Surgery at Sea: Why My Time on Mercy Ships Changed How I See Global Health

By Ange-Cedric N’zi

Five billion people.
That’s the estimated number of individuals worldwide who lack access to safe, affordable surgical care when they need it. For many of us in high-income countries, surgery is a phone call, a referral, or a short wait away. For others, it is an unattainable luxury — a gap that can mean the difference between living in pain or living with dignity.

This summer, I had the privilege of serving aboard the Africa Mercy, one of the world’s largest civilian hospital ships, during its field service in Toamasina, Madagascar. Operated by the NGO Mercy Ships, this floating hospital delivers free, specialized surgeries to people who would otherwise have no access to such care.

I joined the crew for two weeks through the Luger-Mikelberg Travel Award for Global Health, stepping into a world where operating theatres meet ocean swells, and where medicine is not only about skill but also about equity, humility, and hope.

The Human Impact: Two Stories I Will Never Forget

Every patient I met aboard the Africa Mercy came with a story, and each story carried the weight of years without access to care.

One of the most unforgettable patients was Jean — a young man who had lived for years with a large ameloblastoma, a benign yet aggressively destructive tumor of the jaw. In high-resource settings, this condition is typically treated early, preventing significant facial deformity. For Jean, years of delay meant the tumor had reshaped his face and his life. After a complex maxillofacial surgery performed by the volunteer surgeons, I stood with him as he looked in the mirror for the first time. His smile — wide, relieved, unrestrained — seemed to fill the room. Later, when his family visited post-operatively, the joy was overwhelming. That moment reminded me that surgery is never just about tissue and sutures — it is about restoring identity, confidence, and possibility.

Another patient carried a story of continuity and legacy. Ten years earlier, she had undergone corrective surgery aboard a Mercy Ships vessel for severe knock knees — a condition that not only caused physical pain but also carried deep social stigma in her community. Now, a decade later, she returned — not as a patient, but as a mother — bringing her young son for a cleft lip repair. Watching her place her trust once again in the ship’s surgical team was deeply moving. It showed me that global health is not a one-time intervention; it is a relationship built on trust, respect, and the knowledge that compassionate care leaves ripples across generations.

Barriers and Realities in Madagascar

Madagascar is an island nation of immense natural beauty, but it is also one of the poorest countries in the world. For many patients we treated, simply reaching the Africa Mercy was a journey in itself — traveling for days from rural villages, sometimes by foot, taxi-brousse, or boat.

The barriers they face are not just geographic. Surgery can be financially devastating in low-resource settings. Even when care is available, the costs — including transportation, accommodation, and lost income — can keep patients away until conditions become severe or life-threatening.

There is also stigma. In some communities, facial deformities or congenital conditions are misunderstood, leading to isolation and discrimination. I met patients who had hidden from public life for years. For them, surgery was not only a medical intervention but also a doorway back into their communities.

Mercy Ships addresses some of these barriers by providing surgeries free of charge, covering transport and lodging for patients, and working closely with local partners to identify those in need. But the reality is clear: even with these efforts, the need far exceeds the capacity of one ship, one program, or one field service.

What I Learned About Global Surgery

In the operating theatres of the Africa Mercy, I observed complex maxillofacial tumor resections, cleft lip and palate repairs, and reconstructions for conditions rarely seen in Canada due to early intervention.

From these experiences, I took away three key lessons about global surgery:

Teamwork is Non-Negotiable – Each operation was the product of seamless collaboration between surgeons, anesthesiologists, nurses, sterilization techs, and translators. The surgical skill was exceptional, but so was the humility with which the team worked across languages, cultures, and specialties.
Adaptability is a Core Skill – Working in a shipboard OR means limited space, adapted equipment, and the ever-present awareness that resources must be carefully managed. Delays and changes are common; the best surgeons are also the best problem-solvers.
Capacity-Building is the End Goal – While Mercy Ships provides direct care, it also trains local healthcare providers, strengthening the surgical system long after the ship sails away. True global surgery is not about parachuting in; it is about leaving behind skills, systems, and sustainable change.

The Emotional Reality

It would be easy to present these two weeks as purely uplifting, but global health work also comes with emotional weight. Seeing advanced noma in a child — a preventable, gangrenous disease of the face — is something I will never forget. In high-resource settings, early antibiotics would have prevented such disfigurement. Here, the delay in care meant complex surgery, long recovery, and a life forever changed.

Processing these moments required community. I leaned on the ship’s chaplaincy team, joined in daily morning devotions, and shared meals with volunteers from over 60 countries. These connections reminded me that global surgery is both deeply technical and profoundly human.

A Call to Action

My time with Mercy Ships has reinforced my conviction that surgery is a human right, not a privilege. The ability to chew, speak, walk without pain, or smile without fear should not depend on where you were born.

For fellow students, I encourage you to seek out opportunities — whether on a ship, in a rural clinic, or through research — to engage with global health early in your careers. The need is vast, but so is the potential for impact when skills meet service.

We must also advocate for models that go beyond episodic care. Programs like Mercy Ships show what is possible when world-class surgical teams are mobilized, but they also highlight the importance of integrating local training, infrastructure support, and health system strengthening.

Looking Forward

As I continue my training in Dental Medicine and Oral Health Sciences, I carry with me the faces, voices, and lessons of Madagascar. I hope to weave global surgery into my career — combining clinical expertise with teaching, advocacy, and mission-based service.

The Africa Mercy will be sailing on to its next port, but the stories I witnessed remain with me. They remind me that behind every statistic in global health is a person with a name, a family, and a future worth fighting for.

In the end, surgery at sea taught me something simple yet profound: the scalpel can heal more than flesh — it can restore dignity, rewrite futures, and bridge the gap between what is and what should be.