Day of...

June 16^th was the Day of the African Child.
It also happened to be a Monday; a clinic day.
Well, in all honesty, it ended up being a Day of Frustration for me.
There were lots of children at the gate.
I feel horrible sending children away, but even more so on this day.
So, I thought, since it’s the Day of the African Child, we’ll let them all in.
In the end, it was way less busy than a usual Monday; ‘only’ 53 children.
BUT my lab tech was at home, sick!Oh no.
That meant doing my own lab work, which in itself, isn’t so bad.
It means using the battery operated hemocue to check hemoglobin.
Using the quick tests for malaria and using the urine strips to test urine.
The essential tests; not the most ideal (microscopy is better) but it’s still more than many clinics here can do.
And the tests only take 2-20 minutes and the blood can be taken by fingerprick.
Sounds easy.
Unfortunately, the quick tests for malaria we have do not seem to work all the time.
Many times the control line on the test does not show up, meaning the test is invalid.
This means it needs to be repeated, which means calling the child back for another prick.
If that happens once, it’s not so bad.
But when it happens over and over and over and you keep having to poke a child, it’s not good.
It’s frustrating.
So, we ended up using more tests than I hoped (we have an allotted number per year).
And calling children in multiple times to take samples.
And had a very long clinic day because of all of this.
However, we did manage in the end and the children were all seen and treated.
And as frustrating as it was, in the end, the mission was accomplished.
It was the Day of the African Child (like every day in our clinic is!)

Another day in Africa...

My plan for today was to sleep in and go to the beach.
Sounded like a great plan for a Saturday in Salone.
Well, of course, in Africa things always go differently than planned.
First of all, I was woken up by pounding on my neighbors window.
The guard was looking for my other neighbor (in charge of maintenance).
So, my one neighbor was yelling at the guard saying he had to go next door, to my other neighbor.
Next thing I hear is the doorbell ringing next door.
And my other neighbor talking to the guard.
It seemed there was a problem with our generator.
A pipe burst and gas was leaking.
I later learned that 50 gallons of fuel spilled out! Oops.
It was 6am, so much for sleeping in.
After maybe an hour of dozing I woke up again.
And decided I may as well get up and get breakfast.
While eating my breakfast I got a phone call; from work.
The ward supervisor was trying to reach our lab tech (who reports to me).
Agghhh.
I told her I would try to find him.
Fortunately I managed to get ahold of him and he was able to make it to the center.
There was a patient that needed some 'urgent' blood work done.
So if he couldn't go in, I would have gone (and done the limitted tests I can do).
Another phone call with the ward supervisor, a couple more with the lab tech and a couple of calls with the surgeon later, and I was enjoying my breakfast again.
However, before I knew it, it was almost time to get going.
So I was then rushing around trying to get my stuff together for the beach!
But in the end I got off okay and the beach was lovely.
Mind you, we did have a couple of downpours, but we were wet from the sea anyway.
It was an enjoyable day in Salone after all.
(Fortunately our gas leak also got fixed and we can use the generator again)

From garden to swimming pool...

Welcome to rainy season in Salone. Where gardens become swimming pools and roads turn into rivers. Yes, it's that time of year again. Slowly but surely we are getting more and more rain. First it starts with the rains at night. Then there are more and more downpours during the day. It's great because it is a lot cooler now. This week we've had a couple of good rain storms. One of which even managed to wash away part of the beach road with a car ending up in the ditch; kinda scary. Anyway, towards the end of clinic on Monday we had a huge downpour and we slowly watched our courtyard/garden turn into a swimming pool. It was quite a sight. Talk about a lot of water! Hopefully it washed out some of the mice that tend to hide out in the courtyard too.

Rain early in the morning usually means less patients at the clinic. Less meaning 45-50 rather than 60-65! Which to be honest, is kind of nice. Although I also realize it means that there are just as many (if not more) sick children out there, but they just aren't being brought to the clinic. That's the bad side of the rains. Even some of our follow-up cases don't show up on Wednesdays because of the rain. A few then come the next day and blame their lateness on the rain. Such is life in Sierra Leone.

Less than desired...

So, isn't it funny how people write and write and write about things they like and look forward to. Then when things don't go as planned, the subject is no longer talked about. Well, that's what it's like with things like the European Cup. After my 'Go Orange' post and writing about watching the games I realized that as soon as my team was out, I avoided the topic. Well, just so you know- I did watch the Holland-Russia game. And must say I was disappointed. Orange just didn't quite GO for it. And Russia certainly did. A deserved win. Anyway, I haven't been as fanatic a watcher since, but I did go to watch a bit of last night's game (with a very enthousiastic crowd of Spaniards) and will definitely go and watch the final on Sunday. So, even though there's no Orange to be seen anymore, the final can definitely still be enjoyed...

8 to 8...

Okay, so you may have noticed.
There has been a lack of posts.
What can I say except that life has been busy.
Yesterday for example was a long day.
I worked from 8 till 8.
Gotta love those Mondays.
Today was a little less long.
8 till 6.
But seeing as we have guests at our house I spent the evening socializing!
Rather than sitting behind the computer.
And of course it's my laundry night and doing laundry here is always quite the process.
And I had to prepare for Sunday School.

Needless to say, there will be more posts coming up soon.
Because, as usual, there is always something to blog about when you live in Africa.
Like our clinic courtyard turning into a swimming pool after a downpour of rain.
New companions on our compound: Lancelot, Percy and Lucy.
Doing clinic without electricity: a consultation with a headlight.
The visit of a child who I had sent to the feeding center last month; all fat and healthy now.
Telling a patient I met over a year that he has to travel to Liberia the next day because I managed to get him a surgery date.
Having a laugh with 10 month twin boys in the clinic.
Etc.
Enough to write about.
So, stay tuned for more.

Euro Cup, Sleep, World Cup and Lobster...

Football, sleep and lobster sum up my fantastic weekend.

It started with the European Cup Football game on Friday Evening. The Netherlands versus France. A 4 - 1 win. Meaning Holland beat both World Cup 2006 finalists in their first two Euro games. Go orange! What will happen next? Another brilliant victory against Romania, or will Romania win- kicking both France and Italy out of the tournament??!?! We're in a good position.

Saturday morning started off nice and slow. Sleeping in! Lovely.

In the afternoon we went to the National Stadium here in Freetown. Time to watch a World Cup Qualifier match. The Sierra Leone Stars versus the South Africa Bafana Bafana. The game did start of a little sloppy. And it was a little strange when the game was halted a few minutes in and for a good 4 minutes or so the players on field hung about while the referee sorted something out in the 'dugout'. (too many players on the bench?) Then the action began again. With a penalty shot 20 minutes into the game, the Star's team captain scored 1 for his team. The second half was full or more excitement as the World Cup hosting nation (SA) strived for a goal. To no avail. The Salone Stars won! An exciting match. Lots of noise; whistles, cheering, radios (many men had handheld radios, I guess to hear what the commentator was saying!) I can imagine the cheering is similar at the Euro Cup games! And of course there were lots of vendors carrying their loads on their heads, trying to sell meat pies, egg sandwiches, little plastic bags of water, meat on sticks, smoked fish, fish balls, 'raw' hot dogs. Talk about an equisite assortment of snack food! At the end of the game supporters were allowed onto the field; for a little while. Then the police 'kindly' escorted them off of the field- the police, some of which had rifles and most had shields. These football matches have been known to get out of hand in the past (with police using tear gas and all) so I guess the over-abundance of police, military police etc. was needed as a precaution. Anyway, it was an excellent way to spend a Saturday afternoon.

Today a group of us went to a place called Franco's or Florence. A restaurant with great (sea)food with view of the beach. After a lovely pasta and lobster dish, and a grilled crab, we headed out to sea. Playing in the ocean and lying on the sand soaking in the sun. Great fun!

Go Orange...

Euro 2008 here we come.
"We" being Holland that is.
All of a sudden I sense my roots again.
My Dutch roots that is.
Having grown up abroad and traveled around, I don't always feel Dutch.
But, when my country plays in international tournaments, I know where I'm from again.
Last night I went to Alex's Sports Bar close to the clinic to watch the game.
Holland versus Italy.
First of all, watching the games here makes me feel like I'm back at home, not in Africa.
Secondly, within seconds, I felt a connection with my 'home' country again!
A good feeling.
And I have to say I thoroughly enjoyed the game.
Who wouldn't if their team's beating the world champions.
Anyway, it was a spectacular game to watch.
And I'll definitely be watching more...
GO ORANGE!

Wrapped up in a blanket...

As we were driving to church through the hills,
I noticed a man walking on the side of the road.
It was a beautiful Sunday morning;
A perfect day for a walk.
Or so it seemed at least.
The man was holding something in his arms.
So, as we drove past I turned my head to take a closer look.
It was then that I realized what he was carrying.
I could be mistaken but am almost positive,
That he was holding a child wrapped up in a blanket.
A child, who was no longer alive.
This was not a leisurely walk.
It was a walk of sorrow and grief.
It made me wonder how often these walks take place here.
And also reminded me of the child we lost in the clinic two weeks ago.
When I myself was wrapping up a small child, in a blanket;
Waiting for her parents to take a look, one last time.
They too had to take away a small child, wrapped up in a blanket.
Unfortunately I think this is all too common in Sierra Leone,
A country where 1 in 4 children do not reach the age of 5.
Grief. Sorrow. Loss.
All a part of daily life.
And so I spend my day trying to offer a little hope.
Trying desperately to change reality.
Making a difference in the lives of individuals.

Something went wrong...

Unfortunately I am not sure what happened to the little boy I referred earlier this week.
The one that I had come back for review, who looked worse.
Supposedly he was seen at the referral hospital.
But sent away again.
Diagnosis: hunger???
Very unclear.
I know he was malnourished, but he was also acutely ill.
Something obviously went wrong.
At least he was asked to come back the following day.
But when I called later that afternoon, he still hadn't shown up.
What happened?
Probably the mother felt rejected and went elsewhere for help.
Or stayed at home.
To wait and see what happens.
Until it is too late perhaps.
Or maybe the child passed away that night.
I watched the movie Enchanted yesterday.
Lots of talk about happy endings, happily ever after, forever and ever.
Unfortunately many stories here do not have happy endings.
This story, for now, has no ending.

Reviews...

Another long day.
But no problem, I really don't mind the long days.
What I was hoping (praying!) for today was that all of my reviews would show up.
I had scheduled 5 children for follow-up.
1 I've been seeing for the past two weeks for wound care.
The other 4 were children I had seen for the first time yesterday.
They weren't looking great so I wanted to see them again today.
Thank God all 5 of them showed up!

A 9 year old with a post-op wound infection.
Finally, after 2 weeks the wound has closed nicely.

A 6 month old with a respiratory tract infection.
Breathing less fast, feeding well and looking a bit better.
Another intramuscular injection given and told to continue antibiotics and she should be fine.

A 3 year old treated for malaria last week but having fever again since the weekend.
He's being treated for typhoid now and looks a little better too.

A 5 month old with diarrhea and vomiting yesterday and not feeding well.
Fortunately he looks much better today, the symptoms stopped and he is feeding.

A pale and undernourished 1 year old with a bad urinary tract infection.
Unfortunately he was not doing better.
Although his mom said he was better, he looked miserable.
His white blood count shot up from 20,000 to 33,000 (= high to higher).
I was not impressed.
Unfortunately by this time it was after 6 pm.
Fortunately when I called the NGO hospital the coordinator said they had beds.
So I wrote the referral letter and chartered a taxi.
Off he went.
Now I need to continue praying that he will get better like the others!

Good day or bad...

Hmmm.
What was the day like?
Was it a good day or a bad day?
Let’s see…

Good because there was no death in the clinic, unlike last Monday
Bad because I worked from 8am till 715pm
Good that by the end of the day we were able to help 65 children
Bad that the first patient I saw really didn’t look very good
Good because fortunately there was a bed for her at the NGO referral hospital
Bad when I had 5 more kids that didn’t look so great which in the West would be admitted
Good that a number of kids didn’t look so bad
Bad that I never took my lunch break
Good that I knew dinner would be ready when I got home

Really, overall, I would say it was a long but good day. I just hope that the ones I saw today that are supposed to come back tomorrow for review start getting better quickly! Otherwise there's going to be a lot of referrals to the government hospital tomorrow! But now it's time for a raspberry hot chocolate to end the day on a good note!