Run for Welbodi Partnership...

We are excited to announce that there are places available in The Welbodi Partnership Team for the Bupa London 10k on the 27th of May.

Following part of the 2012 Olympic circuit and running through London’s most famous streets (with not a car in sight), this is a highlight in any runner’s calendar.

The Welbodi Partnership is growing and you can be part of that growth. By taking part and raising money through sponsorship we can continue to save the lives of children in Sierra Leone.

As well as supporting a fantastic cause the day will be great fun for runners and spectators alike. For information on how to apply and details of how we can help you prepare ring Seb on 07990 500 277 or email sebastian.wilson@welbodipartnership.org.

Official entry has closed and our places are limited so act quickly.

Many plans...

I can't believe it's the end of March already. And three months since Christmas. Incredible. It is definitely getting hotter here - March is known as the hottest month in Sierra Leone. I think we're in the lower thirties these days. Celsius that is. Anyway, things are well but busy as always. Someone was talking about being bored in Sierra Leone last week - I don't think I have ever been bored here.

The next few weeks are really busy:

Research: two colleagues arrive at the hospital tomorrow to start their research for a Masters they are doing in public health. I'm helping them with the research which is exciting but means more work too. We have a meeting at the Statistics Sierra Leone office tomorrow to look at some detailed community maps and hope to meet one of the leaders in the community later in the day. We will be doing surveys and focus group discussions with community members - looking at health seeking behaviour - what do they do when their child has a fever? I am sure it will be interesting.

Kenema: I am finally going upcountry for work! I have been asked by a VSO nurse educator to help facilitate a mentorship workshop for nurses at Kenema Government Hospital. I am excited about that. Not only because I'll be out of Freetown for three days but more so because I can take two of our own Sierra Leonean nurses along so that they can learn what it means to be mentors and help facilitate the next ETAT course we do in the Children's Hospital. My colleague, Suzanne, will help with the workshop as well. We head off very early Tuesday morning with a local bus and hope to be back Thursday evening.

Board meetings: on Saturday I have two Board meetings - one for SLICH (Sierra Leone Institute of Child Health) in which I take the minutes and give some advice (I'm not an official board member) and one for ETC (Enable the Children) where I am a Board member and will likely minute the meeting. Exciting stuff is happening in both SLICH and ETC and it is great to be a part of it.

Easter: the plan is to trek for 4 days - first by car to the south of the country, then by ferry to Bonthe, then by speed boat to Turtle Islands and then by speed boat back to Freetown. I've been wanting to go to these islands for a while, so I hope we are successful. It will definitely be an adventure.

And then there's the usual: trying to sort out radiology, laboratory, attend academic sessions, finally finally handover finances to the new program manager, support the team where I can, help implement some of the SLICH projects and maybe get in some more clinical work. Oh, and start studying! I'm still waiting for a table for in my room and for some reason have gotten it into my mind that the table is essential for the launching of my study program....

Water 4 Life completed...

Do you remember the Water 4 Life campaign that I spearheaded in December 2009?
Do you remember that together we raised $5,325 for water projects?

I have exciting news for you. I found out that the water projects were completed last month and the money we raised contributed to three different projects in Ethiopia. Click here for details.

Thank you again for contributing to this campaign. I am sure that in Main Gorit, Giratwedigodif and Maimelhis villages, the people are grateful for your support. They can now enjoy access to clean water!

“Women and children here used to walk up to two hours to collect water for their families. Even then, each family member had to make do with just five liters of water per day for drinking, bathing, cooking and everything else. The water was not safe to drink and often made people sick. Thanks to your help, people here are walking significantly less every day to collect water. On average, they’re less than 15 minutes from their water project, which means each family now can use up to 15 liters per person per day! And most importantly, the water they bring home each day is also safe enough to drink.”

Annual ETC beach gathering...

Yesterday, Enable the Children hosted its annual beach gathering. We had a great time with 50+ children and their caregivers - playing in the sand, paddling in the water, singing and dancing competitions, testimonies, eating etc. I loved seeing some of my former Aberdeen patients and the progress they have made. It was great to see the families support and encourage one another. It's a privilege to be on the ETC Board and be a part of such an amazing project.

Clinical work at ODCH...

After many months at ODCH I finally spent a substantial amount of time on the wards. Last week I took the opportunity to work alongside a German doctor to do ward rounds in the intensive care unit every morning - some clinical work at last. It was great to talk to parents, examine children, discuss cases etc. And, I did a lumbar puncture on Friday, after not having done one for quite some time. Success!

I have to say that after a time away from clinical work it's once again a bit of a learning process. But that's okay, in the world of medicine we are continuously learning. Also, intensive care of course is very different medicine altogether! Having said that, when I talk about intensive care, I am referring to the ward in the hospital where the most ‘sophisticated’ care can be given.

Compared to the developed world, however, we are still talking basics; about half the beds have access to an oxygen concentrator and a third of the beds have access to a cardiac monitor. There is no ventilator, no infusion pumps, etc. It is a basic ICU with 10 beds, where the sickest children in the country end up.

Some children die, some children survive. Fortunately last week, most of them improved. We did however have two deaths. One child was transferred to us from another unit and stopped breathing within minutes of arriving. We resuscitated the child after 30 minutes but she died a few hours later. The second child was with us for about 6 hours before passing away. We saw a variety of conditions varying from complicated malaria to severe dehydration, sickle cell anemia crisis to meningitis, congenital heart disease to severe pneumonia.

What I found difficult was that at two different instances parents decided to discharge their children against medical advice. They wanted to take their children upcountry, to treat them the traditional way. I guess they didn't think their children were improving quickly enough. One child was so weak he could barely walk. We tried to convince them that the best thing for the child would be to stay in the hospital but for some reason they didn't believe us. It was hard to see them go. We decided to send the child away with oral medication thinking it was better than nothing! Really though, I wanted the child to stay for a few more days. The other child was in respiratory distress, in need of oxygen, when the father and aunty decided to take the child home. The mother had no choice in the matter. Again, nothing we said made a difference and with great frustration we had to let the child go. I can't imagine either of those patients will make it at home. Tough.

Having spent about 15 hours on the ward last week I can say that I am happy to do some clinical work again, however, I can also say ICU is impossible to combine with non-clinical work. So I think, since I need to find a balance between the two, I'll try out the outpatient department and admissions! At least that way I can get my non-clinical work done without feeling like I'm abandoning patients. I'll keep you posted on how it goes...

7 years ago...

7 years ago today I flew into Lungi airport on an SN Brussels flight together with a few other people who were soon to be my colleagues and housemates. I remember it being hot and sticky while we were waiting to get on a helicopter to reach Freetown. I remember the drive along the beach road to get to Wilberforce to our team house. I remember falling in love with our amazing gazebo there. And getting settled in to a place that I would call home for the next 4 years!

My plan was to come to Sierra Leone to set up an outpatient clinic at the Mercy Ships Centre in Aberdeen. I planned to be here for a year. After being in Sierra Leone for only a week I soon realized the horrific child health statistics and the dire need for paediatric care. I knew what my mission was: a paediatric clinic. And that is what happened. I successfully set up a paediatric clinic for children 12 years old and under in Aberdeen and managed/ran clinics there for 4 years. Despite the many challenges, I loved it. I loved getting to know the children and families and being able to follow-up my patients. I enjoyed working with my Sierra Leonean colleagues. But after 4 1/2 years it was time to move on.

I left Sierra Leone for a period of 10 months, in which I spent time in the USA, the Netherlands and Haiti (post-earthquake). I was keen to continue with healthcare in the developing world and looked into various options in Africa and Haiti but Sierra Leone's magnet pulled me back. I looked into various options and fortunately, Welbodi Partnership, my first choice post, was keen to have me on board and before I knew it I was on my way back to Salone. And so, since June 2010 I have been working at the only children's hospital in the country. I initially worked as medical coordinator and team leader and have recently switched to the role of senior advisor. I am leaving a lot of the team management and logistics behind and hoping to be involved more clinically as well as continue with projects such as the development of the laboratory and radiology departments. There’s enough work to do, so I’m sure I’ll still have my hands full!

It has been an amazing 7 years. I have met so many people - many expats have come and gone and I've definitely made some life-long friends. I have become friends with a number of Sierra Leones and appreciate how they put up with me, my complaints, and my ignorance at times and I am grateful for the advice they give me! The work has been challenging. It's sometimes hard to see how things have changed when you're in the middle of it. But, having been here for 7 years, I can definitely say that although we have a long way to go, things have certainly improved. The Children's hospital now has running water, a back-up generator, oxygen concentrators, an emergency room and triage system, etc.

I have no idea how long I'll stay. It could be a year, it could be years. There's still a lot to do here. Although the child health statistics have improved (we are now have the 4th highest child mortality rate in the world instead of the highest), they are nowhere near good enough. I feel like my mission is not yet over. So, I will press on and play my part. Thanks for journeying with me!

TEDx Lumley...

I am not sure how many of you are familiar with TEDx events? Up until last year, I never heard of it. It wasn’t until a friend of mine spoke at an event and sent me the link to watch it that I learned about TED. I was impressed.

Technology, Entertainment, Design. TED is a nonprofit website (www.TED.com) devoted to ‘Ideas Worth Spreading’. It’s a great international resource of free videos, speeches and materials for international ideas sharing. TEDx events are independent events held all over the world in which people can share their ideas in presentations that are 18 minutes or less.

The TEDx event held at Lagoonda in Aberdeen last Wednesday was the first-ever in Sierra Leone; it was an event I did not want to miss. The theme was “Visionary Leadership and the application of Technology to change lives”. There were two speakers from Sierra Leone as well as international TEDx videos. We listened to talks on the digital divide, bringing low-cost satellite television into the homes of Sierra Leoneans, using mobile phones to fight poverty in Bangladesh and a mobile phone money transfer system in Sierra Leone. We also listened to a very inspiring speech by Steve Jobs entitled ‘How to live before you die’.

The talks were thought provoking and inspirational. Some questions that came up were: Is access to internet a right? Does foreign aid only empower authorities and not citizens? Is business enterprise more effective than financial aid to governments? How can you drive behavioral change? Should you reward good performance and punish non-performance? What are people passionate about?

I’d say the evening was a success, although the opportunity for discussion in small groups would have been really interesting. I am already looking forward to the next TED event and will try in the meantime to download a few TED videos to watch on my own if possible.

What keeps me busy...

People often ask me what I get up to in Freetown. To be honest, I am out many evenings. I can never quite re-call what I spend my time doing because it’s a mix of seeing friends, going to events, etc. Although I get out a lot, I still feel like there are many people I don’t catch up with regularly. So what do I actually do?

I usually go to a Wednesday night Bible study group and a Thursday evening women’s group. On Tuesdays I’ll often go for a run on the beach and then hang out with friends. On Fridays and Saturdays there’s often some kind of event, or dinner out or sometimes I’ll go to Bliss to make use of the internet. There are a lot of expatriates here that I try to catch up with – sometimes in a group setting, sometimes one-on-one, as well as Sierra Leoneans that I meet up with.

Just to give you an idea, this is what my evenings looked like this past week: a goodbye party for a friend who has been here for 3 years, an afternoon and evening at River 2 beach until after sunset, visiting my friends Hawa and Gibrill at their house and enjoying a Sierra Leonean dinner, a run on the beach followed by a chat with a friend, a TEDx event, an open mic night at O’Casey’s bar, the Thursday night women’s group, a photo exhibition at Bliss.

As you can probably tell, Freetown life is actually quite exciting. It’s such a diverse place with so many opportunities. Today I went to the launching of a new hiking trail up Sugar Loaf mountain. That’s not an everyday happening. Neither is a TEDx event and a photo exhibition. And that all happened in the past week. Life is far from boring here. It’s definitely nice to have a change from the busy/crazy/rollercoaster days at the hospital but it is also important to get the balance right. There are definitely times when I need an evening in as well; like tonight. A night to catch up with life, write a few blog posts and rest after a hike up Sugar Loaf Mountain!

The top of Sugar Loaf Mountain, finally...

Saturday marked the day that I made it to the top of Sugar Loaf Mountain. After living in Sierra Leone for almost 7 years, I finally did it. To be honest, there was only one other time I attempted to climb Sugar Loaf and although that hike was quite an adventure, we didn’t make it to the top. If you read my previous post “The Wrong Mountain…” you’ll see that we actually made it to the top of another mountain. It happens.

I have waited for the opportunity to climb Sugar Loaf again so when I found out there was a hike today, I ‘signed up’ for it. Not only was this going to be a hike up Sugar Loaf, it was also the launching of a new trail from Regent to the top of the mountain. The event was organized by WAPFoR (Western Area Peninsula Forest Reserve) an organization working with the Ministry of Agriculture to preserve the forest. One of their activities is to create 80 km of trails to encourage eco-tourism and educate people on the need of preserving the forest.

Being the time-oriented folk that we are, us ‘white people’ showed up at 9 am on the dot (or earlier) and found ourselves waiting for our fellow Sierra Leonean climbers who were running on ‘BMT = black man time’. I think the group was mostly complete shortly after 10 am. Without much more delay a speech was held, followed by the cutting of the ribbon and after that the hike began.

The hike itself was enjoyable although a bit more difficult than I thought it would be. I am definitely out of shape and was breathless here and there. I think we started off far too quickly. After a little while I decided to take it at a slower pace; after all, I wanted to enjoy the hike, not feel like I was about to die. I met a number of new people and had some interesting chats along the way.

When we got to the top we enjoyed the view from various spots. It was a bit hazy, so we did not have brilliant views, but the sight of the forests and hills was still great. We were given a packed lunch and drinks from the organizers (a pleasant surprise) and also took a group photo at the top of the mountain which ended with some crazy singing. It really was a fun trip.

The way down was much easier than expected and it was nice to be able to enjoy the view a bit more and hold a conversation without worrying about being short of breath. It was fun chatting with my two colleagues, Tom and Suzanne, as well as two new friends who I met on the water taxi 10 days ago who are new to Freetown. It was definitely a memorable experience and great exercise although I think I’ll be feeling my muscles tomorrow!

I’m glad I made it to the top and am sure I’ll do it again in the near future. More people need to climb it and I now know the way!

Life in SL versus NL...

I’ve been back in Sierra Leone for 10 days now and have been thinking about what makes life here so different. Here are some examples…

• I don’t have Internet access at home
• I do go to Bliss with satellite Internet, smoothies and crepes
• I shouldn’t drink water straight from the tap
• What I can do is drink water from 500ml plastic bag
• I eat/drink ants when they sneak into my food or tea (via milk powder)
• Luncheon meat (a.k.a. spam) or laughing cow cheese usually accompany my bread at lunch
• Dinners consist of noodle soup all too often
• I cook using a gas stove and have to get the gas bottle filled when empty
• And when I do cook, aubergine (eggplant) is a used in most meals.
• I can sleep in my own bed!
• I can’t walk down a street anonymously
• On my road the children frequently call out ‘Sandra, Sandra’ as I walk past
• I sleep under a mosquito net at night
• I have security guards on the compound 24-7
• I get around on taxis or poda podas (minibuses) rather than a bike
• I get to attend exciting events like a TEDx night, photo exhibitions and the launch of a new hiking trail
• It’s around 28 Celsius rather than about 5
• There are about 3 traffic lights in Freetown, none of which work
• There is a thick layer of red dust hovering over the city
• I thankfully have a lady who cleans the flat and hand washes our clothes, saving me a lot of time
• People ‘flash me’ with their phone, meaning the phone rings once or twice and they hang up so that I’ll call them back on my phone credit
• I have a driver drive me to and from work everyday
• I get to speak Krio and rarely use my Dutch
• I have various groups of friends I meet with a couple of times a week
• The water pressure is low meaning I can’t wash my hair standing up
• I hang out with people from many different countries/cultures
• I have a stock of good chocolate I cherish in the fridge
• Sleeping is difficult at times due to barking dogs, loud music and heat
• No one looks at me strangely if I strike up a conversation with him or her on the street or in a taxi
• A lot of my neighbors live in shacks
• Water and electricity are not constant at the children’s hospital or at home (although pretty good)
• I drink an average of one bottle of Coca-Cola a day
• A lady comes to our office most days selling cakes, banana bread and other Sierra Leonean snacks
• I’m enjoying the kilo block of Dutch Gouda I brought back but very much missing milk
• If I wanted to I could go to the beach every weekend
• The sermon at church is generally an hour long
• I teach Sunday school a few times a month to lively 6-10 year olds
• I sometimes miss decent roads and sidewalks and fear I’ll fall into a gutter
• I eat much more fish here and it’s fantastic

The three hardest differences are probably that:

• Children die in the hospital I work at on a daily basis
• A lot of people do not seem motivated to help sick children
• Family is very far away

The best is that I feel like I can make a difference here and hopefully improve child health and in the meantime enjoy life in Salone.

Coca-Cola...

It is true. On average I have a bottle of Coca – Cola a day. It’s not so good for the teeth, I know. However, during a hot day in the office it is SO refreshing to sit outside in the shade and drink a cold bottle of Coca – Cola. It definitely picks me up. And the bottles are so much tastier than the cans. That’s a fact. While I was away in the UK and the Netherlands I decided to do a Coca - Cola fast. For 2 weeks I didn’t have any soft drinks. And it actually wasn’t difficult. I felt like I had more options at home, like juices, milk, iced tea etc. Plus, it was really cold outside, making it easier too, meaning I often had hot tea! Of course, now that I am back I’ve re-started my habit but I will try to stick to one a day! I can think of many worse things in life, so I am going to continue enjoying my Coca – Cola.