A Worldly Perspective on Covid-19
In February, I was serving the people of Senegal on board the AFM as a Maxillofacial, Thyroid and Reconstructive surgeon with my wife Hilary, a Methodist Minister from the Forest Circuit, North East London. Within a few weeks of arriving back in the UK, I found myself working overtime in the race against the surge of coronavirus in several London hospitals. My calling to serve the forgotten poor in developing countries with the Mercy Ships for nearly 20 years now gives me the same motivation and energy to join the battle against this invisible enemy and to keep the NHS from sinking under the surge of Covid-19. I am very glad indeed to congratulate everyone in our nation for saving the NHS by adhering to social distancing, staying at home, rigorous personal hygiene, helping one another and not taking the gift of our NHS for granted. We together have prevented an overwhelming tsunami of Covid-19 hitting our nation and our NHS.
Africa and Covid-19
Africa is bracing for Covid-19. I heard someone once said: “When the global north catches a cold, Africa gets pneumonia”. This is because of poor healthcare infrastructure with high levels of poverty (earnings less than US$2 per day) and lack of education. Let me give you an example: there are only 60 ventilators for some 80 million people in part of West Africa. In the UK our NHS has 6,000 ventilators, according to the Department of Health and Social Care, and this number is increasing 3 fold to 18,000 in order to deal with the worst-case scenario for the spread of Covid-19. You can see the unbelievable and huge inequality of healthcare resources and capabilities between the developed and developing world.
The majority of the populations in West Africa are in the informal economy as their earnings are not fixed, taxed, monitored or protected day-to-day. Many do not have access to sanitation, clean water supply or electricity which we take for granted in the developed world. Social distancing does not mean anything in these poor countries because many people share crowded accommodation.
Our Mercy Ships UK Executive Director, Lea Milligan believes that as the Covid-19 epicentre has moved from China to Europe and then to America, it won’t be long until the continent of Africa becomes the epicentre.
Dr Odry Agvessi, a surgeon from Benin, West Africa and a trainer with the Mercy Ships said, “When you face some danger and you do not have anything to fight with, you just put yourself in the hands of God. So, we are just praying and educating our population the importance of lockdown.”
For nearly 20 years, I have used my annual leave to serve with the Mercy Ships in the poorest of the poor in West Africa providing free specialist Maxillofacial, Thyroid and Reconstructive surgery to the forgotten poor. Some of my outreach trips have been accompanied by my wife and our 2 daughters serving desperate patients together as a couple or a family.
Mercy Ships operates the largest charity-run hospital ship in the world, delivering free, vital medical and surgical care to some of the world’s least developed countries. This floating hospital is staffed by selfless volunteers, who give their expertise for free to help patients with dental and eye problems, facial deformities like cleft lip and palate, gigantic tumours of the head, face, neck, limbs and body, club feet, child-birth injuries, burns and many other deformities and conditions.
Since 1978, Mercy Ships has visited 56 countries, providing services worth more than £1.2 billion that have directly helped more than 2.8 million people. We have also trained 45,000 local professionals in their areas of expertise to leave a legacy that lasts.
Mercy Ships and Covid-19
When Covid-19 started to spread round the world, the situation made it impossible for Mercy Ships to continue our field service in Senegal. In line with the measure taken by the President of Senegal and his Ministry of Health, Mercy Ships made the difficult decision to stop our field service and bring the Africa Mercy into drydock in Tenerife for early essential annual maintenance. The Africa Mercy is a specialist surgical unit and is not equipped to deal with a highly contagious respiratory infection. Once the maintenance work is carried out and the global situation allows, we will return to Africa and help strengthen healthcare systems emerging from the pandemic. The Africa Mercy was there for Guinea in 2016 after Ebola swept across West Africa and we will be there for West Africa after Covid-19.
Before setting sail in March, Mercy Ships donated £120,000 to Senegal for the prevention and treatment of Covid-19. We also donated vital equipment, e.g. PPE and sterilising kits to hospitals in Dakar, Senegal. The healthcare professionals we have helped and trained in the past are now the front line workers in the battle against Covid-19 in their own respective countries. As they face these challenging events, Mercy Ships will continue to stand with them. In the face of this unprecedented crisis, we reaffirm our commitment to Africa, to the medical professionals we support and to those desperate patients who otherwise have no hope of getting the surgery they badly need. Our own volunteers surgeons and health care workers have returned to their own home nations to help on the front line against this invisible enemy.
My work during Covid-19
In this Covid-19 time, my work at the NHS has not only been challenging but also strangely satisfying to see colleagues working together selflessly to keep the death toll down!
My team and I are providing surgical airway support for those seriously ill Covid-19 patients by making holes in their windpipes (tracheostomy) in order to facilitate their lung ventilation in Covid-19 hospitals (‘hot’ hospitals). At the same time, I continue to offer some cancer surgery in Covid-19 free hospitals (‘cold’ hospitals).
Donning and operating with Personal Protective Equipment (PPE) have been a learning process as we have to ensure adequate hydration while minimising toilet breaks (tricky at times!), clear articulations to avoid miscommunication with a muffled voice under the FFP3 (N99) mask and visor, alteration of surgical procedure to reduce unnecessary generation of aerosol, extra procedure and checks to reduce the risk of ‘return to operating theatre’, extended personal hygiene against the invisible enemy...etc. Telephone and virtual clinics have become the ‘new norm’ for most of our clinics and patients. Teleconferencing has become a major part of my clinical time connecting with our clinical and management teams, and multidisciplinary cancer team meetings.
As John F Kennedy once said that there are two Chinese characters for the word ‘crisis’, the first character is ‘danger’ and the second character is ‘opportunity’. I believe that God is using this crisis and pain to shout at His people, His LOST people’s hearts through suffering because He loves us so much and He will never give us up. As CS Lewis said, ‘God whispers to us in our pleasures, speaks in our consciences, but shouts in our pains.’ Pain and suffering are therefore God’s loudspeaker and megaphone to wake up a self-centred and deaf world. May the Holy Spirit guide us as we reach out to each other’s hearts in this time of searching and opportunities. God is in the gift of pain and suffering!
We pray that in this challenging time of lock down and great uncertainties, we put our trust in the strength of God. We can reach out to a place in all of us where perfect peace in the Kingdom of Heaven lies, a place where nothing is impossible because this is a place where God’s strength abides. We therefore pray for God’s strength and protection in all that we do to rebuild our nation and our world. With the strength, love and grace of God, nothing we do is impossible in name of Jesus Christ, our true guide, teacher and saviour, Amen.
I look forward to seeing and serving with you guys in London and on board the Mercy Ships after Covid-19.
Take very good care, keep safe, keep healthy and keep serving.
LLM BDS MBChB FRCS FDSRCS FRCS(OMFS) FHEA
Consultant Oral, Maxillofacial, Head and Neck Surgeon
Barts Health and Homerton University Hospitals, London, UK
Clinical Lead, Homerton University Hospital, London UK
Volunteer Maxillofacial, Thyroid and Reconstructive Surgeon
M/V The Africa Mercy, The Mercy Ships, West Africa
Local Preacher, Forest Circuit, London District, The Methodist Church, UK.