I round with surgeons and ward physicians and act as a liaison between physicians and nurses. I also sometimes end up doing triage, since it's almost a daily occurrence for patients we haven't seen before to show up on the dock with no warning and no appointment card.
Starting this month, I'll be moving into a new role as an Assistant Ward Supervisor. This means I'll be a permanent charge nurse, and will also be more involved in training new staff, working together with the management team and creating and implementing new policies and procedures as we work to better the care we give our patients.
And of course, in whatever role I'm in, a big part of my day consists solely of building relationships with my patients. Many of them have been ostracized their entire lives because of birth defects or injuries. For some, the love we show them is the first they've known, so we spend as much time as possible giving them as much love and care as possible.
Q: How has working for Mercy Ships allowed you to grow professionally?
A: As a nurse here, I've been stretched in ways I never imagined. Nursing in the States, you're surrounded by a well-developed healthcare system, there are supplies on the shelves and the equipment is up to date. Here, our equipment and medications are donated, our nurses come from 30 countries, all our staff is volunteers and there is barely any healthcare infrastructure in the countries where we're docked. That means that patients are coming in with tumors you'd never see in the States, conditions totally foreign to me, and we're treating them knowing that we might run out of supplies, we might not have the right medications and we might not have the right doctor to treat a condition that shows up on the dock. I have learned to oversee as many as 40 patients at a time, as well as mentoring new nurses all the time. (Since we're all volunteers, people don't stay forever, and our staff turnover is incredibly high.) My role as an ICU Coordinator is allowing me to constantly problem-solve and brainstorm new ways to make the most out of the equipment we have here. I'm involved in developing standard orientations for new nurses and in writing and getting policies approved. For a former ICU nurse who used to feel a little overwhelmed caring for more than one patient at a time, I've learned an incredible amount, and have really been able to get more confident in my skills as a nurse leader especially. I've always been the nurse who said she'd never go into management, but here I am, looking forward to the opportunity to grow in that role!
Q: What are the greatest challenges you face?
A: One of the hardest things about my job is the fact that I'm dealing daily with people who don't speak my language, who come from a completely different culture and who, at times, have no concept of basic health and hygiene. It's as if I'm starting every day from square-one, and it can be a daunting task at times. On the flip side, though, seeing a patient learning to care for his own surgical wound and come back to follow-up appointments with a consistently clean incision—and finally being able to discharge him healthy and whole to live as an accepted member of his community—is an incredible feeling.
Q: What is the most rewarding part?
A: The most rewarding part of my job is the fact that I can see in such a tangible way that I'm helping put people's lives back together. Our patients come to us from the fringes of society, with conditions that, in African culture, almost always cause them to be shunned, ridiculed or cursed. Once they get on the ship, though, they're taken immediately from the fringes into the very center of a loving community. We don't just go about healing them physically by correcting deformities and removing tumors. We're also healing their spirits, sometimes by showing them love for the first time in their lives. It's so incredible to watch a child like Antoinette come alive. She came to us with a parasitic infection eating away at the flesh of her nose and cheeks and lips. She didn't meet our eyes, never smiled and rarely left her bed. By the time her month-long course of medication was finished, she was prancing up and down the halls, throwing kisses to whoever passed, trying out her new English words and running over to hug me when I stepped onto the wards. To see that kind of transformation, not just physical, but also emotional, is so incredibly rewarding, and I get to be a part of it every single day.
The love and gratitude that I get back from my patients every single day is more than enough to make up for the fact that I live on a ship halfway around the world from my family.
Q: What has it been like to work with other professionals on the ship?
A: The people I work with help to make my job amazing as well. At any given time, there are over 30 different nationalities represented in the staff on the Africa Mercy. I work with women and men from around the world, but we're all in West Africa for the same purpose: to show God's love through our care for the people there. It's really sweet to look around me on the ward and realize that I'm working shoulder-to-shoulder with a nurse from Britain, one from Australia, a Canadian and a German, all on the same shift.
Q: What advice would you have for someone thinking of working on a Mercy Ship?
A: The only advice I can give is to go for it! Being a nurse in Africa has been a dream of mine ever since I was a kid at my church, listening to other missionaries tell their stories. Back home in the States, I had a job that I loved at a hospital that had done so much to train me, teach me and mentor me as a new nurse, and so leaving there was really difficult. Even though it was hard, I never doubted for a minute that this is what I was supposed to be doing. If your heart tells you to pick up and go to the other side of the world, try to listen to that, and not to all the people around you who will tell you that you're crazy for even considering it. And if you're not sure that nursing in another country is your cup of tea, Mercy Ships is actually great because you can come for as short as two months. Most hospitals will give a leave of absence for as short a time as that, and it's a really good way to get a taste for this kind of life.
Q: What is the most important thing you've learned from this experience?
A: The most important thing I've learned while working with Mercy Ships is that I can't do this on my own. Nursing in another country, with patients from a radically different culture from my own and who almost never speak my language, is so emotionally draining. Yes, the rewards are huge, but in the process, I find myself pouring out my own heart in ways that I never thought I could. And at the end of a shift, I often find myself wondering whether or not I'll be able to do it for another day. And that's where God comes in. I'm here in West Africa because God loves me with an inexhaustible love, and I know that I'm not just giving of myself to my patients here. I've got this never-ending store of love to draw from, and so I can go to the wards every day and give everything inside me because I know I'll be filled up again for the next day.