Hwang boarded the aircraft, tears streaming down her face, the reality of what this paediatric nurse was about to embark on was suddenly clearer to her than ever before. She was about to fly from Melbourne to Madagascar to spend two months on an anchored ship with a group of medical professionals who were set to provide much needed medical care to those unable to receive it.
Hwang had signed up with Mercy Ships, a charity organisation that administers health care for people who lack access. Doctors and nurses sign up on a volunteer basis, pay for their own flights, accommodation and all other expenses. Every year, the Mercy Ship docks in a different country, the medical professionals working with the local government to announce to the public that the ship is coming. They treat medical problems that here in Australia we see as minor because we can receive attention almost immediately, relieving us relatively quickly of our what ails us. But in a third world country, where people must travel up to nine hours to reach a mode of transport which will then take them the rest of the way to an inferior hospital, access to this treatment is ultimately life changing but largely inaccessible.
“I always felt bad for people who don’t have access to health care. I think that growing up in Indonesia helped me realise that there is such a need in the world. Growing up I saw a lot of poverty around my neighbourhood,” said Hwang. She recalls a childhood illness. Her parents had taken her to the hospital, and the only conversation she remembers hearing was between her parents and doctors. “[It was] about the cost of the hospital treatment for me. My parents were yelling because they were not rich, they just had enough to get by, but my parents didn’t have a choice but to go ahead and pay for the treatment,” she said. “And I think since then there has always been a voice in me to see justice in health care because what if my parents were so poor that they couldn’t pay for the treatment? I wouldn’t be where I am right now.”
Last year Hwang visited West Papua for three weeks with some friends. They started in a remote village where Hwang said it allowed her to see the disparity between the first and third world. She remembers seeing a woman who was suffering from chronic pain and was unable to walk. They didn’t know what was wrong with her. The only other medical professional was a mid-wife and nearby there was a pharmacy. There was no access to a doctor nearby. The only doctor was eight hours by truck ride and nine hours by boat. “My heart just broke for her,” said Hwang. “And I came back to Melbourne after West Papua and told my colleagues about this, and one of my colleagues told me ‘oh Yenni you’re passionate about this! Go and join the Mercy Ships’ and I finally got onto it, and it was a scary prospect, but the next thing I knew I was on the plane.”
Upon her arrival in Madagascar and along with the other volunteers, she walked down Avenue of the Baobabs, particles from the dusty ochre earth rising and settling on her shoes, exploring the innermost sanctuaries of Ranomafana National Park, all the while sharing stories with the others. In many ways, reflected Hwang, Madagascar reminded her of Indonesia, recognising the difficulties with which these people live every day.
Hwang provided her assistance as a nurse mainly in the paediatrics ward. Children of all ages would come to the ship. She recalls a fourteen-month-old toddler and his guardian. The first time she saw him she thought he was a baby, around six months old. He was skin and bones and had a cleft-lip, some of his upper lip was missing, creating a hole, which meant that he had not been eating properly since birth. “He was so malnourished,” she said. “As I was looking at his paperwork, my heart just sank for him because toddlers, babies and so on can’t just go for operations straight away because they must gain enough weight.”
When he had gained enough weight, finally being able to proceed with the surgery, Hwang learned that his real parent was not with him – it was his grandmother, his mother was fourteen years old. She had a boyfriend, and her boyfriend abandoned her when he found out that she was pregnant.
“You can imagine, I couldn’t speak their language but sometimes you picture their stories in your mind, what would it have been like for this family. And because they were poor, they weren’t feeding the baby properly, forced to use rice milk which is made by pounding rice and mixing it with water,” she said. “Even when they have ‘enough’ money they then just buy condensed milk and they put it in the rice milk.”
The grandmother and child traveled for five days to reach the ship, and despite the many unknowns: living in a remote African village means that there can be many things that one has not seen before, like white people, a ship, bed, toilet or even a shower.
For these people to come onto a ship and trust them was a privilege for Hwang, forming close relationships with the patients and their families.
“It’s unlike what I have experienced in Australia,” said Hwang, “where the relationship is very professional – we are not allowed to stay alone with the child, we have to go by parents and so on. Just by the ship is an outpatient hospital, I would go there and visit the patients almost every day, and we’d play, it was great. You don’t have that here.”
She recalls another sick child who could have been cured with a very simple surgery and could have returned home the next day. But there were some complications and he had to undergo another surgery that day although the ship was due to leave in two weeks which meant that the hospital had to be cleared a week ahead.
“There was a lot of pressure to make sure that the patients could go home as soon as possible, so that the ship was ready for maintenance to sail to a new country and this patient was one of the two patients that was not ready to go home yet and he was the sickest,” said Hwang.
“I remember two days before I was due to leave, I went to the ward and spoke to the mother who then just burst into tears asking ‘what do I do when the ship leaves? I don’t trust any of the local doctors. You guys have just done an amazing job’. My heart just broke for her because there was so much trust that came from her.”
Hwang felt that for people that have never had surgery before, let alone seen a doctor in their lives, or had never been to a hospital before, they trust the Mercy Ship volunteers. She compared the trust from the Malagasy patients to those in Australia and thought how many times she has experienced, as a nurse in Australia, being questioned by patients and family. For the grandmother and the 15-month old child, who was told that it would be a simple surgery and that they could go home the next day, only to be met with multiple complications and had to stay with us, Hwang was compelled through their trust to make a commitment that this is what she is going to do, “this is what I was meant to be doing for people like her.”
At the end of the ship’s stay, Hwang was joyed to discover that all her patients had been nursed to health. “I think my greatest fear has always been whether my capabilities and my skills are enough to help people, and I was always worried that what I could offer is not required, that what I can do is not enough,” she mused. “But that fear was not justified because the Mercy Ship people were helpful, they were amazing, the doctors were amazing, my team mates were very supportive and so encouraging.” The experience re-affirmed her passion and steps for the future, and now she’s working towards it. “It has opened my eyes to a lot of things professionally, like what I should be doing for the rest of my life …”
When Hwang returned to Australia and went back to work, she told her colleagues of her experiences. They were inspired, so much so that some even volunteered for Mercy Ships, and are set to sail off next year. “It’s interesting to see what it’s like on the other side of the world,” said Hwang. “We are so lucky here, we are so privileged to be in Australia where the health care system is so great. I know that people often complain, but in comparison, we have experts here and in a lot of countries they don’t. They must walk one day to get help, and when they get there they find out that they don’t have enough money to get the treatment. It’s heart-breaking and I think that you must put things in perspective.”