Jun 02, 2014
By Leah Geller

Creating a safe harbour

Volunteering on an international hospital ship opened Nelleke Kerkhoff’s eyes and her heart

Kerkhoff and Alice Aloa
Courtesy of Mercy ShipsKerkhoff with patient Alice Aloa

Gracia was one of the first patients to walk up the gangway of the Africa Mercy when it docked in the Pointe-Noire harbour in the Republic of the Congo. A cloth was draped over part of her face in an attempt to hide a massive three-kilogram tumour.

Nelleke Kerkhoff, who was waiting on board for patients to arrive, wasn’t especially surprised by the teenager’s deformity — she had seen many similar cases during her previous work on the hospital ship. Over the last six years, Kerkhoff has volunteered three times with Mercy Ships, an international charity that provides ship-based specialized surgeries and other health-care services to the world’s most impoverished people.

Previous missions have taken her to Liberia and Togo. “In the beginning, everything was a complete culture shock,” she explains. “The overwhelming reality of seeing people with deformities because they lack access to appropriate health care was difficult. However, it didn’t take long to look past the surface to see the person inside.”

Kerkhoff, who lives in Chilliwack, B.C., works in the intensive care unit at the Abbotsford Regional Hospital. The idea of combining nursing and travel, two of her passions, was on her mind from the day she graduated from the University of the Fraser Valley. “I’d heard about Mercy Ships through an overseas friend, and when an opportunity to volunteer at a land-based hospital mission in Zimbabwe fell through, I applied right away.”

To get the time off that was required, Kerkhoff used vacation days, took leaves of absence and traded shifts. Like all other volunteers with Mercy Ships, she paid her own way, including room and board and travel expenses.

Mercy Ships

The Africa Mercy, a converted railway ferry, is the world’s largest charity hospital ship. Health-care professionals from around the world, with wide-ranging scopes of practice, volunteer to work as part of an international medical team. When the ship docks in a particular country, Kerkhoff explains, it stays for up to 10 months, while patients and staff come and go.

Kerkhoff describes the ship as a kind of floating community, with its own bank, post office, store, library, community dining room and café. The hospital itself is located on the third deck and has five operating rooms and five wards for up to 82 patients. The nurses’ accommodations are mere steps from the wards. “Sharing tight sleeping quarters with five other nurses and living space with 450 other crew requires patience and cooperation,” she says. “I think flexibility is one of the biggest assets a volunteer can have.”

There’s no real privacy for patients either, but Kerkhoff says they don’t mind. “The close quarters actually promote a sense of bonding, camaraderie and hope, as patients observe the healing of others around them.”

Creating a safe harbour - Esther had surgery
Courtesy of Mercy Ships“Esther had surgery to remove two large tumours from her jaw. I looked after her the entire time; we had a close bond.”

During volunteer stints that ranged in length from six weeks to 4½ months, Kerkhoff served both in the ICU and on the wards, working alongside nurses from the U.S., Europe, Australia and New Zealand. Her ICU patients included a four-year-old boy who underwent facial reconstruction surgery and a 40-year-old woman who had a thyroidectomy for a large goitre. “You’re expected to serve where you’re needed. There are excellent care plans that help you figure things out, but you’re often pushed beyond your comfort zone.”

The language barrier was another challenge: patients spoke either French or a local tribal language. “We had a team of local translators to help us, but any time you have to go through a third party you lose the immediate emotional connection. We used a lot of hand gestures and drawings, especially when we were teaching how to take medication. There are ways to make connections — it just takes longer.”

Kerkhoff says her experience on the Africa Mercy has taught her to be more flexible in her critical thinking and more culturally competent in caring for patients of other ethnicities. “On the ship, I learned to do what is accepted in West Africa. That immersion has helped me be more understanding of the cultural preferences of my patients at home.”

She has also gained a greater appreciation for the quality of health care Canadians receive. “I’ve learned to take better advantage of the resources we do have, rather than focusing on the need for more and better resources. You only have to work in a developing country for a short time to realize how blessed we are with our health-care system.”

While she says she definitely left a small part of her heart on the Africa Mercy, Kerkhoff wants to broaden her horizons on her next volunteer mission abroad by going somewhere she can integrate right into the community — “living with the people rather than just beside them,” as she puts it. “I don’t have any immediate plans, but I always have my ears, eyes and heart open for new opportunities.”

10 questions with Nelleke Kerkhoff

What is one word you would use to describe yourself? 

If you could change anything about yourself, what would it be?
I’d stop procrastinating

What are you most proud of having accomplished?
My CNA certification in critical care nursing

What is one thing about you that people would be surprised to learn? 
I’m deathly afraid of spiders

“If I had more free time, I would…”
Work at becoming a better harpist

Where did you go on your last vacation?
Utah’s Zion National Park

Name one place in the world you’d most like to visit.
Machu Picchu

What was the last good book you read? 
I reread my favourite: Anne of Green Gables

Who inspired you to become a nurse?
My older sister, who regaled me with stories of her days in clinical as she was studying for her RN diploma

What was the best piece of career advice you’ve received?
Be flexible and open to change; sometimes you just have to make a leap of faith and trust that your decisions will be the right ones!

Leah Geller is a freelance health and science writer in Ottawa.
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