Do not be anxious...

"Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God." Phil. 4:6

After donating blood in February I found out I'm anemic. I've been wanting to donate again, but only if my blood was back to normal. So, now that I'm in Holland for 10 days, I figured I should get my blood checked (since laboratory results are not the most reliable in Freetown). Well, I'm still anemic and we are now trying to figure out the cause of the anemia. My mind automatically switches to doctor mode. I recall the three categories of causes: blood loss, faulty or decreased production, increased destruction. I look at my results and try to draw some conclusions.

Considering my eating habits in Salone (not always cooking, little meat due to electricity issues, poor variety of vegetables), some type (or combination) of deficiency seemed it would be the most likely cause. But surprise, my iron stores, vitamin B12 and folic acid are normal! In some ways that is good because I really did not tolerate the iron tablets well before, however, treatment would have been straightforward! Now we need to look further and I'm waiting for more results.

Am I worried? Only a little. Only because there is always a small chance that there might be a serious underlying cause and only because I am supposed to travel back to Sierra Leone on Saturday. To be honest, my guess is we may not find a cause. Besides feeling tired (and having lost a fair amount of weight) I feel fine. I also think that likely my hemoglobin was much lower a few months ago and I am hoping it's on the mend. I suppose it's the uncertainty that is worrying me and realizing that if I go back to SL and something goes wrong, I'm kind of stuck.

Although this is something small, it reminds me of how vulnerable all of us are. And it brings life into perspective. It makes me think of people I know who are fighting for their life and dealing with issues so much bigger than what I am facing. For all of you out there who feel like you are facing an impossible situation and do not quite know what tomorrow holds: Do not be anxious. Go to our Father. Trust in Him. He is Able.

I'll wait and see what the doctor says seeing as there's nothing I can do about any of this now anyway. In the meantime I will enjoy the rest of my time here. Today's plan is studying and then heading over to my sister's place to hang out with her and her family and celebrate my brother-in-law's birthday! Good times with family.

Nine days in Nigeria...

Nigeria. What can I say? I went, I survived and I came back. I did not get a t-shirt or any other souvenirs for that matter but I do have a stamp in my passport and more importantly by West African standards, I have a certificate of participation to hang on my wall! That's all that really matters, right?

Honestly, it was a pretty good trip (I can say that now that I'm back). It could have been a lot worse. I was not pleased that it took us about 1 1/2 to get our luggage on arrival and much less pleased by the 3 so-called police officers that harassed us in the parking lot at midnight. It wasn't the nicest welcome. Let's just say that as soon as I arrived in Lagos, I was ready to move on to Ibadan.

Of course, in Ibadan we were again faced with the somewhat less safe conditions in Nigera. Dr. Jalloh was supposed to stay with friends but their house had been broken into the previous night. He decided he would stay in the hostel on the hospital compound as well. So, 4 of us stayed in the hostel- small but decent. The only annoying thing was that the electric stove took about 1 hour to boil water. Oh, and the toilet didn't flush properly and the tap was broken but other than that it was fine.

The revision course was good. I was pleasantly surprised by the high quality of teaching - what a relief!? I would have backed out of this whole idea had the teaching been rubbish. Thankfully it was good- interactive, up-to-date, relevant, etc. Of course, there were a few lecturers who were extremely boring, but that can happen anywhere. We had lectures from 8am-7pm which meant long days, after which we stumbled back to the hostel for some more studying and sleep.

Really, the course was worth going to but I have honestly never missed Sierra Leone as much in my life. It sounds strange now but I was counting down the (nine long) days to come back. I was so thankful for phone calls and text messages with Suzanne, Allison, my mom, Gibrill and Osman. And the random calls from people in Sierra Leone that didn't realize I was out of the country. It's quite convenient that Airtel works in Nigeria!

Thanks to those who prayed for my trip! I appreciate it. Especially Allison and Suzanne who prayed after I texted them from a crazy highway on our way back to Lagos. I'd not been so afraid on the road for a while. Talk about manic driving. As you can imagine, I was happy to arrive in Lagos again, thankful we could stay at Prof's son's house (thanks Prof!) and happy to be flying home the next day. It's a bit of a shame we didn't see much of Nigeria... maybe next time. We did see Prof's hospital which was quite fun and I was impressed by the level of the commitment the staff showed. All in all, it was quite the experience...

Exam Day: T-49...

Many of you may already know this but I have done something crazy. I registered to take the West African College of Physician (WACP) Primary Exam in Pediatrics this October. This is a very difficult exam which one needs to pass to enter the residency program through the West African College.

Why am I doing this? That’s a very good question and one I ask myself often. Believe me, having to study for this exam is quite stressful and I wonder why I am putting myself through this when I could be hanging out with my friends! Since I’ve just done general medicine but love pediatrics (and have been doing pediatrics for the past 7 years) I’ve been contemplating actually specializing in pediatrics. However, it just didn’t seem like doing so in Europe or the USA made much sense. First of all, I’m not too keen to practice in those places, plus it’s not quite as relevant for the situation here. So, since I heard that the WACP is recognized as an equivalent to the Royal College of Pediatrics in the UK, I thought this might be the way to go. Another reason why I’ve chosen this option is because I still want to contribute to improving child health in Sierra Leone, and with that, the postgraduate training program for doctors here. What better way to support the program than to go through it myself and show people this can be done. That’s the idealistic reason behind this of course.

So, it’s another 7 weeks till the exam. This is the first hurdle and a very difficult one. The exam has a 20% pass rate and it’s not because people don’t study. It really is a tough exam. I recently went to Nigeria to attend the update course – a very intense week with about 10 hours of lectures a day and I’m hoping that increased my chances. All I can do is try. I’ll try in October, and if I don’t pass, I’ll give it a go again in April. If I still don’t pass, we’ll just say God has other plans! It’s not like there aren’t any options out there…it’s a matter of figuring out what’s His best plan for me.

I already know that once I master this hurdle there will be many more to come. First of all, our residency program is not established yet, but we are trying. We hope to get the Children’s Hospital accredited early next year through the West African College. This involves making sure we get the digital x-ray system up and running (thanks for donations so far) and improving the laboratory and medical records as well as many other things. We have our work cut out for us! It also means I would start rotating around the hospital and doing on-calls – both frighten me a bit. And it means many more things will come my way that I’ll have to deal with as they come up. It also means staying here for the next few years, which some days excites me and other days really doesn’t. I think the hardest thing for me has been seeing so many friends leave over the past few months…I get tired of doing this ‘on my own’. Even that is something God knows and sees and I truly am thankful for the people He’s brought along my path!

Anyway, for now, I’ll try to study when I can and trust that God will open and close doors along the way.

Guma Valley Trip...

For my birthday I thought it would be fun to go to Guma Valley Dam. It's one of my favorite places in the Freetown area and it had been 3 years since I last visited. So, I convinced Osman, Suzanne and Gibrill to come with me.

We had to spend a couple of hours in the morning trying sort out the permit, but once we got it we were ready for our adventure. Mind you, I hadn't really counted on the rain but nevertheless it was fun and it wasn't until the end of our visit that it really started pouring. The Dam is an amazing place. It's great to be in the middle of nature, away from the city noise. I'll definitely go back again!

Guinea trip...

In June, I went to Guinea. It was a bit of an unexpected trip. A week earlier I had sent Osman on a mission to take a patient to the neurosurgeons at the hospital there. 8-year old Sulaiman came to us with hydrocephalus (water on the brain) and needed more help than we could give him. Within the next week 2 more patients showed up needing to see a neurosurgeon - 7 year old Mamadu and 8 month old Sheik. We decided to take them to Guinea as well. So, at 6am on a Sunday morning Osman and I took two families to Guinea.

I have to say the set up was pretty good - with a house for all of the patients and parents to stay at. It did take us a long time to get from there to the hospital due to Conakry traffic. At the hospital they had designated rooms for hydrocephalus patients. Overall I was impressed by the organization and what they could offer. Sadly, both Sulaiman and Mamadu had brain tumors and both have since passed away. They did have shunts placed, but removing the tumor proved too difficult, especially since no other treatment was available (like radiotherapy). Sheik is still there. He had a shunt placed about 6 weeks ago but had a few problems recently and is still at the hospital. Please pray for his recovery and safe arrival back in Freetown.

Osman and I had a bit of time on Monday afternoon to meet up with his brother and uncle which was fun. We then heard there was a naming ceremony taking place the next day at his aunt's house...so we ended up going there. It was an easy way for Osman and his brother to meet up with family. I'll just say it was an interesting experience! We had a special treat - a type of gari with a yoghurt like sauce - it was quite nice. After being social for a few hours we decided it was time to hit the road and get back to Freetown. We knew we had various checkpoints to battle and didn't want to delay our trip too much longer. Thankfully Osman dealt with all of the police officers on the way! Some were quite thoughtful and caring when they saw the patients on the back seat, but most didn't care and only wanted a bribe. Typical. Anyway, all in all it was a good trip.