Mission of mercy

By Nancy Wesenberg

Sarah Gieschen conducts a follow-up exam on a woman who had cataract surgery on the Africa Mercy.

Sarah Gieschen's online journal from last summer leaves no doubt that she’s a person of faith. But as she recorded her day-to-day activities as a volunteer aboard the Africa Mercy, the world's largest nongovernmental hospital ship, it also was clear that she has at least two other passions: service and singing.

A 2005 graduate of UW-Eau Claire's nursing program and now a postoperative nurse at Wausau Aspirus Hospital, Gieschen spent last July engaging in both passions in and around Monrovia, the capital of Liberia, West Africa.

Imagine the surprise of the Liberians, as well as volunteers from 30 other countries — including the United Kingdom, New Zealand, South Africa, Germany, Canada, Nigeria, Ghana, Denmark, Sweden and the Netherlands — when this pale young nurse from Wisconsin was able to sing traditional songs in native African languages.

"UW-Eau Claire did a good job of preparing me to work in this international community," Gieschen said, explaining that she'd learned the songs while participating in the university’s African Choir.

During her month aboard the Africa Mercy, Gieschen served with more than 400 other volunteers and a handful of permanent staff members. Owned and operated by Mercy Ships, a nonprofit mission organization founded in 1978 to deliver free health care and community services in developing nations around the world, the Africa Mercy is the newest in Mercy Ships' fleet of hospital ships. It is equipped with six state-of-the-art operating rooms and ward space for 78. During the 10 months it was docked at Monrovia, this floating hospital offered ophthalmic care; orthopedic surgery; ear, nose and throat procedures; maxillofacial reconstruction and plastic surgery; and other surgical procedures.

For two weeks Gieschen worked with the mobile eye care team, visiting four clinic sites in and around Monrovia to assess and treat eye patients ranging from infants to elders. Common problems included glaucoma and cataracts. The team of nine people, including five local translators who also helped with screenings, saw anywhere from 50 to 200 people per day. And although Gieschen usually worked with a translator, she quickly learned to speed the process by saying, "Wha's ya nam?" and "Wha's wrong wit' ya eye?"

"English is the official language in Liberia, but it's tricky," Gieschen said. "It sounds a bit like Jamaican English, only quicker and with a slightly different accent."

Despite the intense heat and long lines of patients, Gieschen said she loved the experience.

"I really enjoyed being with the people and learning to speak with them directly," Geischen said. "But it was challenging to turn people away when there were more than we could see in one day or when the appointments for surgeries started filling up."

During the weeks of clinic exams, the eye care team determined which of the patients would be coming to the ship for surgery in the coming weeks and months.

"Those decisions were hard to make, but the team focused on patients with the greatest need, and children were always the first priority," Gieschen said, explaining that there is a high incidence of childhood cataracts in that region, even in very young children.

Another common problem, according to Gieschen, is pterygium, a condition that affects people who live in very dry, dusty areas close to the equator and receive high levels of ultraviolet exposure. A skin growth that starts in the corner of the eye can keep enlarging until it covers the pupil, so it is important to try to catch it early or prevent it altogether.

"Operations were scheduled only for the worst cases," Gieschen said. "With people who were just beginning to have symptoms, we stressed the importance of wearing hats and sunglasses with UV protection and using artificial tears to keep the eyes moist."

During the weeks when surgeries were being performed, Gieschen’s role switched to one familiar to her from her hospital work. She assisted the ophthalmologists by prepping patients for surgery, measuring eye strength and administering eyedrops to dilate the pupils. Patients stayed in recovery only during the day of the procedure and then went home overnight with an eye patch. They returned the next day to have the dressing removed and the eye cleaned and tested again.

Gieschen said one of the eye team's favorite stories involved a 90-year-old woman with cataracts who was initially reluctant to leave her village and afraid to board the ship. But when she returned to have her dressings removed, she was so delighted that she could see that she danced about, clapping and singing.

"Of course I was excited at the prospect of seeing more of those kind of reactions," Gieschen said.

When she was off duty, Gieschen never missed a chance to get out and connect with the local people. One of the first things she did was go with other volunteers to a Liberian worship service. On the way there, she got to sing some of the songs from African Choir. On another day, after visiting a clinic in a smaller village, she wrote, "I had fun with the kids, singing and talking with them. I taught them one song, and then they taught me two!"

Gieschen said the volunteers also are encouraged to adopt a patient who stays onboard ship during recovery. She befriended a patient with vesicovaginal fistula, tears that can occur during childbirth and cause an uncontrollable leakage of urine.

"I would go see her every day, make her cards and pray with her," Gieschen said, noting that this was especially important for the VVF patients, who have often been shunned by their communities, and even their own families, because of the unpleasant odor associated with their condition.

Gieschen sang "Amazing Grace" for her new friend and sang along with other VVF patients as well.

On other occasions, Gieschen visited a Sisters of Charity home for people with HIV/AIDS, an orphanage and a prison. And almost every time there was more singing.

Professor Susan Moch, one of Gieschen's mentors in UW-Eau Claire's College of Nursing and Health Sciences, said she was not surprised to hear about her former student's activities.

"Sarah was always interested in working in other countries," Moch said. “She has a lot of interpersonal, research and leaderships skills to bring to the work. Even here at UW-Eau Claire she would always offer help or have a kind word for the younger students."

Gieschen collaborated with Moch on a project that showed how undergraduate nurses can be involved in research. She also was on the Research Council and led a team that interviewed nurses at local hospitals to determine how evidence-based nursing research could more quickly be brought into practice.

"Sarah presented that research at a nursing conference in Montreal, and she really impressed people there, just as she impressed them at the local hospitals and at Wausau Aspirus where she worked summers as a student," Moch said.

Gieschen cited Moch as a mentor who helped her learn how to think critically and solve problems and pointed to Cheryl Brandt, associate professor of nursing, as someone she could always turn to for advice.

"I’ve wanted to be a nurse since the second grade," Gieschen said, "and when I was a senior in high school, I went on a mission trip to Mexico, so I got interested in missionary nursing."

Gieschen heard about Mercy Ships from a Christian radio station ad. After researching the organization, she took the advice given and waited until she had two years of nursing experience before applying. During that time she saved money by living with her parents. All Mercy Ships volunteers pay their own way so funds raised can go toward the Mercy Ships mission of offering hope and healing.

"I met so many incredible people," Gieschen said. "Besides working with the Liberians, I got to work with an international community of volunteers. I made some friends that I plan to stay in touch with, and some of us hope to coordinate our plans so we can work together on a Mercy Ship again."

Nancy Wesenberg is a writer for the UW-Eau Claire News Bureau.