“I will always remember seeing the results of a surgery removing cataracts on a three-year-old girl in Benin, [West Africa]. The day before – when I had assisted with her anaesthetic – she had felt my face in order to understand where I was, as she was completely blind. I took her eye patches off the day after surgery and watched as she took a red brick directly out of my hand. The previous day she wouldn’t have seen it, so in 24 hours we had turned her life around. It was a magical moment and every time I tell her story I still choke up,” says Ali Herbert, a theatre sister working at the Nuffield Hospital in Cheltenham.
Herbert has worked as a volunteer on Mercy Ships – an international organisation that provides healthcare across the globe – since 2008 “after a colleague at work, who volunteered with them regularly, suggested that this would be something I might enjoy. I applied and six months later was on the ship”.
Since 2008 she has completed many trips on the Africa Mercy Ship, known as “the world’s largest charitable floating hospital”.
She has worked on the ship when it has been stationed in many African countries, including Liberia, Sierra Leone, Togo and Madagascar.
The days were varied; no two days were ever the same. Her experiences have allowed her to meet a variety of people that can share their skills in nursing. She says: “I work with up to 14 different nationalities at any one time – that has its challenges but also its joys. Nowhere else could I sit round a table and have a discussion with so many different nationalities who all bring their own expertise.”
Herbert has now been nursing for 35 years, as her career first began in 1980 when she qualified as a state registered nurse from St Luke’s hospital in Guildford. Following this she went straight into working in the operating rooms at St Luke’s hospital. She knew she wanted to stay in the operating room but she yearned for a wider experience than she was receiving. Therefore, she decided to undertake a specialised theatre-nursing course in 1983-1984, otherwise known as a one-year post-registration course at Southampton General Hospital to widen her nursing horizon. It was at this time she first began to think about travelling.
“In 1982 I began thinking about it, but it took me another 28 years before I was able to do anything because I did lots more training, got married and had children.”
With increasing skills Herbert then began working as a staff nurse and later became a theatre sister at North Staffordshire Royal Infirmary in 1984 where she stayed for eight years.
In 1992 she began a role as a theatre sister at Glasgow Royal Infirmary. By this time she had welcomed two children, a son named Simon and a daughter named Rebekah.
In 1994 Herbert’s career headed down a different path, leading her to the front doors of education. She began working at Stafford College teaching pre-nursing courses to students aged 16 and above. Speaking of this time she says: “I absolutely loved it, I still enjoy doing the clinical work but also doing the teaching work. I love that mix.”
Following this she has worked at private hospitals in Gloucestershire and Nuffield Hospital in Cheltenham where she still works today.
But it was in 2008 that Herbert’s sights turned towards volunteering, and she decided to join Mercy Ships. She says: “The opportunity was there and as a Christian organisation it appealed to me. I knew that the reasons for people volunteering for Mercy Ships would be the same as my own and I would find people with a similar outlook.”
Her first adventure was in Liberia, Africa, working as a service scrub nurse for three weeks in June 2008. She returned again later that year for another three-week trip volunteering.
Describing how the Africa Mercy Ship typically works she says: “It goes into a country and docks and is [usually] there for 10 months of the year, so I fly out to the country.”
Volunteering has given Herbert the opportunity to grasp skills she may not have even encountered while nursing in the UK. “I have learned difficult airway [management] skills because as an anaestetic nurse I deal with far more difficult airway [cases in patients] on the ship.”
After her first taste of life volunteering for the organisation, Herbert couldn’t wait for the next opportunity, so in 2009 she travelled to the Africa Mercy docked at Benin, West Africa, to work as a scrub nurse and anaesthetic assistant for six months.
Herbert spent six months in Benin, three of which she worked in the eye rooms where they would see up to 50 patients per day.
Now the mother of two has several volunteering experiences under her belt. The length of the trips she has completed vary, with some lasting two weeks and others seven months.
During all of her trips she has encountered similar surgeries, she says: “we will do big facial tumours, eye surgery, women’s health and general surgery like hernias and structured plastic surgery.”
Additionally, a pediatric orthopedic surgeon will usually come to the ship for around eight to 10 weeks to conduct surgery that straightens children’s legs and feet, for example for children who suffer from bowlegs or feet that turn in.
She adds: “We see a lot of burns, partly because of the way they cook, they don’t have electric cookers that are well out of the way of children, they are often [cooking] on the floor and young children fall. We also have horrendous cases where women get acid chucked in their faces.”
But there are restrictions in the work that Mercy Ships can do, “we are limited, we don’t treat cancer or vascular surgery”. This is due to the follow-up that is required because “it is important to know the limits, so you can leave the patient in a good way”.
Herbert, who now has two granddaughters aged seven and four, feels that surgery is often necessary because medical conditions have worsened due to the financial situations residents of these countries are in. She explains: “It is partly because of the lack of medical care, they cannot afford medical care at an early stage.
“Some of the tumours are caused by a simple things like a cyst that here [in England] would be operated on when they’re really small, but again they can’t afford to go to a doctor and have surgery so it just grows and grows until it becomes a very big thing,” she adds.
One particular patient she saw while volunteering had a tumour for 20 years that weighed “several kilograms”.
But the great thing is that “once they reach the ship everything is free, all of their surgery, treatment, drugs and food”.
People who need healthcare access the ship through a screening programme. “Before the ship gets into a port a team will go out and put up dates for screening in local places. That message is also broadcasted through radios. Posters and churches will also let people know when the ships are coming out,” says Herbert.
In 2014 Herbert was invited once again to join the Africa Mercy docked in the Republic of Congo, central Africa, for seven weeks and then continue to Tenerife in the Canary Islands for three weeks.
After Tenerife the ship was meant to travel to Benin but after news emerged of the Ebola outbreak and the fact there was Ebola in Nigeria at this point “it was decided very reasonably the ship would not go to Benin as it is right next door. They were very concerned about having Ebola on the ship because we would have only needed one patient on there [with Ebola] and it would have been disastrous for us.”
At this time Herbert was contacted by an organisation she was already signed up to, Samaritan’s Purse – a Christian humanitarian organisation – to do some training on Ebola so she could work as part of a response team.
The Africa Mercy Ship therefore released Herbert early so she could train in Brussels with the Médecins Sans Frontières (MSF), a healthcare association also known as Doctors Without Borders. She later travelled to Liberia where she trained staff working in a community care centre and became a co-ordinator.
“This time last year I was in Liberia for seven weeks, it was very different to anything I have ever done before,” she says.
Madagascar in southeast Africa has been her most recent trip, working as a anaesthetic assistant for the first six weeks and then for 15 weeks as a team leader last year. She travelled around Madagascar’s regional hospitals and reached 14 hospitals in 13 weeks where she trained hospital operating room staff to make their own World Health Organization Surgical Safety Checklist.
“When we leave the country we leave it with staff who are much better trained than when we arrived,” she explains.
While visiting the hospitals she noticed key differences to nursing in the UK. The lack of equipment was one, however the lack of trained staff assisting in operating rooms was an eye opener.
“Scrub nurses are not so common and often the junior surgeons take on that role. Sometimes the staff simply have an oven to sterilise the instruments. No good cleaning processes, but the staff care about their patients and I have seen great compassion and concern for patients,” she explains.
Returning from her trips she has been greeted with family, friends and colleagues interested to hear about her work. “Friends outside of medicine don’t hear all the medical details but my guides are always fascinated to hear about the work and the country from where I’ve returned.” This has even developed into her journey being tracked online. “This last time as I’ve been travelling around Madagascar I’ve used a website to track my journey, so that they have been able to see how far I have travelled. Including flights to and from the UK I travelled well over 10,000 miles.”
But Herbert feels volunteering is only possible because of the help of practice nurses. “Without Jane Dalrymple at my local GP Surgery [Churchdown Surgery in Gloucester] keeping close tabs on me I might have been stuck once or twice.”
Adding: “At one point typhoid vaccine was in short supply, and they only had a couple left. She checked my record and saw that I was due this vaccination, so she made sure she held one back for me.
“Actually the glue to [volunteering abroad] is the fact that I need practice nurses’ help.”
Returning just before Christmas, Herbert is now working as a bank nurse in the operating department of the Nuffield Hospital in Cheltenham, but she insists she her volunteering with Mercy Ships hasn’t come to end just yet, “I enjoy myself far too much to do anything else”.
The experience she feels she developed while travelling on the ships has not only improved her competence in difficult airway intubations but it has given her a headstart at nursing in the UK.
“We can have three difficult airways in one day if we have either large maxilla facial benign tumours called ameloblastomas or very large goiters. We had some equipment on the ship that my workplace did not have for about a year. So I was familiar with it before I had to use it at home.”
Explaining whether she feels it’s important that nurses volunteer for organisations like she has, Herbert says: “If the opportunity arises to work for a charity like Mercy Ships and the desire is there, then absolutely.
“The experience will be far more than just the nursing skills, and can have far-reaching effects on our personal lives.”