Enable the Children...

Yesterday afternoon Enable the Children’s Executive Board unanimously approved me as their newest Board member here in Sierra Leone and I have to say it is an honor to work with them.

Enable the Children is a charity set up by Vez, a good friend of mine, in 2007. I have been involved from the sidelines since its inception – basically by supporting my friend in her endeavors and referring patients from the Aberdeen Clinic to ETC for therapy. It is great to be a part of the work more formally and I hope that my advice and input will be valuable to the organization and children they are serving.

Enable the Children reaches out to provide physiotherapy and occupational therapy to children with disabilities in Sierra Leone. ETC is unique in that the rehab therapists meet the children in their own homes and teach the families or carers how to treat their own children using play, developmental positioning and feeding support. By doing this they promote the acceptance of disabled children, who are so often seen as outcasts in their communities. Their on-going visits show their commitment to the children. This has a great impact on the families and communities and in most cases the individual child becomes more accepted and included in life.

“We bring hope into hopeless situations and love into love starved lives.”

Once a year ETC hosts a beach gathering so that all of the beneficiaries can meet up and of course so that all of the children can have a good time. The children laugh and play. Some of them absolutely love the water and spend all of their time splashing around, while others sit on the beach and play with balls and other toys. It’s a good time for the carers as well, as they meet up with others who have children with special needs and can support each other in this. This past April, when Vez and her husband Rob came to visit Sierra Leone, ETC held their annual beach gathering. It was great fun to be a part of it. The children are amazing. We all had an amazing time. I’m thrilled to be able to play a bigger role in ETC.

For more about Enable the Children go to: www.enablethechildren.org

Sierra Leone Pop Quiz...

What is worse: no electricity or no water?
Answer: no water

What’s worse than that?
Answer: no electricity and no water

And what is even worse than that?
Answer: having both electricity and water but getting electrocuted when the tap is turned on

Yeah, so the very impressive lightning and thunder storm last night knocked down some wires and now our flat is no longer earthed. Lucky for everyone else in the building, their flats are fine. What does this mean? Basically if you touch or turn on a tap, you get shocked. And apparently, if you take a shower, like my colleague did, you get shocked throughout your body. Oh Sierra Leone. I had to test it for myself of course plus we wondered if flip flops would give enough protection to spare us from getting shocked. Since I always wear flip flops, I was the guinea pig. Sure enough, with flip flops on I could touch the tap without any trouble. However, after being provoked by my colleagues, I removed my flip flops and touched the tap. A pretty significant shock went up my arm! I wasn’t too impressed. So, it’s flip flops on at all times until the flat is earthed again, which should be tomorrow if the electrician show up. And lastly, no shower for me tonight, except maybe a bucket shower. The adventure never ends...

PS: this post is dedicated to Jen. I think she'll get a kick out of this one!

West-side Wednesday...

Yesterday one of my colleagues arrived in Salone after a few weeks away. Her flight was delayed so we ended up at the flat at midnight and talked until 1 am. A late night plus the fact that our driver was home sick, made the decision easy to forego the 6:50 am trek to work. My plan was to wake up at 8 am and head in by 9 am. However, plans changed and I ended up on the West side for most of today.

After breakfast and more catching up with my colleague we headed to the Welbodi office on Spur Road for an actual Welbodi catch-up meeting with the three of us. It was good to talk through current projects and do a bit of discussing and planning. There is progress in the air. We then carried on working.

At about 1 pm we went to Mamba Point for lunch (a 5-minute walk from the office), a real treat. I then worked until 4 pm when National Power cut out. I had been umming and awing about whether or not I should run some errands in town but was not eager to deal with transport. However, lack of power at the office made my decision easier.

First stop: Medical and Dental Council. I walked to the roundabout and got a one-way taxi to New England. I was first told by the secretary to come back the following day. However, she swiftly changed her mind and asked me to wait a minute. Sure enough, ten minutes later she presented me with my registration document. Bingo!

Second stop: Ministry of Foreign Affairs (MoFA). As soon as I stepped out of the Medical council building a taxi drove by and took me to Siaka Stevens street. I then walked up to Gloucester Street. Seeing as my visa runs out in July I needed to get that sorted out! This of course, is a multi-step process. Last Thursday I collected the forms at the MoFA. On Friday I submitted the forms, my passport and photos to the Ministry of Health and Sanitation (MoHS). The MoHS was very quick to write a letter on my behalf and delivered the documents to the MoFA on the very same Friday. Impressive! I went today to see what the status was and found out that it should be ready on Friday. Great! My second aim was to get the phone number for the guy in the MoFA office, so that next time I can simply call to check the status. Mission accomplished!

Third stop: Connaught Hospital. I walked from Gloucester Street to Connaught, dodging traffic. I went to visit a patient – an 8 year old who I referred from the Children’s Hospital to Mercy Ships initially after which I ended up referring them to an orthopedic surgeon at Connaught. Turns out a month later, with confirmation from a pathologist, that the boy does have cancer. The doctor told his mom the news yesterday and so I wanted to see how they were coping. They are saddened. They will be discharged home to Kono; with hopefully enough pain medication so that the boy will not suffer. Unfortunately his prognosis is very poor. Heartbreaking!

Fourth stop: Home. From Connaught it’s a bit tricky to get a taxi. Not today. I got a taxi on Siaka Stevens. However, when driving along Campbell Street the driver then told me to ‘get out’. It sounded a bit harsh, but he was actually doing me a favor. He told me to get out and cross the street and wait opposite the Mende church on Dillet Street for a taxi that goes straight to Wilberforce. So, I did just that. Within a few minutes I was in a taxi on a one-way journey to Bottom Mango in Wilberforce. Perfect!

After a successful day I decided to go for a short run at half past 6. Start: Bottom Mango roundabout. Finish: Lumley police station roundabout. A quick, downhill run along Spur Road, followed by a brief walk to Lumley roundabout and then a taxi ride back up Spur Road. Fortunately there was no traffic going up Spur Road, going down it was at a standstill. More success!

When I reached home it was time for a shower (yeah for water!), some food (leftover pasta with vegetable and tomato sauce), Bible Study preparation and a bit of work. And now, it’s time for bed. It’s been a good Wednesday.

Why do children come so late?

One night, not too long ago, four children died in the emergency room at the Children’s Hospital. Two of them had been sick for more than two weeks before coming to the hospital for treatment and sadly, both children died within a few hours of admission. They had simply come too late.

Day after day in the emergency room at Ola During Children’s Hospital, parents arrive with extremely sick children, often on the verge of death. It is not uncommon for a mother to come in with a child gasping for breath, or a child who is extremely pale, or is unconscious or with extremely cold extremities and in shock. Occasionally they even come with a child who has (unknowingly to them) died en route. It is tragic.

Why are these children reaching the hospital so late? Is it ignorance or a lack of knowledge? Do they not realize how sick their children are until it is too late? Are there additional financial barriers even though health care is now free, like the cost of transport or a family’s loss of income during the time they are in hospital? Maybe people do not know about free health care. Or maybe it is inconvenient to come because the mother has other children at home. Are there other family pressures that keep them from coming to the hospital? Or is it because they can buy any medication they want at pharmacies located on every street corner? Is it due to traditional beliefs embedded with witchcraft and other (in our minds) bizarre ideas? It could be because the family thinks the child is ‘country sick’ and in need of herbal medicine, rather than ‘hospital sick’ and in need of ‘western medicine’. Is it because of the hospital’s reputation of children dying here? I suppose it is probably a combination of these things, and more, and to be honest it will be difficult to find out in most cases.

I had hoped that with the introduction of free healthcare for children under five years old, parents would come to the hospital sooner rather than later. Ideally they should come to the hospital when the child is mildly or moderately ill and get treatment at an earlier stage. For many, that just does not seem to happen. They tend to come when they are very sick. Is it that since free healthcare, the children who would have otherwise died at home in silence are now accessing the hospital in the final hours of their illness? It is hard to know.

Still, the majority of the children coming to the hospital have treatable diseases like malaria, pneumonia, anemia and diarrheal disease. These are all diseases that can be cured (and better yet prevented) if treatment is started on time. But in the cases in which treatment is delayed, unfortunately the chance of survival plummets. We do what we can, with our limited resources but often cannot save the children coming in so late. Of course, our (emergency) care needs to be improved. I will not deny that, but I also know that if some of these children would show up at a hospital in the developed world, they would not survive either. Sometimes they are just too sick and close to death.

So what can we do? If only we had more insight into why children come to the hospital so late. Maybe if we understood why families are not coming to the hospital quickly, we can look into ways to remove the barriers and encourage a change in behavior. Maybe with some more time and results from a survey on health seeking behavior in nearby communities we will have more of an idea. Time will tell. For now, we need to continue to improve the services at the hospital so that optimal care can be given. We all need to try even harder, stay motivated and work together in order to give these children the best care possible in this challenging setting. And we need to advocate for more sensitization within the communities to encourage parents to come to the hospital sooner. There is a lot of work to do.

Part 2 of beach run...

As always, plans change. I did go for a run but didn’t make it home until hours later! I started out at 4:30 pm. The run down Spur road was great. To the disappointment of the Sierra Leonean runner that joined me, I chose to walk through Lumley rather than continue with him. This was mainly to reduce the risk of being hit by a car. I then walked down to Atlantic where I started running again. Part of me wished I would have continued running with my new ‘friend’ because he set a pretty good pace. Of course, before I knew it I was joined by another Sierra Leonean. We ran a bit and then walked a bit. At one point I thought I was done running for the day and we continued walking down the Aberdeen side of the beach.

Suddenly the sky became dark and the wind picked up. We started running again in the hopes to reach Family Kingdom. No chance. Within seconds the rain started. With about 30 others we dashed into a rather long ‘strip mall like’ building under construction on the side of the road. I was now stuck in a construction site with a stranger I met along the way! I was happy there was a bigger group. I did not have a phone on me so I couldn't call anyway to pick me up either. It was now a waiting game. After about 30 minutes I felt a tap on my shoulder. Two doctors I know who work with UNFPA were standing behind me. They had been ‘stuck’ in the far end of the same shelter. What are the odds? We chatted a bit and the conversation ended with an appointment to meet on Tuesday to discuss the neonatal unit! By this time it was after 6:30 pm. Two hours after I set out. Seeing as I was supposed to meet up with Sarah at 8 pm there was no point in going home first. Once the rains died down, my second runner friend and I headed to the beach again to finish off the run (before the rains started again!). He’s convinced that his mission in life is to be my running coach. I wasn’t as convinced!

From the beach I walked up to the Aberdeen Centre. Sarah wasn’t there yet, but Mikey was and as thoughtful as he is provided me with dinner. (Thanks Mikey). I then had a good chat and prayer time with Sarah. It’s lovely to have good friends here! All said and done, I was picked up from there at 9 pm by a friend and headed home. It was a successful evening in the end.

Spur road & Lumley beach run...

This past week has been rather busy and I've been out every evening. This means I have not been able to fit any runs into my schedule. So, seeing as I am unoccupied this afternoon and don't have any plans till 8 pm, I should probably head out for a run.

This time I am going to start running at Bottom Mango roundabout in Wilberforce, about a 7 minute walk from my house and then run down Spur Road to reach Lumley. I've done this before and it was quite enjoyable; one can't complain when running downhill. Last time I ran through Lumley but that was a bit of a mistake. It involved having to dodge too many vehicles and humans. Also, the road works are still in progress and so one has to watch every step as to not fall on the rocky road. Today I'll just walk through Lumley, to the second roundabout and then take a right down to the beach road. I'll walk past Ice Ice Baby and Fish Fish Baby, past Isha's shop (a friend who sells fabric and necklaces) and past the SOS Children's village and greet the disabled children playing in their yard. Once I reach Atlantic I'll continue my run down the beach or on the road (if it's high tide). I'll run as far as my lungs and legs will take me and then walk down the stretch of the beach until I get to Aberdeen. I'll buy a bag of cold water along the way for 200 Leones (5 cents) to rehydrate! In Aberdeen I'll get a taxi to Congo Cross and another taxi from Congo Cross to Wilberforce. This is the plan. Let's see what happens.

Trying to get radiology sorted...

I have been trying to get the x-ray department up and running but like many other things progress is very slow. A proposal of sorts has been written and I'm meeting with some key people next week....but there are still many obstacles. So, does anyone know anyone in the x-ray world? If so, let me know. I so wish we can have a functioning department by the end of July! If only we had a functioning machine, money is released for consumables, the accessories appear, suitable staff is available to train and be trained and salaries would be paid to such individuals. If only...