Wednesday, December 31, 2008

Wishing you a...

I'll be hanging out at a tree house in the chimp reserve tonight but will be back online in the new year. As we enter this New Year I am reminded of Him who gives me life. "For God so loved the world that He gave His one and only Son that whoever believes in Him shall not perish but have eternal life." John 3:16 He gave. We received. He loves. We believe. It always seems complicated but it's really that simple. In Him we can have LIFE.

Back from upline...

After a 12+ hour journey yesterday, we found ourselves back in our home in Freetown. Our trip upcountry was excellent, filled with all sorts of adventures. There were many cultural experiences. Many fun times but also sad times. More blog posts to follow in the New Year...but here is a glimpse of the diversity.

From picking potato leaves in the garden for our dinner to hearing about a very sick 13 year old.
From meeting the 13 year old and taking her urgently to a hospital across the border to walking around Koindu and seeing its ruins.
From eating dinner at the 'cookery' in the evenings (local 'restaurant' with rice and sauce) to playing with the kids outside of our guest house.
From walking to the place our neighbor fetches her water to touring diamond mines.
From bucket showers to standing in a hut praying with the family who lost their 13 year old daughter.
From star gazing in the silence of the night to driving on a bumpy road for hours.

It has been an incredible trip and I have learned a lot over the past few days. My mind has definitely been on the run with lots to think about. One of the verses that sticks out to me is: "My thoughts are nothing like your thoughts,” says the Lord. “And my ways are far beyond anything you could imagine. For just as the heavens are higher than the earth, so my ways are higher than your ways and my thoughts higher than your thoughts." Isaiah 55:8-9 (New Living Translation). So, even though I have questions, even though I faced an unexpected (or unhoped for) outcome, I need to remember He has a plan. We can't see the big picture. He can. All I need to do is trust in Him. He has never let me down. What a great thought to carry into the New Year.

Friday, December 26, 2008

East bound...

Early tomorrow morning 6 of us, plus our Sierra Leonean driver and his wife, are heading to the east of the country for a 4 day adventure trip. We have little planned but our driver is from that area so will give us the grand tour I'm sure. We're hoping for a good, safe, fun trip. I'll be back on the 30th; in time to go to the chimp reserve on the 31st for New Year's eve...

Christmas Day...

MERRY CHRISTMAS from River 2 beach!!!

We had an amazing day at the beach. I especially enjoyed the amazing views. The ocean. The lagoon. The islands. The mountains. The huts. And last of all the sunset. God's creation. Amazing.

An amazing day.
Remembering an amazing time in history.
History that can change our future.
The birth of our Lord and Savior Jesus Christ.
God, giving us His son, as a gift.
So that we may have LIFE!
And spend eternity with Him.


Eve by candlelight...

Christmas Eve.
An evening with friends.
Unfortunately without family.
We had some time to mingle.
A lovely dinner.
Turkey. Mashed potatoes. Gravy. Cranberry Sauce. Salad. Green bean dish.
The works.
And a dessert for those who still had room of fruit and jello.
There's always room for jello in my books.
Then we did our team gift exchange.
Everyone got each other little gifts, so we exchanged and opened.
Then we were joined by more expats for our Christmas video: Elf.
And there were more treats to enjoy; cookies, mince pies, mulled wine.
Following the movie we moved out into the candle lit gazebo.
Time for our Christmas Eve service.
A humurous skit with Mary, Joseph and the angel.
A time to remember that He descended deep so that we may ascend high.
He came to earth to die, so that we may have life.

At the orphanage...

This year we again decided to celebrate Christmas with the children in one of the orphanages that my friend Vez (children's physio) works at. Last year we did sports/games, this year it was time for crafts. When I heard from Vez that the kids did not have a Christmas tree I had the brilliant idea to make a big paper tree for the children, stick it on the wall and have them decorate it. On Sunday morning we loaded a box of gifts, the paper tree, soft drinks and lots of craft supplies into Vez's land rover, went to church and then continued on over the mountain to the East side of town. After a welcoming song by the kids, we sang some carols and then Vez explained/quizzed about the Christmas story and talked about how we can be close to God and can talk to Him. We then started on the big paper tree; making ornaments for it. Momoh was very excited to put the first ornament on the initially very bare Christmas tree...
The youngest in the orphanage, Binta, was thrilled to show off her very own ornament master piece! She was later the chosen one to glue the big yellow star onto the top of the tree, which also brought a big smile to her face.

We had a little trouble finding good spots for the last few ornaments, but I suppose there's always room for more. The children (and adults) loved decorating the tree with all sorts of items: twisted tissue paper glued onto the paper, feathers, stickers, glitter (known as "shine shine" in Krio), surgical peanuts (which we had to get rid of), etc. Lots of colors, lots of fun. Everyone pitched in and the orphanage now has a great tree. The younger children pose in front of their FIRST CHRISTMAS TREE.

After the BIG tree, it was time for the children to decorate their smaller personal trees. By now they knew exactly what to off they went... The 'shine shine' was a big hit this time. And by the end the floor and most of us were covered with glitter!

Last but certainly not least, we went outside for a group picture, with all the children proudly displaying their own Christmas trees. What an amazing opportunity to share Christmas with others. Not only were we able to have a lot of fun with these kids, but we were also able to remind them of God's love, His gift to us, and His desire to be a part of our lives.

Sunday School Christmas...

Like last year, we spent some time on the Sundays leading up to Christmas, rehearsing our contribution to the Christmas service. Last year we did a play of the nativity story combined with songs. This year we wanted to do it a bit differently. So instead of a play we decided to quote Bible verses mixed with carols, to tell the story of the birth of Jesus. The older kids all memorized 1-2 verses each- from Isaiah and Luke - and learned the carols. The little children, aged 2-5 years learned a song of their own, to the tune of a Krio song. After getting the 55 children seated on the benches at the front of the church, they were ready to begin. They did an excellent job once again. And even most of the little ones joined in on their own song. After the children's program the men's, women's and youth groups did their contributions- none of which were very much related to Christmas. But it was entertaining.

The song the little children sang was singing out what the angels sang in Luke:
"Hear the angels sing, Glory to our God, Peace upon the earth, Favor to all Man"
"Halelujah, Jesus Christ is born"

Saturday, December 20, 2008

Christmas prep...

Today was in the spirit of Christmas. First - off to town for some shopping. Actually, a couple of people were going to buy shoes since they were stolen this past week. I tagged along for the ride and picked up a few things for Christmas along the way. Town was busy as usual. The difference now is that besides the usual vendors all along the street; you now have people walking around with 2 or 3 Christmas trees in their hands, for sale. And there are stalls with the most interesting collection of Christmas goods on sale. Lots and lots of tinsel- multi colored and random assortments of lights etc.

When we got home I decided I better sort out my gifts for our expat team. Got that done and gifts wrapped and it looks like Christmas in my room. More so because I have wrapping paper and gift bags scattered all over the place. This is one of the things I like about Christmas- wrapping up gifts for others. Once done, it was then time for some preparation for tomorrow. Followed by a Christmas movie. And followed by wrapping gifts for my local staff, Joshua and his foster family and an amputee football player and his kids. Fun fun fun.

Tomorrow will be busy. Christmas program at church with the Sunday school kids reading out scripture and singing. Prep before hand (during sermon) will be rehearsing, making crowns, and putting on angel outfits. After church Vez and I are going to one of the orphanages she works at (where she does physio). We went there last year to celebrate Christmas with them and will do the same tomorrow. Since they don't have a tree I came up with a brilliant but some what time-consuming idea. Make a tree out of green & brown construction paper and hang it on their wall. The kids can then decorate (pre-cut) ornaments, and stick them to the tree. So, by tomorrow evening, the orphanage will have a decorated Christmas tree. We hope to go through the Christmas story with them, watch a short video and enjoy snacks.

After all of that it'll be Monday before I know it. Last clinic day of the year. Followed by a Tuesday of reviews, statistics, and outpatient clinic Christmas get-together. And then it's time for some rest...after finishing off a few work things on the 24th...

Friday, December 19, 2008

Feeding Center X-mas...

I went down to the government-run therapeutic feeding center today as I often do on Fridays. However, this time I didn't only come to check up on the patients I referred, but to share Christmas with the moms and children. This is one of my favorite parts of Christmas- spending time with those who are less fortunate and being able to make them feel special, loved and not forgotten. I have done this every year so far, so actually, it is kind of expected. A few months ago the head nurse was already asking if we were going to come with Christmas this year. Today was the day, but unfortunately the head nurse was not in.

When I entered the feeding center to check with the nurses that the timing was okay, a little girl of about 2 years ran up to me. Hawa. I met her last week. She's not one of my patients, but is obviously admitted due to malnutrition and tuberculosis. Her mom says she has been there for 1 month now. I picked up little Hawa and she let out a little squeal. Despite being sick, she was happy. And fortunate for me not at all afraid of the 'white man'. Together, we wandered back to the land cruiser to get the rest of our staff and the boxes of gifts.

Before handing out the gifts I thought it important to share the Christmas story with the ladies- not the whole Mary, Joseph, stable, manger, shepherds, wise men bit. But the fact that God sent his ONLY son to die for US so that we could be in RELATIONSHIP with Him. One of my nurses was translating my Krio into perfect Krio and ended up adding a good bit of the gospel message in there. Great chance to minister. During the translation I was playing with little Hawa as she was chatting away, messing up my hair, and tapping me constantly as if to tell me something. I could tell that many of the moms enjoyed me spending time with this little girl.

After the talk I thought it would be fun to sing. When I asked if they knew a song, they started singing a Krio Christmas song in unison followed by 'We wish you a Merry Christmas'. Little Hawa and I then displayed the various gifts we brought with the help of other staff. Little Hawa proudly showed off her little stuffed animal. Small gifts bringing lots of joy. A cute stuffed animal, baby lotion, baby shampoo, toothbrush, toothpaste. Everyone was happy. Funnily enough I think there were more kids playing with the toothbrushes than the stuffed animals! : ) Many of the moms said 'thank you' which is not all too common here. They truely were appreciative.

We had to wait for our driver to pick us up. So in the meantime I hopped from bed to bed seeing the kids, talking to the moms, trying to show them I care. One mom was there with 7 month old triplets- one being normal size, one small and one very small. There was another 9 month old that was very tiny but still managed to giggle when I tickled her. All in all it was a very succesful Christmas celebration. Short but sweet. And special to share Christ with the moms and show love to the children. I was again reminded that these children have a special place in my heart...

Monday, December 15, 2008

We've been thieved...

At 6:15 am today I was woken up by the sound of one of our guards wailing.
My first thought was that one of his family members died.
However, I soon learned that he was crying for fear of losing his job.
We had been thieved and the theft happened during his watch.

Background info:
We have two guards on duty at our compound every night.
We use an official security company for this.
To be honest- it sometimes seems like a bit of a joke.
It seems like we’re often faced with either sleeping guards or stealing guards.

The crime:
So, supposedly at 5 am this guard checked the water level of our water tanks, as usual.
Then about 30 min later his colleague came to him saying there was a problem.
All of the chairs were missing in our gazebo!
And we’re talking about 30 plastic chairs.
Unfortunately some of my colleagues had their trainers and tevas etc outside of their rooms.
Later we realized that these had also been stolen.

The crime scene:
Our own ladder was found leaning against the wall in the corner of the compound.
The glass along the top of the wall had been removed, yet the razor wire was still in place.
Strangely enough- none of us expatriate staff woke up- which means a well-planned, thorough job.
It means I was fast asleep as noise in the gazebo always wakes me- esp. on weekends when I can sleep in!
But weird that our surgeon was in the living room (with view of gazebo) around 5 am.
So, something does not quite make sense here.
What I do know is that we were left with a CHAIRLESS gazebo.

Honestly, there is no point in speculating because we will never get to the bottom of this.
Things here just tend to disappear and no one ever knows who really did it.
I guess Christmas is near; people are looking for a little extra.
Maybe it was an outside job. Maybe it was an inside job.
If people on the inside were involved, then I am again saddened that we cannot trust people working for us.

Bottom line:
Praise God no one was hurt!

Christmas in Salone...

I cannot believe it's just over a week till Christmas! However, having said that, I do realize that I have been playing Christmas music almost everyday since just after Thanksgiving. I guess part of the reason is because life is just SO busy. Work is crazy- today we again worked from 8am-7pm and still had to turn children away at the gate. My 'to do' list just keeps growing everyday and it looks like some of that may just need to wait until the Christmas break. In the midst of the craziness, last night we spent the evening decorating our team house living room, which was a lot of fun! To the rhythm of Christmas carols we assembled our Christmas tree, strung the lights and ordained it with ornaments. We filled the room with candles, strung some more lights, placed our snowman climbing up a chandelier type thing and decorated the fan with crazy ornaments which fly around as the fan spins. A bit of a bizarre combination of things really, however, it REALLY does look like Christmas.

The previous weekend I decorated my own room small small; cutting out stars from yellow construction papers and taping them to my window and wall. Many candles are now scattered throughout my room. And of course I had to blow up my inflatable Christmas tree which stands about a foot tall!!! You can't beat that.

As far as spreading the Christmas cheer goes: we had a football team at our gate today singing carols! And tomorrow night some kids from the children's home are coming to carol. I also hope to be able to reach out to others during this season too- that's my favorite part. I am hoping to bring some gifts to the malnourished kids in the feeding center this coming Friday and go to an orphanage for some Christmas fun on Sunday. I am hoping to be able to spend some time with Joshua and his foster family as well.

All in all- it's still my favorite season and I am sure it will be a great Christmas. I am just a little sad because it will be the FIRST Christmas that I am not with any of my family : ( For the past 31 years I have always spent my brother with either my entire family, just my parents, or my brother. This year, it's just me, which is a bit sad. Especially hard since my parents just left and I know my little nephew is celebrating his first Christmas and Í haven't been able to meet him yet. At least I have my Salone friends to celebrate with...

Monday, December 08, 2008

Doctor needed...

I feel like I am getting a little desperate when it gets to the point that I need to advertise on my blog for a position but here it goes. It’s worth a try. To put things simply- I need a doctor to come and help out in the clinic since no one is lined up for all of 2009. If I can’t find anyone it means running the clinic on my own again (which means turning away even more patients at the gate everyday and more stress again for me). It would also mean possible having to close the clinic when I go on holiday – I have been advised not to cancel my holiday – since it’ll have been 9 months without. ANYWAY- see if you think you know someone who meets the criteria and might be interested. Otherwise you can simply join me in PRAYER that God will send the suitable person my/our way. Thanks!

Some info: Mercy Ships is seeking a volunteer doctor to work in a land based outpatient clinic for children 12 years old and under in Freetown, Sierra Leone as of early January 2009. The outpatient clinic’s mission is to serve as a primary care facility for the children of the Aberdeen community as well as in the Greater Freetown area. The doctors and national nurses provide initial diagnosis, treatment, and immunizations, seeing an average of 55-60 patients per day. Most children are treated as outpatients. Those needing admission are referred to hospitals with in-patient care. Criteria: The ideal candidate should have a valid doctor’s license, preferably 2 years post graduate experience, is committed to serve the poor by following the example of Jesus, and could commit to serving with us for 6-12 months. Shorter posts (minimum of 2 months) are sometimes available. Experience in a cross cultural setting and in pediatric medicine would be helpful but is not required. Candidates must cover travel costs to and from Sierra Leone, room and board at the team house and have health insurance.

Trusting Him...

Where's Sandra...

Well, it's not hard to find me in a picture since I'm the only white face. I love this picture. It was taken half a year ago at Joshua's school. He's the little guy who is squased next to me! Anyway, this picture reminds me of those 'Where's Waldo (or is it Wally)?' books. I know I have not been blogging very regularly...but I am still around and as busy as ever. Fortunately today is a public holiday so a day for me to catch up on work and personal admin! I'm happy to have electricity today.

Sunday, December 07, 2008

Tribute to my mom...

Saying goodbye is the part I don't like about missions work. And when it's your parents it's even harder. Waving my mom off at the heliport Thursday night was particularly strange. My mom and I are very close and it's strange to think that she won't be in Salone anymore. I have loved being out here with her and wrote a special tribute to her. Here is part of will give you an idea of what we've experienced together and how much she'll be missed!

Dear mom,


When I was in Liverpool and you suggested me joining you I said: ‘no way’.
Fortunately I did consider the offer.
And look at where we are today; 3 years and 9 months later.
It’s been quite a journey.

We have been through so much together in Salone.
Good times, bad times, fun times, crazy times.
So many experiences together.
Making memories that will last forever.

A construction site turned into a medical facility.
Angry councilors turning into a thankful community.
400 application letters leading to recruitment of 50+ amazing staff.
0 patients to start with to over 13,000 women and children being served.

Spending hours in the dark or rain off loading containers.
Catching security guards sleeping at the team house.
Drinking liters of tea in the gazebo.
Going for runs along Lumley beach.

Water problems.
Electricity issues.
Scary roads.
And much more.

We have worn many matching outfits to Sierra Leonean weddings.
Enjoyed many trips to Lakka and River number 2.
Traveled to the Anastasis together.
First the sail from Liberia to Ghana then a last Easter onboard.

Our times with Joshua were always good fun.
Going to the beach with him, eating ice cream, visiting him for his birthday.
Him staying over at our place for Christmas and Easter.
He has won our hearts over once again and I know he will miss you!

Working together has been great.
Pharmacy orders and dispensary stocking to lab needs and procurement.

Bouncing ideas off of each other and trouble shooting.

Barging into your office to print stuff or show you one of my patients.

You have been a tremendous support to me.
Went I felt alone in the OPC and somewhat distant from the whole project, you were there for me.
You have encouraged and supported me every step of the way.
I couldn’t have come this far without you.

You and dad have made this place into what it is today.
Your dedication, hard work and perseverance have been amazing.
The people in Sierra Leone will be forever grateful.
And I feel privileged to have been a part of your work here.

I love you. I appreciate you. I will definitely miss you. And I will be thinking of and praying for you often.

With much love forever, San

Saturday, December 06, 2008

Mercy Ships and Continental...

Mercy Ships is featured on every Continental Airlines flight in November and December. We have a 2 minute video that showcases our effort and encourages all to join us in helping the forgotten poor of the world. We are also mentioned in their onboard magazine during this time. Click on the following link to watch the clip: MERCY SHIPS VIDEO CLIP (keep an eye out for me...)

Wednesday, November 19, 2008

What to do/say/think/pray...

I saw 3 year old Abdul again today.
I felt a bit rushed seeing him at the end of a long clinic day yesterday so had him come back today.
Unfortunately he has a chronic, probably lethal condition.
He was diagnosed with a type of cancer of his eye over a year ago.
It was only months ago that he came to our clinic.
We managed to help get him to an eye doctor to remove his right eye; probably too late.
Last month he started getting strange swellings on his skull.
In the past month these have increased a lot.
Unfortunately his appointment for a biopsy fell through.
I have nothing left to offer him.
No means for a diagnosis.
No means for treatment.
Even in the West this looks like it would be difficult to treat.
If this is what I think it is, the cancer has spread too much.
He has lost 2 kg, is anemic and weak.
The only good thing is that his mother is doing her best to care for him.
He is receiving the love and comfort he desperately needs.
What more can I do for him is what I wonder now?
How can I support this family in their time of need?
I know we need to trust God in this.
But it's hard to know how to pray.
Pray for healing?
For God's will to be done?
It's hard to pray these prayers when so often people are not healed.
All I can do is keep bringing this back to God.
Ultimately, He is in control.
That's all I can hang on to.

Tuesday, November 18, 2008


Clinic went well today...up until my last 3 patients.
Then things became a bit discouraging.
I felt hopeless.
3 of my patients came for follow-up and were worse.
And unfortunately their conditions are difficult if not impossible to treat here.
A 5 year old with a nasalmaxillary tumor, now with multiple large lymphnodes.
A 3 year old with previous retinoblastoma needing removal of his right eye and now has large swellings over his forehead and scalp that are likely metastases.
A 3 year old with possible tuberculosis and major complications (hemiplegia) due to a prolonged convulsion this weekend and family not taking him to the hospital due to traditional beliefs.
So many problems, so little I can do.
I can only hope and pray that somehow I find ways to help these kids.
But right now the situation seems hopeless...

Thursday, November 13, 2008

Salone's frustrations...

This week has been rather frustrating in the medical world of Sierra Leone; frustrating to the point that I have wondered if healthcare here will ever improve. But surely it has to improve. How much worse can it get? The country is already at the bottom of the list with the highest maternal and child mortality rates in the world. There are so many changes needed; big and little. Change for the good, because believe me things are changing but not necessarily in a good way. Don’t get me wrong- of course I always have positive stories too and I still love my work here BUT sometimes it’s discouraging. I wonder if the Ministry of Health needs to open their eyes to what is really going on. Maybe everyone knows what goes on and no one knows where to start. How do you start to change a system that has crumbled to pieces? Which pieces do you put together first? I don’t have answers, but let me share with you what has frustrated me this week…

An adult patient (one of our staff in her early 20’s) with a respiratory rate in the 50s and saturations less than 80% (!) needed to drive around the city to find a hospital with a bed, oxygen and x-ray facility. The MAIN TERTIARY government hospital had an ICU with Oxygen but no bed and another ICU with a bed but NO oxygen. They offered her a temporary bed while waiting for space in the ICU with oxygen, but when you can hardly breathe, that’s just not an option. She ended up in a small private hospital, with oxygen, but the cost of admission is more than a month’s salary! And she still had to go elsewhere for an x-ray

Prices for x-rays are sky rocketing; from one day to the next the price increased from Le 30,000 to Le 50,000 (Le 3,000=$1). Most people couldn’t even afford them at the initial cost due to high unemployment and an average daily wage of $3-5 per day

Patients I refer to the Children’s hospital are charged Le 30,000 for a doctor’s consultation instead of the official fee of Le 15,000

Standing at the gate at 8am having to send away 15-30 patients because the clinic is already full, not knowing if the kids will find decent healthcare elsewhere that's affordable.

Treating a child with Burkitt’s Lymphoma in a government facility is almost impossible due to lack of needed drugs for chemotherapy and high costs and unfortunately the NGO run program has to stop as of this week

One of my kids died; a 6 year old, sick at home for too long, partially treated for malaria by some nurse (given wrong dose of malaria meds), showed up in the clinic on Monday, looked terrible, referred by me to the hospital (no space in the NGO one, so went to government one) but unfortunately died only 5 hours later

One of my referred kids discharged from the hospital on Monday was sent home with drugs that should NOT be taken as an outpatient: a vial of Lasix, a vial of quinine, a vial of powder without a label, an already used 2-day old vial of chloramphenicol. The granny was told to ‘find a nurse near her house and have her give the drugs’. Praise God the child was better, and thank God the granny did not give these potentially dangerous drugs. We threw them in the trash and prescribed the 2 medications he needed in tablet form.

That was just a glimpse of the frustrations & challenges of my work here in Sierra Leone! By God’s GRACE I carry on, and thankfully there are many bright sides to life here as well.

Wednesday, November 12, 2008

Update on Deborah...

On the 19th of October I wrote about patients I referred that week to the Children’s Hospital. Fortunately most of the patients recovered. At the time however, I mentioned that I was worried about 5 month old Deborah with a chest infection that was just not improving. She had received 3 days of iv antibiotics already since being admitted on the 14th but still had a high fever and respiratory rate. She had not been seen by the doctor in two days. When I left the ward that day I asked a nurse if she could make sure a doctor saw the child. The nurse wasn’t too convincing; I could only hope.

Well, on the 31st of October on my Friday visit to Children’s hospital I was very surprised when I walked into the therapeutic feeding center to see Deborah lying on one of the beds. Her mom was quick to get up and greet me. Unfortunately, now almost 2 weeks after admission, she was still having a fever and breathing fast. But at least she had been transferred to the feeding center and was receiving nutritious food. The doctor requested a chest x-ray a few days earlier but it had not been done yet because the mother lacked the money. I gave her the necessary funds to get it done but seeing as it was Friday afternoon she would have to wait till Monday. Hang in there Deborah.

This past Friday, the 7th of October, I again went to Children’s. I met up with Deborah and her mom in the feeding center once again. The chest x-ray had been done and the diagnosis of pulmonary tuberculosis had been made. Thankfully she had been started on anti-tuberculosis treatment already and guess what? Deborah no longer had a fever when I saw her and was looking better already. Although she is still admitted, she’s on the mend. As long as mom continues giving her the treatment for the next 6 months, I think she has an excellent chance of full recovery!

July's snake...

Fortunately we don't see that many snakes here. But seeing as I recently blogged about a snake we killed not too long ago, I thought I would post a picture of the snake we killed in July. Any idea what type of snake? I really can't stand snakes. Part of the problem is not knowing if they are poisonous or not...but even besides that I just don't like them!

Tuesday, November 11, 2008

Snakeless nights...

Alright, just to add to my previous 'Snake' post...
The snake was actually found in the roof of my good friend Vez' room.
Scary thought, to have a snake living above you.
Pretty much above her bed, to say the least.
Even scarier, since 2 shed skins were also found.
I guess Vez was harboring a snake for some time.
Fortunately she never knew it was there until the day the snake was found.
She has been very clever and checked her ceiling for holes. : )
The 1 hole in the ceiling has been stuffed with a piece of paper (or was it tissue paper?).
That should do the trick!?
Let's hope for many more snakeless days and nights.
Meanwhile, we're scaring ourselves with Season 4 LOST episodes...

Sunday, November 09, 2008


This event took place in October of this year. After hearing that a snake had been spotted at the team house, some of our maintenance guys geared up and prepared themselves for the snake hunt. Long sticks, coveralls, goggles. They were ready.

After fixing the machete to the end of a long pole, making sure the camera man was ready, the kill began. I actually wasn't there but heard from a friend that the guys were pretty nervous. I don't blame them. How do you go about killing a snake? Well, a long pole with a machete at the end did seem to do the trick. And before long one of the guys moved closer to see if it was a done deal.
He then held up his prized possession, for the others to see. Seeing as I was busy saving childrens lives in the clinic, I missed all of the excitement at the team house. However, just a few hours later, one of my consultations was interrupted by one of our local staff saying, "Doctor, you need to go to the gate. There is a snake there." To which I questioned whether or not it was alive or dead, and upon hearing it was already dead, said it could wait." Of course, after finishing my consultation I made my way out to steal a glance at our kill.

To this day the question remains: what kind of snake was it? and was it poisonous?

Tuesday, November 04, 2008

US elections in SL...

Often I feel detached from the outside world. Take the US elections for example. It wasn't until I was driving home from work today that I heard a little bit about it on BBC World News. And of course my local staff was discussing their political views wrt Obama and McCain. I've missed the whole campaigning and work up towards today- maybe I should be thankful. I'm not much of a political person anyway. But still, I am intrigued. Elections are interesting. I suppose with the Sierra Leone elections last year we were more worried with respect to violence, corruption etc. Thank God all went well. I actually don't have much more to say except to post a piece that was emailed to me today - Sierra Leonean thoughts on the US elections. FYI: Bo is the second largest city in Sierra Leone, Makeni is a city about 3-4 hours drive from here. Enjoy...

"By Tia Miyaama (Political Correspondent)

It has been reported that the people of Bo Town are preparing to celebrate the victory of Barrack Obama, should the Illinois senator capture the White House on November 4th. The reason, the Paramount Chief announced, is that Barrack Obama's initials, B.O. represent their town and what they stood for. Bo (BO), the report continues, will fly the CHANGE flag all weekend and replace the green and orange flags with BLUE to represent the Blue States that voted for the African-American senator.

Meanwhile, it is reported the the people of McCaine-ni (Makeni) are planning a riot should their own candidate lose the US election."

Sunday, November 02, 2008

Lack of blogging...

Seeing as I am starting to get comments about my lack of blogging I thought I better post something. What can I say? Life has been busy. Yes, there has been plenty to blog about, but little time to do it in. Too much has been going on. No explanation needed. But rest assured there will be more blog posts to read later this week. Coming soon: snakes, carrot costumes, beach trips, patient stories and more. In the meantime, if you would like something meaningful to read, why not try Luke 15. That's what I did my Sunday School lesson on today... "The Father who Waited"...

Sunday, October 19, 2008

Meet my referrals...

Last week I ended up referring 18 children with severe pneumonia, malaria, severe anemia, sickle cell crisis, Burkitts Lymphoma, abscess, sickle cell testing, hemangioma, malnutrition. 10 of these children were sent to the government-run Children’s hospital. So, on Friday I went there with my nurses to follow-up on my patients. Unfortunately one child wasn’t there; he had either been discharged already or never went. Out of the others 1 looked much better, 1 looked worse, 2 had literally just been admitted and the others were improving. So, overall I was satisfied.

On ward one I found 9 year old Mohamed with sickle cell anemia (Hb 4.5), malaria and a high white blood count. I saw him on Thursday but unfortunately rather late in the afternoon so he didn’t arrive at the Children’s hospital until about 8pm. Fortunately though, his mother was very on top of things, and he started receiving blood before midnight. Way to go mom!

Theresa was on the same ward, only 1 year old, but with an Hb of 3.9 g/dL. I had seen her on Thursday. Seeing her a day later was like seeing a different child, she was sitting and happy, having had received her blood the previous day. Mom seemed satisfied and I was very impressed with the doctor’s notes- very neat, very thorough and good case management. Well done doctor X!

Then there was Mohamed, age 1 year 8 months, weighing 5.7 kg. He was actually referred to the therapeutic feeding center, but since they had no beds, he is temporarily on the children’s ward. Not much improvement to be expected in one day. Hopefully he will be transferred soon because right now he is not receiving the free food supply he so desperately needs.

On to ward two where I found 3 of my patients referred due to chest infections, with respiratory rates between 80-90 per minute, subcostal recessions and on/off nasal flaring. Two of the infants looked a bit better and one of the fathers wanted to take his child home, to which I responded that he needs to wait until the doctor discharges the child. The question is: will the doctor see the child that day? One of the children, 5 month old Deborah, was admitted on Tuesday and actually looked much worse. After 3 days of iv antibiotics she still had a fever and wasn’t breathing well. The doctor last saw her on Wednesday. I was worried about her and hoped a doctor would see her soon.

Up to ward three. The other wards were extremely full, but this ward only had about 10 patients admitted. I guess Friday was their day to receive admissions because the 2 patients I found there were ones I had referred only hours earlier. Fatima, 5 years, with malaria + anemia had an Hb of 5.2 on Thursday but unfortunately when I reviewed her on Friday it had dropped to 4.5 so I sent her in. As I was talking to her mom the lab people came in with her pint of blood. Fatima had big eyes as the nurses attached the blood bag to her iv line and the red blood started making its way towards her arm. I assured her this blood was going to make her strong! And I made sure to let mom know I was very impressed she made it to the hospital so quickly. On the next bed lay 2 year old Eddie, also with malaria and anemia. His Hb was just above the level for transfusion (5.1) but had dropped since I first saw him on Thursday, plus he was quite lethargic and ill looking, so he also was sent only a few hours from our clinic to the Children’s hospital. He was still waiting for his father to arrive to donate blood for him.

After the wards I made my way to the Feeding Center, where in the previous week I had referred two patients. I had seen them both the previous Friday and they were making an improvement, but unfortunately 3 year old Mamadu weighing 8 kg and on TB treatment passed away only 3 days later. Sad.

All in all it was a good day at the Children’s Hospital. I know these families have had to spend a lot of money to mend their children, but better that then to lose their child. That’s what I always have to point out to them. And I was happy that most of the children were receiving adequate care. I just hope someone went in and looked at Deborah…

Thursday, October 16, 2008


The math doesn't always add up in the outpatient clinic.
In contrast to Tuesday, this morning there was NO chaos outside the gate.
The guard started handing out tickets early this am and by 7am all 40 were handed out.
There were a bunch of patients that arrived late, but they were told to go elsewhere.

When I arrived at 745 it was quiet outside.
We went along the line exchanging the temporary tickets with our official ones.
Seeing as there was a 15 year old in the line, he didn't get a ticket, so we gave only 39 tickets.
After handing them out there were another 10 patients hanging around.

Since I planned to hand out 40 tickets I thought I would give no. 40 to the sickest kid out there.
There were two very sick and undernourished kids, so I gave out 2 more tickets.
I knew I had 8 reviews scheduled of which 7 children ended up coming.
But somehow I still ended up with 57 kids today.

39+2+7 does not equal 57.
I don't know how we got the extra kids but in the end they all really did need to be seen.
They were quite sick; I had to refer about 5 and am seeing another 8 for review tomorrow.
We finished work at 745pm but it was a very good, productive AND non-chaotic day!

Wednesday, October 15, 2008

Absolute chaos...

Tuesday morning.
We drove by the gate and saw a huge crowd of people.
It looked like we again had 100 children at the gate.
I already knew I would have to send many away.
Especially since I am alone in the clinic this week.

One of my nurses and I made our way outside the gate to hand out tickets.
Many mornings we've had large crowds and it often took time to form a line.
This morning however, it was more chaotic.
People just weren’t lining up; they were on the sidewalk, on the road, everywhere.
And they were loud.

One granny who often comes with her grandson, told me ‘boys’ are ‘selling spaces’.
They come early and tell moms that arrive that they are too late, that the clinic spots are full.
Apparently they line up rocks on the side walk saying those spots are spoken for.
They tell moms that if they still want to get a spot, they need to pay.
I couldn’t believe what I was hearing.
But by the looks of things, this explained the madness.

Finally the first ten people were lined up so I started handing out tickets.
I got to number 24 but then stopped.
On all sides I was surrounded; by men, women, children.
Yelling, screaming, pushing, shoving.
Children were knocked over, being passed along the line screaming.
Others were being squashed.

I felt like I was in a zoo.
These people were behaving like animals.
Handing out the tickets was like throwing meat to a pack of wolves.
I couldn’t believe what was happening.
I felt like I was watching a movie; such chaos.
I ducked behind the gate again for some security.

I tried to talk to the people.
But talking at the top of my lungs I knew only a few people could hear me.
I felt I was yelling at those few at the front and thought 'this isn’t working'.
I needed to pause, to think, to find a solution.
I let in the first 24 patients with tickets and then closed the gate.
As I walked to the courtyard I was overtaken with emotion.

I went back to talk to the 24 patients; to hear their story.
They acknowledged the buying/selling, although none admitted paying to get in.
I told them how sad it was to see people act this way.
That I absolutely love working here, but not when it comes to this.
Such madness, selfishness, anger, frustration.
My next thought was: what now?

Some staff said to close the clinic, but I had 24 inside and wanted to see more.
I didn’t want the children to suffer because of their parents’ madness.
We went to the gate to hand out more tickets.
A difficult task in all the craziness.
Every time the gate opened to let a patient in, the whole crowd pushed forward.
Much like a stampede, squashing little sick children.

We tried to hand out tickets fast.
Once 45 patients were inside we closed the gate.
Done for the day (with handing out tickets that is).
A few minutes to cool down, and then work would start.
Unfortunately we did turn away about 50 kids.
Some lingered at the gate till as late as 11:30, I could see them from my window.

To sum it up; it was a stressful start.
The ‘system’ we’ve used for 3 years obviously does not work anymore.
The challenge now is finding out what will work.
We have a new strategy for tomorrow; we’ll see what happens.
Unfortunately it seems like whatever system you use, people will find a way around it.
But rest assured, we will keep trying.

Sunday, October 12, 2008

Insights to Lumley destruction...

Here's an article that gives a little more information as to why the beach bars along Lumley beach were destroyed. I do agree, some of the bars were quite ugly and not frequently visited. But Ramada's and Bunkers should definitely have stayed!!! It was their rustic wood and thatch structures that DREW people there. It is sad to see a structure like Bunkers taken down just over a year after it's opening. People worked hard on that place. I guess I should not feel so bad that we don't have a beach bar to go to on a Friday evening but rather feel sorry for the 394 people mentioned that now have to find income elsewhere.
See: Beach bars demolished in tourism revamp

See previous posts: Ramadas destroyed & More on beach bar destruction

Man of the year service...

Today we decided to go to a church in Wellington that is attended by a few of our employees. Little did we know, when we planned this outing that today was also the ‘Man of the Year’ service. Once we found that out we knew we were in for a long day. We left our house at 915 assuming we would probably reach the church just after they started at around 1015. Well, much to our surprise, the land cruiser wouldn’t start, so we ended up taking my friend Vez’ car. No problem. We were a little scrunched up in her land rover but it only added to the adventure. We then picked up our 6 year old friend Joshua on the way and headed to the east of town. Traffic was worse than expected so we didn’t make it to the church until 1100, having encountered a couple of wrong turns as well. However, not to fear, of course the service hadn’t started yet!

When we drove up to the church we met many people outside the gate who, as we approached, all made way for us to enter the compound yelling ‘mercy ships’. They were quick to come to us with ribbons- colored according to the group we were supporting, at the price of Le 1000 each of course (=30 cents). We were pinned with pink ribbons, showing that we were supporting group A. The group A candidate is one of the employees out at New Steps, which is why we were in that group. We soon found out that the aim of the service was to raise money for the church. How? Well, it was a competition between the two teams. Whoever raises the most money wins and their candidate becomes man of the year. Interesting concept and an interesting service it was.

The service focused on this whole ‘Man of the Year’ competition. There was some worship to start off with, and a short sermon based on the fact that we are all winners, and that we need to remember we are raising money for the church etc. Pretty soon, the rallying began. It’s hard to describe the rallies. It really was a bit crazy but a true African experience. Group A would get a turn to raise money and then group B would get a turn. A lot of singing, people coming up for each candidate with money, a string of people going forward putting money in a basket for one group, followed by a string of people going up to give money to the other group, pinning ribbons (pink or blue) on the candidates shirts, etc. For us this meant going forward at 4 different times putting money in a basket, 3 hours of sitting in a church pew, listening to loud music, playing with the kids in the row behind us, and in the end leaving the service at 2pm, after a good 3 hours and just before they announced the final results. It was just taking a bit too long. All in all though, it was fun, and the church did raise a lot of money.

We then had to make our way back to traffic. We were delayed a bit longer when we were pulled over by the police due to an expired insurance sticker on the windshield. (oops- it was renewed last Friday, but the sticker hadn’t been stuck yet). We stopped at a small café to enjoy some lunch (at 4pm by this time) and then made our way home, dropping off a few people along the way. We made it home just before 6pm. Ready for a relaxing evening...

More on beach bar destruction...

I am still not sure what the logic was behind tearing down all of the beach bars on Lumley beach. Apparently the Ministry of Tourism thinks that they will not attract tourists. Well, our favorite place Ramada's certainly would have. It was very much African Beach Hut style with palm trees, thatched roof, etc. Now all that is left along the beach road are a few finished and many half-finished concrete buildings on the other side of the road; not quite as tropical and touristy in my opinion. But I'm not in the Ministry am I.

On Saturday while driving along the beach road we saw a lot of army trucks and soldiers. The soldiers were burning up the remains of the beach bars. As sad as it is that the bars were destroyed, I am glad to see that the remains are being taken care of so that the beach won't continue to look like it was struck by a hurricane!

Wednesday, October 08, 2008

Ramadas destroyed...

On Friday afternoons at around 530pm our expat team can frequently be found at Ramadas Beach Bar on Lumley beach- just a walk, run or drive from the clinic. That was, until this week. Because just today, almost all of the beach bars were destroyed. Apparently they were given a 30 day warning- and the reason they were destroyed had to do with the tourist board not wanting them there, and whether or not they own the land legally etc etc. Apparently it was quite chaotic on the beach this afternoon. I'm not suprised. It's hard to get to the bottom of it. But the bottom line for us is "NO MORE RAMADAS".

It's a shame really because what better way to end the week? Starting the weekend with a stroll along the beach and then ending up at Ramadas to sit, relax, enjoy a pint of coke, savour the roasted peanuts, chat with each other, watch the vendors go by, admiring the impending sunset. I guess we will find another way to welcome the weekend, but it won't be quite the same. Maybe a swim in the local pool, or a drink at one of the 2 remaining beach bars (if they stay up!) Or we may just end up taking a cooler with drinks to the old Ramadas site, and protest a bit while we're at it. I'm sure we'll find someway to finish off our Fridays well...

~ Act Justly. Love Mercy. Walk Humbly. micah 6:8 ~