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00:00She's a floating hospital on the mightiest of missions, operating where few others dare
00:09to venture.
00:10But in order to reach those who need her, the crew of Africa Mercy will have to outsmart
00:17touchy technology, outmaneuver the forces of nature, and outwit human adversaries.
00:29It's a sweat-inducing journey into the heart of Africa.
00:55It's all hands on deck in Santa Cruz, Tenerife.
01:01Africa Mercy, the world's biggest charity hospital ship, is gearing up for her next
01:06mission.
01:17After resupplying in the Canary Islands, she's ready to set sail on a ten-day voyage to Togo,
01:23one of the world's poorest countries.
01:26Her crew, all of them volunteers, will spend six months there, saving and changing lives.
01:38Their work is funded entirely by private donations from around the world.
01:42We're taking a developed world hospital and taking it to places where they can use a little
01:48extra help, and we want it to arrive there all in one piece.
01:53Getting there in one piece means trying to avoid a major storm.
01:59It's blowing right into Captain Tim Trethewey's chartered course.
02:03So we're doing everything we can to finish our securing, all our preparations and checklists
02:08so that we can get underway and on the voyage and hopefully pass to the south of the system
02:14before it moves in.
02:16To avoid getting battered, they have to leave within 36 hours.
02:22They need to test their engines.
02:24They've already hit a snag.
02:26We have a few challenges down in the engine room at the moment.
02:30Unexpected challenges that are causing a big headache for Chief Engineer Andy Cole and
02:35his team.
02:40One of the ship's four diesel engines is giving them trouble.
02:43We try to bring the oil pressure up to operating the normal pressure, which is around 3, 3.2
02:49bar, and we can't raise the pressure.
02:54They're not sure why there's so little oil pressure, or how long it will take to fix.
03:02Oil pressure may be low, but blood pressure is rising for lead mechanic Denis Sokolov.
03:08Right now we have problems with those engines, and we have to do it very fast, we're in a
03:15rush.
03:16We have to start engines as soon as possible.
03:19The guys in the engine room aren't the only ones worrying about the storm.
03:25Upstairs on the hospital deck, Chief Officer Mike Sands has to ensure that fragile equipment
03:30in the operating rooms is tied down tight.
03:33If anything on this ship should get damaged during the sail, in these rooms the ship won't
03:39be able to do the surgeries that they need to do.
03:43Some equipment is so delicate that even a tiny jolt on rough seas could put them out
03:47of commission.
03:48This is a microscope that the doctor uses for surgery, he has to have that, without
03:55that he can't do surgery.
03:57Here is OR3, this is our x-ray machine, that's one piece of equipment that we definitely
04:04want to make sure does not go anywhere during the sail.
04:06If we lost that, we wouldn't be able to do the surgeries down in Togo.
04:14In the galley, head chef Jesse Mitchell is also taking storm precautions, and determined
04:20not to make the mistakes he made on the last voyage.
04:22A lot of stuff ended up rolling under the hallway and dumping over, and we had a huge
04:31mess to clean up, so I'm trying to avoid that this time.
04:39This ship is part of a global charity that started in 1978.
04:44The organisation, Mercy Ships, has helped millions of poor people around the world.
04:51Africa Mercy has completed two missions to West Africa, but she didn't start out as a
04:55hospital ship.
04:57She was originally built as a train ferry in Denmark.
05:05In 1999, she underwent an extreme conversion.
05:09The train deck was transformed into two new decks for a hospital with a 78-bed ward and
05:15six operating theatres and hundreds of cabins for the crew.
05:26Two of her six engines were also reconfigured as generators to power the ship at the dock.
05:32This ship is a tool that we can bring into areas where you just don't have the infrastructure
05:38that's needed, and it's a fantastic tool.
05:42A tool to help the poor.
05:44But Africa Mercy is also a floating community, with a crew of 480 people from 35 nations.
05:55Surgeons, nurses, dentists and their families work and live alongside sailors, engineers,
06:01cooks and teachers.
06:09For Brenda and Andy Cole and their family, Mercy Ships have been home for years.
06:14These are our neighbours, they live next door with their daughter Chanel.
06:19In 2008, nurse Ali Chandra quits her job to volunteer full-time aboard Africa Mercy.
06:26After two previous missions to West Africa, she knows everyone will rely on a strong community
06:31spirit to get through the months ahead.
06:33It's going to be tough, we have a lot of challenges ahead of us this outreach, but we have a phenomenal
06:39team of nurses from around the world, we have amazing hospital facilities and we're ready
06:43to make a difference in Togo.
06:46For the medical staff, the real work begins in Togo.
06:50But during the voyage, they'll pick up skills they didn't learn in med school.
06:55Welcome to the Pirate Watch training, I appreciate all you guys signing up to come here for this.
07:01Tracey Swope is a retired US Marine.
07:05Her experience in regions like Lebanon and Iraq makes her a big asset as the ship's security
07:10chief.
07:11You need to verify that your radios are working.
07:14Today she's training aid workers to think like soldiers, so they can help watch for
07:19pirates.
07:20The instructions on how to use these are on here and I put a...
07:25They're taught what to look for.
07:26There's movement in the water from the ship we're concerned about to our ship.
07:31And how to report suspicious vessels.
07:34Ship on port side, please scan the water between our ship and their ship.
07:40And they are not used to functioning in security, they've come to reach out to the people.
07:44So I have to have meetings like this to refocus their efforts on what they need to be doing
07:49for security.
07:51They'll be safe on the first part of the voyage, but they'll have to keep a close look out
07:55for pirates off the coast of Sierra Leone and Liberia, countries that have been ripped
08:00apart by years of civil war.
08:05I just want everybody on the ship to understand, no heroics if we ever have a pirate issue.
08:12Any questions?
08:14But that worry is a week down the road.
08:16It's not a good sign.
08:20Right now the action's in the engine room, where chief engineer Andy Cole and his team
08:24have discovered that the problem with engine number four is a badly clogged oil filter.
08:30Yeah there's a little bit of metallic particles collected on the magnetic filters.
08:35If I've got serious build up of magnetic particles it means part of my engine is breaking up.
08:41So it's not a good sign.
08:44The filter is so dirty they'll have to soak it for several days.
08:48Time they don't have.
08:50They have to fix it today or their ship will get caught in the eye of the storm, putting
08:55her delicate cargo at risk.
09:03In the Canary Islands, the crew of Africa Mercy is trying to fix an engine problem so
09:08they can sail for Lome, Togo, where thousands of people are desperate for medical help.
09:18They're having trouble with a badly plugged oil filter in engine number four.
09:29Lead mechanic Denis Sokolov has worked in the engine room since Africa Mercy's first
09:33voyage as a hospital ship four years ago.
09:37He's missed a fix-it.
09:38He finds a spare filter that's been swapped out of another engine.
09:44It needs a scrub down, but it's not nearly as clogged as the other dirty filter.
09:55An hour later, engine number four has a clean filter.
10:01And chief engineer Andy Cole prepares to test the engines.
10:07Engines three and four are up and running.
10:10So that's two of the four.
10:12And actually I can see one and two are also running.
10:18So we have four engines running.
10:21So far so good.
10:24There are bigger challenges ahead for Andy, but right now he's relieved.
10:29The ship can now leave on time, giving the captain a chance to avoid the worst of the
10:33storm.
10:38And Captain Trethewey doesn't waste any time.
10:41Roger, all clear aft, thank you.
10:44He's ready to go.
10:45Engine's running nicely.
10:46I love those engines.
10:47They're like my babies.
10:48This is Africa Mercy.
10:49Good afternoon.
10:50Africa Mercy has departed Santa Cruz.
10:52Lima, Oscar, Mike, Echo, over.
11:06Slow ahead starboard.
11:13Everyone settles down for the first night of the voyage.
11:17It's going to be a rough one.
11:27A very large swell, which is causing an uncomfortable roll for us.
11:32We're rolling to the left.
11:36A very large swell, which is causing an uncomfortable roll for us.
11:40We're rolling at times over 20 degrees on each side.
11:45So we've increased our patrols to the hospital area where things are a little bit vulnerable.
11:53Right now we're experiencing the worst seas that hopefully we'll see during the voyage.
11:57So as long as everything is in its place and hasn't moved, we're in good shape.
12:05Africa Mercy wasn't designed to cut through big waves.
12:11She was built with a flat bottom and flat sides for maximum stability while loading trains.
12:18Her square shape, combined with a high center of buoyancy and a shallow draft,
12:23make her snap upright quickly, creating a rough ride for passengers and equipment.
12:32I don't see anything moving.
12:35I kind of watch the load as the ship rolls to starboard here.
12:40Just after midnight, Tracy, the security boss, gets an urgent radio call.
12:46Roger that. I'm heading for the crane now.
12:49A loose crane is trashing the ship's walls.
12:54The crane broke loose and became like trebles for us.
13:00We have to find a way to secure it.
13:05A nine-meter swell can do a lot of damage.
13:08Now it's good. It's not going to go anywhere.
13:11And test the most seasoned sailor.
13:14It's quite a big waste, even for me.
13:16Eventually it would have come through the walls, so it was really important to latch that down.
13:21The storm's full impact doesn't become obvious until morning.
13:25We have a little bit of a mess.
13:27It's tight around there.
13:28The galley is a disaster zone.
13:31I tied it last night because this rack was sliding up and down.
13:37I feel pretty discouraged.
13:39We spent a lot of time tying down, and after the sail up and everything fell,
13:42we thought we had it right this time, but it was a little bit rougher last night on the way up,
13:46so we still lost a lot.
13:48We've got the workings of a really big pancake,
13:50and we mixed all the eggs and cream in here with all the flour that's dumped down in the bakery.
13:55We've got a mess.
13:59As Africa Mercy sails into calmer seas, life slips into normal mode,
14:06with schedules that feel a lot like home.
14:13School starts at 8 o'clock,
14:16and there are three square meals a day.
14:19For tonight's dinner, Jesse churns out 1,000 slices of pizza.
14:29Medical staff take advantage of their time at sea to plan for the hectic months ahead.
14:35I think one of the big things this year that they want to do
14:37is try and have a better idea of what stock we're ordering and what supplies...
14:42Over the next six months in Togo,
14:44they'll treat thousands of patients with all kinds of problems,
14:48from cataracts and clubbed feet to life-threatening tumours.
14:55A lot of the surgery will be done by Dr. Gary Parker,
14:58who first jumped on board Mercy ships 23 years ago.
15:02It's a race that's going to go on for months and months.
15:05You can't go full out and stay up night and day because you'll never make it,
15:10which means in the end you'll help less people.
15:14Once the race begins, there won't be much time for relaxing,
15:17so during the sail, everyone savours evenings on the bow.
15:22This is kind of the social spot outside.
15:24We all come out here and watch the sunset every night.
15:35But on this mission, no one can afford to get too relaxed.
15:40Rapid response, we will start closing some of the fire doors in the vicinity.
15:45All passengers and crew members must be fully prepared for any emergency.
15:49I want you to go down on this side, down the steps with the cargo hold and set up on the left end.
15:53During the fire drill, everyone on board has to play for real.
15:59The crew has to practice dealing with the special hazards aboard a hospital ship.
16:05Be advised you have piped in oxygen in that area.
16:10The oxygen that we use for the surgery is normally used to save lives,
16:14but in this case it becomes a huge hazard for us because the fire feeds off the oxygen.
16:19Drills will continue throughout the mission to keep everyone sharp.
16:29Afrika Mercy has covered almost 1,500 nautical miles in seven days.
16:34She's now off the coast of Liberia.
16:39Pirate watch.
16:40Prime territory for pirates.
16:45Tracy, the security chief, is on high alert
16:48because the bridge crew has spotted mysterious vessels that aren't showing up on radar.
16:54Are they moving off or are they staying in line?
16:56No, they're staying. We're going in between two of them.
17:00What I'm concerned about is these ships, boats, small canoes, drift back,
17:05that they do not have an outboard motor that would allow them to motor up to the back of our ship,
17:11throw a grappling hook on and come on.
17:15Using small motorboats, pirates can outrun and outmaneuver Afrika Mercy.
17:21What are you steering, Herman?
17:230-7-0.
17:25Let's come to 0-4-5.
17:28The third officer has a bad feeling about what's out there.
17:33I can't even see that. It makes me...
17:36The crew of Afrika Mercy is on pirate watch off the coast of Liberia.
17:42OK, I've got the spotlight on.
17:45Several mysterious vessels are popping in and out of sight.
17:49It's not easiest to see out here, so...
17:52But they're not showing up on radar.
17:55A crew member brings new information from the upper deck.
17:59We have six lights. The furthest brightest is to the right-hand side.
18:03Are they directly in front of us?
18:05They are.
18:06As they get closer, they spot six vessels, not two.
18:10They're in the bigger boat with the lights.
18:13They can also see that they're not pirates, but unlit fishing canoes.
18:18They're not showing up on the radar at all.
18:21It is amazing that you can be 50, 60 miles out
18:24and there's just a little canoe with a sail,
18:26made out of rice sacks, out there fishing.
18:33They're a lot easier to spot by day.
18:36Togo is now on the horizon.
18:40A country with six million people and only two hospitals.
18:44Many residents have never seen a doctor, even when they're sick.
18:48Togo is in the bottom 25 of the poorest nations on earth.
18:55So you have as high as 50% of the population that will have no access
19:00to medical care, no access to food.
19:03That will have no access to medical care, either financially or physically.
19:11It's no wonder there's huge excitement in Togo about Africa Mercy's arrival.
19:18They're already heading out to meet us, so our berth is ready.
19:22They're anticipating our arrival.
19:26To maneuver into port, the captain will need more engine power
19:29than he's used whilst cruising at sea.
19:34They're about to bring on two more engines online,
19:37so we'll have the four engines total.
19:41We have four engines online, clutched in, looking good.
19:45But four engines are a lot harder on the ship's cooling system than two.
19:55We are not on full load yet.
19:57Once we'll get full load on the four engines,
20:00the temperature will go up for sure.
20:04It's a challenge to keep the engines from overheating,
20:07because Africa Mercy was not built to operate in tropical seas.
20:13This ship is ideally set up for cool climates, cool water,
20:17you know, five degrees seawater temperature,
20:20as opposed to 30, which we have at the moment.
20:25A warm sea means hot engines.
20:31Seawater is pumped in and out of two giant coolers
20:35to absorb engine heat.
20:38But the combination of tropical seawater
20:41and all four engines working flat out
20:43puts a lot of stress on those coolers.
20:48If they can't keep up, the engines will overheat,
20:51and sure enough, the temperature is steadily rising.
20:56They're still creeping up.
21:01I feel myself that I'm going to go down to the engine and blow on them,
21:06just to cool them down.
21:09In one of the coolers, the seawater is now over 70 degrees Celsius.
21:14That's eight degrees warmer than it should be.
21:20Andy suspects that there's a bigger problem with the coolers
21:23than tropical temperatures alone.
21:25The temperatures are not levelling off.
21:27If it doesn't happen soon, there's danger of engine failure.
21:35On the outside deck, everyone is eager to catch a glimpse of Togo.
21:41After ten days to be here.
21:44Nobody out here is aware of the drama down below.
21:49Dennis can feel that the machinery in the engine room
21:52is getting hotter and hotter.
21:54A sure sign that the coolers are not working properly.
21:58He's got no choice but to open a giant bypass valve
22:01and get more seawater directly to the cooler that's overheating.
22:09Problem is, opening this valve means starving the other cooler of water.
22:15Before long, temperatures in the second cooler start rising.
22:19Cooling water coming up everywhere.
22:24I don't really like it.
22:27Yeah, we're on maximum cooling.
22:30They're hoping to hang in just long enough to get to the shore.
22:34The sooner we get there, the better.
22:42As Africa Mercy closes in on the dock,
22:45the welcome party is creating some communication challenges.
22:49Drowning out the captain who's trying to radio instructions to the bridge.
22:54Right now we've got the celebration going on
22:57and it's making it a little more difficult for us
22:59to do what we need to do up here.
23:04So far, we're adapting and overcoming with the window.
23:07Valve report. Valve report.
23:10So far we're adapting and overcoming with the window.
23:29Meanwhile, down in the engine room.
23:32Maybe just get it off for now.
23:34We're hanging in there, 71.4, hanging in, bring the L2 down.
23:42The coolers have hung in, but Andy has to figure out why they're causing more worries
23:47than usual, and fast.
23:49The hospital can't run without them.
23:58The gangway touches down, and the mission begins.
24:06For most of the crew, there's no time to celebrate.
24:08Starting now, everyone kicks into high gear.
24:11Right now, we're going 100% adrenaline, we're thinking of a thousand things of how to secure
24:17this dock area, so it's going to be a busy time for the next 24 hours.
24:25Tracy ordered a security wall of cargo containers to be built in advance to separate Africa
24:30Mercy from the rest of the port.
24:32It's one of the busiest in the region, and ships and sailors come and go around the clock.
24:43And just a few hundred metres away is the city of Lome itself, and the frenetic bustle
24:48of three quarters of a million people.
24:55The crew wastes no time unloading, and the transformation of Africa Mercy gets underway.
25:05They have seven days to turn a sailing ship into the most modern hospital in West Africa.
25:18Other teams are busy on the dock unloading equipment to be transported into the city.
25:23The dental and eye clinics will be set up off the ship, in buildings provided by Togo's
25:28government.
25:29Most of the medical things happen on the ship, but we're able to see a lot more patients
25:33when we set up a clinic ashore, and then the locals will go there instead of having to
25:38come to the ship.
25:50Tracy does a perimeter check to make sure that the wall of containers around the ship
25:54is tight, and no unwanted guests can sneak through.
25:58There's a gap right in front of me.
25:59It's closed.
26:00Okay.
26:01So the walls come together, so nobody can get in at night and steal anything.
26:16On board, the hospital ward is taking shape.
26:24One floor below, Andy and his team are getting ready for some major maintenance.
26:29That means a power blackout of the entire ship.
26:32Okay, in a few minutes, at seven o'clock, we're going to trip the main breaker from
26:38the running harbour generator.
26:39Stop the seawater system now.
26:40So close that valve.
26:43They have to shut off the ship's power to clean the engine coolers.
26:47Andy suspects that debris in those coolers contributed to overheating during the voyage.
26:52It could also cause problems when they're powering the hospital.
26:55We need the temperatures down to run the air conditioning down here, and also run the refrigeration
27:03plants that keep the ship cool, the hospital cool, and without power, we're nothing.
27:10We're dead in the water.
27:11Here we go.
27:13One, two, three.
27:17That's it.
27:19Breakers out.
27:20The system is shut down, but the coolers are still full of hot water.
27:25They have to be eased open gradually.
27:29The water is very warm.
27:31Maybe 60, 65 degrees right now.
27:34I don't want to burn myself and somebody else.
27:37I have to be very careful.
27:40Raise the wire around the ladder.
27:43Meanwhile, Tracy leaves the port and heads three kilometres into the city.
27:48She needs to check out a local football stadium, where medical staff will assess potential
27:52patients and decide who goes to the ship for surgery.
27:58Because we are in a new country, we'll have concerns about, if the crowds get unruly,
28:04how to get our people out of there safely.
28:08On a previous mission in 2006, a screening almost turned into a riot.
28:13In the afternoon, people get really desperate.
28:17And that's when they start running the gates.
28:19Some people were trying to throw the children over the gates because they were so scared
28:24that they would not be seen.
28:27It's a situation they want to avoid this time.
28:30All right, so let's walk it backwards.
28:32They're exiting here.
28:35You should be there with pre-screening.
28:38We have two lines feeding in here.
28:40If things go wrong, how do we get out?
28:43The only thing that bothers me is that we don't have a back door.
28:46Our entrance for the patient is also our exit in a crisis.
28:50The stadium is not perfect for mass screenings, but it is workable.
28:54We figured out the flow of traffic.
28:56We figured out how they're going to be screened out at various stages.
28:59We also figured out our exit plan in case anything goes wrong.
29:02We actually have two bailout options.
29:04We will slide it here, but we have to take off this device.
29:06Back in the ship's engine room,
29:08it's now clear why the cooling system gave them headaches on the way to Lomé.
29:13Oh, blockages.
29:15I'm not surprised.
29:16Yeah, we have to clean it.
29:19There are 1,500 tubes inside this cooler full of debris
29:23that's preventing seawater from circulating.
29:27I will go through every tube with those brushes.
29:32Clean them, take off all dirt.
29:37We'll go through all tubes in the lower part.
29:40We'll use a high-pressure washing machine to wash it.
29:43Make sure that all particles are washed out.
29:47It's tedious, but standard maintenance.
29:51Then Andy discovers something more worrying at the entrance to the other cooler.
29:56I've got big pieces like this.
29:58So this is just a pure seal.
30:02Yeah, flaking off.
30:04What we've found, which is a little bit disturbing,
30:07is we've found some big flakes of paint
30:11coating from inside the seawater pipes.
30:14These pieces are maybe the size of the palm of your hand,
30:17and one flake will block about ten tubes.
30:25If the paint keeps flaking off inside the pipes,
30:27it could cause equipment failure during surgery.
30:31Andy and his team will have to flush out the pipes constantly
30:34while the hospital is running.
30:39This is an unexpected challenge.
30:46The first day of screening is about to begin.
30:49Tracy and her team head to the stadium well before dawn
30:52to get a head start on security.
30:55But when the crowds are desperate,
30:58the best-laid plans can go wrong in an instant.
31:06It's just after 7am,
31:08and Africa Mercy's medical team is in the city of Lome, Togo.
31:13Everyone who's in the line today will be seen.
31:15I don't want to jump people out of line,
31:17because then we'll get in a situation.
31:21At the stadium, people are queuing up by the hundreds.
31:28So he has, he has his club feet.
31:30The boy can only take a few steps at a time
31:33on the sides of his deformed feet.
31:37They're born with their feet twisted in like this,
31:39and that's allowed to be like that.
31:41He'll walk on the sides of his feet his whole life.
31:43It's a really simple operation to fix.
31:47Africa Mercy's surgeons are experts at treating these kinds of problems.
31:53They've also seen a lot of this.
31:55Untreated tumours growing out of control.
32:00Five-year-old Suleiman hasn't been to school in months,
32:03because the growth on his ear has made him an outcast.
32:07I've seen a little bit of everything,
32:09so I'm excited to get these people through the line
32:11and have them signed up for surgery.
32:16The queue is orderly.
32:18So far, there are no security issues.
32:20Tracy speaking.
32:23But at the eye clinic a few blocks away,
32:26the crowd's getting restless.
32:30A team from the eye clinic just called me.
32:33The crowd is not out of control,
32:35but they have over a thousand and would like some backup.
32:39They started lining up at four in the morning.
32:42Six hours later, the sun's getting unbearable,
32:44and the people keep coming.
32:46It's a situation that could get out of control.
32:50So we've just called back to the ship
32:52and the ship is launching the support team.
32:54The extras we have on standby to provide that crowd control.
32:57They should be there in about 20 minutes.
33:07Back in the ship's engine room,
33:09Andy and Dennis are performing another round of crucial maintenance,
33:12repairing the hospital's incinerator
33:14in time for the start of surgery.
33:17We found some cracks on a broken-up brick.
33:20So we've got to cover up,
33:22and Arthur Dennis is busy filling in the cracks.
33:27And he's also put a new floor covering in there.
33:31Same like in the Russian sauna, but I'm used to it.
33:34I don't worry much.
33:36A Russian sauna.
33:38Yeah.
33:40They're making the best of a sweltering job.
33:44But this is deadly serious.
33:46Sending hospital garbage ashore is not an option in West Africa.
33:50Needles, leftover drugs and surgical waste
33:53have to be burned on board at 1,150 degrees Celsius.
33:58I've seen in other countries
34:00the kids just rummaging through the waste,
34:03and they could, you know, it's horrible to think about,
34:07they could end up with nasty diseases and injuries
34:11if we didn't take care of this waste in this way.
34:14So this incinerator is vital
34:16for the functioning of the hospital and what we do here.
34:23At the stadium, the medical staff is hard at work.
34:29Dr Gary Parker, the chief medical officer,
34:32is one of the world's top specialists
34:34in facial tumours and cleft palates.
34:36Did you have injection afterwards?
34:40He's performed more than 4,000 operations in his career.
34:49Dr Parker's diagnosis of Suleiman's ear tumour is promising.
34:57It's scar tissue, and should only take an hour to remove it.
35:01The next patient has a much more serious problem.
35:05Dr Parker sees this condition a lot in West Africa,
35:09a tumour growing out of the jawbone.
35:12This is still relatively small by West African standards,
35:16but they get big enough that it's difficult to swallow,
35:19and it's not easy to remove it.
35:21It's not easy to remove it.
35:23It's not easy to remove it.
35:25It's not easy to remove it.
35:27It's not easy to remove it.
35:29It's not easy to remove it.
35:31It's not easy to remove it.
35:34It's difficult to swallow,
35:36and eventually they either suffocate or they starve.
35:39The teenager, Kosi, will come to the ship for a CT scan.
35:43If the tumour's benign, Dr Parker will try to remove it.
35:47The sooner you can do these, the better it is for the patient.
35:51Today has gone well.
35:53Security chief Tracy Swope is relieved.
35:56We were able to maintain crowd control
35:58and put them in to the medical people very smoothly,
36:01so please, we'll replicate it again.
36:05Back in the port, a dive team prepares to tackle another dirty job
36:09that must be done before surgery.
36:14They're checking the ship's water intakes
36:17and removing anything that might be blocking them.
36:20Rubbish, barnacles, even raw sewage.
36:23A plugged intake can be a nightmare for the engine room crew
36:27because it stops seawater from entering the cooling system.
36:31It hasn't been a fun job for dive leader Ollie Pete and his team.
36:36There was a bit of plastic, a bit of barnacles,
36:40quite a lot of poo-poo.
36:42That wasn't very pleasant.
36:44One of the volunteer divers, ward nurse Sharon Ruggles,
36:48has a vested interest in today's dirty detail.
36:51I'll be working in the hospital,
36:53so it's very important that we have the intakes clean
36:56so that all our equipment will work,
36:58air conditioning, because if not, it gets very, very hot down there,
37:01and that's not good for patients who are trying to get better.
37:06Further down the dock, the first patients are boarding Africa Mercy.
37:12It's the first time for any of the patients to be on the ship,
37:15so they're all excited, they're all really overwhelmed.
37:17It's not easy for any of them, but they get their hope in their hands
37:21and they come up the gangway,
37:23and it's the start of everything for them.
37:29Doctor, who are you?
37:32I'm in the shower.
37:36One of the new arrivals is Kosi, who's come for his CT scan.
37:40It will tell the doctors if his large tumour is benign.
37:47This is a rare machine in West Africa,
37:49something Kosi would never have access to on shore.
37:53We're grateful to have such a machine here in West Africa with us.
37:59Dr Parker will know within minutes if Kosi's life can be saved.
38:07The scan shows the tumour to be pushing up into the eye socket,
38:12but it does not invade the eye socket.
38:15It looks benign from the X-ray appearance,
38:18so we've got a job for tomorrow.
38:22It's big news for Kosi, and a bit overwhelming.
38:28He's so happy that he's going to turn back into the way he was.
38:33He's so happy.
38:36Kosi's roommate is five-year-old Suleman.
38:39He'll be first up for surgery in the morning.
38:42Here we go, Suleman. Ready?
38:45As Dr Parker prepares to operate on Suleman,
38:48orthopaedic surgeons are already finishing their first job of the day,
38:52straightening a child's deformed leg.
38:57Dr Parker's first job is to operate on Suleman.
39:00It's a very difficult job.
39:02It's a very difficult job.
39:04It's a very difficult job.
39:06It's a difficult job.
39:08A deformed leg.
39:16Check the oil level first.
39:20And down in the engine room, the machinery's running smoothly
39:23thanks to all that pre-surgery maintenance.
39:29But Andy and his team can't let their guard down.
39:32Keeping everything running is now literally a matter of life and death
39:35on the hospital deck.
39:37At the same time, they have to be prepared to react to a crisis on shore
39:41and be ready to head out to sea on short notice.
39:44The big challenge is we always need to be ready to sail.
39:48If the situation in the country changed politically, civil unrest,
39:53we always need our main engines ready to go.
39:56Reset, reset.
40:03Let's take it here first.
40:06Captain Trethewey can't let up either.
40:09We have to maintain the security levels that we've established.
40:13We need to continue to monitor the situation in the country
40:17and we need to continue with our drills.
40:21The job never stops. It's sort of a 24-7 sort of situation.
40:26I love it, but it's demanding.
40:29We will confirm in a moment, over.
40:35It takes less than an hour for Dr Parker to remove Suleiman's tumour,
40:39exposing a perfect ear underneath.
40:49Now it's Kosi's turn.
40:51His surgery will take a lot longer.
40:55The mission's first orthopaedic patient is recovering nicely.
41:00She's just starting to wake up, as you can see.
41:03Her leg is nice and straight now.
41:05Where it was curved before, she has a nice straight bone here.
41:09So we're looking for her to make a full recovery.
41:13Her mother never thought she'd see this day.
41:17It's been four hours since Kosi's surgery began,
41:20and even asleep, he's unrecognisable.
41:24The tumour is gone.
41:26His nose and mouth have shifted back to the centre of his face.
41:30Not only will he live,
41:32but also I think that the reconstruction of his body
41:35is going to take a long time.
41:37It's going to take a long time.
41:39It's going to take a long time.
41:41It's going to take a long time.
41:43Not only will he live, but also I think that the reconstruction
41:46that we've done will work for him,
41:48and he'll be able to go back to school
41:51and should be able to have a normal life.
41:54So that's really good news for him and great for us too.
41:58It's great news for Kosi's father too.
42:03Over the next six months,
42:05the staff of Africa Mercy will perform as many as 2,500 operations.
42:14But there will be far more people needing help
42:16than they can treat on this trip.
42:19Even though this, for me, is my fourth time in Togo,
42:22I keep thinking somehow we're going to come to the bottom of the barrel,
42:26so to speak, but I don't know, not in my lifetime.
42:32Africa Mercy has a lot of life left as a hospital ship,
42:36and everyone on board,
42:39no matter what their job, has the same goal.
42:42Make these queues disappear,
42:45one patient at a time, in Togo and the rest of Africa.
43:13AFRICA MERCY
43:17AFRICA MERCY