Highlight of the week...

This is me and Baby Sherif. Yes, that's her name, Baby. She's 5 months old and daughter of one of the VVF (fistula) patients at the center. She is extremely cute. This picture was taken on Wednesday morning - I got to hold her during our devotions time. She's such a sweetie. Today I spent some time with her again. She smiled a lot! She's a very happy little girl. I took her around with me today while I was doing a few errands- such as handing out pay slips to my staff and printing documents. I walked around the wards with her and she made most of the ladies smile. What a delight and a definite highlight of the busy week. Of course after an hour of playing she got tired and fell asleep in my arms. Sweet!

A bit sad...

Okay, so, I have been a little down today. I think the reality of saying goodbye to friends has hit me once again. Some good friends are leaving this week, and over the next two months more will be leaving. I have gotten a little tired of saying goodbye; over and over and over again. I’m sad. I think that's the hardest about being here long term.

So, it’s only fitting to post something about the Anastasis- my long lost home. A friend posted these links – about the Anastasis in Alang. It was interesting to read the history of the ship and to see all of the pictures; so many familiar shots. But it also made me a little sad.

Click on the following links:

Anastasis in Alang Part One & Anastasis in Alang Part Two

The photographer that wrote the blog entry writes the following- “In the distant reaches of Alang, there was another group of ships, including a chemical tanker, a couple of "regular" tankers, and the most exquisite of them all, the sculpted, sleek ANASTASIS. Seeing such a beautiful creation and knowing that it will soon vanish forever stirs up a strange elixir of emotions. Here was this magnificent and proud ship completely exposed in the most natural of settings. For a ship about to be demolished, the ANASTASIS was in fine cosmetic condition. Ironically, she looked better at Alang than she did at Los Angeles two decades prior. I was so thrilled to be able to wander her decks one final time and take all the views I needed. It is such a shame that she could not be preserved but the cold reality is that ship preservation only happens once in a very, very blue moon. At least she will live on in memories and images.”

Yes, her legacy will live on…

(click here for previous blog post about Anastasis)

Sinking hovercraft...

The drive to work on Tuesday November 13th was a little unusual. Just after the roundabout we looked to the left and saw the hovercraft partially under water! A pretty unusual sight so we stopped to take some pictures.

We still don’t really know what happened.
Rumor is there were 30+ passengers onboard.
No one was injured; they made it safely to shore.
The hovercraft was on its way to Aberdeen from Lungi.
According to some, the engine caught fire.
Other stories are that the filters of three engines were blocked, causing trouble.
Supposedly they ran out of fuel and a boat came to refuel the craft.
Some say that the boat crashed into the craft, causing damage.

We’ll never know what really happened. By the afternoon the hovercraft was towed back to shore. So, hopefully it will be up and running again soon…

Happy Thanksgiving...

Good morning.
This is the 2nd time this week I find myself up & running early in the morning.
This time I woke up at 5 am, but it was my own alarm clock that woke me up.
I wanted to say bye to friends who are heading back to the Africa Mercy.
They were here for a week, helping with the technical/maintenance side of things!
They were a great help, and lots of fun to have around.
Speaking of Friends...
Yesterday was Thanksgiving and I think most of us would agree that friendships are something we can be thankful for.
We had a wonderful time last night.
Celebrating Thanksgiving with 28 people.
Representing 9 countries: America, Canada, England, Scotland, South Africa, The Netherlands, Nigeria, Sweden & New Zealand.
From Mercy Ships Sierra Leone, to 4 American guys ("the guys") planting a church here, people from the IOC in Texas, a visiting mechanic from the UK, people from the Africa Mercy, a visiting surgeon, a lady working at a local orphanage, a physio who works with us part time and her dad who is visiting.
A few people spent the day at home preparing while some of us went to the center.
Clinic was long but done just in time to get us home in time for a shower before our special dinner.
I can tell you we had the most amazing dinner.
Here in Sierra Leone we managed to put together the perfect Thanksgiving meal.
Turkey, mashed potatoes, gravy, cranberry sauce, green bean casserole, stuffing, pumpkin pie, jello, apple pie, ice cream.
What a treat!
We thoroughly enjoyed the dinner.
And afterwards had a great time of worship and sharing.
I couldn't have had a better Thanksgiving.
And I can truely say I am glad I could spend it with friends.

Security at the Teamhouse...

It's 6:10 am.
Why am I in the living room and on the computer already?
Oh yeah, a phone call at 5:15 am woke me up!!
My father called from his residence.
He was called by our security company asking if our house's security alarm had gone off.
So he wanted to check with me, at the other house.

Some background info:
We have guards on our compound provided by an official security company.
With that comes a panic alarm system.
We each have an alarm button in our room.
If something happens we push the button and an armed response team arrives.
Unfortunately the alarm sounds like a faint car alarm in the distance!

I told my father I had not heard the alarm.
But I also did not feel like going out to the guards to check, on my own, in the dark, just in case something was wrong.
I waited.
But I heard loud voices.
I decided to be brave.
After calling my father to tell him I was on the move I left my room with flashlight, cell phone & panic button in hand.

First thing I saw was red & blue lights flashing outside of the gate.
I peaked around the side of the house and saw a man with a red army cap on.
He didn't look familiar.
All of a sudden I didn't feel so brave anymore.
Change of plans.
I went around to the back of the house and went in through the back door.

That's when the alarm came on again; time to wake up one of the guys!
We opened the front door and were met by 5 men- all from the security company.
They said there is a fault in our security system and the alarm was randomly going off.
For the last hour!!!
The armed response team and everything showed up (hence the flashing lights)
Hmmm...some alarm if none of us woke up.
And too bad the guards didn't alert us!

So, all this to say, all is well at the team house and it's been an adventurous morning!
The security system will be up and running again by this evening...

Today is World Toilet Day...

Have you ever heard of World Toilet Day? Well, neither had I until a few weeks ago so I thought I’d take this opportunity to tell you about it. Seems interesting enough!

November 19th was declared 'World Toilet Day' in 2001 by 17 toilet associations (never heard of them before!) around the world. Since then, there has been an annual World Toilet Summit and many other regional conferences. This years WTD will launch the 2008 International Year of Sanitation (IYS), declared by the UN.

"WTD is a day to celebrate the humble, yet vitally important, toilet and to raise awareness of the global sanitation crisis." The theme for this year is “TOILETS FOR ALL”. Can you imagine life without a toilet? I suppose it is something I take for granted, because for 40% of the world’s population, this is reality. Here are some facts:

* 2.6 billion people do not have somewhere safe, private or hygienic to go to the toilet.
* On average, a person visits the toilet 2500 times a year, meaning you spend about 3 years of your life on the toilet.
* One gram of faeces can contain 10 million viruses, 1 million bacteria, 1000 parasite cysts and 100 parasite eggs.
* Suppression of urination due to dirty toilets can lead to urinary tract diseases. In order to avoid visting public toilets, some people refrain from drinking and suffer dehydration.
* The simple act of washing hands with soap and water after going to the toilet can reduce diarrhoeal diseases by over 40%.
* Most toilets flush in the key of E flat.
* Safe disposal of children's faeces leads to a reduction of nearly 40% in childhood diarrhoea.
* There are many people without a toilet yet so many names for them: loo, powder room, lavatory, outhouse, convenience, bathroom, gents, garderobe, necessary, women's room, restroom, potty, privy, the smallest room, cloakroom, latrine, place of easement, water closet (WC), throne room, and more...

Think about (and if you can, help) the 2.6 billion people out there, who have never used a toilet in their life!

Sources: www.wateraid.com, www.ehproject.org, BBC news, World Toilet Organisation

Another day at River no. 2 ...

Today was another great day in Sierra Leone. After church 10 of us piled into the land cruiser & headed to River no. 2 beach. The roads were pretty good (compared to weeks ago) and we got there in less than an hour. It was a very relaxing day besides the struggle against the current to get out of the river meanwhile colliding with huge under water rocks. But we survived, with a minor cut or two. The rest of the day really was perfect: snacks, sound of waves, a fold out bed, sun, music & good company. What more could I want?

Inauguration news...

"We must all be ready now to embrace change. Change in our attitude towards one another, change in our attitude to our work and responsibilities and change in our attitude towards our nation."

This one of the statements President Koroma made during his inauguration speech which was attended by over 30,000 people. He called for a radical change from the way his country and its people have been used to doing things, inspite of the tremendous strides the country has made. All of these changes, President Koroma said, should translate positively into progress and development for the country. The President stated that his government will remain committed to maintaining good relations with all international friends & organizations and that they will remain actively engaged with brothers and sisters in the West African sub-region. He also reiterated his pledge to prioritize the provision of electricity not only for the capital city, Freetown, but for all provincial headquarter towns. He also said his government will exercise zero tolerance towards corruption, after which there were loud cheers coming from the stadium. It sounds like it was a successful ceremony. Now we wait to see how the government procedes and how the people respond.

"Corruption is not only a matter for the leaders and heads of government institutions, it is equally a matter for everybody... unless we change our attitude, we shall never be able to create the prosperous country that we dream about." (President Koroma)

President's inauguration planned for tomorrow...

Driving home from work today we noticed a number of people hard at work; young men painting the street curbs. Red and White. Colors of the All Peoples Congress party. Even the palm tree was decorated with red & white paint; marked with the letters APC. Tomorrow is a big day for the people of Sierra Leone.

Sierra Leone's recently elected president, Ernest Koroma, will be formally inaugurated tomorrow. News is that 8 West African heads of state will be in attendance as Sierra Leone's former president, Ahmed Tejan Kabbah hands over the presidential staff to new president, Ernest Koroma, in a ceremony marking the democratic transfer of power. It is the first transfer of power since Sierra Leone's civil war ended in 2002. President Ernest Koroma was actually sworn into office in September but the official festivities were postponed because of the Muslim holy month of Ramadan.

More news tomorrow...

Frustrations in the outpatient clinic...

What to write?
Well, not much today.
It’s 9pm on a Monday evening.
The day was long.
Some cases were frustrating.
I am tired.

At 8am this morning there were 80 children at the gate.
Waiting.
Unfortunately we had to turn 20 of them away.
The waiting room just can’t really hold more than 60.
And it would be overwhelming for the lab.
And even with 60, the last child didn’t go home until 6pm.

What to say to the parents who are turned away?
Each one says “please see my child, he/she is sick”.
I tell them “all of them are sick, it’s not just your child”.
I tell them “I can’t treat all of the children in Freetown”.
I tell them “I am sorry” and tell them what their options are.
But what does any of this mean to the mother holding her sick child on the other side of the gate?

We do what we can; today, we did it for the 60.
By the end of the day I was somewhat frustrated.
Why do some parents here seem to know so little about so much?
They load up their kids on meds, they barely feed them, they wait too long to see a doctor.
I realize again that “lack of knowledge” and sometimes “ignorance” is the root of many problems.
If only parents knew more, surely more childhood deaths would be prevented!

To be continued...

A reminder...

One night I had a dream.

I was walking along the beach with my Lord. Many scenes from my life flashed across the sky. In each scene I noticed footprints in the sand. Sometimes there were two sets of footprints. Other times there were one set of footprints. This bothered me because I noticed that during the low periods of my life I could see only one set of footprints. So I questioned the Lord about my dilemma.

"Lord, You told me when I decided to follow You, You would walk and talk with me all the way. But I'm aware that during the most troublesome times of my life there is only one set of footprints. I just don't understand why, when I need You most, You leave me."

He replied, "My precious child, I love you and will never leave you. When you saw only one set of footprints, It was then that I carried you."

Bucket showers...

In my last post, I mentioned having to take a bucket shower.
To some this may sound strange.
But for most people in Sierra Leone, this is daily routine.

I do have a regular shower; however, it doesn’t always work.
Sometimes the water tanks that lead to my shower are empty,
So I have to go looking elsewhere for water.

No problem; a bucket shower is a great alternative.
To be honest, it’s not all that bad.
You get wet, you get clean. Whatever works right?

For the children, I’d say it’s much more fun!
It’s more of a bucket bath at times than a shower.
(I do miss baths!)

We often see little kids taking bucket showers outside of their houses.
I think they look the cutest when they’re covered with soap suds.
Doesn’t this little guy look like he’s having fun?

Not so normal Tuesday in the clinic...

Unlike most Tuesdays, today was hectic; many children at the gate and many ‘interruptions’. Here’s the run down…

0715 - Phone rings. A patient of mine that had surgery on the Africa Mercy has been discharged. The father wants to know if I need to see the child, or if they can go home to Kono. I tell him he can go home.

0750 – I arrive at the clinic.

0810 – I go to the gate to face the line of 60 children; time for triage. I see a girl who looks pale & weak; I’ll see her first. I am asked to talk to 2 other patients; they have tumors. I need to discuss the possibility of surgery on the ship.

0820 – The patients are inside. My first patient is 4 years old, febrile, pale and breathing fast. I take her to the lab to do the history & examination while the lab tech draws blood. We wait for the results.

0845 – Her Hb is 6.7 g/dL. Her blood smear is full of malaria parasites. I send her to the referral center with a letter, hoping they have bed space.

0920 – By this time I have just seen a 2 month old boy with a persistent cough & fast breathing. He is struggling; he needs oxygen. A referral letter is written, a taxi is chartered, and off he goes.

1000 – I see a couple of ‘regular’ patients.

1030 – One of my follow-ups arrives. He’s 5 months old and I’ve been treating him for 2 weeks. He was pretty sick yesterday, today he looks a little better, except for a respiration of 80 per minute! I arrange for a chest X-ray elsewhere. He’s on his way.

1100 – A nurse asks me to see a patient; a 2 year old I saw last week (malnourished, breathing fast, poor condition) that I referred to the TB doctor. He is now on anti-TB drugs and looks a little better; he has a long way to go.

1245 – I have another follow-up case. Usually follow-ups come in the afternoon but I was concerned about this one yesterday and wanted him to come earlier. I diagnosed him with malaria & anemia (Hb 5.6 g/dL =low) and started him on anti-malarials. Today he’s eating & playing. I send him to the lab again.

1250 – I have a 5 minute lunch break while waiting for this child’s results.

1255 – Oh no, his hemoglobin is falling. It’s now 5.3 with the centrifuge and 3.9 with the hemocue. Yikes! I call the referral center; no beds left. The child is stable so I send him home with clear instructions, in case he gets worse. I will see him again on Wednesday. I say a quick prayer.

1300 – I continue seeing patients. There are at least 30 still to be seen. At least there’s another doctor now.

1600 – Children that were in line at 8 am have been seen. It’s now time for the 10+ scheduled follow-up cases. Some are better; some need to go back to the lab, some need other meds.

1630 – The boy I sent for an x-ray at 1030 is back. The x-ray was fine. I’m puzzled by the case; he is again on antibiotics and will be followed-up again.

1700 – The father of the 2 month old I saw earlier today shows up at the gate because his wife & son did not return home. I call the referral center to check if the boy was admitted – he was (so was the 4 year old girl). I tell the father. He seems disappointed that we didn’t give medicine; he is concerned. I explain that the child needed oxygen and stronger medicine. In the end he seems to understand and leaves for the referral center.

1800 – We’re all waiting for the last lab results so that we can send the last few patients home; almost done.

1830 – I’m on my way home.

Of course the craziness didn’t end there. I got home to find out there was no water in my bathroom and so washed my hair under the stand pipe outside, and finished with a bucket shower. I then realized that I missed my laundry slot. Then I went to a movie night at a local restaurant, to watch a great movie that unfortunately finished before it was really over. Then when I got home I had to finish up the October statistics for the clinic. It’s been quite the day!

More of Robin Utrecht's pictures...

The pictures say enough.

Amazing pictures, amazing place, amazing work, amazing children.