Vacation has begun...

Finally another post from me! It's been a little while I know and I'll try to post more frequently. You'd think that it'd be easy to post since I'm on vacation, however, internet has not quite been as accessible as I expected. But here we go...

I arrived in Holland Saturday evening after a 25 hour journey. There was no reason for it to have taken that long- we're talking an 8 minute helicopter ride, a 5 1/2 hour plane trip to London and a 45 minute plane trip to Amsterdam. However, it really did take me 25 hours. It started with a 5 hour wait at the Lungi Airport. However, I met a South African lawyer there and converation about poverty, corruption, legal aid (or lack of it), etc. in Sierra Leone was quite interesting. I arrived in London at 445am! There wasn't much else to do except find a bench and lay down and try to sleep. But the fear of waking up and finding out that I missed my flight or seeing that my bags were gone kept me up. I shopped around a little- but that's not the greatest with a suitcase either. At least there were interesting conversations taking place around me :) I was happy to finally board the Easy Jet flight at 1pm and make my way to Holland. On arrival in Amsterdam I was surprised to see my mom there to pick me up! She was in the area visiting her mom and thought she'd meet me so that we could make the 2 1/2 hour train journey to Middelburg together. It was nice to have some company. And she brought a 1 liter pack of milk for me- so I enjoyed lots of REAL (versus powdered!) milk on the train.

When I arrived in M'burg I was picked up by my almost 2 year old niece, Zoey, and her dad at the station. I have to say that Zoey was more interested in seeing the train, nevertheless it was fun to see her! She's so cute and quite the toddler now; very chatty and playful. And of course I met Esmee, my new niece. She is very small but precious. Obviously the picture posted is of me and Esmee. I'm sure I'll be posting more pics soon.

Anyway, I am having a good time in Holland. And I'll be writing more about that. I have to be honest- culture shock is a reality and I'm still trying to give things a place. More on that later.

A controlled experiment...

(click on pictures for larger view)

Introduction: A couple of weeks ago we needed to get some blood work done on one of the VVF patients and on one of our expatriate staff; tests that we can’t do in our smallish lab at the center. So, our local lab tech took blood specimens, put them in a ziploc bag with a request form and handed them over to the driver who then took the samples to a lab in town. Later that same day the driver drove back into town to pick up the results. Well, the results that came back weren’t quite what we expected. Both ladies had very low sodium levels; pretty much incompatible with life. We decided we better stick with bedside case management and not rely on the results. It made me wonder…can we rely on other labs to do our blood work? And that’s when it all began. Phase One of the experiment was instigated.

Phase One: I decided to have my blood tested at the same lab (picture:right arm). Since I was feeling fine, I figured the results would be normal. Wrong. Again the results were not what we expected; I too had a low sodium. Not as bad as the others but pretty close to putting me in a coma! All of a sudden I wasn’t feeling to well anymore. This led to Phase Two of the experiment.

Phase Two: Having checked one lab in town I thought it was only right to check both of our ‘referral’ labs in town. And we needed a control lab; a lab we can rely on. So I chose a lab that I was pretty sure would give accurate results. Being the sole investigator in this experiment made me the guinea pig, or should I say pin cushion! In phase two I again willingly provided some of my precious blood (picture:left arm). This time my blood was being scattered throughout Freetown- having to go to three different locations.

Results: Maybe we should just skip to the conclusion. By now I guess I should say that the results were what we expected as none of the labs gave the same results. Two of the three labs (one of which was the ‘control’ lab) pretty much concluded that I was near death (with a sodium as low as 113.2 mmol/l). The third lab however fortunately confirmed that my sodium levels were normal and that I would be okay; but can we trust this result?

Conclusion: Maybe it is not so wise to get your blood tested in Sierra Leone; at least not your sodium and potassium levels. No, seriously, if I would have been in a hospital here and the docs would have started treating me because of these results I would have probably died because my actually normal sodium and potassium levels would have been sky high because of treatment.

Final word: it was a fun experiment.

NB: Normal levels: sodium 135-155 mmol/l & potassium 3.4-5.3 mmol/l

Day on the town...

Going downtown Freetown is always quite the experience. The thing about downtown is that it is always very congested, the streets are somewhat narrow and there are a lot of one-way streets. The trick is figuring out which streets are one-way before it’s too late. Well, I made a wrong decision; I told Justin to take a street that I thought I’d been down before and sure enough halfway down the road we were stopped by a police officer; a one-way street. Oops. Fortunately for us we were in a Mercy Ships car. For your info: the name “Mercy Ships” is very popular in Freetown – this can be a real pain because when you’re walking around everyone yells ‘Mercy Ship’ at you. On the other hand, it can be quite helpful and work to your advantage. We told the officer we didn’t know it was a one-way street, that we would never do it again and that we didn’t see a sign. Luckily for us, he let us go; without asking us for money! I still think one of our local drivers has taken me down that street the wrong way before though.

Once in town we went to Crown Bakery- an expat hangout- nice but overpriced if you ask me. We did however enjoy a nice breakfast, which for me was an egg and bacon croissant.

After breakfast we went to an Exchange Bureau. I heard of this place before and people always made it sound mafia like. Really, it wasn’t. The only thing mafia like was that we had to go along a narrow path alongside the house to a flight of stairs at the back. Then we went up a few flights of stairs, which strangely enough seemed to get narrower and narrower. Then we were led through a corridor to a waiting area and ushered right into the boss’ room. From my chair I could peak into the room next door and see a monitor with live video footage- I quickly spotted the not-so-hidden video camera on the wall in the waiting area. We quickly did our transactions with a few phone call interruptions on the money changer’s side which did sound a little sketchy. Anyway, after turning down an espresso we were on our way. So it wasn’t your typical money changing place either but it wasn’t too dodgy.

Our next stop was the ‘Big Market’- a big covered market with a lot of colorful fabric (sold by the yard, as dresses, shirts, table cloths etc) and other souvenirs (wood carvings, necklaces, bags etc.). Our plan was to get some Christmas shopping done. I like the Big Market, but you definitely have to be in the right mood, otherwise you just can’t handle the pushy ladies, the people tugging at you to come and look at their shop, the feeling of being ripped off, the need to get ‘the best price’, the men hassling you, the potent smell of sweat etc. My mission was to buy some kids shirts and in the end I was successful thanks to the help of a little 2 year old Sierra Leonean boy who acted as a live model!

By the time we finished at the Big Market we were starting to get a little dehydrated and remembered we were close to Reda supermarket- which is where we buy goods for the Centre every other week (chicken, tomato paste, sardines, eggs, spices, cleaning supplies etc.). So we thought we’d run in and buy a drink. When we approached the counter with our pineapple juices the owner realized we were with Mercy Ships and we were given our drinks for free.

While Harriet and Justin were doing an errand, Morgen and I figured we’d walk down to the fabric street to find some fabric to take home as gifts. We went to one of the shops the Centre frequently does business with to buy material for patient dresses and greeted our friend, the Lebanese owner. We talked a little about our vacation plans and looking for gifts. I think we outdid ourselves at the ‘Big Market’ because both Morgen and I had lost interest in shopping. Our friend noticed this and suggested we follow one of his workers to another shop to choose some fabric there. So, we did what everyone would say not to do in a place like this and we followed a stranger to an unknown place in downtown Freetown. Well, 100 meters later we stopped at a shop and they really did have the most beautiful fabrics. We chose pieces of fabric which were once again given to us free of charge, again thanks to the name of Mercy Ships.

I would say we had a very successful and eventful day on the town.

Some pictures...

The top pic is of me and 8 month old Fatmata, daughter of one of the VVF patients. Fatmata was on the ward with her mom for about 3 weeks. She came in with malaria and bullous impetigo (a bacterial skin infection) but soon got better. I visited her on the ward everyday and was always happy to find her smiling. What more could a doctor ask for. Besides another episode of impetigo she was quite healthy. And she learned to wave while at the clinic!

The other picture is of my parents, Stefan and me; taken just before Stefan was leaving us to go back to Connecticut. It was sad to see him go but fortunately I’ll see him again in about 7 weeks. I love my brother! It’ll be fun to hang out with him in the USA and to meet Genae, his sweetheart.