A Culture of Giving

While I was on assignment photographing leprosy in Myanmar last year I visited the aforementioned Ma Yan Chaung Leprosy Resettlement Village near Yangon. Frustratingly, due to Myanmar still being a very carefully controlled state, I was only allowed to visit for a few hours, when I would have liked to have stayed there for a week or more.

The area was made up of a leprosy hospital, a church with houses for selected vulnerable former/current leprosy patients, a village made up predominantly of people affected by leprosy and their families, and two dormitories.

The dormitories had about 30 beds each, all of which were occupied, and in which lived individuals affected by leprosy. It wasn’t a hospital, but a community. They all had duties, some of them even had jobs. There was a strict routine each day, getting up early, eating together at specific times and going to bed early. There was little privacy as each dormitory was just one long room with beds facing each other. Some people had been there for many years, others quite recently.

On the face of it, it appeared to be a charitable situation; though there are several social enterprises in place to keep the dormitories going, it still relies on donations of various forms. I know this to be a very simplistic view, and though I wasn’t allowed much time to observe the complexities of this relationship I wanted to turn this view on it’s head somehow.

So I asked them each to think of when they last gave something to someone else – an intrinsic part of the Burmese Buddhist culture. Then I took just one or two shots of them on their bed. I didn’t direct them at all, I just wanted to show them, with their worldly possessions around them, and their quote that makes them the donor, and not the beneficiary. I’m going to try and expand this concept in my long-term project Leprosy Eliminated?.

“10 days ago I gave rice to a teacher in a remote village.” Daw Lone Tin

“Last week I donated some food to a monk living in the forest.” Daw Mya Sein

“Yesterday, on 2^nd December I gave some noodles to a monk.” Daw Sun Tint

“2 months ago I gave a longyi to one of the people affected by leprosy.” Daw Than Khin

“On the 15^th November I gave a longyi and some noodles and other food to a poor patient.” Daw Tin Shwe

“10 days ago I was given an extra blanket which I felt I didn’t need, so I gave it to someone who needed it more.” U Thein Han

“15 days ago I gave some longyis to some local people.” U Ko Mya Oo

“I donated a thermoplast to a monk on 19^th November” U Mg Mg Khin

“Last Saturday I donated packs of noodles to a monk.” U Tao

“10 days ago I gave one shirt and one longyi to a person in the village here.” U Tin Khaing

The tooth, the whole tooth and nothing but the tooth

I did a post of dental work in Togo last year, stressing the importance of the work Mercy Ships do in this area. The dental clinic is located at the ‘Hope Centre’, the name given to the venue a short walk from the port where many long-term patients recover after their operations on the ship. The amount of people the dental team see each day is huge. On average they get through 120 patients. Last week alone they pulled out around 1100 teeth. I spent just over an hour at the clinic observing and photographing their usual routine. They are a close team with excellent management and organisation – a well-oiled machine. It is refreshing to watch such good work done with such efficiency.

Above: The lazy atmosphere at the entrance to the clinic is deceiving.

Above and below: Waiting patients are instructed by Comfort Yeboah, a long term resident on the ship as to the best way to look after their teeth. Basic routines like brushing your teeth twice a day is news to many of them.

Above: This mother turned up at the dental clinic with her severely cleft-lipped daughter. She was moved onto the ship 10 minutes walk down the road at lunchtime for surgery due later in the week.

Above and below: patients wait in the main hall to be called in to be seen by the dentist.

Above: A patient waits in the chair while the dentist finishes an procedure.

Above: A patient waits for five minutes for the dentist to return after receiving an injection in his mouth.

Bob reaches for a tool while working on a patients mouth. He is an incredibly fast worker, and seemed to be operating on three to four patients at once – a bit like watching a master playing several games of chess at the same time.

Above: A woman waits for the anaesthetic to take effect. She then has a rotten tooth removed later (below)

Above and below: Alistair extracts a number of teeth which come with a few inevitable drops of blood…

Above: A day volunteer has a quick rest from assisting the dentists.

Above: Jesse, a Mercy Ships cook volunteering for the day holds a patients hand as the dentist pulls out a tooth.

Above: A day volunteer briefly assesses a patients mouth before the dentist comes over.

Above: A patient waits for the dentist to come over.

Above: Alistair explains to a patient why he cannot pull the teeth out that are giving him pain.

Above: Dusti, one of the dental hygienists cleans up a few teeth.

Above: Bob operates on a patient.

Above and below: Alistair examines and explains a procedure to a patient amid the businesses of the clinic.

Above: Mona, one of the dentists a work.

A patient waits anxiously for her name to be called.

Screening (and an eye screening)

Death is a fact of life, necessary for nature’s cycle to continue and for humankind to carry on evolving.

The first day of screening happened on Monday 7^th of March and unfortunately it didn’t go to plan. Due to the overwhelming amount of people that needed care (as well as a series of unfortunate circumstances and events) pressure built up at the gate and when it burst open from the weight of the crowd several people were injured and taken to hospital. Sadly one man died. Screening was cancelled just after midday and all staff had left the premises by the end of lunch.

Mercy Ships released an official statement and their report can be found here, so the previous and following words and opinions are very much my own as a witness.

A small number of people were successfully screened before the aforementioned incident occurred. I took a great deal of photographs before and after it of the crowds that had gathered as well as photographs of the few that were seen in early morning. However management has decided that for the moment we cannot show anything. I wasn’t actually present when the gate burst so I never had any photographs of that and the crush. I can understand why any that were taken of this incident are not being shown. Sometimes pictures are necessary and sometimes they are not. Showing photos of the man that died is not necessary – however I do believe that showing photographs of the crowds, the clear need and desperation present, and the few patients that were admitted is necessary.

Despite the fact that we are expecting to do another screening very soon the fact that that day happened should not be ignored and not showing photographs indicates that there is something to hide. So I disagree with that decision. Photographs can lend a good deal of understanding and in my opinion that is rarely negative.

Mercy Ships has nothing to hide. They have a vast experience since the early nineties of dealing with large screening days in African countries. They could not have predicted that this particular crowd would get out of hand. I don’t want to dwell on this. A number of factors led to the gate bursting – one of which is that a number of boys in the crowd my age seemed to enjoy the distress. I spent a good deal of my first two hours in the crowd initially taking photographs, but then trying to persuade people to gradually shuffle back to relieve pressure at the front – the safety of of those at the front of the crowd was of course precedent on everyone’s minds. While the majority of people in the crowd shared my concern a few laughed at my attempts in way that shocked me. I thought at the time that perhaps they were laughing at the futility of my commands rather than at the fact they were deliberately trying to exacerbate the situation. Speaking to others after, many reckoned that there was an element of maliciousness however. I don’t know – I can’t say that for certain.

The crowd was due to be directed through the pool entrance (so that they could slowly filter through into the stadium for pre-screening). However instead of one line forming around the stadium as in previous screenings people had already formed several queues. I think that because no queue had priority people were slowly edging forward to get seen. They didn’t want people in the queue next to them getting seen before them, probably out of fear they may not be screened themselves. Over several hours from early morning queueing this lead to the huge pressure that built up at the gate. Unfortunately my photographs illustrate my point much better.

What happened happened. I just wish I could show you photographs to lend a better understanding. Perhaps in time Mercy Ships will allow them to be shown. Meanwhile spare a thought for the many Mercy Ships staff and Freetown citizens that witnessed a man’s death on a day where hope was supposed to be realised for a great many Sierra Leoneans.

After a week of reorganising a much smaller eye screening was organised the following Monday at the Kissy Eye Clinic. I have photographs of that. Life is starting to get busier again.

Above: People wanting to be seen after the cancelled screening crowd outside the gate. Everyone is reassured that there will be an announcement of a second screening.

Above: People queue outside the Kissy eye clinic.

Above: Woody pre-screens patients before they enter the clinic building for screening.

Above: Local police help resolve any potentially tricky situations.

Above and below: Bill Donovan screens a patient.

Above: A young patient has his eyes tested by a day volunteer.

Above and below: Potential patients wait patiently outside to be pre-screened. Everyone will be seen.

Black and white photos of life on the Africa Mercy

This is a rather general blog; I thought I’d share some of the individual photos that don’t usually get made into stories. These were taken at a variety of times, usually when reporting on another story, or while I’m down on the wards taking medical photos. However the first photo is of myself and Claire (Bufe – the writer who pretty much gets all the information that I put in these posts) in our little office.

(Left to right) Missie, Dick and Marina inside the admissions tent (on the dock by the ship).

A toddler wandering around one of the wards where their mother’s bed is.

A cargo ship from Thailand on the dock next to us.

Painting the bow of the Africa Mercy.

A mother sits with her child while day volunteers and nurses sing and dance in ward devotions.

Mary, a ward nurse, takes stitches out of a patient post-operation.

Day volunteers singing during a VVF dress ceremony.

This is Kossi, a 5 day old baby sleeping next to his mother. He was born with a large tongue lesion that almost prevented him from breathing, and became one of Mercy Ships’ quickest admission patients (most are screened many months in advance).

Members of the fire team put on their gear at the start of a fire drill. There are two alarms, a first for the fire team, and a second for everyone else to assemble at the their muster stations on the dock. This ensures that the fire team aren’t blacked from getting to the fire by crowds of staff trying to get off the ship.

Having already been the first group in to fight the (simulated) fire Elliot (centre) and the rest of his fire team changes their oxygen supplies while another team goes in to continue fighting it.

Deck hands help secure a new tyre to the side of the dock. These help cushion the ship when hitting the dock as it sways in the water. New tyres creek very noisily, keeping many of the people in the cabins next to it awake during the following few nights.

Christina, a charge nurse, cheerily looking after an infant (that’s not so cheery).

Day volunteers and staff spontaneously form a band in the corner of Starbucks, keeping everyone entertained after the church meeting on Sunday evening.

(Centre to right) Theo, James and Cael entertain in the corner of the Strabucks cafe in Midship.

In the orthopaedics tent a mother breastfeeds her child while a day volunteer takes off the babies correcting shoes (for club foot) ready for a post-op photograph. Nick, the physical therapist makes notes in the background.

Anama (left), Nick (out of sight) and another day volunteer put the babies correcting shoes back on. They’re not particularly comfortable.

Eye patients sit outside the admissions tent on the dock.

Tracy (Ship Security Officer – centre) and the Gurkhas, who guard the ship: (left to right) Lok, Pradip, Tek, (Tracy,) Ganesh (head of security), Chitra and Min.

A VVF lady listens to a speech during her dress ceremony.

A day volunteer drums during a VVF dress ceremony.

Americans celebrate their independence on the fouth of July with a barbecue on the dock.

Amanda and Anouchka enjoy the dock barbecue on the fourth of July.

Above and below: Crew and members of the Academy throw an American football around on the dock.

Maaike, a charge nurse, tickles Irene, a patient, on a bed in a recently emptied ward.

Josee (centre) plays a card game with Claire and a couple of visitors.

Dr. Leo Cheng explains to Kakou the details of the operation he will perform on him later that day.

Dr. Cheng operating on Kakou later that day.

The port of Lomé from the Bridge.

A member of a vision trip from Texas pulls along a patient on a buggy.

Patients resting in the ward.

Deck workers take a moment to look out over the port of Lomé.

A nurse pushes a patient along on a tricycle.

Maaitina, Gafar and Tani

This is a more light-hearted post than some of those I’ve had before. Maaike and Christina are nurses down in the hospital, here demonstrating how you might pass time when you’re not on an afternoon shift. In case you’re wondering what on earth they’re doing, they attempted to cause amusement by wrapping Christina on Maiike’s back in the same way that African mothers wrap their babies on. It didn’t quite tie in with African humour, causing mild confusion on many of the patients faces.

Some of you might remember Tani from a previous post about a Vision Team in the wards. She fell into a fire and severely burnt most of her head and face, losing her nose and right eye. Gafar, the young boy seen here grinning inanely is in stark contrast to the 10 year old who I photographed being operated on. His pre-op photograph in black and white on that blog summed up the depression that no 10 year old should ever have to suffer. Gafar and Tani have developed a brother sister relationship and are charismatic centres of D ward. Here Maaike and Christina encourage them to make a few prank calls from the hospital corridor.

First week on board the Africa Mercy

This is a rather odd mix of photographs from my first week, hopefully as I get settled into my role the blog posts will be more subject specific rather than a random assortment of my favourite shots.

At the moment there are three photographers on board, but there are only supposed to be two. This is because the long term photographer is taking three months leave in a couple of weeks time. There are a number of jobs the photographers are needed for. One is marketing requests to be used to inform donors/followers of the charity of what is going on on the ship – patient stories, events, crew stories etc. These are used in the general promotion of the charity and a photographer and a writer is generally assigned to each request. This week I photographed the arrival and departure of a French Naval frigate behind the Africa Mercy. It was a nice opportunity to get used to photographing and submitting an assignment (with all the relevant admin and metadata – not fun) without too much pressure on me.

Here the newly arrived French sailors are welcomed by a traditional Togolese dance troupe.

French sailors secure the frigate behind the Africa Mercy.

Pete, one of the ship engineers chats to some of the French officers in the midships lounge on the Africa Mercy.

French sailors and Mercy Ship volunteers on the dock by the Africa Mercy.

This is a view off the stern (rear) of the Africa Mercy as the frigate pulled out of dock to start military exercises with the Togolese Navy. On the left is Anouchka, who works in Marketing and PR, and on the right the captain of the Africa Mercy, Tim Tretheway.

We also do general photos each week, such as photographing the nurses and the patients chatting and playing on Deck 7. This gives the nurses and opportunity to have some casual photos with their patients as only the official photographers are allowed to photograph down in the wards.

Naturally if you’re carrying your camera around the ship and you see a good photo opportunity such as the one below of fresh food being delivered to reception for the cooks to pick up then it can always be used for marketing at some point…

Finally our other job is Medical photography for Mercy Ship and doctors records, and also (like the case below) so that cleft lip and palette photos can be sent off to the charity smile for verification that a cleft operation has been performed. This is very important as smile then and only if the photos meet their specifications will give $400 to the Mercy Ships per operation. Photos that fail to pass their standards will not be awarded anything and this is occasionally the case. I’ll be posting more pre and post operation photographs when I have more a portfolio. I’ll be on call every other day during the week and every other weekend. This means I can’t leave the ship and will be paged by the doctors when a photo needs to be taken. They vary between 8 and 12 patients per day. Days on call end between 8.30pm and 10pm.