Embedded in Africa

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Two adjoining surgical rooms contain two surgical tables each. Each table contains a patient. Each patient is being cared for by a team of nurses of both sexes and, judging by their accents, originating from all parts of the globe. Their ages range from early twenties to one Englishwoman I'm pegging for close to 70. Working beside them are two doctors and an anesthesiologist. The Chief surgeon, a green-scrubbed, 50-something, gray-bearded American by the name of Dr. Glenn Strauss, greets me with a warm smile. I'm aware that he plays guitar and, since I'm a punk rock drummer, I break the ice by saying, “I hear you play a mean axe.”

Ice officially broken.

His smile brightens. He positionss himself so that the patient's head rests as close to his lap as possible, without actually resting upon it. Lifting a tiny scalpel, he sets the blade-tip on his patient's eyeball.

“Yeah,” he says, “I love to play guitar. But I'm not giving up my day job.”

Pressing down on the blade, he cuts.

The patient whom Strauss is operating on is an elderly Beninois woman. Elderly in Benin is a relative term. I'm guessing she's maybe sixty (Benin men and women do not keep track of their ages). A local anesthetic is applied to the affected eye in order to mask the discomfort derived from the stretching of the eyelid and pressure on the socket. Other than that one injection, no other pain killers are required, since the eyeball itself feels no pain. But when Strauss begins to cut around the eyeball’s lens, she starts to squirm and shiver. She shouts something in French and a nurse standing nearby answers her; tries to comfort her. It goes on like that for what seems forever—Strauss cutting, the agitated woman moaning, moving; hoping for the cutting to end.

By the end of the fifteen-minute procedure to replace the badly cataract-tainted lens with a new one, Strauss appears to be relieved. Raising himself from his chair, he removes his soiled scrubs like a bad habit and, once more, smiles at me.

“Grew me a few more gray hairs,” he says.

In the operating theater beside me, the second surgeon, Claudine Lee, a South African GP, isn't making the blind see. She's saving what little eye a 14-year-old girl has left, after a major trauma caused her left eyeball to infect and swell to four times its normal size. This surgery involves total extraction of the interior of the eyeball. I am encouraged to observe the surgery by the attending nurses. At the same time, I'm ordered to sit down if I begin to feel woozy or sick to my stomach. I can't help but begin to feel like the brunt of a cruel joke.

A chair is placed beside me, but I refuse to sit. I refuse to give in to the nausea. I'm not sure if I'm getting dizzy or if what I'm feeling is the ship listing beneath me. When Strauss loses his footing for just a brief second, I know it is the listing I'm feeling, and I can't help but feel a sense of relief, if not pride.

In the one hour I spend in the operating room, the 14-year-old's eye innards will be removed and the organ's remaining outer shell filled with a prosthetic material that will make it appear as normal as possible. Strauss will perform three more cataract removals and oversee one from a Benenois surgical student who is learning her craft from him. All in all, Strauss will perform up to 30 surgeries on this day alone, and he will do them all for free. There is so much surgery going on, I feel like I'm on a military hospital ship immediately following a particularly brutal battle.

Strauss isn't afraid to tackle any surgery, no matter how complicated, no matter how spooky. Case in point: just days before my arrival, he performed the same cataract removal surgery on the Voodoo King of Benin. I wondered if he worried about being cast under a dark spell should he botch the operation. But his Christian beliefs prevent anything like that from happening. Or so I'm told. And botching surgeries is apparently foreign to the 30-year, ground-breaking, surgical veteran. In the end, when the Voodoo King entered post-op, he could see almost perfectly out of his bad eye. And he didn't owe his good fortune to the Voodoo spirits anymore than he did to Jesus. The Voodoo King owed his newfound eyesight to Dr. Strauss and the Africa Mercy team.

I'm wiped out after my hour of observing surgery. The interior of my skull feels a lot like the ship's hold—a hollow steel shell - with a multitude of thoughts, emotions and sensations bouncing around inside it like little steel balls. I'm wondering how these Africans will react to their new surgery once their bandages are removed and, for the first time in years, or, in some cases, the first time ever, they will see their world. I'm wondering if they will be frightened, or if they will rejoice as happily as they did just moments before going under the knife. But at the same time, I can't help but wonder about the unlucky people who had to be turned away from surgery. I'm wondering how they will continue to cope with their own private darkness on the Dark Continent.

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Africa is long known as a dark, unforgiving continent.

Flying over the western nub of the vast land from its top-most point at Algiers, all the way down to the Slave Coast that runs along the Atlantic, I can see why. Looking out the window at 30 thousand feet, I witness endless miles of Saharan desert that gives way to seemingly impenetrable mountains and finally, lush, dark bush country veined by numerous rivers that snake their way through the growth. But the rugged landscape is not the only thing that makes this massive continent dark. Countless numbers of its native inhabitants suffer from a blindness that could have been prevented, had they been born a westerner.

But in a developing West African country like Benin, which is sandwiched between Togo and Nigeria, a simple cataract can turn into a catastrophic loss of eyesight. Children in particular, who are born blind, become a terrible burden for their already-struggling-to-subsist parents. They don't know enough not to put their hands in a fire, or place them on a coal-burning stove or run out into the middle of a busy street. Their mothers can't afford to hire help to watch them. They also can't send them to a school for the blind, since no such school exists. In a country like Benin, where belief in voodoo can go hand in hand with a belief in Jesus Christ, a child born blind will often be looked upon as possessing an evil spirit. In many cases his or her parents will be accused of practicing witchcraft.

Take the case of Genevieve, a young mother of three blind children. When local villagers began to suspect her of practicing witchcraft, resulting in her children's blindness, she sought out the help of Mercy Ships, a global charity that has been providing ship-based medical care to the world's poor and impoverished for more than 30 years. The doctors aboard ship not only operated on her children but, for the first time ever, they were able to see their mother's face. Sight was so foreign to one of the children that he kept his eyes shut for a full day before mustering up the courage to finally open them.

It was moving stories like Genevieve's that drew me to Africa in the first place, and the hospital ship that cured her children's blindness. Having arrived in the Dark Continent however, I didn't want just to listen to the stories of the children and adults who have gained or regained their sight through shipboard surgery. I wanted to observe the miracle ship-board surgery firsthand.

It's aboard the Africa Mercy, a converted Danish train-ferry, presently docked at the busy Port of Cotonou for ten months, that I am led down into a surgical suite. Inside the narrow corridor, I'm brought to a waiting area that once served as the ship's hold. Now, it houses a few dozen partially or completely blind Beninois who, dressed in their traditional red, yellow, violet and green wrap-around skirts (for women) or loose pajama-like tops and bottoms (for men), anxiously await their turn at surgery.

The hold is not a pleasant place to be for a westerner like me, who is used to carpeted waiting rooms with soft Muzak filling the silent spaces, and glossy National Geographic Magazines to pass the time. The hold is a battleship-steel-enclosed hot and humid place. The acrid smell of diesel fuel and human sweat-laced with a rotting fish odor that blows in from the harbor - pervades the air. The consistency of the air is so thick it settles on the tongue and lips as a vapor. But the blind Beninois don't seem to mind the conditions one bit. In fact the Beninois seem at peace. Or happy to have been chosen as candidates for surgery aboard the Africa Mercy. In a land where blindness, disfiguring facial tumors, severe traumas and crippling polio can strike or occur without prejudice, Mercy Ships volunteers often find themselves in the precarious, if not sad position, of having to turn potential patients away.

I look at the faces of the waiting people caught inside the steel hold. Some of the faces are old, worn and wrinkled. Still others are young and beautiful, their skin a smooth, rich ebony, the whites of their eyes drawing me into them like two white lights emerging from parallel tunnels. An African woman who works for the ship is there to greet them. She holds a Bible in her right hand. She begins to lead the group in prayer in the Beninois’ native French. The praying starts off in a slow soft voice, but gradually builds into a roaring shout which reverberates against the steel walls. When the raucus prayer finally ends, the entire waiting room breaks out in a traditional song and dance.

Somehow a shirtless boy appears. He's carrying a drum or what's known as a djembe. He begins to pound out a kind of tribal rhythms to the song. After only a few moments, the hold is caught up in such a fevered frenzy of dancing, clapping, drumming and singing, that any semblance of medical facility has vanished.

Moments later comes my own moment of truth. I'm led back into the surgical suite, where I'm outfitted with scrubs. I'm given a pair of plastic booties to place over my trail boots. Quickly, I'm ushered to a place I've always known as strictly forbidden territory: the operating room.

Outside the closed steel door, I'm issued a strict warning. What I'm about to witness is gruesome. But despite my natural feeling of revulsion at the mere thought of a razor blade slicing into an eyeball, I know that the work occurring beyond that door is nothing short of miraculous. That bright notion in mind, I swallow a breath, and open the door.

I enter the operating room.

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