KRB Update 2270 Patient Selection

The Search for Potential Surgical Patients for Madagascar 2024 has Started 
Surgical Patient Registration in twelve cities around Madagascar:  Antananarivo, Toamasina, Vavatenina, Brickaville, Amparafaravola, Miarinarivo, Itasy, Ambilobe, Sofia; Melaky, Ihorombe, and Fitovinany.   
All on the same dates: 11 – 29 March on Mondays, Tuesdays, Thursdays, and Fridays = 12 days.  As I shared in my last update that since I returned in August 2023, I made promises to people to provide them with the necessary information, which I did through WhatsApp, Messenger, Email, text, and in person. 
Yesterday I had the opportunity to join the patient selection team working here in the port city.  Our day started at 1:30 am at the largest hospital.  One of their team members is my friend, and his neighbor is a tuk-tuk driver, and so we had transport to get there.  When we arrived, we found more than 200 people under the palm trees on the beach.  I joined my friend at the main entrance, handing out tickets to potential patients (my favorite location during the larger mass screenings Mercy Ships did in the past).  Then I switched over to the pre-screening – primarily just holding up a flashlight and umbrella as it continued to rain.  It was at this location the potential surgical patients shared details on their need for surgery.  Once we got the people inside the building, I helped with crowd control and getting people to the right locations.  I greeted each of them with a smile and the greeting here of: “Salama” and with the older ones, “Salama Tompoko,” which is more respectful.  Some wanted to hear more of my Malagasy language – I shared all I knew, and some laughed, but that’s fine with me.  With the young ones, I would demonstrate the fist bump and then see if they would fist bump with me – success with all except for one little guy who started to cry.  Parents brought their children needing surgery, including unilateral (one side of the lip) 

and bilateral (both sides of the lip) cleft lips, two sweet little girls with cleft palates, a boy with severely bowed legs whose papa was with him.  They both have the same look and amazing smile.  Many others came with facial tumors.  

Photo Caption:  Surgical Patient Selection Poster – try and see if you understand the Malagasy language.  
One aspect that is new to me is that this same team handles selection for all surgical patients —including ophthalmic (eye) surgeries. In previous seasons of Mercy Ships, the Eye Team made their own selection separately. So yesterday, we had a good number of older people blind from cataracts, and getting them from station to station takes a bit more, though most all came with a caregiver. 
I have really missed being a part of the patient selection process. 
Still while in Liberia in 2022, I was invited and was on the patient selection team in Senegal and for the planning for patient selection in The Gambia.  While I was the Country Director in Liberia, we already began discussing how we would reach out for surgical patient selection to 15 counties of Liberia.    

I found great joy in being a part of this activity and found myself smiling. 
Since August, all that I have been doing in getting containers with medical and non medical supplies cleared through customs, arrangements for the hospital ship at the port and all the required services, and some with immigration for our incoming volunteers, is for patients in Madagascar so they may receive the hope and healing.   Please pray as the team continues – they have eight more days in 12 locations around Madagascar.  

May we continue to Love God and Love and Serve Others. 

KRB Update 2269 – First Month – Africa Mercy – in Madagascar

Keith Robert Brinkman                                    02 March 2024 

Photo Caption:  The Africa Mercy at Mole A in Toamasina – Photo Credit: Lisa
 Having the Africa Mercy in Toamasina feels great – much has happened during the first month.  For me, I continue to live in the Country Engagement Team apartment in town and either walk, take a tuk tuk or pouse pouse to get to the main gate for the port and then walk the 13 minutes to the Africa Mercy.  I have enjoyed some meals in the renovated dining room as I sit with friends I have known for over 20 years and with new friends.
 
Photo Caption:  View from Town Hall towards the beach on the Avenue De l’Independance with the tuk tuks and pousse pousse (bicycle version)
 The Ministry of Public Health of Madagascar and Mercy Ships have agreed on the locations for the surgical patient selection process in Madagascar for 2024 – the cities are:  Antananarivo, Analamanga / Toamasina, Atsinanana / Vavatenina, Analanjirofo / Brickaville, Atsinanana / Amparafaravola, Alaotra-Mangoro / Miarinarivo, Itasy / Maevatanana, Betsiboka / Ambilobe / Diana Antsohihy, Sofia / Morafenobe; Melaky / Ihosy, Ihorombe / Manakara, Fitovinany.   We await the actual dates and exact locations for each city.  Since I returned in August 2023, I have made promises to people here in Toamasina to provide them with the necessary information.  I often share that you may know a family member or friend locally or back in the village who our team would never see if you didn’t assist us in providing the information and maybe even getting them and going to the site together.  Our hospital on board will open after the patient selection process is completed.  Please pray that those we can help, will hear the message, have the courage and come and that more healthcare professionals will volunteer and join.
Photo Caption:  a 40′ shipping container arrives at Mole A full of frozen food – 15,395 KG or 33,940 pounds to unload
In my role as Port Liaison, my responsibilities involve the customs clearance processes for our shipping containers and air freight shipments.  Each country where Mercy Ships operates the requirements are different.  With Annick’s help, we learned the system in Liberia as we had about a dozen containers with donations that arrived.  Here in Madagascar, I have and continue to understand the process for customs clearances in accordance with our protocol with the host government.  This is includes a detail invoice of eight columns include source, category, HTS code, unit of measurement, packing list with details, weights in detail, etc.  Most of our containers come from our European Distribution Center in Rotterdam, The Netherlands and the International Support Center in Lindale, Texas.  After reviewing the information, I work to produce official documents which need to be signed and stamped by the officials in the capital.  I work closely with our AGL Clearing Agents to make the delivery of the containers and air freight to the Africa Mercy as smooth as possible.  Though as you have seen on the news with the problems in the Red Sea and container ships traveling around Africa, there have been delays. 
In additional to customs clearance, I am learning about diesel fuel for the vessel and those requirements, inspection permissions, lube oil, a/c gases, and also the removal of oily water and slude.  Many of our former day crew (local workers) from 2014 to 2016 applied to work again with the ship, and the selections were made and contracts signed.  So it is fulfilling to see some of them already serving, and others will join when the hospital opens.   Additional Prayer Requests:  *Safety on the road between the capital and port city – due to the heavy rains, the road has been more challenging to travel.  *Health for our crew, day crew, staff, incoming patients, and myself.   
May we continue to Love God and Love and Serve Others.