Wednesday, March 30, 2011

Oxygen for the feeding center...

Last week Monday the final four oxygen concentrators from the “Operation Oxygen” campaign made it to Ola During Children’s Hospital. Thanks to all of you who contributed generously to this campaign. Of course, it was a bit of an epic journey to get the shipment from the airport to the hospital, but after many phone calls, negotiations, and bribe avoiding tactics we managed. Unfortunately getting shipments out of the airport or port is still a big hassle for most non-governmental organisations (NGOs).

This past Saturday I went to the Children’s Hospital, to deliver large bags of leftover bread rolls that the Africa Mercy wanted to give away. Fortunately there was plenty to go around for all of the patients and staff. While I was there, I thought I would assemble the oxygen concentrators, label them, and test them to make sure they were in good working order. All of the units worked, and so four more oxygen concentrators were ready to roll.

Today, I thought it would be good to bring a concentrator to the therapeutic feeding centre. After all, they have never been able to give oxygen there and they do often have severely malnourished children with severe pneumonia, or other illnesses causing respiratory distress. Up until today, malnourished children needing oxygen were sent to the ICU for admission; meaning their feeds were (unfortunately) not monitored as well as they would be in the nutrition unit.

After checking with matron in the morning, I went to the feeding center to tell the nurses they would receive a brand new oxygen concentrator, and they were delighted. They have been asking for oxygen on their ward for their patients for months now.

Since there is an oxygen concentrator in the feeding centre, it means that the malnourished children in need of oxygen can remain there and receive both oxygen as well as 3 hourly feeds of F-75 or F-100 milk, along with the other medical care they need. Being able to keep these children in the nutrition unit will hopefully improve care and will prove to be yet another small step in the right direction. We do realise of course, that in some cases children may need to stay in the ICU for more intensive monitoring.

Unfortunately, when the power went off later in the day, we realised that the feeding centre is not yet connected to the back-up generator provided by Welbodi and so the oxygen concentrator stopped working. Our next aim is to make sure the feeding centre gets connected to that generator. Small steps. One at a time. We’ll get there someday.

Tuesday, March 29, 2011

#2 Photo of the week...

"Five children with Burkitt's Lymphoma receive treatment on the ward"

The Burkitt's Program is a partnership between Ola During Children's Hospital and Mercy Ships.

© 2011 Sandra Lako

Monday, March 28, 2011


Monday was a bit of a different day.

A lot of my work did go on as usual- which is usually a bit chaotic anyway but there were some unusual and fun bits as well.
I said by to Zainab, a 22 month old weighing 4.2kg who amazingly reached the weight criteria for discharge and will now join the outpatient feeding program.
A photographer from Getty images came to take a portrait shot of me on the ward for a possible story.
Unfortunately there was no internet so I failed to get some important emails out until I realized matron's office still had internet (due to a direct cable).
I helped transfer a patient from ICU to the Feeding Center after providing them with a brand new oxygen concentrator and teaching the nurses how to use it.
Then the national power cut out and we switched to the back-up generator.
That's when we remember the feeding centre is not connected to the generator and so the patient on oxygen was transferred back to ICU/Emergency.
I went to the x-ray department to give the three workers there 'CV forms' to fill out because I need their information and they weren't quite sure how to write CVs.
I carried on with SLICH accounting issues and can't wait till that's over.
In the evening I went to the ship to meet up with one of the ship's writers about Namina's story.
I then had dinner with the communications/PR team and the Getty photographer.
After which I went down to the ward and spent time with Namina, her mom and brother.
Namina was full of smiles and we had fun together. She's recovering well.
I then met her 'neighbor' (in the bed next to hers) - Margaret, who is undergoing major surgery today.
On my way out, I saw the photographer and Dr Gary and after chatting for a bit we looked at his images from a hospital in South Sudan. It was interesting seeing the similarities and differences in healthcare facilities.
I finally left the ship at 8:55 pm and was home by 9:25 pm. No traffic - which is a nice change!

Tuesday, March 22, 2011

World Water Day in Freetown...

On my way to Spur Road this morning I walked past a group of children scooping murky water out of the gutter into some buckets. These buckets were then lifted to their heads and carried home. Further down the road there was another group of people, huddled around a standpipe. 45 yellow five-gallon containers were lined on either side, ready to be filled. This is daily life in Freetown.

Can you imagine having to use gutter-water to clean your dishes or wash your clothing? Can you imagine having to stand in line for hours, waiting for your turn at the standpipe? Can you imagine having to walk for miles with a bucket of water on your head?

I cannot.

Although we have had some major problems at our house, we still manage to get some five-gallon containers filled. Yes, it takes time, but it doesn’t take us hours. And yes, I have to carry it up three flights of stairs, but at least it is not three miles. It is not the same, but it gives me a glimpse of what life must be like for the average person here. Clean water is so essential yet still so difficult to access.

Today is World Water Day, an observance day that grew out of the 1992 UN conference on Environment and Development. This year’s theme is Water for Cities, which highlights the connection between rural and urban areas. Water flowing into cities generally originates in rural areas, and it is in those areas that water should be protected and managed well. Water is affected by climate changes, industrialization, natural disasters and rapid urban growth.

Did you know that most of the world’s population lives in cities? 3.3 billion people. Meanwhile the urban landscape continues to expand and expanding slums represent 38% of the growth. City populations are increasing faster than city infrastructure can adapt leading to critical water shortages.

Freetown is a city with more than 1 million people that struggles to provide its residents with the water they need. The Guma Valley Water dam that supplies the majority of the city was originally set up to serve a population of 300,000. It is no wonder that water access and availability are poor. Not only are households affected by water shortages, so are businesses, schools, Ministry buildings, restaurants and hospitals.

The Ola During Children’s Hospital has had water problems for many years now. Since Welbodi Partnership started working at the hospital since 2007, we have tried to address this situation many times but unfortunately the water problems are complex. When one battle is won, another battle arises. But we will continue because the situation is serious. Poor hygiene practices in the hospital lead to an increase of infections on the wards, which in turn lead to longer hospital stays and unavoidably more deaths. Something needs to be done.

Can you imagine one bucket and one bar of soap on each ward of 40 patients for all of the nurses and caretakers to wash their hands? Can you imagine how hard it is to keep the linen and beds clean? Can you imagine how hard it is to clean up after sick children? Can you imagine working in a hospital where water rarely comes out of the tap?

The situation is serious.

One of the problems is that Guma supplies water only a certain number of times per week. This is done throughout the city to ration the water, ensuring that each area in the city at least has some water at some point. For hospitals, this is not adequate. We think that the long-term solution might be to connect the hospital to the main water pipeline on Kissy Road. Maybe. Honestly, we are not 100% sure if that would solve the problem but it seems like the best shot. We hope to work together with hospital management, the ministry, partner organisations, and the water company to see if this is possible.

Last year Welbodi Partnership installed four 5-thousand litre water tanks above the elevator shaft with the aim that when Guma supplies water we can at least store a large amount, so that each ward will have some running water all the time. The most recent project included adding more inlets to the water tanks so that the fill-up time would be quicker and the tanks would fill up to the brim. A project we are about to commence is to install one 5000-litre water tank on the ground level, which will provide more storage of water. We will also use the water pump purchased by Welbodi in the UK to pump water from the new storage tank to the top level because when Guma does supply water, the pressure is often too low and the water does not reach the top floor. We hope that this latest water project will be a success. However, ensuring that water supply is sustainable is important, and so we also plan to partner with an organisation that may be able to get qualified engineers to assess the water situation and come up with long-term solutions.

Solving the water problems at the hospital sure seems like an ongoing battle, but I like to think that slowly we are winning ground. I look forward to the day that the water supply at the hospital will be unlimited and the residents of Freetown will have access to the water they desperately need.

Statistics taken from

First posted @

Sunday, March 20, 2011

Shipments, delayed clearance & ridiculous storage fees…

I have been waiting for a shipment to arrive at Lungi airport. A week or two prior to the shipment being sent I made sure documentation was sent to the Ministry so that they could deal with the official paperwork. Seeing as I did not receive an arrival notice from DHL I called someone a week ago to ask if he knew anything about the shipment and found out the shipment had already been sitting in Lungi for a week. Great. Thanks for the notice!

If you remember, the last time I went to Lungi to pick up a shipment, I was asked to pay Le 9,000,000 (USD 2,300) in ‘storage’ fees. Interestingly nothing was documented and they would not let me speak to the supervisor. Fortunately we managed to get the fee waived and brought the shipment back to the hospital. Apparently there is some kind of storage fee process, but only after a certain amount of days and to be honest it is vague and nothing is communicated with the customer until the moment they try to pick up the consignment. That is when people hear about a fee, don’t have the money to pay, have to leave the consignment, only to come back later to pay for it and by then the fees have gone up even more. Likely hundreds of containers in the port are sitting there for this very reason. Containers take too long to get released, by the time they are released the storage fees are really high, people cannot pay them, they try to negotiate and in the meantime the fees continue to increase. It’s corruption at its best. What is being done about this?

I was not happy about the lack of communication and was adamant about telling DHL that I would not pay the storage fee due to their delay in communicating. I contacted the Ministry’s procurement officer right away who said he would handle it. I think I called him multiple times everyday last week and every time I called he said he was working on it and that he would call me back in either 10 minutes, or 30 minutes or an hour. Of course, he rarely called back; it was always me having to call him. Finally I decided to involve our hospital manager to try to speed things up. I knew that if I would wait till this next week we would definitely need to pay fees. The procurement officer finally said on Wednesday that he would pick the shipment up on Thursday, only to say on Thursday that he was still working on it. Friday morning at 8am I called him again and that is when he said he had to go to Bo. You can imagine how frustrated I was at that point. He then said he would arrange for a colleague to go. After many phone calls and not getting anywhere I had to keep telling myself to be ‘slow to anger’. I really tried.

By 2pm I knew that there was no point trying to get to Lungi that day, because the next ferry was at 4 and by then the office on the other side would be closed. I decided to try to arrange something for Saturday. I wasn’t able to go but figured it would be best to have a Sierra Leonean from the hospital to go anyway. So, everything was arranged: a hospital vehicle, fuel money, hospital driver, admin person, money for ferry crossing, documents, phone numbers, etc. I could only hope that all would end well.

On Saturday, after going to SOS, I decided I would take a break and head to Lakka and then work in the evening and on Sunday. I did just that. However, I soon found myself working on the beach. Sure enough at 10 am my phone started ringing. First, I was told we had to pay Le 3,000,000 (USD 770) in storage fees. I called various people explaining that we never received official documentation to state the shipment’s arrival and they should talk to DHL, etcetera etcetera. Many calls later, lots of credit spent and numerous deep sighs on my part and they finally agreed to forget about the storage fee due to lack of communication of the shipments arrival. An hour later I was called saying there is a customs fee. Again, no clear process, no amount stated, all very vague. Seeing as the clearing agent and procurement officer said they had arranged this I suggested they discuss this and get a move on. Finally they called back saying it was okay and that the shipment would be released. Meanwhile the poor driver and admin person were sitting there waiting, having already missed the 11 am ferry and hoping they would make the 2 pm ferry. It was 1 pm. Thirty minutes later I was called again to say that they could not find the shipment and that the storage unit was closing. We would have to come back on Monday. Seriously? You’ve got to be kidding. I told them that if the shipment can be brought to the hospital on Monday, then fine, and no, I will not be paying extra storage fees over the next two days. Oh Salone.

Really, I cannot believe how difficult Sierra Leone makes it for NGO’s to bring in equipment, especially when it is specifically designated for a government hospital. A Children’s Hospital at that, which falls under the Free Health Care Initiative. If only documentation processes would be quicker then people wouldn’t have to deal with ridiculously high storage fees. I also can’t believe that people in their right mind can charge millions of Leones for the storage of shipments. Absolute madness. So much for helping your own countrymen/women/children. Anyway, I’ll be happy to see the shipment arrive at the hospital tomorrow. Having said all this, one of the hospital’s partners sent a container of laboratory and other medical supplies to the hospital last year. It has been in port since August 2010. Due to a big delay in getting proper clearance (due to incompetence of the handing agency) the container has accrued extremely high storage fees (thousands of dollars) and is basically stuck in port. Like I said, it’s absolute madness. I’m happy I don’t have another shipment coming anytime soon.

Morning of visits...

A morning of visits to Hawa and Joshua. It was absolutely amazing to walk into Hawa's house and have her come up to me with a big smile and hug. She looks fabulous. I can't believe she is 11 now and that 5 years ago she came into my office as a 5 year old girl with a massive tumor growing out of her mouth. I have to say I had little hope that day I saw her. However, I referred her to the ship in Liberia, helped with transport and Dr Gary took over from there. Her surgery was successful and to this day she has not had any more problems. Incredible. It was a unique moment visiting her with Gary (who did the surgery) and Pierre (who supports her). Joshua is also doing well and seems to be enjoying life.

For a previous blog post on Hawa go to: Seeing Hawa again...

(Photos: top left - Hawa, top right/bottom left - Hawa's new twin sisters, bottom right - Joshua to my left next to Hawa)

Friday, March 18, 2011

Normal chaos...

I started writing this post at 6:22 pm when I was stuck in traffic trying to get home. At least I now have usb Internet access, which means the journey home is not as bad. While heading home I was thinking back over the day and came to the conclusion that it was pretty chaotic. Someone later reminded me that my days are usually very busy. I think what actually makes it seem chaotic is the number of people that walk in and out of the office requesting something. I am often asked what I do everyday and to be honest, it's not always an easy question to answer. Everyday is different and sometimes I look back at the day and wonder what I did. Anyway, it is now 11 pm and I am at home working on the bank account annual report so that it can be audited by next week. I just thought I’d take a moment to finish this post. So to give you an idea, this is what I did yesterday and today:

  • Met with both hospital core management teams (matrons, superintendents and managers) and two people from Mercy Ships to discuss a partnership over the next few years. I was thrilled to get both management teams together, as it was the first time in 9 months I’ve seen both teams together. Exciting. I love teamwork. And the partnership sounds very promising.
  • Went into ICU and helped sort out a blood test for a little girl who looked very anemic.
  • Sent an array of emails.
  • Saw a couple of patients who want access to the ship. Sent some away knowing the ship won’t be able to help, put some names on a list and sent a child with possible retinoblastoma to the eye screening.
  • Started to put together the SLICH annual accounts so that they can be audited in the next two weeks! This is something I found out about on Thursday and I’ll need to have it done by Monday. Yikes.
  • Finalized proposals for the upcoming SLICH board meeting.
  • Talked to one of the nurses onboard to see what could be done for some of the surgical candidates I have been seeing at the Children’s hospital.
  • Called a few patients who are scheduled for surgical assessment on the ship on Monday.
  • Sorted out a finance report with the Finance Officer.
  • Met with the hospital’s ‘engineer’ several times to discuss water pump and generator issues of which I know very little of and kept telling him to wait until we discuss some of these things with other people. He must have come into my office for various things 10 times today.
  • Discussed a patient with one of the national doctors- a little girl with meningitis who he wants to present at the next grand round. And so also got consent and took a few pictures of her.
  • Talked to Dr Baion concerning a few patients on the wards and the Burkitt’s program
  • Made a lot of phone calls to the Ministry’s procurement officer to try to get a shipment at Lungi airport released. I must have made about 15 calls today concerning that container and it was very frustrating to hear various promises, different price quotes, etc.
  • Had a surprise visit from a former patient from my Aberdeen days. She was a girl we sent to Liberia for a shunt due to hydrocephalus. She’s grown so much and is doing relatively well.
  • Meeting with the hospital manager to sort out transport, etc. for people to go to Lungi tomorrow to pick up the shipment.
  • Re-assessed a 2-week old cleft lip baby before he went upcountry with his mom to make sure he was breastfeeding well. I advised the mother and told them I would try to get him scheduled for surgery in August/September. I was reminded about how much I love the cleft patients and their families.
  • Met with the Director of Information and Planning in the Ministry and discussed our data collection process. I’m happy to say that he is very pleased with the way Welbodi has set things up. YAY.
  • Happened to see parents in the hall with a 4 month-old baby weighing 1.8 kg and tried to get one of the national doctors to see the child quickly due to low oxygen saturations. There was some doubt about her age and which ward she was to go to, but we got there in the end and one of the doctors agreed to see her.
  • Went around with someone who is here to help with our medical records process/database to see what improvements can be made in both the short and long-term.
  • Arranged for the driver to go to town to pick up a bottle of cooking gas and A4 paper.
  • Sent invitations to the SLICH Board for the March Board Meeting.
  • Ate lunch and drank cold bottled cokes.
  • Burnt loads of phone credits due to the many calls I had to make.
  • Sat in traffic for at least 2 hours this evening to get home.

I think there’s more, but I think this shows the diversity and busyness of the job. And, it’s probably not a surprise that it is chaotic at times. Really, really, I do love it. However, I have to admit, that there were many frustrating moments today. I made it to the end though and tomorrow is a new day. Okay, I am going to go back to the accounting now…

Reason & Passion...

Your soul is oftentimes a battlefield, upon which your reason and your judgment wage war against your passion and your appetite. Would that I could be the peacemaker in your soul, that I might turn the discord and the rivalry of your elements into oneness and melody. But how shall I, unless you yourselves be also the peacemakers, nay, the lovers of all your elements?

Your reason and your passion are the rudder and the sails of your seafaring soul. If either your sails or your rudder be broken, you can but toss and drift, or else be held at a standstill in mid-seas. For reason, ruling alone, is a force confining; and passion, unattended, is a flame that burns to its own destruction. Therefore let your soul exalt your reason to the height of passion, that it may sing; And let it direct your passion with reason, that your passion may live through its own daily resurrection, and like the phoenix rise above its own ashes.

I would have you consider your judgment and your appetite even as you would two loved guests in your house. Surely you would not honour one guest above the other; for he who is more mindful of one loses the love and the faith of both.

Among the hills, when you sit in the cool shade of the white poplars, sharing the peace and serenity of distant fields and meadows -- then let your heart say in silence, "God rests in reason." And when the storm comes, and the mighty wind shakes the forest, and thunder and lightning proclaim the majesty of the sky -- then let your heart say in awe, "God moves in passion." And since you are a breath in God's sphere, and a leaf in God's forest, you too should rest in reason and move in passion.

- Kahlil Gibran

Saturday, March 12, 2011

#1 Photo of the week...

"Patient Namina and her friends in Bailor town"

Regent kids...

I finally got back to church after being away a few weekends in a row. It was my turn to teach Sunday school to the 2-6 year olds: a group of 18 cute but, sometimes, wild kids. Our theme was ‘Shepherds’, since we are working through the alphabet and reached letter ‘S’. I decided to tell them the parable of the lost sheep. The kids got really into it and you could see on their faces that they were really sad when I said one sheep was lost and got excited when I told them the shepherd chose to go out to find the sheep and bring it home. It was a good opportunity to tell them that God cares about each one of them!

In Regent, Sunday school is held outside, under the hot sun, on chairs - there is no separate room and no tables. It’s works well; it’s just a bit more difficult to do crafts. It’s also right outside the church, so we cannot make a whole lot of noise. If we do, one of the adults pops their head out and says we need to quiet down. I experienced this a few months ago when we decided to play ‘Duck, duck, goose’! Definitely not a quiet game- that was a first and a last. ‘Follow the Leader’ is much quieter.

We usually start with a prayer, learn everyone’s names, sing a few songs (favorite is: ‘My God is so BIG’), review the previous week’s story, tell a new story, learn a short memory verse and color. I think I finally found a good system for coloring – lining the kids up along the side of the steps and placing their little chairs in front of them to function as little tables. It seems to work. The key is to make sure they’re spaced out enough to not torment each other and draw on each other’s papers!

Amazingly, I taught the children that when I hand out coloring sheets or crayons they should sit quietly. Usually they call out ‘gi me, gi me’ or ‘aunty yu no gi me yet’. I told them if I hear them calling out, they would be last to get anything. I was impressed at how quiet they were as I was handing out paper and crayons and delighted to hear so many of them say ‘tenki’. I also figured out that giving them 3 crayons each (instead of 2) was just enough to keep them happy longer and encourage them to trade colors with their neighbor, rather than have them calling out to me every two minutes saying ‘aunty change, aunty change’ and being bombarded by little kids trying to grab crayons out of the Ziploc bag. Anyway, last week was good. We had fun and hopefully the kids learned something. I’m on the schedule again in a few weeks time…

Thursday, March 10, 2011

Do you know...

Do you know a doctor, nurse or healthcare manager who would like to join our team at the Ola During Children's Hospital in Freetown? Can you help us spread the word about this opportunity?

We have extended the deadline for our year long volunteer positions. We are looking for healthcare professionals (nurses or medical doctors) and individuals with management experience, particularly hospital management or in another healthcare setting.

Help us kick-start a new nurse training program, support postgraduate training for doctors, and improve the quality of hospital and ward management, among other exciting new and ongoing initiatives.
This promises to be an exciting year for the Welbodi Partnership and for the Ola During Children's Hospital, and you can be a part of that work!

For details, please see our blog postings here and here , or contact Emily Spry at Interested candidates should send a cover letter plus resume or CV to Emily at the same address. We will be considering applications on a rolling basis, so please apply ASAP for consideration and circulate widely to friends and colleagues.

Thank you,
The Welbodi Partnership

Wednesday, March 09, 2011

A lighter read...

Last week Tuesday I had to go to the Ministry in the morning, the hospital in the afternoon, then back to the Ministry in the afternoon and finally to a meeting in Wilberforce. It was a lot of traveling back and forth: some in the Welbodi car, some by local taxi and some on foot. As I was walking from the Ministry building to catch a taxi up to Wilberforce a couple of school girls, probably around 6 years of age, passed by. They were giggling and full of smiles. One girl walked up to me and handed me a beautiful bright pink flower and said “A want yu fo padi.” She wanted me to be her friend. I said “yes” and smiled. A few minutes later another schoolgirl, probably about 8 years old, tapped my arm and said “Aunty, please cross me.” We were at a busy intersection and she wanted me to help her cross the road. I took her by the hand and crossed the street with her. After a few more minutes of chatting and walking, we went our separate ways and I couldn’t help but smile and say to myself “I love these children.”

One of those days...

As you can see from my blog, the screening for the ship on Monday did not end well. And to be honest, I feel like it was one of those days. Screening ended in a tragedy. My journey home took 3 hours. There was no running water in the apartment. And then the electricity went out. At least I knew Tuesday couldn’t get much worse. As I reflected on my day later that evening I realized that still, despite the events of the day, I still have it so much better than so many others in this world. Terrible things happen everyday. Tragedies occur all over the world. Granted, this doesn’t mean that what happened on Monday morning wasn’t awful. It was. It was terrible. It was unexpected. It was shocking. But I was reminded of the people in the world who are going through situations much worse than I have ever experienced. Children starving to death, Christians being persecuted, families losing loved ones in war, people inflicted with incurable diseases. I’ll take this moment to think of the family of the man who died on Monday and to think about those people in the world who suffer day in and day out.

A reminder...

Since God has so generously let us in on what he is doing, we're not about to throw up our hands and walk off the job just because we run into occasional hard times. We refuse to wear masks and play games. We don't maneuver and manipulate behind the scenes. And we don't twist God's Word to suit ourselves. Rather, we keep everything we do and say out in the open, the whole truth on display, so that those who want to can see and judge for themselves in the presence of God.

If our Message is obscure to anyone, it's not because we're holding back in any way. No, it's because these other people are looking or going the wrong way and refuse to give it serious attention. All they have eyes for is the fashionable god of darkness. They think he can give them what they want, and that they won't have to bother believing a Truth they can't see. They're stone-blind to the dayspring brightness of the Message that shines with Christ, who gives us the best picture of God we'll ever get.

Remember, our Message is not about ourselves; we're proclaiming Jesus Christ, the Master. All we are is messengers, errand runners from Jesus for you. It started when God said, "Light up the darkness!" and our lives filled up with light as we saw and understood God in the face of Christ, all bright and beautiful.

If you only look at us, you might well miss the brightness. We carry this precious Message around in the unadorned clay pots of our ordinary lives. That's to prevent anyone from confusing God's incomparable power with us. As it is, there's not much chance of that. You know for yourselves that we're not much to look at. We've been surrounded and battered by troubles, but we're not demoralized; we're not sure what to do, but we know that God knows what to do; we've been spiritually terrorized, but God hasn't left our side; we've been thrown down, but we haven't broken. What they did to Jesus, they do to us—trial and torture, mockery and murder; what Jesus did among them, he does in us—he lives! Our lives are at constant risk for Jesus' sake, which makes Jesus' life all the more evident in us. While we're going through the worst, you're getting in on the best!

2 Corinthians 4:1-12

Screening: the highs and the lows...

On Monday I had an early start, reaching the national stadium at 6:45 am for the Africa Mercy Screening day. When I arrived, I could already see hundreds of people waiting outside and I could only see a portion of the crowd. I was excited to be a part of this day, a day of expectations, and a day that was sure to end with much rejoicing. At least, that is what I thought.

After the organizers cleared up a few small issues with ‘extra’ lines, the screening soon began. One by one people entered the stadium grounds; the first stop was the pre-screeners. The pre-screeners asked people their reason for coming and then proceeded to tell them whether or not they could see a doctor. Due to the specific nature of the conditions treated onboard, there are always people that show up at a screening that cannot be helped. The pre-screeners had a tough job, but it was definitely needed in order to effectively screen those patients who were suitable candidates for surgery. I was impressed to see the pre-screeners persevere, patient after patient.

For those with conditions that could most likely be dealt with, the process continued as they made their way past a few more stations to the specialist screening areas: orthopedics, maxillo-facial, plastics and general surgery. It is there that they find out if they will receive surgery. To me it seemed as though this was a critical moment for patients, since the news they were about to hear could change their lives drastically. And it was these moments that were the most meaningful to me.

I was at the maxillo-facial station with Dr Gary, primarily to learn from him. The station consisted of three tables, each with a dentist and a translator to start the screening process. Dr Gary, the maxillo-facial surgeon, rotated between the three, seeing each patient and making a (differential) diagnosis and plan. It was remarkable to work with Gary and discuss/see conditions such as thyroid glossal duct cysts, cleft lips, neurofibromatosis, fibrous dysplasia, lymphomas, TB adenitis, and encephaloceles. He not only has a wealth of knowledge and experience but also worked with such confidence, humility and care for the patients.

Besides the sheer excitement of being a part of such a big undertaking and knowing that many people would be scheduled for surgery, it was awesome to watch the faces of individual patients light up when they heard they would receive an operation. Imagine a dad and his boy smiling when they heard the boy would receive surgery for a growth he’s had since birth. A woman thrilled to hear she could be operated on. A young guy, happy by the mere fact that he was being assessed properly and scheduled for a CT scan for further investigation. A shy 13- year old girl, hearing she can receive cleft lip surgery. It is these moments I try to remember when thinking about the screening, because the joy was quickly overshadowed by the tragic event that took place.

As mid-morning approached, the crowd became impatient and people started pushing forward. Those in the small, gated entrance to the stadium grounds were trapped. To relieve the pressure, a small gate was opened and people ran out, forming a new line. The situation quickly escalated. The pushing and shoving worsened and within minutes a larger gate opened and those pressed up against the gate, flooded out of the small space, onto the pavement. A stampede followed and the consequences were grave.

Within minutes, casualties were brought to the pre-screening area and there was a rush to attend to the victims. Some were in a serious condition while others had fainted or were still in shock after having been confined in a small, overcrowded space. Despite good efforts, one man died that day and 13 more were injured. This was not how it was supposed to end. A day of anticipation, excitement and joy, ended in a tragedy. It was very difficult to carry on but it seemed wise to continue screening those in the stadium. After an hour however, the situation outside grew tense once again and the decision was made to stop screening and leave the premises.

With heavy hearts the 200 crewmembers that put a lot of effort into the day, returned to the ship. Meanwhile, I walked back to the hospital still in shock at what had happened. How did the situation get out of control? Is this the Sierra Leone I know? I was saddened that the screening had to end like this. Saddened for the crew, the family of the man who died that day and saddened for the people of Sierra Leone. I couldn’t help but think that somewhere in Freetown there might be a family waiting for their father to come home, but he won’t. I kept thinking about the patients needing surgery, still waiting outside of the stadium to be seen by a doctor. I think about those who were caught in the stampede and traumatized by what happened. I think of the crewmembers that have come to Africa for the first time and experienced such a tragic introduction to what is actually an amazing country.

Looking back, part of me wishes I did not go to the screening that Monday yet a bigger part of me would not have wanted to miss the priceless smiles of those who heard they would receive surgery. There were highs and there were lows that Monday. However, I know that this is just the beginning; the beginning of something good. Although it was a very unfortunate beginning to the outreach I am convinced that despite all that has happened the Africa Mercy is going to have a huge impact in Sierra Leone and many lives will be changed. I am sure that those in urgent need of surgery will be scheduled somehow, at some point. The ship’s visit has been anticipated for years and now the time has come. Great things are going to happen. For those of you who pray, do pray for the crew onboard the Africa Mercy. This is not an easy time. Pray also for wisdom for those in leadership who are planning the next screening.

Sunday, March 06, 2011

Namina's village...

Here's a glimpse of my time at Namina's village. I had the most amazing day on Saturday. Full of smiles and adventure. More on this soon...

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