Namina...

There is nothing quite like a visit from a long lost friend. For weeks I had been looking forward to seeing Namina and her mother again but not having any way to contact them, I was not sure when this reunion would take place.

You see, Namina was a patient of mine when I worked at the pediatric outpatient clinic in Aberdeen and I saw her regularly between January and June of 2009. Namina was fortunate to have survived a very lethal disease called ‘cancrum oris’ but unfortunately she was left with a large gaping hole in her face. With the help of my dedicated nursing staff, we were able to help three-year-old Namina with frequent dressing changes, nutritional support and tender care. Months of care followed and slowly the infection cleared and the wound started to heal. Throughout this time, Namina’s mother was an inspiration to me, traveling from Lungi to Freetown by ferry every Monday, so that Namina could come to the clinic 2-3 times a week for care, and then returning back to Lungi with Namina on Fridays. When I left in July 2009 it was difficult to say bye to Namina and her mom, but at least Namina was better and all she had to do was wait for her surgery.

Initially I was hoping to fly Namina and her mother to the Africa Mercy, a hospital ship run by the organization Mercy Ships, currently docked in Togo. However, a better option presented itself. In April of this year I found out that the Africa Mercy is going to conduct it’s next field service in Sierra Leone starting in February 2011. This means that Namina does not have to go anywhere. She can stay in country and have her first surgery here and although this means Namina will have to wait longer for her surgery, it is definitely an easier option from a logistical point of view.

On Friday June 25^th I was sitting in the office working behind my laptop when I heard a knock on the door. I said come in and the door opened. As I looked up to see who entered I was delighted to see Namina and her mother step into the office. Namina’s mom was very happy to see me and we quickly started chatting about Namina and how both of them were doing. I do not think Namina really remembered who I was but that is okay. I am hoping I will see more of her and be able to win her over once again. It would be great to see where they live and be able to assist them where necessary.

I am very excited that I will be in Sierra Leone when Namina goes onboard the Africa Mercy for her surgery. I am hoping I will be able to be there in the operating room with her and observe a miracle unfolding before my eyes as an amazing maxillo-facial surgeon and role model, Dr. Gary Parker, begins to reconstruct her face. I can’t wait for that day.

Emergency Room...

Yesterday I spent a little bit of time in the Emergency Room at the hospital to see how it functions and try to help out a little. I am still doing primarily management work and have to be careful when going to the wards or emergency room as I can easily get drawn into patient care, which the doctors here are hoping for! And to be honest, I also hope I will able to do more in the future. But for now, there is so much to be done behind the scenes, to make sure the clinical care continues to improve.

When I left Sierra Leone a year ago, the Emergency Room did not even exist. And although there is still much work to be done, the ER is a great improvement and a definite step forward in providing the children of Sierra Leone with quality care. Welbodi Partnership worked alongside the hospital to establish the Emergency Room, which opened in November of last year. They also trained the nurses and doctors so that appropriate emergency care could be given.

As I was in the Emergency Room I was confronted again with the burden of disease in this country and the lack of supplies and manpower to combat this problem. There were two to three children on each of the emergency cots and they are really the sickest of the sickest with most just hanging on for dear life. There is one doctor that covers the ER and ICU, meaning one doctor for about 10 patients in the ER and another 40 in ICU. You can imagine they welcome the help of volunteer doctors. Fortunately there has just been a new doctor posted to the hospital so the ER is covered by one doctor and the ICU by another. Supplies are also limited. With only two oxygen concentrators in the Emergency Room we have to connect up to 4 children to one concentrator, which then decreases the amount of oxygen each child receives. As you can imagine, this is not ideal. However, as I stated earlier, the situation is already better than it was a year ago. The Emergency Room was one big step in reaching high quality care in the hospital, many more need to follow.

As I arrived in the Emergency Room this morning, I noticed 5 little bodies wrapped up in colorful cloths on the cot by the door. Five children who did not reach the age of 5 years old. Five families who are dealing with the loss of a child. And one doctor who tried his best to save these children through the night. It was a very sad sight to see and again a reminder of the high child mortality in Sierra Leone.

Reunion at Mercy Ships...

I called Liz, a friend and former colleague, to ask if I could drop by at the Aberdeen West African Fistula Center & Outpatient Pediatric clinic late afternoon. She agreed and so at about 4pm I taxied my way down to Aberdeen, While walking to the center from the beach roundabout where I had the taxi drop me, a couple of adults stopped me and said they were glad I returned. Not knowing who they were, they quickly proceeded to explain I had treated their children in the clinic. Sweet.

When I entered the ‘Mercy Ships’ compound I saw a couple of staff signing out for the day. They were very surprised to see me and very excited. Next thing I saw was Thomas, one of the lab technicians, run out of his lab to greet me. Apparently they had just been discussing whether or not I was still in Haiti or back in Holland. They had not yet been told I was coming back to Sierra Leone. Soon more staff came out of the kitchen, the wards and the clinic. One aunty even pinched my arm to make sure I was real! It was fun to see them all; it was a joyful reunion. The only downside was everyone telling me I had gotten fat; a genuine compliment in Sierra Leone. Here’s hoping to dropping a few pounds.

Liz then showed me around the center and introduced me to new staff. I think I met 6 expat staff and there are a few who I have yet to meet. The two biggest changes for me were: the lab at a new location (the old classroom) and the brand new antenatal clinic with delivery suite (in the former hostel). I was impressed. However, it was a little surreal to walk through the midwifery unit and see a few ladies lying there with tiny babies in their cots. What a huge development. It’s great to see both prevention and cure for fistulas take place in the same compound.

It was great to be back at the AWAFC to meet up with former colleagues and see the outpatient clinic still running. I am so thankful I was able to start/manage the clinic and that it continues to run well. I’m hoping this next job ahead will be as successful.

First 24 hours...

So, here I am. Settling in. Sitting on my bed. Looking out the window with a palm tree in the forefront and the ocean in the distance. I am in a different world. Thankfully, my flight to Sierra Leone was uneventful and the plane landed on time at 6pm. I must say though, it was a bizarre feeling to fly over Sierra Leone and touch down in Lungi. I’m back.

The lines at immigrations were long and chaotic and I quickly remembered that it is who you know that is important under these circumstances. Nationals would walk up to other nationals, exchange a few words and then the national arriving would be ‘escorted’ to the front of the line only to be seen next by the immigration official. Life just isn’t always fair. After immigration came the vaccination card check, which I had never been asked for before. And then came the entry into the baggage hall, which was as hectic as I remembered it, especially since the flight was full. Seeing as I had 2 pieces of check-in I didn’t hesitate at all to let an airport employee assist me. Here I was happy to already know Krio when another man wanted to take my cart and I said in Krio that it was my cart actually. He then left to find his own!

It’s a small world after all because while waiting for my luggage I spotted a familiar face on the other side of the conveyer belt. It was Pastor Mark! A pastor who lives in Lungi and often helped us at Mercy Ships to get people sorted at that end and onto a form of transport to cross the bay to Freetown. It was great to see him and he graciously sorted my ticket for the water taxi while I continued to wait for my luggage. The luggage came and after about a 20 minute wait we were shuttled to the water taxi and another 20 minutes later we were on our way. After a bit of a rocky boat ride and about 30 minutes of the movie George in the Jungle we arrived in Freetown. Total journey time from Middelburg to Freetown (via Dakar) was 15 hours. Not too bad.

Prior to my arrival I had imagined it would be very strange to arrive in Freetown and not be met by a familiar face and head off to a familiar house. Well, actually, it wasn’t that strange at all as I was picked up by Alex and Emily (who I am taking over from) and they are lovely. We had a wonderful dinner at Alex’s (grilled fish of the day – my old time favorite – but now Le 12,000 more expensive!) and then they drove me to my new place.

The place is great, although very strange to be here alone. Fortunately a new colleague/housemate arrives this evening. I’ll have to figure out how things work transport wise, especially in the evenings, as it’s a dark road to the house, but I am sure it will be fine. I’m on the 4^th floor of the building – so great exercise with the stairs- and have a very large bedroom with a bathroom, an enormous bed, lots of closet space and decent size windows. The best is that I have a little closed in balcony with windows giving me an amazing view of Lumley beach, the Aberdeen peninsula and the Atlantic Ocean. And at the other end of the apartment there is a larger balcony with a great view of central Freetown, including the bay and even Lungi! Welbodi only recently started renting this apartment and I am the first to move in. There is very little in the way of kitchen items, cleaning supplies, and the walls are bare but I am sure we’ll be able to make it into a home soon enough. There’s no internet yet, so I’ll have to see if I can come up with a solution for that as well.

Last night I woke up multiple times, due to being in a new place, alone in the house, the noises and the heaviest rain/lightning and thunder storm I have experienced in a long time. The noises are all too familiar – people chatting, barking dogs, children singing (there must be a school nearby). Fortunately I have today to settle in to the house, unpack, acclimatize etc. Unfortunately when I got up in the morning and walked towards the kitchen/living area I stepped right into a flooded area. Leaking ceiling and balcony doors. Fortunately I met the landlady within an hour and she was very helpful to look for a solution as quickly as possible.

I was blessed to have the landlady’s nanny/domestic helper come today and help with cleaning out the fridge (that had wrotten eggs in it!) and clean up the flood in the living room. Meanwhile I cleaned my and my housemate’s rooms because the dust had already settled. The domestic helper is very nice and very hardworking, she is an older lady, who lives on the compound as well. She already told me I must stay for a year. We’ll see what happens. First things first, off to work tomorrow to meet staff at the hospital, see the office and go to a meeting at the Embassy in the afternoon.

On my way...

About to leave for the airport.

A day of travel.

Hoping for a smooth ride and good transition.

More soon from Freetown...

Logos Hope in Freetown...

I just heard that the Logos Hope ship (from OM) will be in Freetown in June. How exciting. I was in Sierra Leone the last time one of the OM ships came to the country- I think that was in 2005, shortly after I arrived. I'm hoping to be able to visit again this time and meet some of the crew. There's nothing like a connection between 'ship people'.

Mefloquine...

Yes, it's that time again. Time to start taking malaria prophylaxis and as usual, I'll take mefloquine. Nice and easy, once a week and hopefully no side effects. Fingers crossed. Exciting, right? It means that the time is drawing near. Speaking of time, seeing as I still have things to do tonight and don't want to make it too late, I better end this post. Sorry it's not so exciting, but I am sure I'll have exciting stories to tell very soon. 3 days and counting...

Nieces...

This afternoon I went to my 5-year-old niece's school to pick her up so that we could have lunch together. Usually she is picked up by her dad and they have lunch at home but she had asked if she could come and eat lunch at my place. Sure. So, we left school on our bikes and went to my house where we enjoyed lovely sandwiches. Her sandwich was a 'surprise' sandwich with different 'toppings' on each little piece of bread and a bright pink candy in the middle of her plate. She loved it. Once we finished, we went outside to enjoy the sun and within no time we were playing hide-and-seek. First we took turns hiding ourselves and looking for each other and then we ended up taking turns hiding a small ball and the other person went to look for it. Good fun. An hour later, it was time to bike back to school. I brought her to her classroom and she requested I walk her to her own little chair, which I did. Then when I said goodbye she very quietly asked if I could please stop at the window on my way out and wave to her. And that's exactly what took place next. What a lovely time we had together.

This evening I was with my nieces again. After dinner we played musical chairs and I must say musical chairs is quite interesting when you're not only playing it with your nieces but also with imaginary people. Oh the imagination of a child. We then let our creative juices flow and ended the day making chalk drawings in the backyard until it was time for bed. Once in bed, I read the girls the story 'Goodnight little bear'. Obviously it is an English book, so I figured I'd just translate it into Dutch. Well, my 3 year old niece just was not satisfied, so every page had to be read in both Dutch and English. I actually thought it was quite cute. After a goodnight hug and prayer my oldest niece was a bit sad and said 'I don't like it that you are going to Africa again because that means I won't have an aunty anymore', and the tears started coming. How sad. I quickly reassured her that I would remain her aunt forever but that we just won't see each other as often over the next months. I reminded her that we could see each other on the computer with skype (she was not impressed) and that I would be back around Sterre's birthday (October). Well, that was way too far off she said. And I suppose she is right. One thing is certain, I'll miss my nieces. 4 days and counting...

Freedom and more...

Today I enjoyed eating strawberries. I will miss strawberries. I also babysat two of my nieces this afternoon. And when I told one of them that I was eating elsewhere for dinner, she said she would miss me. Let's not even mention going to Africa. Yes, they have been told I am going back and yes, I will miss them. Another thing I thought of today that I would miss is my freedom. That might sound strange as I am traveling to Africa, as free as a bird, looking adventure in the eye, but it's true, I will miss my freedom. Biking around town, walking outside for an hour and not being hassled, going for a run in the evenings along the pastures. That's the freedom I will miss. The freedom of being out in the open doors, on my own, without having to worry about my safety or constantly being hassled. This is something I'll have to get used to again. Don't get me wrong, I'm still glad I'm going and I love life in Africa, it just takes a little getting used to. And yes, there are definitely amazingly beautiful places to go to that are safe and hassle free (for the most part). As far as the strawberries go, well, I'll just have to eat some more tomorrow and savor the moment. 5 days and counting...

International Children's Day...

Photo by Robin Utrecht.

International Children's Day. A day to focus on children. A day to put them in the spotlight. The World Conference for the Well-being of Children in Geneva, Switzerland proclaimed June 1 to be International Children's Day in 1925. The holiday is celebrated on 1 June each year and is usually marked with speeches on children's rights and well being, children TV programs, parties, various actions involving or dedicated to children, families going out etc. A good initiative, hopefully addressing ways to make life better for children. A good start, but let's hope it doesn't just stick with this one day. Here's to hoping for a better life for children all over the world. Wishing them more food, water, healthcare, education, housing, sanitation and loving families. Saying a prayer for the millions of children without many of these necessities.

Weather forecast...

While biking to town this afternoon I felt rather chilly, not freezing but definitely cold. I must say we have had some warm days here and I have even gone to the beach once but overall the weather has been too cold for May/June. Last week there were a couple of nights where it was 3 degrees Celsius. Brrrrr. However, while feeling cold today I realized I should enjoy it while I can. Pretty soon I will be wishing it was a bit cooler. To be more specific, I am sure that 6 days from now I will find it hard to believe that I was wearing a sweater/coat on the way to the airport! 30 degree weather here I come. It would be nice however if the sun came out a bit more for the rest of this week and, guess what, it looks like it might do just that.

Tomorrow's forecast:

Middelburg 18 C and sunny with some clouds.

Freetown 26 C and sunny with some clouds and some rain and some lightning.

Hmmm, maybe the weather here is not so bad after all.

6 days and counting...