Consultant surgeon Dr Leo Cheng was in Senegal serving with an international surgical care charity when news of the coronavirus started to circulate. Now that the peak of the pandemic appears to have passed in the UK, he reflects on the experience and whether it has changed his outlook on life.
Degree: BDS Dentistry, 1985
Current treasured object: My faith.
Song of the moment: Amazing Grace (My chains are gone) by Chris Tomlin which is the theme song for the film ‘Amazing Grace’.
As John F Kennedy once said that there are two Chinese characters for the word ‘crisis’, the first character is ‘danger’ and the second character is ‘opportunity’.
In February 2020, I was serving the people of Senegal on board the Africa Mercy with my wife Hilary, a Minister from the Methodist Forest Circuit in North East London. Mercy Ships operates the largest charity-run hospital ship in the world, delivering free, vital medical and surgical care to some of the world’s least developed countries, and for nearly 20 years, I have used my annual leave to volunteer and provide free specialist Maxillofacial, Thyroid and Reconstructive surgery.
It all started for me in Edinburgh two weeks before my final BDS (Bachelor of Dental Surgery) exam in 1985. I was about to become a fully qualified and trained dentist but I was still searching for my purpose in life. I went to Charlotte Chapel (a Baptist Church) in Edinburgh to witness a baptismal service of a friend from my course. The then minister, Rev Derek Prime, invited those in the congregation who were seeking a purpose in life to walk to the front of the church and lay down their burden at the foot of the cross. I went, and my life was never the same again.
I studied medicine and became an Oral, Maxillofacial, Head and Neck Surgeon. I also acquired a Master of Laws degree (LLM) which gave me insight into medical law and ethics. This was the beginning of my journey and my calling in life.
When Covid-19 started to spread round the world, it became impossible for Mercy Ships to continue our field service in Senegal. African Mercy is a specialist surgical unit and is not equipped to deal with a highly contagious respiratory infection. In line with measures taken by the President of Senegal and his Ministry of Health, Mercy Ships made the difficult decision to stop our field service and bring the Africa Mercy into drydock in Tenerife for early essential annual maintenance.
Within a few weeks of arriving back in the UK, I found myself working overtime in the race against the surge of coronavirus in several London Hospitals. Apart from urgent trauma surgery for facial and head injury, my team and I are also provided surgical airway support for seriously ill Covid-19 patients in Covid-19 hospitals (‘hot’ hospitals) and continued to offer some cancer surgery in Covid-19 free hospitals (‘cold’ hospitals).
Operating with Personal Protective Equipment (PPE) has been a learning process as we have to ensure adequate hydration while minimising toilet breaks, clear articulations to avoid miscommunication with a muffled voice under the FFP3 (N99) mask and visor, alteration of surgical procedure to reduce unnecessary generation of aerosol, extra procedure and checks to reduce the risk of ‘return to operating theatre’, and extended personal hygiene.
As John F Kennedy once said that there are two Chinese characters for the word ‘crisis’, the first character is ‘danger’ and the second character is ‘opportunity’. Although the coronavirus has caused extraordinary disruption in all levels of society, it has sped up inevitable changes in embracing technology and internet especially in healthcare. Telephone and virtual clinics have become the ‘new norm’ for most of our clinics and patients and teleconferencing has become a major part of my clinical time connecting with our clinical and management teams, and the multidisciplinary cancer teams.
The Covid-19 peak has passed and the NHS is now working hard to deal with the backlog of urgent elective surgery. Apart from urgent cancer and trauma surgery, I am also engaged in elective surgery, bringing hope as well as healing.
I am planning to serve on the Mercy Ships once the global crisis has settled. I have heard it said that when the global north catches a cold, Africa gets pneumonia. This is because of huge inequalities in health care resources and capabilities between the developed and developing world. When Ebola hit West Africa 2016, Mercy Ships was in Guinea helping patients there. We will be there again after Covid-19, serving the needs of West African nations.
Leo Cheng
LLM BDS MBChB FRCS FDSRCS FRCS(OMFS) FHEA
Consultant Oral, Maxillofacial, Head and Neck Surgeon, Barts Health and Homerton University Hospitals, London, UK
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(Lead photo by John Rolland. ©2011 Mercy Ships. Courtesy of Leo Cheng)
How the hell does Leo get time to take off on a Mercy Ship? I cannot imagine my Australian local health district employer granting any extended leave without a generous period of notice! Maybe employment conditions vary specialty to specialty. You can “arrange” maxillofacial, head and neck cases. The material in obstetrics, the babies, are rather harder to govern!