Mercy Ships strives to make safe surgical care accessible for as many as possible on board its fleet of floating hospitals, providing more than 114,000 life-changing or lifesaving surgical procedures since 1978. However, the sad reality is that not every single patient Mercy Ships meets can benefit from surgery. This is where the palliative care team comes in, serving to bring hope and healing through compassionate care and companionship to those with terminal illnesses.
“As a palliative care nurse, we are trying to not add days to their lives, but life into their days,” explained volunteer nurse Willianne Kramer.
Specialised palliative care nurses like Willianne leave the Mercy Ships floating hospital each morning to visit these patients in their homes. Their mission is to provide holistic care by tending to both their physical and emotional needs.
“It’s about giving total care to the patients. So, we don’t only look at the physical parts, but we also look at the mental parts, the spiritual parts, at the family, the social, the community—how they are doing,” continued Willianne. The Dutch volunteer joined the Global Mercy™ before it first opened for surgeries in Senegal in 2023, later taking over for Mariam Ibrahim as the Palliative Care Team Leader.
Mariam, originally from Ghana, had served four years with the palliative care team. The lens through which Mariam viewed life shifted during her time in this role. “I see joy in a different way that people don’t normally see it,” she said. “And I see healing in different ways.”
Journeying with Patients Through Palliative Care
Mercy Ships vessels are not your typical hospitals. Volunteer medical crew on board operate on a specialised range of health conditions adapted to each host nation’s surgical care system, depending on the needs and healthcare gaps identified by that country. When patients do not fall under the scope of practice for the ship, the national system, or any other available surgical care system, they will most likely be referred for palliative care.
Over a series of visits often spanning months, the palliative care team meets the patient and their family in their home, preparing everyone for the inevitable.
“Dying is a normal phenomenon, and unfortunately, sometimes we forget about it,” shared Mariam.
During early visits, the palliative care nurses on the team speak in-depth about the medical challenges the patient is facing, and how this impacts not only them, but their families as well. These visits also grow to include pain management for the patient and financial planning for the family. After the patient’s passing, the palliative care team often attends the funeral and follows up to ensure the families continue to feel supported and cared for.
Bringing Joy in Hopelessness: The Emotional Effects of Palliative Care
Patients usually feel hopeless when the palliative care team meets them for the first time. “At the beginning of visits, people are often depressed and fearful,” Willianne explained. “People often isolate themselves, so they think they are not worthy anymore. When we come, we try to break the barriers by sitting with them on the ground, sharing with the family and being there with them. They feel special, and they feel hope for the first time in sometimes many years.” Often, these visits include celebratory singing and dancing as the nurses “become truly part of the family,” shared Willianne.
“We see lives transform in a big way… After spending time with them, they become relaxed and hopeful. They are starting to live, and the family and community sees the transformation and becomes also hopeful.”
This last-stage care leads to experiences that run the gamut of emotions. “That’s the beauty in what we do,” Mariam continued. “We come alongside them, and we reduce some of the things that bring suffering to these patients. A simple conversation, a simple holding of hand, a simple pill relieves this suffering. For me, it is taxing. But it’s also joyful.”
Meet the Patients Who Receive Palliative Care
For the patients and family members on the receiving end of palliative care, the loss of hope is often among the most difficult parts of experiencing a terminal illness.
“I was really hopeful. I thought his problem would be solved,” Mary-Magdalene shared about her husband, Abubakarr, who passed an initial screening to go to the ship but was deemed inoperable upon closer examination. “It was heartbreaking when we were told they couldn’t do his surgery. I’m coping, but it’s not easy.”
Between the tumour on his neck, the open wound around his eye, difficulty eating from a previous injury, and his cancer diagnosis, Abubakarr’s conditions were altogether a heavy burden. An army veteran, the 45-year-old was housed with his wife and baby daughter on the military barracks in their nation’s capital, but they were being evicted because Abubakarr could no longer work.
The palliative care team provided some solace for this family that had already been through so much. “It’s really helpful,” Mary-Magdalene said. “Our worries are a little bit reduced.” She elaborated, “Most important is the concern they have, so that gives us a little bit of hope. They usually talk to us like a family. I am pleased with that.”
Another 45-year-old patient, Susan, met the ship’s palliative care team through a community referral. A bedridden single mother, her unemployed 19-year-old son cared for her with his grandmother, while Susan’s two young daughters lived with a friend.
Although they were unable to alleviate the wide-ranging symptoms of Susan’s largely undiagnosed condition to the extent that they could with Abubakarr, the palliative care team was received warmly in Susan’s home during their regular visits. “As long as they are visiting her, she feels good and she feels happy,” her son Ibrahim said. “I also feel happy when I see them.”
Understanding the Impact of Palliative Care Training
It is through partnerships with national care providers that Mercy Ships ensures a legacy in the nations it serves, from port to port. Five years after Patience Sankoh first set up a palliative care unit at Connaught Hospital in the city of Freetown, the senior nurse shadowed the palliative care team from the Global Mercy.
“It’s a big blessing for us,” she said. “It has been so challenging because of limited resources, but we are doing what we ca with what we have.”
During her training, Patience gained new insights into the profession and considered how to apply those principles in her own setting to strengthen the care provided by her team, whose reach will extend and continue long after the ship departs Sierra Leone.
For Patience, the goal is simple: “Giving people the quality of life that they deserve—this is what we are doing. That is, it.
There are countless ways to make hope and healing tangible for those who need it most. Learn more about how your time, talents, and support can be part of transforming many more lives.