A man with a tumour twice the size of his head has been freed from the growth by a team of volunteer medics, including an Australian nurse.
Madagascan man Sambany had lived with the tumour, which was 7.46 kilograms by the time it was removed, for about 20 years.
Doctors on the hospital ship Africa Mercy removed it in a life-threatening operation lasting 12 hours.
The tumour had caused Sambany to be shunned in his village, as well as causing him constant discomfort.
Sometimes it felt “hot like fire,” Sambany said.
“I cannot sleep at night, and even during the day. It heated me up. When walking, it’s too heavy. I have to hold it.
“I was waiting to die. I could not do anything. Every day, I was just waiting to die.”
His search for help required travelling hundreds of kilometres and included 10 hospitals (only three of which had surgeons) and a witch doctor, with no success.
Then one day he heard on the radio a hospital ship had come to Madagascar. Sambany saw this as his last hope, telling his family: “Die or survive, I want to go!”
Mercy Ships bring hospital facilities to regions where clean water, electricity, medical facilities and personnel is limited or nonexistent.
Sambany struggled to walk around his house and the closest road was several days away, with the ship hundreds of kilometres away.
His family recognised his desperation and determination, selling a rice field to pay for his travel.
Five people took turns carrying Sambany on their backs for two days. Then he endured a painful six-hour taxi ride to finally get to the ship.
Australian nurse Naomi Reid, who volunteers on the Africa Mercy, performed Sambany’s screening assessment when he first arrived at the ship.
“My first reaction when I saw Sambany was shock, the reaction that most people had when they saw him or have when they see his photo from before surgery,” Ms Reid said.
“My first thoughts were ‘how are you still alive with a tumour that size?’ He looked so sick.
“My next thought was ‘I hope, I so desperately hope, that we will be able to help this man’.”
It took two weeks for medical staff to work out whether they could operate on the enormous tumour. Eventually they offered him surgery, but warned the risks were extremely high.
The high stakes did not faze Sambany.
“I know without surgery I will die. I know I might die in surgery, but I already feel dead inside from the way I’m treated,” he said.
The operation took more than 12 hours, and over twice of his body’s volume of blood was lost and replaced.
The ship’s crew literally poured life into Sambany by donating blood for transfusions — the blood of 17 people from six nations now runs through his veins.
Chief medical officer Gary Parker said the surgery was one of the most challenging he had faced in nearly 30 years as an maxillofacial surgeon.
“Oftentimes, in operations, you have high-stress moments where you’re in the middle of something — where, in that moment, if something goes wrong, you could lose the patient from a severe haemorrhage or something,” Dr Parker said.
“With Sambany, it was pretty much high pressure the whole 12 hours of the surgery.”
Ms Reid said seeing Sambany after surgery was “incredible”.
“I saw him a week or so after surgery and he was sitting in bed, eating rice, and then he gave me a big smile full of rice,” she said.
“He was so grateful and kept repeating over and over again words of thanks.
“His world was once so small — full of shame, ridicule and fear. He was stuck inside his house, not wanting to leave due to the embarrassment of his huge tumour.
“Now he is strong, he’s healthy, he’s happy and his world is full of hope and possibility.”
The Africa Mercy, where Sambany was treated, includes five operating theatres and 82 patient beds, and has capacity to perform about 7,000 interventions a year.