Welcoming the Africa Mercy...

At 6:30 am I left my house and taxied down to the Seafarers Lodge on Lower Savage Street, just minutes from the port. I met Hannah and the rest of the advance team getting ready for the big occasion. The Africa Mercy was on its way. I felt honored to be a part of the event and be at the pre-fest activities. It was still dark when I arrived but the ship’s lights could be seen in the distance. Exciting!

As is often the case, there was a bit of a stressful moment. The line handlers at the port were on strike. Yes, that’s right. And, what’s worse, there was another ship docked in berth 6, where the Africa Mercy was due to dock. Fortunately this did not get Tracy and Jeremy down. As deck hands they knew exactly what to do and with a team of volunteers, they managed to get the one ship moved to a different berth! The port was now ready for the Africa Mercy.

In the meantime, the team, myself and a few others were waiting for the arrival of the delegation from the Ministry of Health and Sanitation. The honorable minister, Ms Zainab Bangura, the Chief Medical Officer (Dr Daoh), The Director of Hospital and Laboratories (Dr Conteh), the Principal NGO Liaison (Yayah Conteh) and a few others. The head of the advance team graciously introduced me to the delegation as well, which was an added bonus for the Welbodi Partnership. Of course, Dr Daoh, Dr Conteh and Yayah know me, from many meetings that have taken place in the Ministry over the past 9 months. It was nice to know that in a different context, they still knew who I was!

All the while, we kept a look out for the ship. By this time it was light, but also quite hazy. Soon though, the ship appeared through the fog and it was remarkable that it was the cross at the front of the ship that we saw emerging first. As the ship approached and the pilot boat went to meet the ship, we walked down to the port and met a number of people waiting on the dock. There was a Mercy Team, 30 Gateway students, friends from the Aberdeen Women’s Centre (formerly AWAFC/Mercy Ships) and others. There we all stood waiting. Meanwhile on the decks of the Africa Mercy, the crew was anxiously awaiting their arrival in Freetown. I think the ship’s arrival seemed extra special because all of a sudden it was a reality. In 2006 and 2007 the Anastasis was scheduled to come to Freetown, but unfortunately the trips were cancelled. Thankfully, the time has come for Mercy Ships to return to Salone.

As the ship approached, it became easier to spot the crew on the deck and there was a flurry of excitement as friends on the dock and friends on the ship spotted each other. There was a lot of waving and cheering as the ship came closer. Soon the ship docked and after a bit of a wait getting the gangway in place, the time came for a brief ceremony.

The ceremony began with a crewmember walking down the gangway with a Sierra Leonean flag and handing this over to a ten-year old Sierra Leonean boy. The boy was a former Mercy Ships patients having had cleft lip and palate surgery onboard in 2001 and 2002. A symbol of lives touched in the past and lives to be changed in the future. Afterwards, the Chief Executive Officer and his wife met with the Minister and brief speeches were held. The delegation then went onboard for further formalities. At this time, those of us on the dock headed home. We’re now waiting until we can actually go onboard and meet up with friends but happy for now that the Africa Mercy is here!

A big welcome to the crew onboard the Africa Mercy! Welcome to Salone. Kushe. And hope to see you soon. Actually, surprisingly I can see the ship in the distance from my balcony all the way in Wilberforce!! Especially at night when all her lights are on!

Weekend...

I had a lovely weekend however, I have to confess, I broke my own rule. I did end up doing a little bit of work on both Saturday and Sunday but it really was only small small. Other than that I did have a very relaxing weekend, except for a sleepless night last night with a ‘crazy’ man next door rambling all night throwing random things into a bonfire that cast shadows into my room, loud music playing until the early hours from a house nearby and the dogs that sounded like they had gone mad.

I had a lovely dinner at Roy’s on Lumley beach with a team from Texas on Friday evening: great company, good food and the ocean breeze. On Saturday I had a delicious breakfast at Bliss with Shona and we were able to catch up a bit on life. We then went to the UN pool for a couple of hours and enjoyed the cool water, very hot sun and some peace and quiet. That evening I went to Alex’s for dinner with the advance team- for their last meal before moving back onboard the ship. : ) Again, the food and company were great. Yeah for grilled barracuda and friends. On Sunday I woke up early to go to the port for the arrival of the Africa Mercy. Once the ceremony was finished and the officials went onboard, the rest of us headed off, seeing as we couldn’t go onboard anyway. So a few of us went out for lunch, which other than the food taking over an hour, was really nice. I spent the rest of the afternoon at home, taking a nap, doing a little work, sorting through photos and occasionally looking out from the balcony having been so surprised that I could see the ship from there.

I’m now ready for a new week: a week of various meetings, SLICH Board preparation, finance catch up, hopefully a bit of patient care and various other bits of work and hopefully a visit to the ship.

Arrival of the Africa Mercy...

A blog entry will follow tomorrow when I can use my own laptop and have internet at the office. But for now, enjoy these photos.

Yu don loss...

And, I'm back in Freetown. YAY! I arrived Wednesday evening after an uneventful flight but very stormy boat ride and reached my apartment at around 10pm thanks to ‘my’ most reliable taxi driver, Farah. I went in to work Thursday morning and I can say it is good to be back.

Multiple times today and yesterday I've been greeted with: "Yu don loss", which is one of my favorite Krio phrases literally meaning "you were lost" and translates to "I haven't seen you for some time" or "You've been away". Yes, I have been gone, but I’m back. I’ve been found again. : ) And it’s busy.

I spent yesterday catching up, briefing my colleagues on the Directors meeting in London, meeting with the other 2 partners in the hospital to make sure we collaborate (I think there are more expats in the hospital now than ever before – now with 10!), meeting with the medical superintendent, etc. Today started with a meeting with UNFPA discussing how we can work together to improve the neonatal unit (very exciting!) after which I made my way to the hospital. After giving some donors a tour of the hospital it was back to business. I met briefly with the hospital manager to discuss some proposals they are working on, checked up on a few things on the wards, talked with the medical officer overseeing the (skeleton) x-ray department, arranged meetings with the Director of Hospitals in the Ministry of Health, tried to confirm a meeting with the country’s Chief Medical Officer, took some pictures of the medical records department for a conference, answered some emails. Yeah, it’s back to business as usual.

Strangely I came back to a fairly quiet hospital. There were only 11 patients in ward 3 today and about 15 in ward 1. Usually there are 40 (sometimes 50) patients in each of those wards. The Emergency room has only had 3 patients most of the day and the Feeding Centre is pretty quiet too. On the flip side, the Intensive Care is still quite busy and the Special Care Baby Unit is packed! I think for the medical officers, the quieter days are very welcome. They have been working very hard on the wards.

Alright they have finished fumigating my office, so I am heading home now. Hope I’ll be home by half past 6!

Happy weekend.

Hello Sierra Leone...

In less than 12 hours I will be airborne (again) and on my way to Freetown, Sierra Leone via Malaga, Spain. And I can't wait. Well, I am not too excited about the actual trip, but I'll be glad to be back in Salone. Back in my own place and ready to get back to work. I'm going to count on one of my two trusted drivers to be able to pick me up and drive me home, that is, once I take the water taxi from Lungi to the other side.

Have I really only been gone for 12 days? It seems like weeks have gone by. It's been good to get a bit of distance but I really am ready to be home again. I'm looking forward to seeing friends again, going to the hospital, being at the women's group, enjoying the sun (although I might change my mind when I'm all sweaty), etc. I'm not looking as forward to the dust - and the forever dirty feet and the lack of a washing machine and internet. But for the most part, I'll be happy.

I guess my only concern is that I already know I am going to hit the ground running. There are meetings that need to take place with the Ministry and UNFPA, more oxygen concentrators arriving, work to be done on the lab project, medical records/database issues to sort out, liaising with other NGOs in the hospital, preparing for the next SLICH (Sierra Leone Institute of Child Health) Board meeting, and the list goes on. I told you I was concerned. Besides this, there's a big white ship arriving next weekend and along with that comes a list of people coming to Sierra Leone to connect with the ship that I would like to see while they're visiting. My social life is going to be a bit busy. But fun. Anyway, work wise my plan is to continue making 'to do' lists but to prioritize them properly. And focus first on those things that need to be done urgently and basically make sure those get done. If I can at least get the top 4 things crossed off of my list everyday I think I'll be okay. Maybe my goal should be to make sure I have one day (Sat or Sun) that I do absolutely no work, at all. Yeah, we'll see.

Alright, I am going to get some sleep before the day really begins. And, I hope you've enjoyed the regular blogging- I'm not sure if I can keep it up when in Freetown, unless I get internet at home sorted! I'll do my best...

Bye bye Dutch goodies...

Family and friends were by far the best in Holland but I have to say that there were other pleasantries as well. Guess I'll be saying bye to a very sweet Dutch breakfast, 'western' pears and dairy products for a while. To be honest, there isn't much food-wise that I miss when I'm in Sierra Leone. I forget that half of it exists. Having said that, I am bringing back some chocolate, chocolate covered cookies, chocolate chip cookies, stroopwafels, cheese, pack of tortillas. That's about it. Those will last me for about 2 weeks. : ) And then it's back to groundnuts as a snack. A go manage...

Capacity building...

While I have a fast Internet connection here at Heathrow airport I thought I would post a Mercy Ships video (see end of post). I can’t believe that the Africa Mercy will arrive in Sierra Leone in less than a week. And, to think that she will be docked within a 10-minute walk from where I work. I have to say I am looking forward to catching up with people onboard and meeting new faces. I also hope to experience some of screening and maybe watch an operation of one of my former patients with cancrum oris. However, I have to admit that it will also be very strange to have an additional 400 expats in Freetown. That will be a bit of a shock I think. : )

I like Mercy Ships new strategy of capacity building. It is along the same lines as what Welbodi Partnership does at the Children’s Hospital: training, equipping, facilitating and mentoring. All with the aim to empower nationals and enable them to do their jobs well. What we actually want to do is build capacity in the hospital so that they can then be involved with building capacity in the provinces! We realize this takes a lot of time and that’s why we’re in it for the long haul. We’re talking 10 or 15 years. Capacity building is not easy. Especially in a country like Sierra Leone, which is dependent on aid and foreigners coming in and ‘doing things’, it is very challenging. You need to break through the mindset that Sierra Leoneans can’t do it on their own and help them see that they can change things. You have to instill in them the will to make a difference. And then, with time and a lot of patience, things will start to change. From my experience, I find that motivation is one of the key aspects. If you can get nationals motivated, you can get them to become actively involved in making changes. But if they lack motivation, it is very difficult to move forward.

Thankfully, with capacity building, you don’t do it on your own. The most important aspect is that nationals are involved from the onset. For Welbodi, this means the Ministry of Health and Sanitation, the Hospital management and the hospital staff have all been key players since the start. We do not make decisions on our own; they are joint decisions. Ideally, it’s hospital management that takes the lead and shows us where our help is most needed. Obviously, this is still a learning process (for all of us!) and at times much guidance from us is needed. This is something we are still working on; putting systems in place so that management is more effective and so that they can also identify those areas in which we (and other partners) can best help the hospital. (Hopefully that made sense.)

Since Welbodi Partnership started at the hospital in 2007 we have definitely seen changes. Of course we still have a long way to go but that’s the nature of working in Sierra Leone and it’s the nature of capacity building: it’s slow but eventually you make progress. And remember, capacity building never ends because there is always room for improvement. When you make progress in one area, you move on to the next and at all times, in all areas, as things improve, standards are raised, and the work continues. Here’s to working towards lasting (and ongoing) change!

What are your thoughts on capacity building? Feel free to comment...

The wrong mountain...

I’ve been in Sierra Leone for over 5 years and have never made it to the top of Sugar Loaf Mountain. Crazy, I know. I can say I tried though because we did make a serious attempt last December but unfortunately failed. Yes, I know, it’s not even a tough mountain to climb, but we really didn’t make it and I can assure you it’s tougher when you’re going up the wrong mountain.

That’s right, up the wrong mountain. You see, a friend of mine organized the trip (which I am happy about! Thanks S!) and in the end there were probably about twenty of us that headed out together. I suppose with so many people something was bound to go wrong. There were a couple of men at the front of the group, with maps. That might have been part of what made the hike complex: men with maps. We had only just started on the trail when people started to question where we should turn off of the path at the foot of the mountain to head up the mountain. Supposedly there were markings on the rocks and trees and about 10 minutes down the path, the men at the front thought they saw markings and decided to head up the mountain. The rest of us followed. Mind you, there was a lot of serious questioning, doubting and second-guessing because the path was not much of a path and the markings were not very clear. There were two Sierra Leonean guys at the back (neither of which had climbed Sugar Loaf before) who said they thought the turn-off was a bit further along but by this time half of the group was already scrambling over rocks and fighting their way through the bush. It was too late to turn back. So we continued.

After an hour we reached the top – sorry, not 'the' top but 'a' top. Knowing Sugar Loaf would have taken longer to climb we realized that we were not actually on Sugar Loaf. So, even though we could see that Sugar Loaf was the adjacent mountain we were clueless as to how to get there (at least most of us were). What followed next was very interesting. Group dynamics are amazing, especially when you have 20 or so people on the wrong mountain! We ended up walking along more paths, then backtracking, and trying new paths, sitting on tree stumps deciding what to do next, discussing in small groups, etc. I was happily in the group that decided to sit, relax, have a snack and follow the leaders. After some time we decided that we had hiked long enough (2 ½ hours at this point) and we would head back down the mountain and call it a day. After all, we had an enjoyable the hike, some good laughs, were surrounded by good company, but just went up the wrong mountain. So down we went.

Of course, on our way down, we ran into the right path with obvious markings on the trees. By this time we had hiked for 3 hours and knew it would be another hour up and then hiking back down again. So, feeling happy with our accomplishment for the day, most of us decided to continue down the wrong mountain to the cars while a few people continued to the top of Sugar Loaf. We made it back to the cars without any injuries and with smiles on our faces. And to top it off we drove up to Leceister Peak and enjoyed the view followed by a delicious lunch at Mamba Point. To be honest, I thought the hike was great. It was definitely an adventure and now I get to look forward to climbing Sugar Loaf again. Hopefully I’ll make it to the top of the right mountain next time.

Arrival, Assembly, Testing and Distribution...

"Oxygen for Christmas" = a success...

The ferry ride...

"Oxygen for Christmas" = a success...

"Oxygen for Christmas" = a success...

Over the Christmas holiday $11,760 was raised for oxygen concentrators for the Children’s Hospital in Sierra Leone. This is enough for at least 8 new concentrators! I was amazed to raise $5,000 last year for charity: water, this year I’m blown away! Friends, family, churches and strangers have all given generously to this cause. THANK YOU!

With only 6 oxygen concentrators at the Children’s Hospital, children had very limited access to oxygen. Often one machine was shared between 4 children! (see above picture) Obviously this is not sufficient and I can guarantee you that lack of oxygen attributed to child mortality in some cases. With the money donated to the Welbodi Partnership, through my church, my justgiving campaign and other donations in the UK, we were able to buy 11 oxygen concentrators. Seven of them arrived at the hospital a week and a half ago, the other four are due to arrive in the next two weeks.

The concentrators were sent by DHL to the Lungi airport, which meant that after attempting to get duty free concession from the Ministry (but failing) I headed to the airport with one of the Ministry’s procurement officers. I left home at 6am to be at the hospital by 645am, ready to leave by 7 am to catch the 8 am ferry across. All went well and even the paperwork seemed to be moving along until I was told there was a small problem. Because the shipment had been sitting at the airport for more than a week (because we were waiting for the paperwork at the Ministry!) we were told we had to pay Le 9,000,000!!! That’s almost $2,000. There was no way I was going to pay that. After explaining that the concentrators were for the government-run Children’s Hospital, saying someone should have mentioned that there was a storage fee if a shipment was stored for more than a week, some pleading and a text message to some good friends to ask them to pray, we finally got an okay and the paperwork was (slowly) signed off and the concentrators were released. Time was ticking away and we literally pulled up to the 11 am ferry just before it was set to leave the terminal. It’s always an adventure. We made it back to the hospital around 1 pm and offloaded the concentrators. The next morning Fred (my colleague) and I assembled the concentrators, tested them, marked them and delivered them to the wards. It seriously felt like Christmas. I was so happy. And so was the staff. And before we knew it, the machines were switched on, blowing out oxygen and children were benefiting!

Thank you so much to all who donated. A special thanks to: Kristin Harvey, Rene and Marianne Lako, Verity & Rob Boord, Jennifer Vardy, Alyson Denson and family, Niroshan Nadarajah, Jonathan and Joanna Payne, Emily Spry, Alex Paul, Anne Nesbitt, Maggie Ruth and Baby Jo, Jacco and Marit Groot, Susan Wagler, John Dawson (&Lambton Centre summer camping congregation), Lisa Gibson, Morgen Wilbourne, Sjoerd & Carmen Smits, Middle/High School students at Heritage Baptist Church in Texarkana, Doug Hunter, Gemeente de Wijngaard in Middelburg.

Donations can still be made to my justgiving page and will go directly to Welbodi Partnership to be used in some way to continue improving paediatric care at the hospital in Freetown. (It will not go towards more concentrators, as we now have a sufficient amount!)

http://www.justgiving.com/sandralako

Banana island...

I spent 3 days on Banana Island between Christmas and New Years with some friends. What a great place. Butterflies, Birds, Bats, Flowers, Monkeys, Trees, Fish, Fruit, Bungalows, Hammocks, Beaches, Rocks. There's so much to explore. The words that come to mind are: beauty, adventure, rest, relaxation, fun.The island is a great place for a break - a getaway from the city. It's a great place to explore. We managed to find some monkeys in the forest and track them a bit to find some more monkeys. I think we were lucky because the next day we couldn't find them again. We also did some makeshift snorkeling - also lots of fun.

The bungalows are quaint. Comfortable enough but a bit noisy at night with rats running around in the roof. I think next time I'll take a tent. Of course, the hammock made for a lovely spot to rest a bit. You can't compete with a hammock.

On our way to the island we stopped and bought some fish from a local fisherman. Yes, this is him, on his little boat. The food on the island was great and I would highly recommend the baked fish wrapped in banana leaves. Delicious. But, like in most places, order well ahead of time...or you might find yourself getting very hungry.

All in all, Banana island is an amazing and unique place to go. You can enjoy the beach (although a bit too many rocks for me), hike in the forest, rest in the hammock, sit around the table and chat, walk around the village. It's definitely worth a trip and I'm sure I'll be back.

Walking in silence...

I've spent quite some time walking this past week. I love it. I love being able to walk around, on my own, without people hissing at me or calling 'white man'. I love being able to walk alone when it's dark outside. I love not being asked for my phone number, at all. I love walking around without inhaling a cloud of harmattan dust. I love walking down the street without having to keep clear of stray dogs. I love walking along without cars/taxis honking their horns every thirty seconds. I love being able to cross the street without fearing for my life. I love walking on sidewalks and not worrying much about getting hit. I love walking on green grass. I love walking past ponds and streams. I love walking without sweating.

Honestly, for the last few days I have loved walking in silence. Walking without anyone talking to me. Don't get me wrong, it's not that I don't like people talking to me, it's just that in Sierra Leone it is pretty full on. In Holland you get the occasional 'How are you?' but in Sierra Leone almost everyone talks to you, or at you and will say any or all of the following phrases:

'How are you?'

'Give me money.'

'I want you to be my friend?'

'Do you have a man?'

'I love you.'

'Where do you live?'

'Can I walk with you?'

'Do you have a phone number?'

'Give me your number.'

'I want to get to know you.'

And the list goes on.

The week before my holiday I was getting very annoyed with every other person who was calling out to me, to the point that I decided to ignore everyone on my street one day, which of course, did not make me any happier. Don't get me wrong, it's great that people are friendly, but really, all of the comments get a little old. And surely, with so many expats in Freetown, you would think people would stop with the 'white man' jargon. Apparently not. Sometimes I wish I would blend in but somehow I don't think that will happen. And honestly, it's a scary thought knowing that I'll always be a foreigner in a place that feels like home.

I guess the tough part is finding a balance in my reactions. The hardest is to choose to engage in a conversation with a guy and attempt to be friendly yet at the same time hope he doesn't get any ideas. Really, I'm being polite, not trying to show interest! I suppose for now I will enjoy my walks in silence while I can and when I return to Freetown I will brace myself for 'street talk'. I will enjoy it when the children call out and chat and try not to get too frustrated when yet another guy asks for my phone number. And maybe I just need to tell everyone on my street my name. I feel it'd be nicer to hear them calling out 'Sandra' or 'Saffiatu' rather than 'white man' or 'white woman' or 'white girl'. We'll see.

Oops, I forgot a few things...

In my previous post, Things I like about NL..., I forgot a few important things. So here's an addition to the list:

1. Electricity. Continuous electricity without the noise of a generator. And the possibility of charging my phone or laptop at any time of the day.

2. Brown bread.

3. Stroopwafels. Again, something I don't miss much when away, but now that I've had a stroopwafel this evening, I am reminded of its deliciousness. Must bring some back to Salone.

4. Different vegetables. I enjoyed broccoli & cauliflower last night. Nice change to onions, eggplant, more onions and more eggplant.

Things I like about NL...

Yes, I am in Middelburg again for about a week. Although I have to honestly say that I do miss Sierra Leone. I suppose after 5+ years it really has become home. I miss my flat, the work, my friends, my colleagues, the sun, the liveliness, etc. However, having said that, it’s good to have a break, I’m just happy it’s not a very long one.

So, what do I like about being back? The obvious answer is seeing my sister, brother-in-law and my adorable nieces. One of my nieces has been sick, which is not fun for her, but it’s meant I’ve seen a lot more of her over the past few days! The three of them are a fun bunch and it’s always great to spend time with them. I’ll miss them when I go back for sure.

There are of course more things I like about being back:
1. Seeing friends. (although there are many people I won’t see since I’m only here for a week – sorry!)
2. Riding a bike. I rode a bike yesterday with one of my nieces on the back. Dropped her off at school, and then went to town to do some shopping before picking my niece up again. The freedom of bike riding.
3. Normal traffic. Traffic lights. Stop signs (that people abide by). Bike paths. Crosswalks.
4. Walking. I love the fact that I can go for a walk on my own and not be ‘bothered’ by anyone. No one hissing at me. No one yelling ‘white man, white man’. No one saying ‘will you be my friend’. No one asking for my phone number. Nothing. Just me. Walking.
5. Sidewalks. Which also make the walks much nicer.
6. Food. I actually don’t feel like I miss much, food-wise, when in Sierra Leone, except for more of a variety of food. It’s not until I get back to Holland that I realize there are foods I really like and don’t have in SL – tortillas, cheese, yoghurt, chocolate chip cookies, kiwis, grapes.
7. Milk. Fresh. Cold. Milk.
8. Shopping. Buying basic things like shampoo, contact lenses, etc and of course looking for the odd summery item of clothing in a shop (in winter time!).
9. Internet. Fast internet. People here might complain that it’s slow, but they don’t know slow. This is great.
10. Skype. Thanks to fast internet, I can actually skype with friends/family. YAY.
11. Water. Running freely. Cold. Hot. Lots of it.
12. Shower with great pressure. Enough said.
13. Quiet nights. I’m so thankful not to have to listen to loud music at 3 am in the morning. Although I have to say I do miss hearing Emerson and some of the Nigerian tunes during the day.
14. Well-kept dogs. Again, so nice not to have to hear dogs at midnight. And not to have to worry about getting rabies when walking past them.
15. There’s more I’m sure but this list will have to do for now.

Join our team...

The Welbodi Partnership is currently looking for 2 people to join their team at the Ola During Children's Hospital in Freetown, Sierra Leone as early as July 2011. If you are a doctor, nurse or healthcare manager and interested in volunteering with Welbodi for a year to help improve paediatric care in Sierra Leone, please apply! Not only will you be able to experience healthcare in a developing world, you will also be amazed by the beauty of Sierra Leone - both its people and its beaches are amazing.

Come for a year and make a difference at the Children's Hospital.

For more information go to the following pages:

Information for Healthcare managers

Information for Healthcare professionals (doctors and nurses)

London...

Wow. The last week has been crazy. On Wednesday I had a really long day with a trip to Lungi airport which I'll write more about soon. Then on Friday I ended up having to go in to work from 8-12 to get last minute things done (like sort out documentation for a shipment of lab equipment coming to the hospital!). I left at noon and ended up in a traffic jam on Fourah Bay road, which is not so nice when you still have to go home and pack. However, I knew I didn't have to leave the house until 4pm and that if traffic was really not moving, I could even walk home in 1 1/2 hours! I made it home by 1:30pm and started packing and cleaning. I decided to take a small roll-on suitcase since I couldn't even think of what to take with me other than 2 pairs of jeans, two sweaters, some shirts, toiletries and a few other bits and pieces. I'm planning to take more on the way back!

At 350pm Farah, my reliable taxi driver, showed up. We then picked up Shona's parents who had been visiting for 2 weeks and were on the same flight out as me, and headed to the water taxi. We were there by half 4 and it wasn't due to leave until 6pm. Finally we were on the water taxi and crossed over to Lungi. Before getting in the minivan we were all shocked when 6 men were carrying a women over to the boat. Apparently she had been sick for 4 days and her husband was trying to get her on a flight out but the airline wouldn't except her in such a bad condition. She was unconscious and I certainly hope she made it to a decent hospital in Freetown (of which there aren't many!).

I met up with my colleague/boss Tom at the Lungi side which was great, especially since he got me through the check-in line more quickly (with a silver card) and we later went into the business lounge, which isn't super but it has AC which was well worth it. The flight was supposed to leave at 945 but was postponed to 1145, meaning we had a really long wait in the airport. However, the plane was not going to stop for fuel in Malaga, so I guess that was a bonus.

I was so tired after a week with little sleep that I slept most of the flight. I didn't even notice the stewardesses come by with dinner or breakfast and I even missed some hype around a medical emergency which ended up not being a real emergency after all. Like I said, I was tired. Plus they did not call for a doctor, the stewardesses apparently followed a check-list. Anyway, I stayed put the entire flight!

We arrived in London at around 630 am and went to Costa for proper tea and a blueberry muffin. Delicious. We then took a cab to a friend's house - way too expensive - and thinking about the cost in Leones was shocking! After a shower and lovely chat we headed off to central london on the underground and then walked through town (past H&M!!!) to the Royal Society of Medicine on Oxford Street, where I am sitting now. It's a lovely place and quite a change to Freetown. Constant electricity, endless flow of water from the taps, the most amazing lunch with chocolates, raspberries, grapes, bread with cheese, quiche, etc. What a treat! Fortunately it's not so cold today!

We started our Directors meetings at 11 am and continued to 6 pm. It's been good and very productive but I am quite tired now. I'm done for the day, while the 5 directors meet for an hour or so without me. Tomorrow we'll have another day of meetings and then I'll head off to Holland on Monday. I can't wait to see family and friends.

PS: I am amazed at how fast internet is here!!!

Life-saving blood...

While driving past an NGO hospital last week a friend read out a sign painted on the hospital wall stating that patients need to come with their own blood donors. He thought that was very odd but having been here for years it didn’t seem strange to me. I suppose in the developed world, one would not see such a sign.

Every day children come to the hospital with severe anemia, mostly due to malaria. So, not only do they need to receive anti-malarial medication, they often need blood transfusions as well. Unfortunately it can take up to hours if not days for some of the children to receive blood.
The reason for this is that the blood bank runs on a donor replacement system.

Basically, a family member needs to donate a unit of blood to the blood bank in exchange for a unit of screened blood that is stored in the fridge, which will go directly to the patient. Meanwhile the blood donated by the family member will be screened and if uninfected, it is stored in the fridge and used for a patient needing blood at a later time. It sounds simple but unfortunately in practice, the system does not always work. The main problem is that there is often no family member willing to donate; either no one but the mother is around or relatives do not want to donate. And for some reason the blood bank often refuses to take blood from the mothers.

I do not know why, but in general Sierra Leoneans do not like to donate blood. They either assume that by donating they will get infected with something, or are worried about the HIV screen or various other things. This is a problem because it means a child will not receive blood from the bank because the unit taken out is not going to be replaced. And, in all fairness to the blood bank, if this happens too often the blood bank will be depleted.

I have seen in the Emergency Room and ICU countless children in urgent need of blood. Children literally come in with a hemoglobin as low as 1 or 2 g/dL. Some of these children will die if they don’t receive blood within the first hour. It is for these cases that I will take the child’s blood sample and blood request form to the blood bank and ask for a unit from the screened stock, explaining how critically ill the child is. I do end up getting the blood but not without hesitation. And in all fairness, I totally understand the concern because the more we make exceptions, the more relatives will refrain from donating, assuming we will arrange for them to get blood without having to replace it. This is obviously not sustainable.

In December I was asking for blood so often that I decided it was time to replace some of the blood myself. It was time to donate. So, together with Shona (VSO doctor) we headed to the blood bank on a Friday afternoon after lunch thinking we would be in and out in no time. I should have known better. Although it took a while, I have to say we had an interesting experience.

We wanted the technician to go through the usual procedure to make sure we were fit to donate so he proceeded to check our hemoglobin with the Hemocue. Unfortunately it was not working. He pulled out a color card, which literally was a piece of paper with various shades of red painted on it. I questioned this method and suggested he use the centrifuge for a spun hematocrit. We were rather unfortunate once again as the blood spilled out of the capillary tubes while spinning in the centrifuge. What are the odds? Since I had recently had my blood checked at home, I knew my hemoglobin was okay and we decided to go ahead with the donation.

After the blood grouping, we reclined on the two makeshift beds and got as comfortable as we could knowing a large bore needle was about to be put into our veins. We were more at ease when the technician started playing Christmas tunes from his cell phone. He inserted the needle with ease and it was amazing to see my blood flowing into a blood bag, knowing that it could potentially save a child’s life. It felt incredible to be able to help in such a tangible way and be a part of a child’s healing process. It also made me feel good to know I was giving a unit to the blood bank rather than just taking.

I later learned that my blood had been given to two different children and although I don’t know who they are or what the outcomes were, I know that I helped those children. I will definitely donate as often as I can at Children’s and I definitely recommend that people come to the hospital to donate blood. It is a very worthy cause. Seriously, if you come and donate let me know and I’ll buy you a coke while you recover. And, if you’re not in Sierra Leone, donate at your local blood bank. A unit of blood can impact someone’s life. It can mean the difference between life and death.

First posted @ http://blogs.bmj.com/bmj/2011/02/11/sandra-lako-life-saving-blood/

Discoveries...

I kind of surprise myself when I tell people I’ve been in Sierra Leone for 5 years. Has it really been that long? Yes, it has - I arrived almost 6 years ago and took an 11-month break. In many ways this feels like home, but in some ways it does not because no matter how long I am here, I am still a “white man” and don’t blend in with the crowd. People still ask for my number all the time, ask to be my friend, beg for money, etc. And sometimes I wish it would stop. Honestly, there have been expats here for years now, you think Sierra Leoneans would be used to it by now and not have to call out “white man” or “white women” or “hey you” or “baby” all the time. But they do. And I should just get used to it staying like that. (sigh)

So, although I’ve been here for a while, I still discover things all the time. Here are some of the most recent:

There’s a little shop at the petrol station just down the road, which I’ve gone to in the past to buy cornflakes or oats when I run out and can’t get to the supermarket. Just last week I discovered that they sell both fruit juices and chocolate bars. Yum. And the chocolate bars are cheaper than at the supermarkets. As you can imagine, my chocolate intake has increased over the past week and I love it.

I’ve also discovered the weirdness of cravings and about three new popcorn stands. Last week after work we drove past a popcorn stand on Fourah Bay road the smell of popcorn lingered and was amazing. All of a sudden I had an intense craving for popcorn but we had already driven too far. Then we hit traffic. My craving got worse and we weren’t moving. I actually rarely crave foods, so this was quite bizarre but I really felt like I had to have popcorn then and there. It wasn’t going to happen. Finally we were moving again and passed another stand. Seeing as we were finally moving along, I didn’t want to stop traffic and we carried on. My craving got worse. Then a little while later we spotted another stand and pulled over and my driver hopped out and bought two bags of popcorn for Le 1,000 (25 cents). O happy day. It must have been the salt I was craving on a hot and sweaty day. I bought popcorn three days in a row.

Something else I found out is that my last name is also a Sierra Leonean name, found mainly in the Magburaka area. Go figure. Funnily there’s even a doctor at the maternity hospital with the same last name. The Lako’s are from the Temne tribe, so I think I better start learning some Temne.

I also tried a new snack I had never seen before, a snack that looks like a bracelet but is eatable and made out of groundnut (peanuts) and spices. It is crunchy and has quite a taste. The lady in triage at the registration desk actually showed me this snack for the first time since it is her sister that sells them. It’s always nice to try a new snack.

I also discovered the awkwardness of sharing the front seat in a taxi. The taxis I take to Regent are often quite full. Regent is a little ways out and so the taxi drivers want to get the most out of the trip. Understandable. Up until recently I always ended up on the back seat with 3 or 4 other people. However, recently I have been stuck in the front seat with another passenger. It’s not bad at all if you’re on the car door side, but when stuck in the middle it is terrible. How awkward to be squashed up against someone on your right and to be right up against the gears, with the driver resting his arm on your leg as he shifts gear. Not so pleasant. I guess this was a discovery that taught me to sit in the back seat to Regent from now on.

That’s it for now. I’ll be on the lookout for more new and exciting things in Salone.

The world I live in...

Oh no. It’s been an entire month since I’ve blogged, shame on me. I think this has probably been my busiest month ever, both at work and socially. That and still not having an Internet connection at home make blogging a bit more of an effort. So, to those of you who check this page regularly, sorry for my lack of blog posts, as they would say in Krio – “Oshya”. I will do my best to get into the habit again. Seriously, I love blogging and find it’s a good way to ‘escape’ the craziness of my world here.

So, what’s happening in my world?

Work has been really busy with a pre-accreditation that took place earlier this week, meeting with people at the Ministry of Health, checking out support services at Connaught (the main government hospital), helping organize some of the postgraduate training sessions with the residents on Tuesday and Thursday afternoons, signing contracts with national staff, trying to get the x-ray unit up and running, renewing my registration with the Sierra Leone Medical Council, attempting unsuccessfully to get someone’s container released containing items for the hospital lab, working on getting duty free concession for the oxygen concentrators, preparing for the Welbodi Directors’ meeting next weekend, compiling statistics, facilitating a Mercy Ships/Children’s Hospital partnership, and last but certainly not least (although it’s what I’ve unfortunately spent the least time on) sneaking on to the wards now and then to see patients.

There you have it, my work in a nutshell. Well, all of the above plus attempting to solve any immediate problems or small crisis that come my way. They are probably as diverse as the above. Some examples are: nurses coming to the office for connecting pieces for oxygen concentrators or batteries for pulse oximeters, trying to track down one of the doctors when rounds aren’t underway by 9, going into locked consultation rooms in the evenings looking for blank patient charts and prescription pads to put in the ER for the new admissions when ER runs out, running to the blood bank to get blood for a critically ill child, searching for the generator man when we have a power cut so that the babies in Special Care continue receiving oxygen and the list goes on. Honestly, there is never a dull moment.

So, besides work I have been about as busy in the evenings and weekends. I tend to get home at 6, 630 or 7 depending on when I get out of the hospital and what traffic is like and then sometimes have a 10 minute turnaround at home before heading out again. Someone said recently that they get quite bored here. What? Really? Not a chance. I feel like I’m hardly home. I am not even quite sure what I do every evening but I suppose there are various friends I visit, I’m often at the Aberdeen Women’s Centre (formerly Mercy Ships in Aberdeen), Tuesday evening women’s group, Wednesday evening house group, often out for dinner on a Saturday evening, catching up with Sierra Leonean colleagues, birthday dinners, goodbye dinners, beach trips, church, international service and the list goes on. The social life gives me a boost of energy although I have to say that as of late I have been quite tired as well. I suppose everything has piled up a bit and I’ve reached my limit. That might explain my need to buy a small Cadbury chocolate bar after work everyday last week. Desperate measures. Honestly, the last few weeks have been both very difficult and very good. An odd statement, I know, but that’s what life is like here. It’s an interesting world.