THE HOPE SHIP Howard Gordon, M.D. as told to Ruth W . Davts, R.N. The HOPE ship was closing its tour near the small town of Trujillo, Peru, a bleak port on the Peruvian coast. In the past ten months the medical team had treated 45,OOO people, but now the time was up, and everyone was eager to go home. The entire day was spent dismantling the operating room, organizing supplies, and completing hospital records.

The gratitude of the natives and the sincere but perpetual speech-making of the local and national dignitaries were appreciated, but everyone on board was tired.

For the final farewell, the families of our patients decided to shoot off some fireworks. Either their timing was bad or the materials were faulty. At any rate, there was a terrible explosion.

When the smoke cleared, a half dozen people needed surgery.

With renewed strength and enthusiasm such as I have never seen elsewhere, the tired and homesick OR team rushed back to their sta- tion, reassembled the equipment, opened the supplies, and plunged into the task of oper- ating on our six explosion victims. When the team finished, the ship sailed.

This experience is typical of the willing- ness, competence and devotion to duty I found in the surgical nurses aboard the HOPE ship. And this applies to all the nurses on this assignment. To me, they are the greatest group of people in the world, and their esprit de corps is one outstanding factor that makes the HOPE project a gratifying experience to ev-

ery doctor who enters this service. The name of the hospital ship, HOPE,

stands for Health Opportunities for People Everywhere, and that is the goal of this people to people health foundation. This pri- vate, philanthropic organization is dedicated to medical education, and its principal insti- tution is the ship.

Originally called the U. S. Hospital Ship, Consolation, this vessel was commissioned and used in World War 11; it later served in the Korean War. When the crisis was over, it was decommissioned and placed in mothballs.

In the latter part of the Eisenhower admin- istration, William B. Walsh, M.D., of Wash- ington, D. C., conceived the idea of equipping a teaching arsenal of medical instructors and equipment, and setting it afloat, with its pri- mary goal to teach the finest of American medical skills to people in the medical and health fields in deprived nations of the world.

When the ship was loaned to the project, it was recommissioned, “HOPE.” This 550 feet, 15,000 ton vessel is a fully equipped hospital ship, normally carrying 100 crewmen and 90 members of the hospital staff. It has beds to accommodate 110 to 115 patients. By invitation from the government of a

country, the ship goes to a port and stays ten months. Educational activities are carried out aboard the vessel, as well as in institutions of that country. Instructing is done on all levels: physicians, dentists, nurses, and technicians, each to his counterpart of that nation.

Howard Gordon, M.D., is a Miami surgeon who rotates annually to the HOPE ship.

Ruth W. Davis, R.N., is currently part-time st& nurse in the OR at Jackson Memorial Hospital, Fla. She has served in various nursing capacities, including emergency nurse, head nurse, assistant supervisor and night supervisor. A free lance writer, Miss Davis has contributed to several publications including AORN Journal.

Patients are admitted to the ship on the basis of their teaching potential. Some of the hospital workers from that country stay aboard the HOPE, Others come for instruc- tions and leave; still others are taught by HOPE

Doctors and dentists serve a two month in their own institutions.

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William B. Walsh, M.D., and Nicaraguan chil- dren aboard the S . S . HOPE in Corinto.

rotation period, without pay, except for one or two who are on the permanent staff. The volunteers fly to the vessel, serve their rotation and fly home. All other members .of the hos- pital team are salaried, and stay for ten months, living on the ship the entire time.

So far, the ship has made six voyages: to the Far East-South Vietnam and Indonesia; Peru; Ecuador; Guinea, West Africa; Nica- ragua; and Colombia, where it remained until December. This year it sails to Ceylon.

At each place we left a semi-permanent contingent of people to continue education, and to serve as a long range evaluating team.

All financial support is by private contribu- tion from individuals and industry. Equip- ment manufacturers donate their products, pharmaceutical houses give drugs; many in- dustries contribute money.

What has the government to do with this project? Like every American merchant ship afloat, HOPE gets one million dollars sub- sidy, an amount that pays for the upkeep on the hull. The HOPE’S total annual overhead is more than five million dollars.

We who participate in this project are de- lighted with the outcome of each trip. First, in every voyage the prime goal is to upgrade

the standard of medical care in that country, and we feel that the project has been success- ful in this regard. Second, it has engendered good will among the people we served. (This was especially true in Peru where the attitude of the populace reversed from hostility to warm appreciation in the ten months the HOPE docked there.) Third, many people re- ceived treatment who would not have other- wise.

Every region we visit is unique. When we went to Guinea on the west coast of Africa, we learned that their nurses were men. It was rather surprising to walk into a surgical suite and find a huge African man dressed in white, performing nursing duties. But it worked fine.

Language is always a barrier, but when two people really want to communicate, they can-by phrases, hand signals or demon- stration.

Living facilities on the HOPE are very cramped. The nurses live four to six in a room, with no privacy and a minimum of closet space. In spite of this, I have never

A premature infant girl named Hope gets tender care in the ship’s isolette.

66 AORN Joiirnnl

Informal discussions, such as this one in Nicaragua, help the people of developing nations learn the importance of nutrition, sanitation and personal hygiene.

heard an unkind word exchanged between two members of the team. At the end of a long day, they always have the energy to rise for the next emergency.

However, the usual working schedule is a 40 hour week. The girls have numerous social engagements, and when they have some time off, they fly to the nearest large city for a few days recreation. Swimming, golf and tennis are available to them, and in their opinion, they have a great life.

At the end of a tour, I frequently ask them if they are coming back the next year. “Are you kidding?” they routinely reply, “Another year of this? I’ve had it . . . I’m going home and lead a normal life.”

But the next year when I return, I find the same nurses, eager and willing to continue making their contribution to the project.

Although every patient has a special ap-

peal, every now and then one makes inroads into the life of a member of the HOPE team. An unmarried nurse-anesthetist (in whom I was especially interested because I recruit- ed her) had been with the ship for several tours. Then in Nicaragua she fell in love with an 18-month-old native orphan who was se- verely crippled from illness. She adopted the baby and brought it home. This year she isn’t on the HOPE because she has a family.

In Nicaragua one of the surgeons was very fond of a child with a huge lymphangioma on her leg. He promised the mother that he would remove the tumor before the ship sailed. Unfortunately, he was not able to work her into the schedule. Rather than aban- don the tiny patient to whom he had given his promise, he paid for the child’s air passage to Colombia where she could meet the ship on its next tour. I personally removed the tumor and

Srptcmher 1968 67

honored his commitment. Nothing compares with the gratitude of

these deprived people at the end of a HOPE visit. My rotation in Peru completed the ship’s tour there. For a week before we sailed, the natives made garlands of flowers for each person on board. The ship itself was festooned with the most colorful array of flowers you can ever imagine.

Although Trujillo was only a small town, 50,000 people came by foot, mule or ox-cart

to see us off. They brought small personal gifts, presenting them in tearful silence. No one in Trujillo had a dry eye that day.

It is the sincere gratitude of the people that fortifies the HOPE crew to weather the in- conveniences and bear the exposure to con- tinuous pathos of the next trip to sea, to an- other country that is reaching out for the opportunity to learn the best of medical sci- ence and technology that this country can offer.

“It’s strictly hush-hush . . . but we’re doing a heart transplant today.”

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