Wishing you a...

Appi Krismes

Merry Christmas from Sierra Leone!!!

Wishing you all the best from sunny Freetown.

Back to work...

Wednesday was an early start considering my late night! Instead of going to the clinic I went with Jenny (my replacement) to the local children’s hospital and visited some patients we had referred and brought them christmas gifts. A 6 month old I had referred to the feeding center weighing 3.4 kg was now much better, weighing 4.8 kgs at 7 months…still small of course, but she had chubby cheeks which is always a good sign! After that we went to the clinic. That afternoon we had our Christmas party. It was quite different than your average western party. It was quite African…loud singing, dancing, cheering etc. The staff definitely had a great time.

Thursday was my first clinic day and the last of this year as my staff is now on holiday! I saw about 30 patients and it was easy to get back into the swing of things. One of the nurse’s ask if I would see the patients on my own in Krio or if I needed translation. I said ‘well, I’m not sure if I remember everything”. Her response was “try, if you get stuck, call us”. So I did. And I was in their on my own for the majority of the day seeing patients in Krio…once in a while asking one of the nurses to come in and help out! The most fun part of the day was playing Santa. I bought cookies for all of the children and let each child pick out a stuffed animal. They loved it.

It’s Christmas time. My staff has taken leave up until the new year. So for me this is a quieter period…time to catch up on sleep, work on admin stuff (statistics etc), enjoy the season etc. We have some visitors coming from the Anastasis as well so I’m sure we’ll have a great Christmas here in Freetown.

I’ll post some pictures on my blog sometime soon!

Merry Christmas!!!

Trip back to SL...

After spending 3 weeks in Holland I made it back safe and sound to SL. I had a great time in Holland seeing family and friends. I was spoiled over and over again! Thank you!!!

I left Holland on Monday and flew to London. I was in for a treat there as well. We had a mini Anastasis reunion which was fun and our hostess was so generous! On Tuesday I flew from London to Freetown. The flight was delayed, as it often is! We finally left 1 ½ hours later than scheduled. The most interesting part of the trip was watching and experiencing my co-fliers! In London they were very sophisticated and patient while checking-in and boarding. Most were Sierra Leoneans, some of who hadn’t been home for 10 years! On arrival in Freetown things were a bit hectic. I was confronted with the culture right away. When people disagree here, they generally tend to yell and shout. Well, we almost had a fist fight at the baggage claim area as one lady accidently took some one else’s suitcase off of the belt! She was accused of being a thief etc. All ended well. Welcome back…! After getting our suitcases we were hassled by men trying to ‘help’ us out as we were making our way to the hovercraft ticket counter. We could easily manage our luggage on our own, however, these guys like to ‘help’ out because then they can ask us for a tip! To make a long story short after about 2 hours of waiting, watching, avoiding arguments, etc. we departed by hovercraft, arriving on the otherside after 1 am. It was a long day.

It was good to arrive at our compound and felt good to be in my own place again, even though it was a very empty room. Before leaving I had to take everything out of my room so that the walls could be fixed. Well, they were fixed and re-painted. My room had never looked this good, as the walls had started leaking and molding away the day I moved in earlier this year!

Anyway, it’s good to be back and I’m ready to go again.

Mercy Ships SL news...

Mercy Ships Sierra Leone consists of 2 programs: New Steps and the Aberdeen Clinic and Fistula Centre (ACFC). I work in the clinic part of the ACFC. To give you more insight into the programs we run you can check out the Mercy Ships Sierra Leone newsletters. The latest update on both programs can be found by clicking on the following link:

http://www.mercyships.org/News/News.cfm?ID=1030&c=138

Peace in the midst of poverty...

As the UN's 5 year mission in Sierra Leone comes to an end questions arise regarding the stability and safety of the country. Is it only peaceful on the surface? Is the country like a volcano, waiting to erupt? I don't know what the next weeks and months will bring. Sierra Leone is still one of the poorest countries in the world. And along with poverty come corruption, injustice, instability. Only time can tell what will happen in this country. I can only hope and pray that the people will stand together, keep peace and work together to re-build their beautiful country.

Click on the following link to read one of the "10 stories the world should hear more about" regarding the end of the UN mission in Sierra Leone.
http://www.un.org/events/tenstories/story.asp?storyID=1400

H-O-M-E...

“Where is it?” “What is it?” “Does it exist?”
The last few days I've been thinking about home...

After living in Holland for about 10 years, it finally started feeling like home. Then I left. Now I’m back for a few weeks and realize I miss not having a place of my own. It feels awkward and strangely enough it feels like I don't have a home anymore.

HOME: is it a place? is it a feeling? is it a group of people? While figuring this out I'll reflect on the following quotes.

"One never reaches home, but wherever friendly paths intersect the whole world looks like home for a time."
(Hermann Hesse. 1960)

"Home is where the heart is and hence a movable feast." (Angela Carter. 1976)

"Home is any four walls that enclose the right person."
(Helen Rowland. 1903)

"Home is the place where, when you have to go there, They have to take you in." (Robert Frost. 1914)

Chance of a life time...

In November Nathan & his mom travelled from Kenema to Freetown, in the hope that they would find help for Nathan. One look at Nathan and my heart melted; what a happy healthy baby. Despite his deformity he was full of smiles. And his mom, though very concerned, obviously loved him very much- it’s not everyday in Sierra Leone that you see a 10 month old weighing 10 kilograms! I hoped for the best and called the ship to ask if they could do his surgery, knowing this was probably Nathan’s only chance.

A little later I was able to tell Nathan and his mom that they're going to make a trip to Liberia in January 2006 for the operation! Nathan’s mom was happy and it was a relief for her to see before and after pictures of other children who underwent surgery, as she thought that her son was the only child in the world with this condition. Also when Nathan was born, her family told her that it was ‘an act of the devil’. It was great to tell her that her son had not been cursed, that she didn’t do anything wrong, and that there was help available for Nathan. Nathan & his mom left the clinic that day with a letter for the ship, a surgical appointment card and a thankful heart. I left the clinic knowing that another chid has been given the opportunity of a life time- an opportunity that will change his life.

Introducing...

Aminata* and her 9 month old son, Alpha*, came to our center on Wednesday the 19th of October after a day long journey from Kabala to Freetown. Aminata was to be admitted for her vesico vaginal fistula operation.

They arrived at the center just as I was leaving for the day. However, it only took a minute to see that the baby was pale, had a terrible skin rash (scabies with infection), was underweight (5.6 kg) and had pneumonia. I had a few minutes to get him started on the proper medication, before going home. The next morning I did a complete examination- the baby had developed a fever overnight, had a large spleen and was quite pale. He was vomiting and not tolerating oral medication. Blood tests confirmed malaria and a hemoglobin of 5 g/dl. Usually when treating a VVF patient’s child it is like treating one of the out patient children- see the child, prescribe medication and explain to the mother how to give them. The only difference is the out patient children go home, the VVF patient’s child stays on the ward. With Alpha, I knew it was not wise to treat the baby as an ‘out patient’ on the ward. What made the decision of what to do difficult is that I knew that Aminata’s surgery was supposed to get her surgery within the enxt hour. I decided to cancel Aminata’s (elective) surgery and refer Alpha to the pediatric ward at Emergency hospital. In the end it was good that the child was referred- his Hb dropped to 4.4 g/dl and he ended up needing a blood transfusion as well as intravenous antimalarial treatment.

On Monday the 25th mother and child returned to us. Alpha looked much better. He did still have a chest infection and scabies, so I treated those and checked up on him everyday. I also had to make sure he was breast feeding frequently as well as eating solid foods. He was a joy to have around and it was great to see him improve so much. Aminata was able to have her surgery the following day and recovered quickly. Two weeks later, on November 9th, we were able to send home a healthy dry mother and a healthy happy baby. It was great to be a part of their lives.

*names have been changed

Encouraging notes...

A suggestion boxed was placed on the clinic's reception desk a few weeks ago. It was originally put there so that our employees can make their suggestions known. However, when we emptied it before our staff meeting last week we saw that there were only 2 suggestions in the box...and neither were from our employees, but from people from the Aberdeen community. I was encouraged by the notes.

Concerned Citizen - Aberdeen Community
“Appreciate the outpatient doctor for doing a wonderful job and healing to our children because she is the only one and she is doing a tremendous job. She loves the job more than the income and we appreciate.”

Concerned Mother – Aberdeen Community
“We appreciate and very greatful to the outpatient doctor. The medication are very very good and very very cheap and we are greatful for that. We will appreciate it more if you will see all the patient’s that are present in the morning. Above all we are happy to have you (Mercy Ship) in our community. Bravo to the outpatient doctor.”

Fun to read and to know that the clinic is appreciated (and we do try to see as many kids as possible, but more than 40 a day gets tough!

Trip home...

Good news- tonight I am going to the heliport to pick up doctor Jenny Vardy, who attended the tropical medicine course with me in Liverpool last year. She'll be working with me in the clinic for the next month and then she will cover for me while I am away.

So the greatest good news is that I have purchases my tickets! I will be in Holland from November 26th - December 19th. I'm really looking forward to the break and especially to the time I will be able to spend with family and friends. I will be home for my sister's 30th birthday and my niece's 1st birthday. Lots to look forward to.

Hope to catch up with some of you while in Holland!

M/V Anastasis...my home for many years...

Today the Anastasis arrived in Liberia, for what could be her last outreach. I am not sure how many of you have heard the news- but the plan right now is that after this next outreach the Anastasis will be put 'out of service'. You can probably imagine that I was quite surprised by the news and that I have mixed feelings- I grew up on the ship and it is a strange thought that her mission could be over. However, I know that God knows best, and His ways are not always my ways. Here is the official report. If things change- I'll let you know!

MERCY SHIPS FOUNDER UNVEILS CONCENTRATED FOCUS ON AFRICA

GARDEN VALLEY, TEXAS, SEPTEMBER 1, 2005: Following the completion of a recent executive committee meeting, Mercy Ships Founder/President Don Stephens announced a new strategy for Mercy Ships in serving the poorest of the poor, with a renewed focus on the continent of Africa.

Stephens began by affirming the Anastasis is poised to commence field service to the nation of Liberia beginning 28 October. He continued, “We are looking forward to bringing hope and healing to this war ravaged nation with a hospital ship which concentrates on transformational development for individuals and communities in desperate need. Mercy Ships volunteers and crew have now been in active service for almost a quarter of a century, most of it to people of Africa living in extreme poverty.” Stephens continued by announcing in coordination with the launching of the Africa Mercy, the Anastasis will be taken out of service in mid-2006 to facilitate a concentrated focus of efforts and resources on the Africa Mercy, the newest generation of Mercy Ship.

“This new ship will have approximately twice the capacity of all our prior field assets combined. She will serve as the model going forward for the next generation of Mercy Ships”. He noted a study will be conducted on the future of the Anastasis, with an emphasis on the implications of new international technical standards taking effect in 2010. The two ships will join together in Ghana in May at which time crew and equipment will be added to the Africa Mercy as she begins her first season of service.

Mercy Ships is the leader in using hospital ships to deliver free world class health care services to the poor. Since 1978, Mercy Ships has performed more than 2 million services, with a value of $250 million. Each year more than 1,600 short-term volunteers serve with Mercy Ships.

For further information, contact:
MERCY SHIPS
Glenn Price
VP, Communications
Phone: (903) 939-7000
E-mail: priceg@mercyships.org

good and bad...

I am doing well- very busy - saw 44 patients today. The last few weeks have been crazy with some very sick patients. Unfortunately a few of them have not made it and died at the referral center- mainly due to malaria and anemia! Also a few malnutrition cases - a 1 1/2 year old girl, weighing 5 kg and severely dehydrated didn't make it after 4 days of hospitilization. Again, many of these conditions can be treated if the child reaches a health center sooner.

For some reason in the past week I have also seen more children with deformities (large tumors on their faces, scalp, cleft lips etc). People still seem to think that we can do everything that the ship could do. Well, I have to tell them that we can't. However, with the ship going to Liberia we have been able to schedule a few cases. One mom came with a 5 month old baby- born with no right eye and a cleft lip. She said her family thinks the child is bewitched and she is too ashamed to take him home. She almost begged me to write a note saying I was going to try to find help for the child. I look forward to meeting her again on Wednesday- so that I can tell her we have scheduled her child for surgery on the Anastasis mid November!

Another positive note- I diagnosed my first appendicitis here; a 5 year old boy with abdominal pain. The physical exam and lab work sure made me highly suspicious, so I referred to Emergency Center. A few days later the mom and child came back to the clinic. They said the ride out to emergency was pretty bad because the potholes sure made the boys belly hurt, however, they were seen right away at Emergency and the surgery was done within hours. A few days after that the surgeon confirmed that yes it was appendicitis.

As you can see there are good outcomes and bad outcomes. Plenty of things to deal with, be sad about and ponder upon, but also plenty of things to be thankful for!

Video clip...

I am sure many of you are curious as to what exactly I’m doing here.
Well, if you click on the following link, you might be able to get some footage on the clinic.
It might take some time, so have patience :)

http://www.lakomission.org/cms_exodus/images/stories/video/opc_aug_2005.wmv

Celebration time...

Today we registered the 1000th patient in the out patient clinic! Actually, we registered up until 1005 today, but the 1000th patient is definitely a milestone. It’s unbelievable that 4 months after the clinic’s opening we have seen so many children come to the clinic. And some have come back multiple times. Many children come from the Aberdeen area, but some come from as far as Kissy and Waterloo- quite a drive in the taxi (1 hour). It is a priviledge to be able to work in the clinic and help the children here in the Freetown area. As challenging as it can be at times, it is definitely rewarding as well.

Patient 999 was one of our ward patient’s daughter- who I diagnosed with malaria today. Patient 1001 was a boy from Freetown who I also diagnosed with malaria. (We had a lot of positive malaria tests today!) And patient 1000 was a boy from Lumley (near Aberdeen) who came with an ear infection. He is a Sierra Leonean boy but his family has been missionaries in the Gambia and moved back to Sierra Leone only two days ago.

One last reason to celebrate is that last Wednesday marked my 6 months of living in Sierra Leone! I can’t believe I have been here for 6 months already!

taken on our compound...

Latest update...

Many of you may wonder what life is like here. Is it different? Having been here for 5 months, some things do start to seem normal, however, life here is probably anything but ‘normal’, at least compared to life as most of us know it. Can you identify with the following daily happenings???

“Women washing their clothes by hand in front of their homes. Naked kids playing on the streets. Stand pipes along the road for people to collect water. Rusty broken down vehicles on the side of the street or turned over in ditches. A wall surrounding the compound. Street vendors everywhere. A child walking with a bucket of water on her head. Dogs barking throughout the night. Children bathing on the side of the road. Razor wire along the top of the wall. Huge piles of trash on the side of the road. Water filters in the kitchen. A gate with the following painted on it - ‘entrance, do not urinate here’. People digging through dumpsters to find items to sell or re-use. Laundry drying on the ground. Coming home to hear we need to conserve water as the tanks are almost empty. 20+ people trying to cram into a minivan. Guards patrolling the property. People walking around with live chickens in their hands. Enormous potholes on the red dirt roads. A panic button on my night stand so I can trigger the alarm system if necessary. The constant sound of the generator at night.”

If you want to read more about my life here in SL click on the following link for my latest newsletter…
http://lakomission.org/cms_exodus/images/stories/sandra/sandraaug2005.doc

To sleep or not to sleep...

I love sleeping, so I would choose ‘to sleep’ any day. However, circumstances here in Freetown often seem to opt for the option ‘not to sleep’; I either can’t get to sleep, or wake up multiple times throughout the night or wake up way too early. Noise pretty much is the cause of this, although the Lariam pills might help a hand! Let me explain in more detail where this noise comes from...

Our neighborhood is pretty lively with frequent soccer matches that take place on the soccer field, right next to our compound. I’m convinced that the whole neighborhood shows up for the game; it certainly sounds like everyone is out there with all of the music and cheering I hear. If there’s not a soccer match then there’s often a party - again with loud music, people talking through megaphones etc. This can last up until 3am! And if it’s not for the party, the dogs do their best to keep me awake- not only do they lie/sleep in the middle of the street while we are trying to drive up or down it during the day, but they manage to stay awake and bark throughout the night.

Then there’s noise that’s closer to home, right next door to me - my flat mate closing our very loud steel door as she goes to the kitchen (sometimes at 5am – mind you she does try to keep it quiet) or my parents doorbell announcing the arrival of the bread man or the guards who need more diesel for the generator. Speaking of the generator- that is another source of noise on our compound, but fortunately it’s not so close to my room. I do live close to the Hunter’s room however- and they happen to have a very noisy AC unit- so I hear the constant humming of their unit throughout the night. Then there are the guards that patrol the compound, with their walkie talkies on of course (volume on high)! Actually I wish at times that I would hear more from them- then at least I know they are awake.

And last but not least…the rain. Especially now that the rainy season is here the rain can get quite loud! And actually, if it’s the rain that wakes me up, I usually peek out of my window and am amazed at the amount of water that falls to the ground!

Birthday in SL

Yes, this past Saturday I celebrated my 28th birthday. The fun actually started on Friday morning when I walked to my office and noticed a fully decorated door- with balloons and a poster - my nurses and receptionist came in early to decorate. They later surprised me with a gift- a real African outfit! In the afternoon I decided to take them out for ice cream; there’s a local ice cream shop 5 minutes from the ACFC, with great home made ice cream (and it hasn’t made me sick yet!). On Saturday I woke up way too early- but couldn’t get back to sleep, so much for sleeping in. My parents spoiled me with various gifts- including yet another African outfit and a tie-dye skirt. Later in the morning Gisela, my parents and I went to Crown Bakery- a great bakery in town that I had not yet been too. We enjoyed a great brunch there. In the afternoon I spent time making cookies. It was a bit rainy- but not a problem since I wasn’t planning on going anywhere anyway. In the evening the New Steps gang came over and joined all of us at our team house for dessert. Gisela made me the most amazing chocolate cake! And my mom made a delicious apple pie. Plenty of sweet stuff to go around! It was a very enjoyable day. It felt very much like a birthday- and it was nice to once again have some family around to celebrate with. Thanks to all of you that remembered my b-day and made the day special!


birthday treats!

Laundry is an art...

Doing laundry can be an art and a challenge...fortunately we have a washer and dryer- and we have managed to figure out how to use the dryer without overheating the generator :) Doing laundry when we have national power can be interesting (during weekends)- national power can switch on, and then switch off again after an hour...and then an hour later come back on again- that means laundry can take a number of hours and a bunch of trips to the laundry room :) I am very thankful though that we have good facilities!

Down time...

Some of you have asked what we do for down time. Sierra Leone is a beautiful country with beautiful beaches. A group of us often try to go to a beach in the weekend...to spend some time relaxing and enjoying our surroundings!


River no. 2 - a gorgeous beach! ..... Lakka beach - with a great pool too!

The first 'marklate' day...

Up until Wednesday the out patient clinic was primarily focused on cure (besides the health teachings given in the clinic and on the wards). Well, that has changed. On Wednesday we held our first "MARKLATE" (Krio for 'vaccination') day- children could come for their childhood vaccinations- for Free!

A few weeks ago we met with some of the community leaders to let them know of our plan and to make sure they would communicate it with the rest of the community. Letters were read in the churches and mosques, announcing the vaccination day. Later we heard that the 'town crier' had walked the streets of Aberdeen village, ringing his bell, telling people to take their children to the clinic for their 'marklates'!

The turn-up on Wednesday morning was a bit disappointing. There were about 7 mothers with children. It was a start...but not good enough. The frustrating thing was knowing that some vaccines (measles, yellow fever, BCG) could only be given if a certain number of children would be vaccinated. The 9 month measles vaccine for example is a 10 dose vial and can only be kept for a maximum of 4 hours, or the vaccine will spoil. The government (who supplies the vaccines) told us that 40% wastage for the measles vaccine would be acceptable...no more. That meant we needed to have 6 children present in order to open the vial! Well, there were 3 present that needed the measles vaccine. I was hoping for the best and decided to have the patients wait awhile, and to open the vial at noon and start vaccinating. I figured that would give us until 4pm to find more children so that we would vaccinate at least 6 kids and not get in trouble for vaccine wastage! So, the nurses started vaccinating. Of course, there was a lot of noise coming out of the clinic that day- a few crying kids sure makes it sound really busy! Fortunately with time more children came in, but still not enough for the measles vaccine. (DTP and oral polio are multi dose vials and don't spoil easily). At 3pm I had one of my nurses go across the street to a compound called 'The National Dancetroop' (apparently a lot of the occupants are national dancers!). I wasn't sure what to expect...but sure enough at 330 she showed up with about 4 more children for the measles vaccines and a bunch more for some of the others. So in the end it worked out well. We were able to vaccinate 27 children in total- a good turnout for a first day!

We will definitely keep the vaccinations as part of our out patient clinic program; hoping to hold vaccination days twice a month. Maybe before the next time we'll walk the streets ourselves with a megaphone...to make sure enough people know about it!

Mother comes back to say thank you...

A few weeks ago a lady came into the clinic with her 3 year old daughter who had a high fever and was very weak (lethargic) – not even able to sit up. Right away I knew that she was very sick and would need referral. At a time like that it is very difficult to decide whether or not to go ahead and get some lab work done or to refer her right away. I decided to check her blood sugar and do a rapid test for malaria…within a few minutes I had the results- malaria! The next decision was whether or not to start treatment or get her to the referral center as quickly as possible. A call to the doctor at the referral center confirmed my idea- to send her their way immediately. So while I gave medicine to reduce the fever, someone else was waving down a taxi and negotiating the price. Soon the mother was in the taxi with the child and I continued the clinic. During clinic I was of course wondering if she made it to the referral center...on time. After clinic that day I called the referral center and heard that the little girl had made it, and iv treatment had been started. Two days later I went to visit the little girl- she had been improving initially but had now slipped into a coma. That was very discouraging. The mother was sitting next to the bed, happy to see us, but without hope in her eyes. We could only tell her that we were hoping for the best. Looking at the little girl lying there in a coma made me wonder if I could have done anything more for her at the clinic. Leaving there, I knew we had to pray for the best. Five days after visiting the girl, I called again, not knowing what to expect. And amazingly enough the doctor told me that the little girl was doing well. She had pulled through! She ended up staying at the referral center for another 5 days until she had fully recovered. A couple of days after the child was discharged her mom brought her back to our clinic…to say thanks. I told her I was very sorry that we weren’t able to do more for her; since all I really did was refer the child. The mother said that she was grateful that we were able to help the way we did; even if she didn’t get the treatment at our clinic, we helped to get her to the right place. It was great to see her daughter walk into the clinic with a big smile on her face. Sometimes I still get frustrated because I want to be able to do more for patients, and I guess I need to realize that even though at times it may seem like I am not doing much, I am doing something…and something can make a lot of difference.


follow up visit...child doing well!

Walk with a purpose...

This past Sunday my mom, Melissa and I went to the beach for a walk. This was not just an ordinary walk. It was a walk with a purpose. Together with about 1000 other people we walked about 8 km (4.9 miles) along the beach, walking to fight hunger. On the same day, in 90 countries around the world, people were walking for the same reason. “Fight Hunger, Walk the World” is an annual event organized by the World Food Program, to raise awareness and funds and make it possible to eradicate child hunger by 2015.

At 8:30am we got to the starting point. We were surprised to see so many people present, Sierra Leoneans and expats alike. The first thing we noticed was that everyone was wearing the same t-shirts. So we made sure to get in line to buy the shirt! Before actually walking, there was a short program. A number of different people spoke, including the vice president of Sierra Leone. Unfortunately however, the microphone wasn’t working, so I’m not exactly sure what he said. After that we all started walking! The walk took about 1h45m. Fortunately it was dry and not too hot. It was great to take part in a global activity, and to walk with so many others for the children who suffer from hunger. For more info see www.wfp.org or www.fighthunger.org


me, Melissa, and my mom ... and the t-shirts :)

Yummy for my tummy...

Many of you are probably wondering what the food is like here. Well, to say the least, the food is great. And it’s usually prepared for me! That is definitely a blessing. In the weekends we don’t have a cook, so we eat leftovers, prepare our own meals, or eat elsewhere.

Breakfast is self-service. For me, this usually means eating cereal (with powdered milk) or bread (with spread cheese or peanut butter & jelly). In the weekends I have some more time to make breakfast, so I’ll occasionally enjoy other things like French toast, eggs...

During the week we eat lunch at the center…African food! The menu is the same every week…the sauces are different everyday, but the staple remains the same...RICE. I don’t care too much for the potato leaves, but the rest is good. Greens are my favorite. Some of the cooks use more hot pepper than others- you just have to make sure you always have your water bottle close by :)

Just to give you an idea, here is the center’s menu:
Groundnut sauce (peanut sauce), chicken and rice
Cassava leaves, fish and rice
Potato leaves, dry fish and rice
Greens (tastes like spinach!!) and rice
Groundnut, chicken and rice

At the team house our cook, Abdul, prepares our dinner. Here are some of the dishes that rotate through our menu; usually accompanied with fruit salad or normal salad and sometimes cake:
Grilled peanut chicken, rice, vegetables (a house favorite!)
Fish, couscous, vegetables
Shepherds pie, (one of my favorites, believe it or not)
Spaghetti, garlic bread
Chicken kebab, fried rice, avocado salad (favorite!!)
Grilled fish, sweet potatoes, plantain
Meat loaf, potatoes, green beans

So, as you can see...the food is YUMMY! A good mix of African, European and American food!

Finally...some photos...

First patient in clinic


First patient on ward (VVF patient's child)


My office/consultation room


Me and my nurses (Ramatu & Juliette)

Just so you know...

The out patient clinic opened on Tuesday, May 10th. On the first day I saw 3 patients- a slow start I know, but at least it gave us the chance to make sure that the clinic, lab, pharmacy etc. were functioning as they should. On Thursday the numbers increased, and I saw 16 children and 2 of our employees. Today, I saw 27 patients- actually it was a bit too busy. But at least we know there is a need for the clinic! The clinic days right now are Monday, Tuesday and Thursday. Once we start our immunization program we hope to have an immunization afternoon (Wednesdays) as well. And hopefully we will be able to do health teaching etc. in the community on Fridays. And who knows, maybe we’ll have more clinic days in the future.

It’s good to have started the clinic. However, I realize even more how challenging it is. And at times I feel very inadequate for the job. Especially being the only one to see the children and make the diagnosis etc makes it difficult. It would be a lot easier if there was someone else to bounce ideas off of! Most children come with complaints of fever and cough. And then half also have complaints like vomiting, diarrhea, or skin conditions. So as you can imagine, at times it is hard to figure out what is really going on. I at least try to discern which children are very sick and which are just feeling unwell. And I try to diagnose what I can, and treat with what I have! I guess I have to get used to things here too; used to working on my own, with limited medication, limited (and right now part time) lab etc. And it’s hard when a really sick child comes in and you know that you can’t really do a whole lot except refer the child to a center 20 minutes away- at times like that you really hope and pray that time is on your side! There will always be challenges here I know, but hopefully with time, things will get better and run smoothly.

Till next time.

April newsletter

Click on the link for my April 2005 newsletter
http://lakomission.org/cms_exodus/images/stories/sandra/sandraapril2005site.doc

Quick update...

The first VVF surgeries were done at our center this past Tuesday! That is definitely a milestone. A total of 4 surgeries were done this week, and so far so good. It is great having some patients in the ward. It’s a pleasure to be able to go to the ward and talk with them and to be able to show them that someone cares about them. One of the patients has a 7 month old daughter- Faith, and she is adorable. She brings some extra joy to the place. The out patient clinic (which will most likely start as a clinic for children 12 years and under) will hopefully start up next week. There are some small things that need to be in place before we can start…for example, benches for the patients to sit on in the waiting room etc. And sometimes little things take a little longer than expected here. But I think that we will start when the time is right. I think I have a great clinic team- two community health nurses and a receptionist, working alongside me.

Oh, some more good news. The container from Holland came this week…we spent about 3 hours unloading it Tuesday night…till about 9pm. It was a long day. But I was happy to finally see my furniture again. This weekend I’ll be putting together my wardrobe, book case etc. It’ll be nice not to have to live out of a suitcase anymore!

All the best.

On national tv...

Hello again.
Last week thursday I went to the official opening of our Mercy Ships New Steps center in Waterloo. New Steps focuses on rehabilitation for polio victims and war victims, using a holistic approach. About 400-500 people showed up for the opening, including representatives of the Ministry of Health and leaders of the local communities. To celebrate the event all Mercy Ships staff was wearing tailor made outfits out of the same material. Pretty funny sight!
On Friday I was watching the one and only local tv station in one of my team mate's rooms and the New Steps opening was on tv. It was a good overview of what took place and what the center is about. They even showed me and some of my colleagues sitting in the 'audience'. So that was fun to see. So that was my first time on national tv. :)

Good news...

Last week we met with the representatives from the community we’re working in as well as with other stakeholders, and it seems as though things are moving forward.

We all managed to come to an agreement and the community has accepted the scope of our services. I was able to explain what we could provide in the out patient clinic (starting small- a clinic for children 12 years and under, also providing vaccinations and growth monitoring, and a focus on prevention- including health education, possibly provision of bed nets etc.). Those present seemed pleased. They also seem to understand that we are limited in what we can offer…as far as beds/ambulance etc. are concerned, due to limited funds, staff, expertise and equipment. At a dinner party the next night we were able to talk with each other some more and I think that a foundation has been laid and we can starting building a relationship with those involved.

It looks like we will start surgery and begin seeing patients in the clinic around April 26th..

The last few weeks haven’t been easy, but in the end ‘all things work together for good’. And we are seeing good things come out of this situation. Thanks for your support and encouragement during this time!

Drop in the bucket...

Today I went to a National Symposium for World Health Day. The theme was “Make every mother and child count”. Women and children make up a big part of the society, yet they are the ones most vulnerable. Although it was good to go to the symposium and hear first hand what the health care problems in Sierra Leone are, it was also a little discouraging.

Here are the facts…
More than 10 million children die in the developing world per year. 4 million of these children die within 28 days of birth. Sierra Leone has the worst indicators, ranking as number one in the world. In Sierra Leone the child mortality rate is 286/1000 live births per year (compared to about 5/1000 in Holland). This means that almost 3 out of 10 children die before their 5th birthday! 70% of these children die due to diarrhea, pneumonia, malaria, malnutrition and measles; all could be prevented! The maternal mortality rate is 1800/100000 live births. In other words, a woman has a 1 in 16 life time risk of dying due to childbirth complications. (compared to about 1 in 3500 in Holland). As you can imagine, this is difficult to tackle.

It was fairly easy for everyone to address the issues underlying poor maternal and child health- poverty, lack of transport, cost of health care, cultural aspects, lack of safe water and sanitation etc. However, it was impossible for anyone to come up with a concrete plan. Yes, you can try to provide mosquito nets for all children and pregnant women- but where will you get the nets, how will you distribute them, who will reimpregnate them? No one here has the money to do that. Now there are better drugs to treat malaria (less resistance) but these are expensive- who can afford them? What about increasing access to health care facilities (better roads, more vehicles) so that a patient will reach the facility before it’s too late? But what happens when the patient arrives at the hospital? There is a shortage of trained & skilled staff, there are limited supplies, and the patient usually can’t pay the fees charged! The problem seems too big to tackle.

Although I know that my work here will be very limited in scope, I do want to be optimistic. Instead of looking at the millions of people that I can’t help, I want to focus on the individuals that I can have an impact on. I hope that during my time here I can make a difference in the lives of some of the Sierra Leoneans in our area. Sometimes it is the drop in the bucket that counts!!!

Holding pattern...

First of all, I went to let you know that I am doing well. It’s weekend, and that’s always good :) I enjoyed a long walk on the beach this morning! It was great to hear the sound of the waves crashing on the sand. And there is always a lot to see. A lot of people running on the beach, kids playing in the water, fishermen pulling in their nets, etc. We were there on time to see the catch of the day- not a big catch and I can’t tell you what kind of fish. But it was interesting to see.

I am not sure what to write as far as work goes because there have been some interesting twists this past week. Too make a very long story short…we are in a holding pattern right now. We had a meeting this week with a number of key people involved in our Center. We found out that the community we are working in isn’t very pleased with the services we are planning to provide. They pretty much were hoping for their ‘dream center’ – a general hospital. Due to resources, staff, facilities we cannot provide them with a general hospital. So obviously, the meeting did not go well. And we had to decide to lay low for now. We have put everything on hold- construction has stopped, we have been working from the house, and our employees have been told that there is no work for them at the moment. This as you can imagine is tough. Tough not to be able to proceed with something we all believe is the Right thing. Tough to tell our employees that we don’t have work for them right now. Tough that riight now we can’t do a whole lot when there is still a lot that needs to get done. We are waiting. Waiting on God and trusting that He will see us through this. Hopefully matters will be resolved very soon and we can continue on. We want to be able to serve the ladies that will come to the center for VVF repair and we want to be able to serve the people in the community in the out patient clinic.

During our Easter service (which was very beautiful) we talked about being HUMAN BEINGS and not HUMAN DOINGS. It is not what we do that is important, but who we are. With everything that is going on right now, that is what we want to hold on to. We are here, not only to work, but to BE. We want to be able to have an effect on those around us by who we are in Christ.

Okay, this is it for now. Hopefully I can update you on our situation soon!

More news...

Here's another short update on how I am doing. I tried emailing earlier this week...but couldn't connect. I guess that's just a part of life here in SL. :)

I am doing pretty good. We are all very busy, trying to get the VVF centre as well as the clinic ready so that we can start seeing patients. I have already realized that this is definitely a pioneering mission- which means that it takes a lot of time and effort to get systems in place! For many of us, this is a whole new line of work. We're trying our best to get things done but it's not always easy. We are sometimes limited by transport, often by time, and by lack of resources. We do all know that this is what we should be doing. And that God's timing is perfect!

We're not only trying to get things ready at the Center, but also trying to get settled in at the team compound. We are very happy with the place we have- it's amazing. A container arrived last Wednesday from Holland- and we spent most of this past weekend putting together our kitchen tables and chairs, dressers, beds etc. A busy weekend! Up until yesterday I was sharing a room- which was fine really. But it is nice to now have a room of my own (at least for now!) and I was able to move in yesterday. I don't have any furniture yet, as that is on the next container- but with time I will make it my little home. I even have my own bathroom! The best part about our compound is the gazebo...a place where we sit and talk, eat, catch a breeze, have our Krio lessons, enjoy tea parties etc. Hopefully in the future we'll have some great barbeques and parties there :)

Okay, this is it for now!

First week in Sierra Leone

Greetings from Freetown, Sierra Leone; where I’ve been since Monday.

On Monday a friend dropped me off at the airport in Brussels. The flight was only 6 hours, since we flew directly to Freetown instead of stopping in Abidjan first. After collecting our luggage (I met up with other team members in Brussels), we found out that the hovercraft was broken. Surprise, surprise.That meant we had to take the helicopter- a 7 minute ride. Of course we had to wait awhile before we could actually get onboard, because we were in the 4th load of people going, and the helicopter had to refuel. It was a hot and sweaty wait, at 32 degrees Celsius. The helicopter ride – my first ever – was, to say the least, noisy, but exciting too.

The team house is great. Quite a bit of space and a good lay out. And the team is great too. We have a generator, which is on during the evenings. But of course, as one would expect, it cuts out every now and then. We also have running water -most of the time- on day 2 we got back from a sweaty day at work and had NO water till the next morning. And we have normal (western) toilets and showers. I can’t complain.

I spent this past week sorting out boxes and their contents, and finding places to put them. One of the wards, our storage ward for now, was filled from right to left and top to bottom with boxes. We had to move boxes out of the room in order to be able to get an overview of what was all in there! And all of the boxes needed to be opened because what was written on the box often wasn’t what was actually in the box! Finally we were able to put all of the boxes in piles, according to where they belong. It was quite a job…and is not quite done. And we’re expecting another container to come in this week!

Never a dull moment….
We are storing some of the boxes in a huge shipping container…next to the hospital, which we now refer to as the HOT BOX as it is about 40 degrees C in there. Diane (nurse) & I were clever enough to load the boxes onto a bed with wheels, so that we could just roll the bed (with boxes) to the container. Well, we might be clever, but we can’t steer very well. As we were going off of the ramp to the hot box, the front wheel slipped over the edge of the ramp! The bed started tipping over…almost squashing one of the local guys who was sitting there mixing cement. And a bunch of our boxes fell into his wheelbarrow – which was filled with water and cement! Oops! What could we say- except that it was the wheels fault! Everyone thought it was quite funny…except for the cement guy! I guess we need moments like this every once in a while!

The end of an era

As I got on the train yesterday afternoon, I soon realized that this wasn't just another train ride for me...

During the past 10 1/2 years that I've lived in Arnhem I often got on the train to go places, always returning (at some point in time) to Arnhem...a place that has become my home.

Now things are different.
This time I left behind two empty rooms.
I said goodbye to friends.
And I no longer have a house key.
This chapter of my life has come to an end.

It's strange not to have a place of my own.
It's hard to say bye to family & friends.
And it's a bit scary to go out into the unknown.

But...it is also exciting to move on and start the next chapter of my life.
A chapter in which I will find a new place to call home.
I will meet people who will become my friends.
And I will be able to do that which I believe I was called to do.

What makes my day?

...a smile/laugh from my niece.

Actually, just spending time with Zoey makes my day.
She's such a beautiful baby and I am very proud to be her aunt.
I love you Zoey!


Zoey 2 months old

Latest news...

Click on the link below for my latest newsletter (January 2005)

http://lakomission.org/cms_exodus/images/stories/sandra/sandra2005-01.doc

First message...

...from my blogspot.

I thought it was about time to come up with a website of my own.
That way I can keep you updated on all of my upcoming adventures!
My latest news, photos, thoughts and who knows what else.
Hopefully I'll be able to access my blog in Africa!

Keep an eye out for new posts!