Nate Claus’ commute is always the same – but his destination changes every year. The Chicagoan is the hospital director aboard the Africa Mercy – the world’s largest charitable hospital ship. Over the last seven years, his role has taken him up, down and around Africa’s 18,000-mile coastline. But wherever he wakes up, Claus’ morning routine remains a welcome constant.

 “I usually get up around 6am and head straight to the galley for breakfast,” says Claus, who has recently completed an 8-month stint in Senegal, overseeing medical operations aboard the unique 500ft vessel, with its 170-strong medical team. “From there, I have a little ‘me’ time to enjoy the morning wherever we are docked, and then it’s down to work at 8am. Both my cabin and the galley are just a few steps away from our onboard wards, where we treat up to 2,500 local patients a year. This job is always busy – we joke that the ship is more like a little village – but it’s also immensely rewarding.”  

Claus volunteers with Mercy Ships – a Texas-based Faith based charity set up to provide “hope and healing” to the world’s most poverty-stricken nations. 

“Our year involves 10 months moored in a specific place, treating patients, before two months off for repairs and recuperation in the Canary Islands, then a fresh 10 months in a new African country,” explains Claus. “Our time frame is significantly longer than most surgical missions – and that makes the entire process significantly more complicated too.” 

That ‘process’ involves everything from liaising with each country’s political leadership (often with the Health Minister, but sometimes directly with the President or Prime Minister in question), to arranging for the safe, smooth shipment of medical supplies from the US and Western Europe. Not to mention the streamlining of hundreds of volunteers, flooding in from across the world to work aboard Africa Mercy, for anything from two weeks to a whole 10-month stint. 

Put simply, Mercy Ships is a major international undertaking. The humanitarian not-for-profit is based near Dallas, Texas, but has offices as far afield as Australia, New Zealand, South Korea, Sweden, South Africa, the Netherlands and the UK, to name just a few.

a photo of Mercy Ships doctors

“As an organisation, Mercy Ships is like a vast international web, with the ship at its center,” explains Claus. “There’s an incredible number of strands and connections we’ve got to maintain in order for that web to hold together and function correctly.” 

During his seven years aboard Africa Mercy, Claus has worked in countries including Guinea, Cameroon, Benin and Madagascar, not to mention his most recent mission to Senegal. In each case, after consulting at length with the country’s government and identifying where its need is greatest, the ship is directed to a specific port for its mission (in Senegal, for example, this was Dakar), where the onboard medical teams treat patients across seven broad categories. 

Corrective surgeries that change lives

One of these major areas of treatment is maxillofacial surgery – the operating on tumors of the head and neck, plus facial deformities like cleft lips and palates. Another is plastic reconstructive surgery – largely focused on the correction of major birth defects or severe scarring and burns. Others include orthopedic, ophthalmic and dental surgeries, as well as a specialism in women’s health – particularly providing medical care for those who have suffered childbirth issues – and palliative care for the terminally ill. 

An additional part of the Mercy Ships mission is the legacy it leaves behind in each country. During each project, the charity actively seeks to train local healthcare professionals alongside its own expert medics and surgeons – as part of its 5 year Country Engagement Plan for each host nation, with the goal of leaving a lasting impact behind when the ship finally sails off into the sunset.   

In the 42 years since Mercy Ships was founded, its statistics are incredibly impressive. They have provided services and materials in developing countries valued at over $1.66 billion. Volunteers have performed more than 100,000 life-changing or life-saving surgeries, as well as 488,000 dental procedures. They’ve trained more than 43,3700 local medical professionals – and completed over 1,110 infrastructure development and agriculture projects. It’s a monumental achievement over four decades, navigating the peaks and troughs of life as a non-profit organization.

At the heart of that success is a steady stream of willing volunteers from across the globe – up to 1,200 a year to be precise, with hundreds of non-medical personnel joining each mission, to assist with everything from cleaning and cooking to the upkeep of the ship’s engines. They come from over 55 nations: led by the US, but closely followed by the likes of the UK, Canada and Australia. 

“In each destination we’re performing a lot of major surgeries, and we tend to see rapid results, which is very rewarding” says Claus. “We see patients that have undergone enormous transformations, have had these massive tumors removed from their faces, and they leave with their chins up, their heads high and a brightness in their eyes that they didn’t have when they came on board. It’s extraordinarily special to see that, to be a part of that.”   

Those patients can number anywhere from 1,500 to 2,500 over a 10-month period, coming from all over the host nation in question. From a strategic point of view, it’s an enormous undertaking – meaning that planning and preparation are paramount from the very top of the organization, all the way down. 

Coordinating care across the globe

One of the key stakeholders is Dr. Andrew Clark, the charity’s Director of Organizational Development. And he pinpoints one fundamental factor above all others that is essential for keeping Mercy Ships on an even keel: good communication.  

“As a global organization with over 55 nations represented in our staff and crew, it’s vital that we communicate well and clearly, so that we are united in the essentials of our work,” says Dr. Clark, who is based at the Mercy Ships headquarters in East Texas. “Having an open channel of clear, frequent communication is very important. Clarity is crucial – it’s essential that everyone can hear and understand what they need to.” 

To ensure this need is met, Mercy Ships relies on a specific online application to ensure strong, dynamic and effective communication throughout the organization: a collaborative tool called Confluence.  

“We could not accomplish our mission – to deliver hope and healing to the forgotten poor – without being able to communicate clearly and in a timely manner with all of our stakeholders, from governments in the nations we serve to our patients and our partners, staff and crew,” says Dr. Clark. “Confluence has become our tool of choice to cascade information to the whole organization and to allow people to interact with that information – ensuring clarity and diminishing ambiguity.”

According to Dave Shwadlenak, Mercy Ships Vice President of Information Services, Confluence is “utterly invaluable” on a day to day basis, as a means by which multiple teams can organize and edit documents, discuss strategies and make key decisions – across thousands of miles and dozens of different time zones.

“The way we use Confluence is largely as a knowledge warehouse,” says Shwadlenak. “All of our data, processes, procedures and working documents are stored in there, and that gives us the ability to be completely virtual. It also means that we can access everything without the internet – and that’s absolutely crucial when you’re talking about a ship at sea. 

Great communication builds trust and a shared mission

As a non-profit organization, Mercy Ships has not just survived, but thrived since its founding in 1978. Dr. Clark believes that is largely down to having the right people – and keeping them all on the same page.     

“To succeed, organizations need to be healthy, which means paying attention to the people side of the equation,” says Dr. Clark. “When you don’t engage in clear and transparent communication, then trust – the bedrock of all relationships – is eroded and the health of a global team is affected.

“Without that trust, you’re going to see low morale, high turnover and low productivity, which ultimately ends in a failure to deliver on the mission. But by prioritizing people – and good communication with those people – we can avoid those problems.” 

The once-in-a-lifetime offer of living and working on a ship off the coast of Africa doesn’t hurt either. It’s an exciting, adventurous existence that has hooked plenty of young westerners – including Claus himself. 

“Some of the places we get to see are just mind-blowing,” he says, wistfully. “As a surfer, I’ve loved our recent stint in Senegal, because the beaches and the waves are incredible. But for me, the ultimate highlight was Madagascar. It’s such a magical country – absolutely breathtaking in terms of landscapes, but also incredibly beautiful and diverse in terms of its people and culture. We went out to 11 different cities around the country to recruit patients and that was an amazing experience which I’ll never forget. Seeing all the different corners of that beautiful island while doing a job that I’ve grown to truly love was very, very special indeed.”

For Claus, the future is bright. Once the present refitting of the ship in the Canary Islands is done, the Africa Mercy will return to Senegal to finish off the field service it had to cut short due to Covid-19 before heading to  Liberia – another beautiful West African country with more than its fair share of beaches and surf spots. For Mercy Ships as a whole, it’s full steam ahead (as soon as it is safe to do so, post COVID-19), as the charity sails towards its 50th anniversary, with a second ship now close to completion too.

As all of its employees will tell you – from onboard volunteers like Claus to digital wizards like Shwadlenak and top tier management like Dr. Clark – the waters have sometimes been choppy and challenging to navigate as a non-profit, but good communication has always proved a true compass for this particular organization. 

“There’s a quote I like that sums it up perfectly,” says Dr. Clark. “How well you communicate is determined not by how well you say things, but by how well you are understood.” It’s a perfect sentiment for a charity that is awash with understanding – because it’s built its success upon communication. 

On a merciful mission