The Curveball that is COVID-19

"Things work out best for those who make the best of how things work out." Jeff Wooden

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Four weeks ago I attended a training in the Netherlands. I recall looking at the news on my phone one morning. Italy had something like 609 cases of COVID-19. That blew my mind. 609 seemed like an exorbitant amount at the time, but that number obviously pales in comparison to the caseload of many countries (Italy included) these days. That same week, the Netherlands announced its first patient with the virus as did Switzerland. While waiting in the Schiphol Airport for my flight home, I saw some travelers wearing masks. I intentionally distanced myself from people knowing that international travel quickly transfers diseases across the world. But, even then, I didn't think too much about the wide-reaching implications of COVID-19.

View from my room in the Netherlands
Who would have thought something terrible was brewing

When I passed through immigration in Pennsylvania, the officer asked my purpose for being in the Netherlands. I told him I was there for work. The natural follow up came next: "What is your profession?" "Public health", I stated. He looked at me with what seemed like a sudden sense of respect. "I've seen a number of public health professionals today. They think this is going to get a lot worse." I went on my way soon thereafter thinking about what he said but grasping it only to the extent that one can comprehend a situation they've never come close to experiencing.

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The next few weeks I worked remotely from Virginia - connecting with teammates via What's App, reading up on the countries I would visit, and scheduling numerous meetings for my time on board the Africa Mercy. I used our guest bedroom at home as a staging area for packing. I was getting excited to embark on this new adventure. As I forged ahead with my work, the virus also forged ahead with its devastation. Just a day after I returned from the Netherlands, Senegal noted it's first case of COVID-19. And a couple of days before my planned trip, Liberia followed suit. The virus had reached West Africa.

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In the end, for a number of reasons, my journey to Senegal and onward travel were cancelled. I knew it was the right choice, but I didn't like it. My heart really wanted to be back in Africa.

Around the same time, Mercy Ships, in consultation with the Ministry of Health and Social Action of Senegal, made the very tough but well informed decision to suspend surgical care and medical capacity building activities in the country.

Orthopedic surgery patients, Ousseynou and Assane, exercise their straightened legs
Photo Credit: Lara Arkinstall

Mariama receives care for infected teeth at the dental clinic

Here is the official announcement:

The evolving situation of COVID-19, highlighted by the WHO as a pandemic and the increasing travel restrictions applied by several countries, has made it impossible for Mercy Ships to continue to carry out its programs to the required standards, while protecting against the possible spread of the virus. 

Therefore, in line with the measures taken by the President of Senegal and in consultation with the Ministry of Health, Mercy Ships has reviewed the activities associated with the Africa Mercy and has made the decision to suspend the programmatic activities in Senegal. 

The main concerns of Mercy Ships are the health of the Senegalese people and the safety and well-being of our own volunteers, crew and staff worldwide. Following the suspension of programmatic activities we are presently considering alternative ports for the Africa Mercy. 

Annually the vessel undergoes routine maintenance, and we currently are assessing how we can accelerate the commencement of that work. This would enable us to bring the Africa Mercy back to Africa once the immediate crises is over and continue our mission of bringing Hope and Healing to the forgotten poor. Mercy Ships is also evaluating how the organization, given certain operational limitations [as a specialized surgical ship] can be utilized to assist in the global COVID-19 response. 

For the announcement in its totality and for future updates, please visit https://www.mercyships.org/covid-19-update/

Just as with my cancelled flight, even though I knew winding down the field service early was wise and actually a very responsible and caring thing to do given the circumstances of this virus, my heart still grieved that decision for the many who would be impacted.

I heard the news online just as it was announced to crew on board the Africa Mercy. We are a community that spans the globe, but in that moment, I think we all longed to be on that ship to process together and support one another. The next few days were especially hard. My thoughts were constantly on the ship even though I was physically still in the USA. I knew all the departments were very busy given the sudden altered plans and the need to pack-up and secure loose items for sailing. Some crew members were additionally occupied with arranging last-minute travel at a time when flight routes were being cut left and right. And, of course, they were dealing with physical and emotional exhaustion too. I wanted to be present to help in a tangible way because I am a "doer" when there is a need - but there was very little I could actually do from a across the Atlantic. So I prayed and sent words of encouragement when I felt prompted, but they seemed insufficient in the scheme of things.

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In recent days, my heart's been focused more so on the region of West Africa. The government leaders and health officials have witnessed this virus wreck havoc on China followed by Europe and now the United States. They know what COVID-19 is capable of doing to a population. It's still hard to comprehend how something so minute can be so powerful and destructive but that's the reality. In the countries I am following, precautions were announced relatively early, however. I hope and pray they're enough to keep the impact to a minimum.

Here in the USA, we have governors requesting thousands of extra ventilators for their states...and rightly so as they are needed. Yet, I think about the medical staff working in countries that are really still recovering from the harsh effects of Ebola and whose healthcare resources - including personnel - are stretched thin on an average day. They want desperately to do well for their patients just like nurses and doctors do worldwide. However, even in large hospitals, they'll be fortunate to have a handful of functioning ventilators at their disposal.

And what about the feasibility of social distancing in countries where many people live in tight quarters just to have a roof over their heads and where there may be no food on the table if one doesn't make a few dollars selling odds and ends on the street that day. Whereas we talk about living "month-to-month" in the USA, the reality is that many people in West Africa still live week-to-week or even day-to-day when it comes to having sufficient income for their basic needs. To get by, and because community is still highly valued, neighbors often share prepared meals. Children - and the elderly - may be looked after by multiple family members or friends in one week. People offer rides to one another if they are fortunate enough to own a vehicle. Can they afford to distance themselves as we're called to here? Can they afford not to?

Last summer, in preparing for the arrival of the Africa Mercy, I met a couple professionals in Dakar who specialize in infectious diseases. I asked about disease surveillance, transportation for those affected, isolation capabilities etc. The conversations were grounded in the desire for Mercy Ships to be prepared for any circumstance - no matter how far fetched - that may come its way during a field service. I have thought of those people often in recent days. Their dedication to the work. The long hours they must be enduring now. The emotions. The stress. Do they feel appreciated, I wonder? That goes a long way to boost one's spirit during challenging times.

I've also thought about the Institut Pasteur de Dakar, home to a state-of-the-art laboratory, a vaccine center, and a public health research unit in Senegal. Scientists there, in partnership with UK-based Mologic Inc. and with support from the UK Government and the Bill and Melinda Gates Foundation, are running validation trials on a COVID-19 diagnostic test that can be produced for $1 and is easy enough to use at home. You've probably heard about it in the news. This would be groundbreaking, and it can't come soon enough.

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At this moment, the Africa Mercy is sailing. She departed the shores of West Africa a few days back, but I hope her absence won't be for long. A quick return would be excellent for our host countries, future patients, the crew, and for Mercy Ships as an organization. However, her return to providing specialized surgical care in Africa would have a far greater significance in this era. It would mean that COVID-19 is under control and that the world is opening up again.

Worship on the bow
A sailing tradition

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So where does all that leave me? I'm still processing the past few weeks and feeling moments of sadness, but I know that I am very fortunate. I have my health. I have a place to live. I have work even if it looks different than I expected. I have other activities to keep me occupied and learning. I am also basking in the amazingness that is spring, pollen aside. I love this time of year - the flowers, the sunshine, the chirping birds, and the fact that my craving for frozen desserts has returned with the warmer weather.

I do have faith in God's timing in my life. I may not be in Africa yet, but I am preparing so that I can be ready when that opportunity arises. In the meantime, I am trying to appreciate life's simplicity at the moment and to be intentional with this gift of extra weeks (or months) in Virginia.

Spring has arrived! 
Norfolk Botanical Gardens