Monday, May 18, 2020

A clinic day during the COVID19 pandemic…


It’s 6:45 am on a Monday. As I head out the door, I put on a cloth mask and make my way to the paediatric outpatient clinic at the Aberdeen Women's Centre. Unlike many places in the developed world where outpatient services have switched to telemedicine, here in Sierra Leone due to limited connectivity we are still doing in-person consultations. It is the only way to keep essential health services going, which is vital in a country with some of the highest maternal, child and infant mortality rates in the world. 

It goes without saying, safety is our priority: personal safety, colleagues’ safety and that of the patients and caregivers. This is not an easy task and takes considerable planning and resources. Hand hygiene, screening, personal protective equipment (PPE) and social distancing occupy my mind throughout the day. Psychologically it is challenging. Everyone I come into contact with potentially has COVID19. 

On arrival I wash my hands and go through the screening process. Once screened, I enter the hospital compound and make my way to the children’s clinic. I wash my hands. After changing into my scrubs, I wash my hands again before I don personal protective equipment (PPE): head cover, mask, apron, face shield, gloves. Now I am safe, as long as I don’t touch my mask or my face and I wash my hands frequently.   

I walk out of the clinic’s side gate and meet the line of patients waiting to be seen. Our first priority is triage and screening. Triage to ensure that the sickest children are seen first, and screening to identify any potential COVID19 cases to isolate them for testing. During this process we have to ensure that patients are socially distanced and masked up. Although it is made somewhat easier due to painted markings on the sidewalk and chairs placed at least a meter apart, it can be chaotic, requiring a lot of patience. 

Screening takes time but eventually the patients enter the clinic; all wearing face masks. Next, one of the nurses does a health talk, using the time to educate the caregivers about corona virus and how to prevent it. Meanwhile I attend to very sick children in our observation room or, if there aren’t any emergency cases, I prepare my consultation room; disinfecting the table and chairs and making sure I have gloves and hand sanitizer. Finally, I start the general consultations. 

Consultations are carried out as usual except that I consider every person to be a suspect case. Although we screen at the gate, we will miss cases, in particular asymptomatic caregivers. So, I make sure the caregiver and child are sitting at least a meter away from me and I keep my mask and face shield on, using gloves for every patient contact followed by hand hygiene. This process repeats itself until every patient has been seen, either by my colleagues or myself. 

After all of the patients leave, I remove my face shield for disinfection and reuse, wash my hands and attend to administrative tasks, trainings and meetings. My mask is kept on, because even those I work with are suspects. Anyone could be an asymptomatic carrier. 

It’s time to clock out. I doff any remaining PPE, wash my hands, change my clothes, put on a cloth mask and make my way home. On entering my compound, I wash my hands before heading indoors. The workday is done and I can only hope that I kept myself safe today. 

All across Sierra Leone, healthcare workers continue to provide essential health services, as well as COVID19 care. Please pray for courage, safety and perseverance. 

#TogetherWeCan #EndCorona #ProvidingEssentialHealthcare #ChildrenMatter

Sunday, April 12, 2020

An unexpected Easter in COVID-19 times...

I am writing to you from mandatory quarantine; all is well. I am currently healthy. Spending time in isolation has given me the opportunity to reflect and although this Easter has not gone as planned, it is probably one of the more meaningful Easter’s I’ve had. 

Over the past few weeks, the following words have become all too real to people all over the world. Isolation. Chaos. Confusion. Fear. Death. Suffering. Loneliness. Pain. Hurt. Loss. Doubt. Distress. Uncertainty. Despair. We are confronted with the reality of separation, disease and death. Our world feels like it has been turned upside down. Maybe it’s not so crazy that this pandemic happens to coincide with Easter.

The moments leading up to Jesus’ death were full of turmoil. Jesus was distressed and troubled in the garden of Gethsemane. One of his very own, Judas, betrays him. Peter disowns him. Soldiers mock him. Those who pass by the cross hurl insults at him. And at noon, complete darkness fills the land. Jesus cries out “My God, my God, why have you forsaken me?” How many of us have asked where God is in the midst of this COVID-19 pandemic? The earth shook. The temple curtain split in two. Unprecedented. A day like no other.

The good news is, resurrection Sunday came. The angel said to the women, “Do not be afraid, for I know that you are looking for Jesus, who was crucified. He is not here; He is risen, just as he said.” (Matthew 28:5-6)  Death did not hold Jesus. The darkest moment in history transformed into the greatest love story the world has ever known. Amazing grace. Through His death and resurrection, we are brought out of the darkness and into the light.  He does not promise us an easy life but He promises us a life with Him. In the middle of our current unexpected storm, He is our anchor. He is our light and our strength in these dark times. He is our peace. Hope is not lost. 

Christ is risen! Let’s rejoice today as we celebrate our Lord and Saviour – our hope and our strength! May you have a deeper awareness of His love and peace today. 

Friday, April 10, 2020

Good Friday: in the midst of chaos and uncertainty

On Good Friday, I am reminded that in the midst of the chaos and uncertainty in the world, and despite Easter weekend looking very different this year than we may have imagined or hoped due to the COVID-19 pandemic, Jesus is the same yesterday, today and forever. 

Our circumstances change, but He doesn’t. We feel like we’ve lost control, but He hasn’t. We may feel alone, but He is with us. He is the same yesterday, today and forever. 

Today I reflect on the amazing sacrifice He made, the outrageous love He displayed and the grace He extends to me over and over again. May we rejoice in the hope that we have in Him. And may we remember that He is the same yesterday, today and forever. 

Tuesday, March 31, 2020

Whirlwind Weeks: COVID19 confirmed in Sierra Leone

The last few weeks have been quite something; it's hard to even put it in words. The whole world is consumed by COVID19 with daily increases of cases, deaths, lockdowns, overwhelmed health facilities, shortages of personal protective equipment and pretty much every headline focussed on the disease. Meanwhile, Sierra Leone was amongst a small group of countries in the world yet to confirm a case. However, as the President of Sierra Leone stated on the 24th March 2020, when he declared a State of Public Emergency, it was not a matter of 'if' the coronavirus would come to Sierra Leone, but 'when'. 

Sadly, today is that day. The first COVID19 case was confirmed in Sierra Leone. The index case is a national who traveled from Europe back to Sierra Leone. Symptoms were experienced during quarantine and the index case went to an appropriate health facility for isolation and testing without first going home. Confirmatory tests were positive. Thankfully, the person is in stable condition and measures have been put in place for contact tracing in a systematic manner. We all hope and pray this disease will be contained. 

The government has made good efforts during the preparedness phase to try to prevent/contain COVID19 from coming to/spreading in Sierra Leone. The big shift came on the 19th of March when the government announced that flights would be suspended for a period of 90 days. Within hours and days a myriad of measures were put into place including no large gatherings, closing of mosques and churches, schools stopping by the 31st March, stopping the LUMA markets upcountry, restrictions of passengers in public transport, closing the land borders and declaring a State of Public Emergency. Now that we have a case in country, additional measures will follow.

While the government plays its part, and the various pillars at the Emergency Operations Centre work hard to contain COVID19, it's important that we as individuals take ownership and make sure we prevent spread of this disease.

Wash your hands with soap and water frequently for at least 20 seconds.
Cough and sneeze into your elbow.

Do not touch your face. 
Avoid contact with sick people.
Keep physical distance from each other. 
Call 117 if you are sick.
Follow local health advice.

Let's pray for Sierra Leone and for the world.

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