One of the hardest realities in the world is poverty. Not only does it cripple the chance of people living a full life, it holds people back from what we would consider a ‘basic standard of living’. And the saddest reality, it that poverty isn’t caused by a lack of resources, but unfair distribution of the world’s current resources. In other words, we have enough money, food and security to stop poverty, but it’s not reaching the people who need it.And often the poorest are born into it, grow up poor, have big families in poor communities, and the cycle continues generation, after generation. The world is getting better at fixing it, but we’re not quite there yet.
West Africa is the poorest region in the world. Many people here don’t have access to safe surgery, let alone one that is affordable or timely. So often, with a combination of poverty and malnutrition, diseases and disabilities are magnified to proportions that we would not see at home. I am working in the Plastic Surgery team, and a lot of what we are seeing now is related to burns. Poverty often means that people are cooking with open fires.Open fires, boiling water and young children do not mix. Many of my patients, now teenagers and adults, were burnt or injured as young children or infants. A lack of safe surgery, understanding or access meant that a burn contracture – tightening of the skin effectively – equals a lifelong disability. The role of Mercy Ships is to bring a hospital, with medical access that is free and safe, right to the people. It is also there to teach and train local staff and facilities to perform these surgeries in the ships absence. And it works.Many years ago, the ship visited another West African country and saw many cleft lips and palates. When the ship returned many years later to the same nation, they were surprised to see very few children and adults with the same condition. When they asked why, the answer was because the local surgeons now knew how to see, diagnose and treat it too. This is why we share knowledge, so that together, we can do better.
Many of my patients currently have burn contracture to their hands, and elbows. So they have 3 or 5 fingers literally melted into the palm of their hand, or their elbow locked into a 90 degree angle cause the inner skin is taught and unable to stretch open. One 15yr old, whose shirt caught on fire when he was 5, had his elbow locked, and his armpit effectively stuck to his chest wall. Although his arm has been stretched out in a splint for nearly 2 weeks now, he looks remarkably different. The story is the same, one bed to the next: burnt as a child, had no access to safe surgery, lived with permanent disability. The surgery is amazing, usually taking a skin graft from their thigh, groin or chest and using it to form new fingers, hands, and release the contracture. Plastic surgery is much more than just boobs, lips and noses!
No story has impacted me as much yet though as the one of M.
M is a 21-year-old male patient who came in from home to us for surgery that lasted over 4 hours. When M was only a newborn, only a few days old, his house caught on fire when a candle fell onto the bed. The house was ruined and most of M’s body was burnt. Honestly, it was a miracle he survived. Although he spent some time in hospital, M was left with permanent injuries.
For the next 20 years, as he grew, M’s body contracted. His left hand was completely destroyed. He has no recognisable fingers, only a smooth fist and his right hand has small fingers, pulled back and almost stuck to the back of his hand. His right cheek was pulled completely down and stuck to his chest. Almost like you were pulling your face down intentionally. He couldn’t close his right eye and his jaw was deformed from 20 years of his skin pulling. But he was so sweet, polite and smart. I met him the day he arrived to be admitted, and when I spoke to him and read his story, my heart broke. Although we could not fix his left hand, we were able to release his face from his chest and operate on his right hand to give him function.
He spent a few days in ICU, then returned to our ward. Looking after him has been special. He is so determined to get well. His hands are still bandaged, his graft sites are healing well, and we took off the bandage on his face the other day. He now can turn his neck both ways, can close his eyes and can smile. He is eating, walking and moving around independently. He still cannot use his new hand yet, but he is doing so well.
Every day they get an hour outside for fresh air, and he argued with me one day when I said he couldn’t go. He told me that he just wanted to see the sea – how can you argue with that! So I took him upstairs to the deck in a wheelchair and sat with him admiring the beautiful Atlantic Sea.
We cannot save everyone, and it is unlikely that we will ever do enough to ‘change the world’. But this is also how you make a difference, where ever you are – one life at a time.
There is so much healing happening here, and I am loving being a part of it.