Surgery Ship – Behind the Scenes

It’s the first day of screenings at Don Bosco in Cotonou. Don Bosco is a school and a group of local boys is playing soccer on the sandy pitch. Meanwhile in the screening line five young boys with severely bowed legs wait together with their mothers. Later, inside at one of the screening tables, nurse Mel asks one of the boys, 8-year-old Isaac, what kind of games he likes to play. Isaac says he loves soccer, but recently the boys he plays with told him they don’t want him to play anymore because he’s too slow. Through the open shutters of the classroom screams of excitement can be heard from outside as a goal is scored. The cameraman, sound recordist and I all stop and look at one another. It’s one of many poignant and arresting moments in our first day of filming the work of Mercy Ships.

Today we visit a young burns patient Marina and her family at Fijrosse Beach, a very bumpy half-hour drive along the coast from where the Africa Mercy is docked. When we arrive Marina, her sisters and friends take us down onto the sand to play. They seem to have an endless stock of games involving dancing, singing and clapping. The youngest child in the group starts to cry rather loudly so I pick him up and rock him on my shoulder, off-camera, much to the relief of the sound recordist. This becomes a theme of the visit. Our translator Bernadette also has her baby son with her, wrapped on her back in the African way. To keep him quiet while we film with Marina’s mum and dad Bernadette performs a kind of side-to-side jig familiar to parents all over the world. At a crucial point in the interview Marina’s baby brother Samuel wakes up and starts to wail. I retrieve him from his cot and begin a side-to-side jig of my own. And there we are – director and translator dancing side-to-side while Marina’s parents quietly recount the near-fatal moment she spilled boiling soup all over herself.

During the morning’s surgical team briefing the crew is warned that the surgery we’re about to film may take all day. The patient is Ramani, a 27-year-old Muslim man with a rare disease that has caused the bone and soft tissue of his face to grow abnormally. Today maxillofacial surgeons Dr Gary and Dr Kyley will address the bone deformity. They plan to realign the symmetry of his skull. To me, the most staggering part of this is that it’s essentially a cosmetic procedure. Ramani’s condition is not life threatening. But, as Dr Gary explains, it is gravely threatening his quality of life, and therefore it’s a justifiable use of the ship’s limited resources. The surgeons begin by peeling Ramani’s scalp down to his eye level. They saw and chip away at the overgrown bone on the left side of his cranium. Then they grind it into tiny fragments, mix it with bone putty, and pack the mealy mass under a titanium plate to fill the depression on the right side of his skull. Each of us in the crew agrees this is one of the most amazing things we’ve ever witnessed, and it’s only the first of several stages. The surgery does indeed take all day. 15 hours, in fact. In the American hospital where Dr Kyley works, he estimates this one surgery alone would have cost upwards of $100,000.

The latest round of maxillofacial screenings is underway on the dock. In the screening tent Dr Gary is mentoring a local Beninese maxillofacial surgeon, Dr Yurian. Almost 20 years ago, when Mercy Ships did its first field service in Benin, Dr Gary worked with Dr Yurian’s father, a local paediatric surgeon. Today the first patient screened is Prunel, a baby boy with a cleft lip. Dr Gary immediately recognises Prunel’s mother, Emilienne. He operated on her 19 years earlier to correct the same deformity. Dr Gary – a 30-year veteran of Mercy Ships – jokes that these two connections to his past make him feel very old. But it’s a happy reunion. With Dr Yurian translating, Dr Gary reassures Emilienne that the fact her child has a cleft is due to genetics and not because she has done anything wrong. A common myth in Beninese culture is that clefts are a curse placed on the child as punishment for the mother’s wrongdoing. But Dr Gary says that’s untrue and that he can see she’s a good mother because her baby is plump and healthy. Emilienne’s relief is palpable.

In a local clinic in Cotonou, Mercy Ships’ clubfoot specialist Nick is taking a step back. Over the last few months he’s been mentoring Beninese physiotherapists in the Ponseti method of treating clubfeet. It’s a process that begins with serial casting to stretch the foot into proper alignment, then a neat little surgery called a tenotomy that involves cutting the Achilles tendon before casting one last time and allowing the tendon to regrow, only this time a little longer. Finally, the cast is removed and a specially made brace is fitted. Until now Nick has been the driver of each stage, but today he’s letting one of the local physiotherapists, Melchior, take the lead. The Ponseti Clinic is part of Mercy Ships’ Capacity Building Program, which aims to train and mentor local people so that when the ship leaves, its expertise remains. Melchior is already a highly qualified physiotherapist, but this program has given him new skills. And if you’re ever in Cotonou, he gives the best deep tissue massages on earth.