Same child???

Aug. '06- 7w 2.8kg..........Feb.'07- 8m 8.5kg

In August 2006 a mother showed up with her 7 week old boy, weighing 2.8kg. Apparently after her first child died as an infant, the blame was put on her breastmilk. Consequently, to ensure her second child’s survival, she was told not to breastfeed him. Instead he was fed a total of about 250ml of watery milk a day! Obviously he wasn't going to survive like this. We strongly encouraged the mother to start breastfeeding the child. She probably spent half the day with us learning how to breastfeed the child; needless to say the baby was quite eager to be fed.

A week later mom and baby came again; unfortunately his weight had dropped to 2.7kg. According to the mom breastfeeding wasn’t going well and she wanted to give milk. So, although we encouraged her to continue breastfeeding as well, we showed her how to make the milk properly- enough water, enough scoops of milk and enough times a day, Unfortunately they didn't come back the next week. I thought the worst and every time I looked at pictures of him I wondered what happened.

Well, just last week a mom came to the clinic with her 8 month old son; a chubby, healthy boy except for a pretty bad diaper rash. Mom was happy and thankful. I didn't think anything at first but as we started talking I remembered who they were. This was the little guy that came in looking so malnourished. I could hardly believe my eyes!

Canoe trip...

Yesterday was a lot of fun. My parents, Melissa (new physiotherapist- here for 9 months) and I drove out to River number 2 to meet up with some friends there- Annekoos (doctor) and her husband Bastiaan (engineer), who were staying overnight at the beach. We arrived just as our friends were arranging a boat trip up the river. Perfect timing!

At 1130 we climbed into the canoes and set sail. There were 5 of us in our canoe plus our local captain. It was very peaceful as we started our way up the river, along the beach, gliding past the mangrove swamps, spotting little stretches of deserted beach, listening to the birds chirping away while moving forward into unknown territory. About 30 minutes later we reached the end, or should I say beginning, of the river. We pulled up alongside the rocks and got out of the canoes.

The waterfall we were expecting to see was really not much more than a water ‘trickle’ but maybe this was because it is the dry season now?? Needless to say, it was still a beautiful spot. There was a small pool of water which looked very inviting. Now, I know fresh water is supposed to be out of bounds in the tropics…but sometimes you need to take your chances. Annekoos , a new friend Addy (MSF doctor from Holland doing a lot of pediatrics upcountry) and I figured the chance was small that the pool was infected with Schistosomiasis ‘bugs’ and got in along with a few others. I guess the others figured that if three doctors were getting in, it must be alright. Well, we also figured we can always treat ourselves when we leave the country! Maybe it wasn’t so smart but it was very refreshing and relaxing.

After spending about an hour on the rocks we made our way back to the canoes and headed back. Halfway down the river we were stopped by a man standing waist high in the water in the mangrove swamp with a bicycle on his head! Go figure. He wanted us to come over and give him a lift to the other side of the river. So, we stopped, he loaded his bike onto the canoe, climbed in and we crossed the river. On the other side he got out and disappeared into the mangrove swamp again. We then continued our way back down the river to the beach where we ended our boat trip. The rest of the afternoon was spent relaxing on the beach, swimming in the water and enjoying the day!

For more pictures: http://www.flickr.com/photos/sandralako

Cat dies after being trampled by refugee...

The following post has been reproduced with permission from the author, my friend Cecily. Her post (from Friday Feb 23rd) really said it all...so I thought it best to share her thoughts with you.

Pamplemousse, a baby cat who was rescued by a Mercy Ships employee three weeks ago, died late yesterday evening after being trampled by a 2 year-old refugee. The boy had been staying at the Mercy Ships house with his family after having fled from a conflict situation in Guinea where his parents were missionaries. While playing in the yard at the Mercy Ships home, the small boy trampled Pamplemousse who was laying quietly in the grass. She died, hours later, surrounded by her loved-ones. She was buried that evening in the Mercy Ships yard. She will be missed by many. She is survived by her loving caregivers and friends. Pamplemousse, we will never forget.What follows is a poem, written by a friend of the late cat, printed with permission of the owner...

Pamplemousse
You came into our lives
So small, so hideous
Covered in dirt, you were
We washed you
We fed you
You survived...
but not for long.
Your young life was taken so soon.
Now we are only left with the memories...
How you used to swim in your milk bowl
How you used to meow incessantly
The way you would find a place to curl up and sleep between the neck and the collarbone of a nearby friend
Now you are gone.
Gone forever.
So sad.
So very, very sad.
Goodbye, sweet cat.
Rest with your fathers.
We will go on...
with the memories we have.
And we will be sad.
So very, very sad.
Pamplemousse.
Trampled, you were.
Trampled.
You were so young.
So free.
And now,
You are gone.
Goodbye.
Forever.

Posted by Bos http://www.thatssobos.blogspot.com/

African internet...

So, here I am trying to create an interesting post…and it’s not working. African internet is such that the connection is not always great. Tonight is one of those nights. On…off…on…off. So much for our internet providers slogan "Always connected". Every time I try to upload a picture the connection is lost…again. I guess it’s good for my patience. However, there comes a time when you just need to give up for the night! That time has come. So, I’ll post a picture next time; if the connection is okay of course.

Don’t get me wrong though. I am thankful that we even have internet here! A big thanks to the anonymous donor that made this possible!!! It’s amazing that we have a connection at both the center and the house…even if they don’t always work. I remember very well that for the first 8 months that I lived here we could only email at the local internet cafes…talk about bad connections!!! I can’t believe the number of hours we spent waiting for emails to download, or driving to the internet café only to find out the server was down, waiting for a computer to be available. At least now, if it takes a while to download or upload I am in the comfort of my own home and can do other things in the meantime. I am thankful!

Hmmm…wonder if I’ll be able to publish this post…

Guess so : )

Global water crisis...

It’s a fact…

"Worldwide 1.2 billion people still lack access to clean water and 2.6 billion lack adequate sanitation. While each person in the UK or the USA sends 50 litres down the drain each day simply by flushing the toilet, many poor people survive on less than 5 liters of contaminated water a day."

In Sierra Leone, this too is a reality. Every day I see men, women and children walking up and down the streets with buckets of water on their heads. Some of this water comes from proper stand pipes, some comes from illegal tapping into water pipes. People literally break water lines on the street to get access to water. This is illegal of course, but when you have no other water source nearby you aren’t left with many options. Some people have to walk very far to get a bucket of water. And often the water collected is contaminated. As I am writing this, there have been reports of a Cholera outbreak (not yet laboratory confirmed) in Tonkolili district. Earlier this year we had Cholera cases in the Freetown area. Even in the clinic I am again seeing an increase in the number of diarrhea cases. Annoying of course, since this is a preventable illness. However, in itself diarrhea isn’t a huge problem, but when combined with lack of knowledge, it becomes a HUGE problem because children end up dying due to dehydration. Unfortunately, mothers here are more likely to give their toddler tetracycline capsules or some kind of injection, than to give ORS! Sad but true.

The question remains: "what can we do to make a difference?"

“Like hunger, it [the water crisis] is a silent emergency experienced by the poor and tolerated by those with the resources, the technology and the political power to end it.”

Based on: “Beyond scarcity: Power, poverty and the global water crisis”
For more information: http://hdr.undp.org/hdr2006/

The All African Amputee Football Tournament...

Wednesday after work a group of us went to the National Stadium in Freetown to watch the final match of The All African Amputee Football Tournament, which kicked of Friday the 9th. The tournament included Sierra Leone, Ghana, Angola, Liberia and Nigeria. In the end it was the Ghanaians that won the tournament.

It was awesome to watch the amputees play. Each team had 6 one-legged players and 1 one-armed goalkeeper on the field. They are all amazing to watch- such speed and determination! It fascinates me every time. They move around on their crutches to kick the ball with their single leg faster than I could with two legs. All of the players out there were winners in my eyes.

FYI: Sierra Leone’s team formed in an amputee camp in western Freetown and has already competed in competitions in the UK, Russia and Brazil. The Liberian team on the other hand only started playing three months ago. After the Sierra Leonean team competed in Russia last year they decided they should organize an event in Africa.

Most of the amputee players on the Sierra Leonean team are victims of the civil war that lasted 11 years. Limbs were mainly lost due to gunshot wounds, often received while trying to escape rebels or while caught in crossfire. Players from Liberia and Angola were also affected by the ravages of civil war. Most of the players from Ghana and Nigeria on the other hand lost limbs in accidents or due to infection.

"We're here to explain to our African brothers that after war, after conciliation, something positive is happening. We're like ambassadors of peace," said Mambu, who is star goalkeeper of the Sierra Leone side. He is missing one of his arms.

New look...

So, after about 2 years of blogging I got tired of my blog layout...so today was the day to change that. The look is very much the same, but different. It works for me anyway. Hope you continue to enjoy reading my posts and have a great week!

Weekend...

Saturday was spent at River number 2. I had a wonderful time at the beach especially since. I hadn’t been since November. It was great to get away again and relax. And the road out there (60 minute drive) was so much better than it had been- probably a 70% reduction in the amount of potholes since the rainy season ended in October. It was a day with lots of sun (and a sunburn to show for it), refreshing water, fun conversation and a beautiful setting. It was a nice break after a very tiring week!

Face to face with reality...

This morning I was once again faced with the reality of the dire health situation in this country. Just as I was heading out to go to a health task force meeting at around 930 this morning two ladies walked into the clinic. One of the ladies was holding a baby and said the child had a problem. When I looked in her arms I only saw his face. Expecting to see a child with a facial deformity like a cleft lip I was surprised to see his face looked okay. However, the child lay motionless. I quickly looked under the blanket and saw two very white little hands. There was no movement of the chest. The child wasn’t breathing. There was no heart beat. The pupils were dilated. I noticed all of this in a split second and rushed into my exam room with the child grabbing the bag and mask, realizing though that it was probably too late. It was. The story unfolded as I found out that the child was born at home at 1am this morning after a two day labor. The child had a bad start. In the early hours of the morning they took the child to a nurse who seemed to think the child would be okay. They then went to a pediatrician who for some reason didn’t see the child. Supposedly when they left there, the child took his last breath. In the hope that something could still be done they showed up on our doorstep. Too late.

Today the statistics once again became a reality to me. But for so many people in this country it is a reality day after day after day as they loose their babies, their toddlers, their teens, their brothers, their sisters, their mothers, their fathers. Sierra Leone is ranked second to last on the UN Development Index mainly due to the poor state of the medical system. Many diseases can be prevented but aren’t. Many diseases can be treated but aren’t. To me a day like this is frustrating, heart breaking, discouraging, infuriating. To those around me it is daily life.

Emergency surgery...

Last night the surgeon called us at the house saying that one of the patients (10 days post-op) was unexpectedly bleeding and needed to go to the operating room for a cystoscopy to figure out what the problem was. At first it didn’t seem like he would need my help, so I stayed at the house. But an hour later at 2230 I was called and asked to come in as well. Apparently the patient’s bladder was very distended due to a very large blood clot and the surgeon needed to do an emergency laparotomy.

Now, on a Sunday night in Africa it is tough to get your staff rounded up…cell phones aren’t switched on, transport is difficult to find etc. Fortunately we were able to call the anesthesist as well as the lab technician (who went to get units of blood). We also managed to call two OR nurses, one to circulate in the OR and one to scrub in and hand the surgeon the instruments. However, one more person would be needed to scrub in and assist. Well, that someone was me!

Fortunately the patient was stable and the blood arrived quickly. Our surgeon and I scrubbed in and started the case. I was a little nervous because it had been about 4 years since I had scrubbed in! In the end however, it was another good experience. I suctioned, sponged, held retractors, helped search for the ureters and in the end stapled the wound closed. We managed to get rid of the blood clot and irrigate the bladder much to the patient’s relief. The sweetest thing was that as soon as the case was over the patient was saying thank you to the surgeon. I was glad to see she was still doing well in the morning.

Needless to say it was yet another unexpected occurrence in Salone. Fortunately with a good ending. The only bad part was that I didn’t get home till 215am and had to be back at the clinic at 8am- for crazy Monday clinic! So, I worked from 8-6 today seeing 55 patients! I have to admit I am pretty tired now!

Chicken run...

Okay, so you’re probably wondering why I have a picture of a chicken on my blog today. Well, in the past week on three occasions we have had a chick visiting our compound. They belong to our Sierra Leonean neighbors and somehow sneak in through the gutter in the back of our compound. They then wander around aimlessly making a lot of noise. I happen to be the one to hear them every time and since I am not an expert chicken catcher I call one of our guards to catch the chick that’s on the run. By the time the guard catches the chicken our neighbor is already at our front gate asking for his missing chicken! Only in Africa do your neighbors come knocking on your gate for their missing chicks!

Someone's getting married...

And that someone is my little brother!

In the beginning of January, Stefan proposed to Genae, during their trip to Paris. I had spent the previous two weeks with them and was one of the lucky ones to know that the event was about to take place. It was great to be able to spend time with Steef and Genae- especially to get to know Genae. After all, I knew that my brother was serious about her! And what can I say??? Genae is great. A wonderful addition to the family! Needless to say I am very excited about the upcoming wedding in July. Congrats Steef and Genae!! Love you guys!