What began as a sore throat for Harimalala, a young woman from Madagascar’s east coast, slowly turned into a life-threatening neck mass that left her gasping for breath and hiding from the world. But thanks to a team of volunteer surgeons from the international charity Mercy Ships, her life has taken a dramatic and hopeful turn.
Harimalala was just 12 years old when the discomfort in her throat first started. “I took medicines, but it kept growing,” she recalled. “I even went to a traditional healer, but it kept growing.”
Over the years, the swelling became impossible to ignore. By the time she turned 24, it had grown into a visible and heavy mass that made it hard for her to breathe, bend, or carry anything. Ashamed of how she looked, she dropped out of school, avoided public places, and wrapped scarves around her neck to hide the growth. “I don’t dare go to church because people stare at me. They gossip and talk – they say I have a big thing on my neck,” she said quietly.
With limited healthcare options and no money for surgery, Harimalala found herself in a position familiar to millions across sub-Saharan Africa, where nearly 93% of the population lacks access to safe, affordable surgical care.
“I feared it was life-threatening,” she said. But hope came unexpectedly when a neighbor told her that Mercy Ships, a hospital ship offering free surgery, had returned to Madagascar. Harimalala made the difficult journey alone to Toamasina, where she was met by volunteers aboard the Africa Mercy®.
The medical team quickly determined that her condition was critical. “She had a massive multinodular goiter,” said Dr. AJ Collins, a thyroid surgery specialist who has led Mercy Ships’ program for 17 years. “It was compressing her airway, making breathing, speaking, and even swallowing extremely difficult. It had reached a critical point.”
Before she could undergo surgery, Harimalala spent several months at the ship’s HOPE (Hospital OutPatient Extension) Center, receiving care to stabilise her condition and prepare for surgery.
Her long wait ended with a complex four-hour operation. Dr. Collins removed a 1.35-kilogram mass — almost two pounds in weight — freeing her neck and her future.
“I feel like I’ve entered a new life,” Harimalala said afterward, her voice lighter and more confident. “Before, I didn’t know if I would die or live.”
Now she can do what once seemed impossible — wear her beloved necklaces, return to public life, and even dream of marriage and children. “I can get married and have children now because the growth is gone,” she said, smiling.
Dr. Collins, reflecting on her journey, added: “She had a deep feeling that life was passing her by — seeing others her age move forward, get married, have families, and she felt stuck. Now, that has changed.”
Harimalala’s story is a powerful reminder of the urgent need for accessible surgical care across Africa — and how timely intervention can save not just lives, but futures.
Meanwhile, in partnership with the Sierra Leonean Ministry of Health, international charity Mercy Ships is preparing to launch the next phase of its mission to provide free, life-changing surgeries and clinical training in Sierra Leone. The Global Mercy™, the world’s largest purpose-built civilian hospital ship, will return to Freetown in August following a scheduled maintenance period in Cadiz, Spain.
This upcoming deployment marks Mercy Ships’ third consecutive field service in Sierra Leone and its eighth visit to the country since 1992, reinforcing a decades-long partnership focused on strengthening access to safe, affordable surgical care.
Since its arrival in August 2023, the Global Mercy™ has provided over 3,630 free surgeries and onboard training for more than 290 healthcare professionals, including weekly in-ship training for 4 to 8 Sierra Leonean participants. Beyond clinical care, Mercy Ships has supported capacity-building initiatives in collaboration with the Ministry of Health and the University of Sierra Leone.
“We look forward to the ship’s return in August as we continue our collaborative efforts with national partners,” said Dr. Sandra Lako, Country Director for Mercy Ships in Sierra Leone. “Our shared commitment goes well beyond the ship’s presence. Even after the Global Mercy departs in 2026, our work will continue through 2030 to ensure lasting impact.”
Health Minister Dr. Austin Demby echoed this sentiment: “Our partnership with Mercy Ships has been truly life-transforming. Their surgical services and support for workforce development are invaluable, and we are committed to ensuring even more Sierra Leoneans benefit during the upcoming field service.”
Looking ahead, Mercy Ships will continue its support of the nurse anaesthesia diploma course at the University of Sierra Leone to help address the shortage of anaesthesia providers. The program aims to transition to full local leadership, ensuring sustainability and greater national capacity.
Additionally, the organization is deepening its collaboration with Connaught Hospital through the Safer Surgery programme, aimed at strengthening surgical teams and improving patient safety. Dental education support will also continue, including the sponsorship of Sierra Leonean dental students at Gamal Abdel Nasser University in Guinea, under a partnership with the University of Sierra Leone.
