Sierra Leone on ABC News...

A couple of weeks ago, ABC featured a story concerning child health in Sierra Leone, focussing mainly on the prevention of neonatal tetanus. The clip emphasizes once again the high child mortality rate in the country and shows some of the daily occurrences including a child death and pictures of malnourished children. To see the video click on: http://abcnews.go.com/video/playerIndex?id=6817290 (you'll have to watch the ad first and then you can see the clip).

Last zip-line shots...

Some final zip-line shots. Our guide doing one of his crazy stunts. Which makes my zip-lining look a little boring. A view from the ground, looking up at the last platform. And then our zip-line team- working in the Middle East, Uganda, Cambodia, Sierra Leone. This is definitely a great team-building activity for those interested, and who happen to be near Chiang Mai!

Tree top views...

Needless to say, the views from the platforms were amazing. Surrounded by jungle. Trees immensely high. The ground far below. The sound of birds. Fascinating. Honestly, the pictures just don’t do it justice. My favorite view was from the third to last platform. A beautiful bridge linking two platforms and then a zipline from there to the last platform. The last platform was anchored to an amazing tree! From there we were lowered to the ground.

Zip-lining backwards...

There was variety in the zip-lines which made it extra fun. Some were short, others were very long. One we could do in pairs, and one especially was suitable for going backwards. I of course wanted to be daring and went backwards as well. How exciting! I didn’t even look behind me as I was approaching the platform. I just lifted my feet up when our guide yelled ‘Feet up’, as they did. And made it smoothly onto the platform. A couple of times we were lowered from one platform down to the next, which was also quite an experience!

A few of the zips required us to use a bamboo v-shaped brakes to slow our approach to the next platform and so the guide would yell out ‘Brake’ as we were approaching. Good laughs. I must say though, I was happy when we were done with the brakes as I felt I had more freedom (of releasing my grip) without the brake.

Zip-line take off...

Two guides joined us for the ‘ride’, ensuring our safety and entertaining us with their jokes; making us laugh, bouncing the zip-line up and down, but never threatening our safety. One would go ahead of us to lead the way, while the other one stayed behind to ‘send us off’ and follow behind. We were always connected to either the main zip-line or to a tree when on the platform, they made sure of this. Initially I was a little nervous and afraid, but after a few zip-lines that soon changed. Mind you, if I wouldn’t have been continuously connected I would have been very scared on the platforms. But this way, I could peak over the edge and not be shaken when looking down. Ellen (working in Uganda) and I had signed up together, so it was only appropriate that we did one of the zip-lines together. That was quite funny.

Flight of the Gibbon...

Zip-lining has got to be one of the most exciting activities I’ve done yet. Initially I wasn’t so sure if this was something I would have the guts to do, seeing as I am afraid of heights. But after persuading a friend to sign up and paying immediately as not to back out, I started telling myself that I wasn’t going to regret this decision.

Sunday afternoon rolled along and we were picked up by a van to take us on a very windy road right into the jungle. After 1 ½ hours drive we found ourselves surrounded by rainforest.

The Flight of the Gibbon is a unique way to experience the rainforest canopy; on zip lines and skybridges. From high above the forest floor you view life from a perspective once reserved only for a select group of scientists.

The rainforest is 1500 years old and situated just outside of Chiang Mai, Thailand. There are 18 platforms over a 2 kilometer stretch, which includes 2 skybridges and 3 lowering stations. It is probably the highest of its kind in the world with the highest platform said to be 120 meters from the jungle floor. The longest zip-line was 100 meters long.

In Thailand...

Yeah, I’m in Thailand! The reason for being in Chiang Mai is to attend a medical conference hosted by the American Christian Medical and Dental Association for continuing medical education. The conference is especially for doctors working on the mission field and is geared towards those working in Asia. I went to a similar conference in Kenya in 2006 focused on Africa. Since the Kenya conference was cancelled last year due to political unrest, I decided to come to Thailand this year.

So far my time here has been great. I have met some interesting people working all over Asia, some in Africa and some in the USA (lecturers). I also caught up with some people I met at the Kenya conference (fun!) and some people who have worked on the ship. The resort is amazing! It’s big – no walls, no razor wire! – lots of Thai huts and houses, pavilions, even some shrine type deals which just add to the whole cultural atmosphere. And there’s a pool and they sell amazing chocolate cake (among others) which I have yet to buy! The days are long with breakfast at 7am, worship & sermon at 735 and then full on lectures from 845 till 4pm. Then in the evening we have another meeting from 75-845pm. And in between there is lots of food. There are 3 buffet lines and places inside and outside to eat. The food is great- a large variety- especially a lot of Thai food. It’s funny that for dinner you can often have pasta, rice and potatoes! And the best is the vegetables (Broccoli! Cauliflower! Bell peppers!) and fruit (mango, pineapple, guava, banana, watermelon, papaya – which of course I get in Salone too, but it’s still excellent). I really can’t complain about the food. There really is such a huge selection each time and always fruit. Every breakfast there are eggs (fried or scrambled), bacon or ham, pancakes, french toast, yoghurt, cereal, toast, etc. I love breakfasts like that! Maybe I’ll gain back some weight I lost over the past 6 months!

The lectures are really good as well; some topics being more useful than others. So far I have been to a wide arrangement. Let me give you an idea: Adult and pediatric case presentations, Rheumatic fever and rheumatic heart disease (useful as just had child with this in clinic), Dermatology, Preterm labor, Management of anemia, Dengue fever, Basics of clinical ultrasound, Fine needle aspiration, Fever of unknown origin, Leprosy, Malaria & HIV, Spirituality & Health, Malaria in Asia (some relevance to Africa), Tropical neurology, Malnutrition. And there are many more lectures to come!

It’s time for bed as I have an early start again tomorrow. But I’ll try to post pictures soon. More lectures Friday all day and Saturday morning. Then it’s off to see an elephant show, go elephant riding, visit a snake park, enjoy a thai dinner and experience thai dancing and last of all venture out to the night market till midnight. Not sure about Sunday yet, but I am sure it will be good!

Thailand journey...

The journey was long but uneventful. I left Middelburg by train at 2pm, was checked in at the airport very quickly and then spent a couple of hours wondering around. The first flight was 10 ½ hours. Long but not too bad. I didn’t get restless thank goodness. I slept a lot actually. The last few weeks in Freetown were very tiring- with very long work days and very short nights (probably averaging 6 hours a night the last week) due to all of the packing and sorting I had to do since we are moving house. I then had a fairly long lay over in Bangkok and roamed around being amazed at how big the airport was and how modern everything looked. While sitting in the waiting area I was looking around for people that might be going to the conference, but just couldn’t tell. The second flight with Thai Airways was only 1 hour or so. And fortunately, there was a gentleman holding up a CMDA sign who helped arrange a taxi to the center. Even better was the fact that I met up with another lady who was also traveling to the conference. So we were able to share the cost of the taxi, as well as the 45 minute drive in the dark to the outskirts of the city. I was happy not to have to make that trip alone!

We arrived at 8pm. Exactly 24 hours (keeping in mind 6 hours time difference) after leaving Middelburg. So a total of 42 ½ hours of travel from Friday afternoon till Monday evening. The introduction meeting was already in progress so we just slipped in and joined them. My journey to Thailand was over and my experiences began. YAY for adding a NEW COUNTRY to my list!!!

Tea with Esmee...

Stop-over in Holland...

My trip from the clinic to Holland took about 18 ½ hours. I was scheduled to fly out of Amsterdam the following evening, which meant I had a 28 hour stop in Holland. So, after getting myself settled in the house (& starting to unpack and repack my suitcase) I decided to pay a visit to my sister and family. They had just come back from vacation so we hadn’t really communicated about my arrival time. But hey, a surprise would be fun. I hopped on a bike and cycled all of 5 minutes to my sister’s house. As I rode up, I could see my nieces playing in the living room. So cute! It was Esmee (2 years) who saw me first and wasn’t quite sure what to do. Only seconds later Zoey (4 years) looked up and saw me. She looked surprised and ran out of the room. My first thought was ‘oh no, I hope I didn’t scare her!’. I hadn’t. She had gone to tell my sister that I was outside. Zoey remembered me and thought it was fun I was there. Esmee wasn’t so sure yet. But to my surprise, it didn’t take all that long for her to warm up. About an hour later, we were sitting down to drink tea and all of a sudden Esmee gets off of her chair, runs over to me, announces that she is going to give me a cuddle and then proceeds to do so. Sweet! After that it was all fun and games. Zoey remembered that last year I let her take pictures with my camera; and was of course expecting to do so again, as was Esmee! I don’t mind; gives me a chance to take pictures of them too! Later that evening Esmee asked me to help her with everything. I had to help her get into her pajamas. And I had to come and give her one final kiss in bed. Very sweet. It was great to be able to see them, although very brief. And I look forward to more time with them in a few weeks!

Arrived...

So, two take offs and two landings since my last blog post and here I am in Holland.
An excellent water taxi service got me from Aberdeen to Lungi within an hour.
It was a fun ride, not too rough, lovely breeze and sunshine.
Yay for Pelican Water Taxi service- definitely the best way to travel.
I arrived at the airport at 3:50pm and was checked in and up in the waiting area by 4:10pm.
Hooray for the very speedy check-in, customs, immigrations, security despite a longer wait upstairs.
I tell you - speaking Krio and working with Mercy Ships got me right through; not a bag opened.
I was impressed with progress at the airport since 10 months ago.
Check in was all done electronically, the conveyer belt for luggage was working and there was no chaos.
After a flight from Freetown to Dakar to Brussels I made it back to Europe; 30 minutes ahead of schedule.
The most strenuous part of the trip was that the train ticket office was closed in Brussels.
In the end I just got on the train and purchased a ticket from the conductor.
I had to take 3 trains, and wait 45 minutes for one of them, so it took 4 hours from Brussels to Middelburg.
But I made it.
And it was snowing when I was on the train!
I surprised my nieces which was fun and by the end of the day we were buddies.
Tonight it's time to re-pack a suitcase and then get some sleep (finally!).
Then off to Thailand tomorrow.
Pray for safe travels and an insightful time in Thailand at this medical conference.

Sick sick...

Today the children were quite sick. "Sick Sick". 1 out of 3 had malaria today. And two of those had to be referred.

Christiana is 3 years old and was sick for a week before her mom brought her to the clinic. She had been giving paracetamol at home. Not only did she have a lot of malaria parasites in her blood, but she was also anemic resulting in shortness of breath. Although she took her oral malaria medication fine, I ended up sending her in for admission due to some respiratory distress. She was also underweight at 10kg.

Gifty is 10 months old and had also been sick for a week. Her mom had been giving her paracetamol and aspirin. She had a fever, diarrhea and vomiting. Her blood showed some malaria parasites in her blood as well as a milk anemia. She also was breathing very fast at 82 breaths a minute. I monitored her in the clinic for awhile, but by early afternoon she was not looking much better, so I referred her for admission.

Respiratory problems were also a bit of an issue today. There were a number of colds and coughs, a few kids with bronchiolitis and two kids with more severe respiratory problems.

Alison is 2 months old and has been sick for the past 2 weeks. Two weeks! Today he was breathing at 80 breaths per minute. He was having major coughing spells and could hardly get any normal breaths in, much less breastfeed well. His mom had gone to a pharmacy(!) and bought various syrups (antibiotics etc.), all of which did not help. I sent him to the hospital fairly urgently for admission.

Unisa who is 7 years old was also breathing fast. His aunty who normally takes care of him had gone upcountry for over a month. When she returned to Freetown, her nephew was sick. He has had a fever, cough and weight loss for over a month. One month! He had been left in the care of a 17 year old. Obviously not much had been done for him. He was very anemic as well as jaundiced, very very skinny and had various other problems. I am actually treating him as an outpatient for now but did refer him for a chest xray as well as some other blood tests. I will see him again later this week. An interesting case.

Then for some bizarre reason, I have seen 2 children with Burkitt's Lymphoma in the past week. I saw 6 year old Mohamed last week with a large tumor of his right jaw and referred him to the Children’s hospital for further treatment. He came back to see me this morning to take care of some logistical (read ‘financial’) issues. I then went out to the gate and was met by another child with a large facial mass. This was an 11 year old with a 6 month history. This child actually sought help at various places but due to financial constraints had not been able to get the correct treatment. Sad but such a reality here. The other reality is that Burkitt's remains difficult to treat in Salone- lack of medications, cost of drugs, uncertain protocols, failure of follow-up. We'll see how much I can help, and what can actually be done for these two at the local hospital.

It’s been an interesting day. Long but good. And now it’s time to get back to some packing…

Half in, half out...

It's another Monday.
A clinic day.
With many children waiting outside the gate.
It's still only me in the clinic.
So, 35 children will be allowed in.
Meaning the rest will be left outside.
Unfortunately today there were about 70 kids outside.
This meant that after letting 35 in, I was sending about the same amount away.
Not a very great start to the day.
How do you explain to the mom's and dad's that they need to go somewhere else.
Somewhere else in a place with such a poor health care system.
The decent places are either too full or too expensive.
The affordable places are often not very good- handing out meds, giving injections, etc.
My guess is, a lot of these kids will end up outside my gate again tomorrow.
Hopefully the 'sick sick' ones will have gone to a decent facility.