screening - 0550 monday

Monday
5:50 a.m.

I'm in the middle car of an impressive convoy of white Land Rovers pulling away from the Anastasis. Now something I didn't know living in New York for 10 years, is that a Land Rover is absolutely NOTHING like a Range Rover. For one, the folks at LR forgot to include shocks in the design, and A/C and radios never work. But they are rugged, carry 10 people and have cool ladders on the back leading up to the useful roof racks. Anyway, we snake through a cluttered Cotonou port, littered with sleeping African bodies and broken down trucks. A week in now, I know that the port is an ever changing gauntlet - an unpredictable organism which this morning has allowed us surprisingly easy passage as we climb over the curb and use the sidewalk to make our way out. I feel an acute sense of purpose and damn proud to be an American in the scorching morning heat. Light won't come for at least another 40 minutes, and I feel the excitement a soldier must experience crammed in a rolling tank, high on adrenaline, on life.

Let me back up.... I am spending a year as a photojournalist aboard the hospital ship Anastasis with the humanitarian organization Mercy Ships. Mercy Ships operates a fleet of hospital ships, the Anastasis being the largest with more than 400 of us on board now. We are en route to the Halls des Arts in Cotonou, Benin where we hold the medical screening, choosing those we can help and scheduling them for surgery on board the ship over the next four months.

A few of us had driven by the site the day before, a medium sized sports stadium five miles from the port, and to our surprise, about 400 people had already secured their places in line. About 20 of the ship's deck crew, doubling as security this morning, had left the ship at 3:45 a.m., and as we pulled up, I see them directing traffic and maintaining order. The Land Rovers pull around the back of the stadium, and an army clad in blue and green scrubs head for the gate. Gametime.

6:25 a.m. finds me negotiating in broken French with the owners of the seedy Hotel De L'union across from the stadium to get onto their fifth floor roof. It's dark in the lobby, and after they wave their hands upwards - more in confusion I think than assent - I charge the stairs. I want to capture the crowd, make the thing real for myself - make it real for those waiting so patiently with an indelible image. I've given some thought to these crowd shots. I want to reward the time in line somehow - difficult travels from far away. I want to show the Need. Fit it all into the viewfinder for those back home to see. It's a decent view up here, and after snapping away in the early gray light, I can't wait to get back down there. Bounding two steps at a time, I proudly show the hotel porter the digital back of the Nikon D1X then dash out the door towards the stadium. They've setup all the stations indoors by now, and have begun letting people in. The stadium is stifling hot and shafts of light sift in much like in that black and white poster of Grand Central that's a bestseller on Bleeker Street. 600 plastic chairs and 34 tables are set up in circles and at stations, and as the waiting sick shuffle through the door, I can sense the excitement of the staff.

Screening is the Superbowl of Mercy Ships. With 7 overtimes and an eventual win it's twelve hours of high stakes teamwork and the culmination of months of preparation and planning. It's sometimes referred to by long-termers as "screaming" with fondness and a smile. It's surgeons, neurologists, pathologists, nurses and eye doctors manning stations to perform for an audience of 5000. Special things happen under this roof.

The audience truly Needs. The audience is afflicted with things you and I have never seen in the west. Horrors that sanitation and preventative care and hospitals save us from. Things we have no comprehension of. Things that truly do go bump in the night. Tumors the size of basketballs growing from necks and mouths and eyes and legs. Burns that have sewn body parts together. Cataracts so thick they give eye doctors pause. Cleft lips rendering speech impossible. Elephantitis, Squamos tumors, flesh-eating diseases, the list goes on.

7:05 at the Max Fax station and my heart is in my throat. I've just come face to face with a boy named Alfred with something unexplainable growing out from where his mouth should be. His eyes meet mine and I freeze - camera in hand and tears in my eyes. I'm told he's 15 but there's no way he's more than 8 and has been brought by his mother. Dr. Gary Parker, chief medical surgeon of the Anastasis takes me aside and gently tells me not to hesitate. The pictures are needed for the surgeons. It's normal to take them. This happens every year. Snapping out of my stupor, I begin shooting the boy and looking through the viewfinder seems to make it easier - less real perhaps.

This year the medical staff is doing biopsies on site - an innovative process that's replaced sending samples to British labs and waiting a week for results by on the spot analysis with high tech donated cytology equipment. Within 10 minutes, Alfred's test results are back and thankfully, the tumor that's taken over his face is benign. He is given an appointment for the life changing surgery onboard the Anastasis. A surge of excitement passes between the medical staff involved and within me, knowing I'll have a chance to take his photo once again before he leaves the ship, and will shoot a boy, not a monster.

11:45 finds me sitting on the floor in the center of the stadium taking a break from the med stations to play with the children. More than 100 crew workers from various departments on the ship have come to pitch in - to hand out water and bread to the waiting, to entertain the children with puppet shows and music and face paint and bubbles. I'm with the bubbles as it seems most of the children have never seen them before but I quickly upstage them and become the center of attention, shooting their portraits and immediately revealing their brightly lit faces on the digital camera back. Some of the children are deformed. Some are cross-eyed, some have cleft lips. Some badly burned. Some are well clothed. Some are not. I find myself touching as many of them as I can. Hugging and holding them hoping to express that I recognize their value, and realizing how ridiculous that notion really is.

3:09 p.m. and I'm standing in front of the stadium on top of the flatbed truck shooting the crowd. It's probably the most difficult moment for everyone involved - the closing of the line. As the stadium is full of prospective patients that must still navigate their way through the stations, the thousand plus outside must be told to go home. Specialists have just combed the line before this closing act, looking for small children and the severest cases of treatable afflictions among adults. As the barricades are put in place, a wave of reality - finality sweeps through the crowd as they surge, pushing and shouting. As fists punch the air, a blind woman and elderly man slump on the fence in front of me, silently defeated. Mercy Ships workers stare at them, bewildered, helpless. The hope has been taken from these remaining sick for this day, yet the crew will return on Tuesday and hope to process the remaining. We've been well prepared for this moment. I remember at the briefings thinking it redundant but now I can't say it enough to myself. Focus on those we can help. Those we can feed. Those we can heal. Those we can heal.

12:55 a.m. and I'm eager to wake up at 5:15 and do it all over again. I've taken way too many photos but feel I've still missed so much... Need to get at least 4 hours sleep.. We'd given out hundreds of return appointment cards to those we could not screen today, and I pray we'll have time for the unseen crowd waiting for our return. Perhaps the blind woman and elderly man are still clutching that silver barricade.