On the frontline

Dr Leo Cheng operates on a patient aboard the Africa Mercy
Dr Leo Cheng operates on a patient aboard the Africa Mercy

Chingford doctor Leo Cheng discusses his charity work with Mercy Ships and returning to the NHS to fight coronavirus

Before the pandemic, in February, I was serving the people of Senegal onboard Africa Mercy, part of the fleet run by international health charity Mercy Ships.

I am a maxillofacial, thyroid and reconstructive surgeon. Within a few weeks of arriving back in the UK, I found myself working overtime in the fight against coronavirus at several London hospitals. I congratulate everyone for saving the NHS by adhering to social distancing, staying at home, following rigorous personal hygiene, and not taking the gift of our NHS for granted.

Now the lockdown is being eased. But at the same time, Africa is bracing itself for Covid-19. I heard someone say this: “When the global north catches a cold, Africa gets pneumonia.”

Africa suffers from poor healthcare infrastructure, high levels of poverty, and lack of education. There are only 60 ventilators for some 80 million people in parts of west Africa. In the UK, with under 70 million people, our NHS has 8,000 ventilators and is working on increasing this to 18,000. So you can see the unbelievable and huge inequality of health care resources and capabilities between the developed and developing world.

The majority of people living in west Africa are part of the ‘informal economy’ because their earnings are not fixed, taxed, monitored, or protected. Many do not have access to sanitation, clean water supplies, or electricity. Social distancing does not mean anything in these poor countries because many people share crowded accommodation.

Mercy Ships operates the largest charity-run hospital ship in the world. This floating hospital is staffed by selfless volunteers, who give their expertise for free to help patients with dental and eye problems; facial deformities such as cleft lip and palate; gigantic tumours of the head, face, neck, limbs and body; club feet; child-birth injuries; burns and many other deformities and conditions.

For 20 years I have used my annual leave to serve with Mercy Ships to help the poorest of the poor in west Africa, providing free specialist surgery. Some of my outreach trips have been accompanied by my wife Hilary, a Methodist minister, and our two daughters Zoe and Kat, serving desperate patients together as a family. Since 1978, Mercy Ships has visited 56 countries, providing services worth more than £1.2billion that have directly helped 2.8 million people. We have also trained 45,000 local professionals to leave a lasting legacy.

Mercy Ships UK executive director, Lea Milligan, believes that as the Covid-19 epicentre has moved from China to Europe and then to America, it won’t be long until the continent of Africa becomes the epicentre. Dr Odry Agvessi, a surgeon from Benin and a trainer with Mercy Ships, said: “When you face some danger and you do not have anything to fight with, you just put yourself in the hands of God. So, we are just praying and educating our population the importance of lockdown.”

When Covid-19 started to spread around the world, it became impossible for Mercy Ships to continue running our field service in Senegal. In line with the measures taken by the Senegalese government, Mercy Ships made the difficult decision to bring the Africa Mercy into dry dock in Tenerife for early annual maintenance. The ship is a specialist surgical unit and is not equipped to deal with a highly contagious respiratory infection.

Once the maintenance work is carried out and the global situation allows, we will return to Africa and help strengthen healthcare systems emerging from the pandemic. The Africa Mercy was there for Guinea in 2016 after Ebola swept across west Africa and we will be there for west Africa again after Covid-19.

Before setting sail in March, Mercy Ships donated £120,000 to Senegal for the prevention and treatment of Covid-19. We also donated vital equipment and sterilising kits to hospitals in Dakar, Senegal. The healthcare professionals we have helped and trained in the past are now the frontline workers in the battle against Covid-19 in their own respective countries. As they face these challenging events, Mercy Ships will continue to stand with them.

My work with the NHS during the pandemic has not only been challenging but also strangely satisfying, to see colleagues working together selflessly to keep the death toll down. My team and I are providing surgical airway support for seriously ill patients, by making holes in their windpipes (a tracheotomy) in order to facilitate their lung ventilation. At the same time, I continue to conduct cancer surgeries.

Donning personal protective equipment (PPE) has been a learning process as we have to ensure adequate hydration, minimise toilet breaks, give clear articulations to avoid miscommunication with a muffled voice under our masks and visors, alter surgical procedures to reduce unnecessary generation of aerosol, conduct extra checks, and extend personal hygiene.

Although coronavirus has caused extraordinary disruption in all levels of society, it has sped up inevitable changes to our use of technology and the internet, especially in healthcare. Telephone and virtual clinics have become the ‘new norm’. Teleconferencing has become a major part of my clinical time. As we have passed the peak of the pandemic, the NHS is working hard to reinstate other urgent surgical and medical services.

I am extremely grateful and thankful for the resources and provision of our nation’s free world-class NHS, the availability of all basic essential utilities, food and consumables on supermarket shelves, and sensible expert advice from public health professionals to combat the spread of this invisible enemy. Together we will come through this extraordinary global health emergency stronger and wiser.

Find out more about Mercy Ships and make a donation:
Visit mercyships.org.uk