In anticipation of welcoming her eighth child, a heavily pregnant Ernestine had to make a two-day journey to the nearest hospital in the district of Mandritsara, Madagascar. She sat in a canoe and then walked for miles, eager to see her baby, but her joy was short-lived. Ernestine lost her baby during labor and had to travel back home in pain, walking with a health condition she had never heard of – obstetric fistula. Caused by prolonged and obstructed labor, obstetric fistula is a hole between the genital tract and the urinary tract or rectum, resulting in the leaking of urine, feces, or both.

A father of three can sleep comfortably on his back for the first time in 15 years after having a massive tumor – weighing 11lbs (5kgs) – removed by surgical charity Mercy Ships. Malagasy builder and rice farmer Fidisoa was 38 when what appeared to be a tiny pimple on his back started to grow, first into a lump and then into the size of a fist. It continued to grow until Fidisoa looked as if he carried a backpack underneath his shirt.

Malagasy president His Excellency Andry Nirina Rajoelina visited patients and volunteers on board Mercy Ships’ hospital vessel to see for himself the lives being transformed.