Sandra's Latest

Cleaners strike, trip to Bailor and more...

2012-01-27T19:21:00.002+01:00

I'll be sure to write more soon. I realize I have not blogged in quite a while. It's been busy with new colleagues, handing over a number of my responsibilities, etc. That and no internet at home means that blogging does not happen much.

Come back soon to read about what happens when cleaners decide to strike and how a trip to Namina's village turned into a big outing for the children and more.

New Year's resolutions...

2012-01-04T00:33:00.003+01:00

"A New Year's resolution is a commitment a person makes to one or more lasting personal goals, projects, or the reforming of a habit.This goal must be reached by the next New Year. Keep in mind that this is a goal, not a wish and should be something that you as a person could strive for." (Wikipedia)

I tell myself on December 31st that I don't make New Year's resolutions because I know I'll never stick to them anyway. However, I think secretly, in my mind, I do make some resolutions. They're not huge milestones or significant changes, but things I would like to improve and change slowly over time. Or maybe things I want to focus on a bit more, and be more aware of. Really, they are things that I should be working on for a lifetime.

Here are some of the things I came up with:

Focus more on the positive
When frustrated, try to figure out how to use the moment to bring about something good
Walk with more humility
Be a better listener
Try to be more understanding
Be more considerate
Love life and all it brings my way

Those aren't really resolutions in my book. They are things I should be working on all the time, and things that I'll never quite accomplish this year. I'll confess though that I do have one or two true resolutions now that I think of it, but to be honest, I thought of these a few months ago - before New Year - and that is to learn a little bit of some of the local languages like Temne and Fula and to push myself a bit more academically. We'll see!

Happy 2012...

2011-12-31T10:56:00.002+01:00

Wishing you a Happy New Year from Hamilton Beach.
May it be full of great adventures, many successes, lots of laughter, special moments with family and friends and fun surprises.
Let us endeavour to act justly, love mercy and walk humbly in all we do.
All the best in 2012.

Christmas 2011 in Salone...

2011-12-31T10:36:00.002+01:00

Christmas 2011.
Away from family but with friends. I was surprised with Christmas mail and presents from family and friends from all over the world. Thank you! Colleagues that went home for Christmas left gifts in my stocking. Tenki plenti! My friend and colleague Emily came to spend Christmas and New Years here, which has been fun. The morning was spent at Regent church where the children performed their Christmas play. They did an excellent job. We spent the afternoon with an English family - good conversation, playing with playmobil castles and dragons, watching the children open their gifts with delight, enjoying an amazing Christmas dinner (thanks Anne!), blowing out candles on the Happy Birthday Jesus cake. It was so nice to spend the afternoon with a family here. In the evening Emily and I went to Lumley beach and enjoyed the sunset. It was a good Christmas!

Top 11 of 2011 in pictures...

2011-12-30T20:44:00.007+01:00

"Oxygen for Christmas" 2010 was a big success with concentrators arriving in February.

Welcoming the Africa Mercy to Sierra Leone.

The pleasure of helping the children with Burkitt's lymphoma.

April 27th - Independence Day and all of the festivities plus Vez and Rob's visit.

Decorating Easter eggs with Sarah, Mikey and Francis.

The Comic Relief Reveal and receiving the grant money to improve child health.

Namina's surgery on the Africa Mercy.

The successful Welbodi quiz night at IMATT.

Time with family in Colorado.

Time with family in Middelburg.

Multiple trips to Namina and family in Bailor town.

2011 has been an amazing year. There have been many highs and of course some lows too. All in all it was an excellent year and I look back with fond memories. I'm hoping for an exciting 2012 with many adventures.

Thanksgiving...

2011-11-24T20:06:00.004+01:00

Today is Thanksgiving. Although I won't be feasting on turkey, stuffing, mashed potatoes or pumpkin pie, I can definitely say I have a lot to be thankful for:

Health - I've only been sick 3 times since coming to SL in 2005 and only required time in bed with ORS and paracetamol.
Safety on the road - I've been in a couple of near-accidents, but have been kept safe on the roads and avoided major incidents
Electricity - well, we didn't have NPA for a week, but now have power again. YAY.
Water - so far so good, we've had a long stretch with water. Now that the rains have stopped we'll have to get water bowsers (trucks) to fill the water tank.
Friends - grateful for a good group of friends around me, both colleagues at work and others in the international community especially
Africa Mercy - even though I have only been onboard a few times in the last two months, it is great to have the ship here. Especially in the first 6 months I was onboard a lot, both for work and pleasure. It has been a blessing to be able to send patients to the ship for diagnostics and treatment.
Family - I really miss them, especially getting to know my nieces and nephew.
Internet - It's not been working well at the hospital and we still don't have it at the house, but at least there are places I can go to access the internet, which is especially good for facebook and skype.
Life - we had a morbidity and mortality meeting today. 152 children died in October. That's a lot of death. The average life expectancy here is less than 50 years of age. There are funerals all the time. I am happy to be alive today.
Chocolate - chocolate bars, chocolate milk, chocolate anything. Chocolate makes me smile. I know my diet is pretty poor here (as in, I skip too many meals, and hardly eat meat), and chocolate probably doesn't help matters much. But the happiness it brings is worth a lot!
Beaches - rainy season is over, I think. It actually hasn't rained at all this week, not even at night. This means that Saturdays can be spent at the beach again. Thankful. I love the beach. I've also tried to start running again. Coming home around dusk though means I can't run during the week, but weekend, here I come.

There is so much more I am thankful for! A de tel papa God plenti tenki!

Hot from the press...

2011-11-22T20:21:00.001+01:00

Kuwait Fund Gives US$15m to the Health Ministry in Sierra Leone

The Minister of Health and Sanitation, Haja Hawa Zainab Bangura has disclosed that her ministry has received $15 million United States dollars from the Kuwait Fund which will be used to upgrade the Ola During Children’s Hospital. She said the money will also be used to commence post-graduate training, build oxygen and fluid factories and also revealed that by next year 13 doctors will be sent to further their studies abroad.

She was addressing the press at the Information and Communications Ministry yesterday Thursday November 17, 2011 where she maintained that by next year, they will be building 49 health facilities. “Three hundred and fifthy (350) State Enrolled Community Health Nurses, three hundred (300) State Registered Nurses will be employed and three hundred (300) doctors are expected to graduate from COMAHS. They will be given full residential and horsemanship training to fully prepare them to meet the challenges in the health sector,” Minister Bangura revealed.

She stated that there are presently 21 hospitals nationwide, in which 18 provide Free Health Care facilities, and that they also intend to have at least 8 doctors in every district hospital. She said out of the 40 Gynaecologists needed only one is available in Sierra Leone. She also affirmed that the distribution of the Free Health Care drugs is one of their major problems in terms of accessibility.

The Minister also revealed that they will continue the distribution of the Free Health Care Drugs nationwide today. She said the Free Health Care policy was introduced by President Ernest Bai Koroma for children under 5 and lactating mothers so as to meet the MDG’s 4&5. She said they have 140 containers of drugs worth US$11m in stores, and 52 of the 140 containers will be distributed nationwide and the exercise is expected to end on the 15th December, 2011.

“To achieve an effective delivery process we have put strategies in place so that no discrepancy will be reported in the delivery process and that 6% loss was reported during the initial delivery process. Initially the problems we had include infrastructure, human resources and combined criminal acts, but all these have been sorted out and this will enable the drugs reach the real beneficiaries,” Minister Bangura stressed with optimism.

Source: http://news.sl/drwebsite/publish/article_200519187.shtml

Sierra Leone elections: One year to go...

2011-11-17T17:12:00.000+01:00

I believe it was last week that the electoral commissioner, Christiana Thorpe, announced that the presidential elections in Sierra Leone will take place on Novmeber 17^th 2012. That’s one year from today.

Will His Excellency Ernest Bai Koroma, APC, be re-elected as president or will another party take the lead? Only time will tell.

I clearly remember the elections that took place in 2007. Everyone was wondering whether or not they would pass peacefully. While thousands, actually about 2 million, people went to the polling stations to vote, we were confined to our team house compound on Lumley road. Just in case. Fortunately, both the first round of elections and the run-off was peaceful. Fingers crossed the same will happen this time around. I’ll keep you posted.

Another day of bliss...

2011-11-05T14:37:00.000+01:00

Today is a lazy Saturday. I didn't sleep much last night and was woken up early for various reasons, one being very loud music coming from the compound next door, but I managed to get out the door before 10 with my flat mate. We headed for Bliss patisserie. Our plan was brunch and internet. The internet was slow at first but picked up as the morning progressed.

After a busy week it's great to have some down time. The week was a bit unusual. On Monday we worked as usual. Tuesday marked the start of Comic Relief funding. Wednesday we attended the opening ceremony for the Sierra Leone Medical and Dental Association. The Minister of Health officially opened the Congress and a very experienced paediatrician, Dr Robbin-Coker, gave the key message. Since the theme this year was Child Health, it was very relevant to us and worth going. It was also a good place to network! Thursday I spent the day with three doctors from King's College in London. It was a very good/productive day, but kept me from my usual work. We met with key people in both the Children' s and Maternity hospital and also made a visit to Kissy Mental Hospital. On Friday work was as usual and ended with a management meeting in the afternoon. A meeting that should take place every month, but hadn't taken place since July. After that I was ready to call it a day but got caught up with some patient care - trying to find a patients chart for re-admission and trying to convince the dispenser to dispense ceftriaxone to one of the children on the general ward. It's a long story, but we tend to have a complicated medication system.

Anyway, it's great to have a day off. I have a Board meeting tomorrow afternoon - by skype! We'll see how that goes. It's supposed to be a skype meeting with two of us from Freetown, two people in the UK and two people in the USA. We'll see what happens. Monday is a public holiday (Eid) and seeing as we've all been working pretty hard, we thought we would plan a mandatory team outing to the beach! We'll see what happens. For now, I am going to enjoy a crepe with apples and ice cream.

Green light from Comic Relief...

2011-11-01T09:44:00.001+01:00

A few months ago Welbodi Partnership was awarded a three-year grant from Comic Relief to support the work we are doing at the Ola During Children’s Hospital. We are happy to say that the funding should be released today, November 1^st. The money from Comic Relief will enable us to support bigger projects that will have a greater impact on the care provided in the hospital. Of course, in leading up to the money being released we have taken the time to improve our financial systems and make processes more robust. We are now ready to GO!

In the next few months, as the grant starts up, we will continue to develop monitoring and evaluation tools. We do not simply want to fund projects and walk away, we want to be able to show three years down the line that the money spent has had a positive impact here at Ola During. We will not only look at the affect on the child mortality rate but also look at the impact of our work on parent satisfaction, staff satisfaction, staff empowerment and the quality of care provided by the doctors and nurses. These are all areas in which we hope to make a positive change. Together with our partners at ODCH and the Ministry of Health and Sanitation we hope to make this grant a huge success.

Breathe in, and out...

2011-10-31T19:04:00.000+01:00

This week is especially busy. I am reminding myself to breathe in and breathe out. What I get done, is done, what I don’t will have to wait until next week.

Our Comic Relief funding starts tomorrow – November 1^st, which is very exciting. However, it also means that we’re starting with a new financial system, which involves a variety of forms that need to be filled out per transaction, spreadsheets to update and a new coding system to learn. I hope I will get used to it quickly. I also need to get cracking again on the Monitoring and Evaluation side of things for Comic Relief, which involves developing tools to monitor patient satisfaction, staff empowerment, quality of care in the hospital and other things. It’s an exciting project but also a lot of work.

I also have to prepare for a Skype Board meeting on Sunday, which means compiling reports and the like. I’m sure it will be a good meeting, if Skype works that is, but it always takes a little preparation time. We’ll be Skyping in from Freetown, London and Boston!

A small team from King’s College in London arrived yesterday. They are here to see how they can partner with Sierra Leone in the area of undergraduate/postgraduate medical/nursing training. They have various meetings lined up and we hope to tag along to some of them. A colleague and myself are meeting with them tonight to finalize the schedule. It’s a fly-by visit with them leaving on Friday but I’m sure it will be productive and hopefully impact training in Sierra Leone in the (near) future.

There is also a congress this week for the Sierra Leone Medical and Dental Association. We’ve been invited to the opening ceremony on Wednesday, which will be a good networking opportunity since most medical professionals in the country will likely be present. It frightens me to think how this will affect clinical care in hospitals on that day... The following two days they will hold scientific sessions, but considering the amount of work to do in the hospital, I’m not sure if I’ll attend. We’ll see how the week goes.

And of course, the usual work goes on. I don’t think I’ll make it to the wards much this week but that’s okay. I spent all day in ICU/Ward 3 on Friday so I’m saturated for now. A physiotherapist from the USA arrived last week and is willing to volunteer her time at the Children’s Hospital a couple of days a week. So, I spent Friday showing her around, introducing her to staff and patients and kicking-off in-patient physiotherapy at the Children’s Hospital. Exciting times.

All right, I have a few more emails to finish off before heading up the road to Mamba Point for a dinner with the Kings crew.

HRH Princess Anne in Sierra Leone...

2011-10-31T08:00:00.000+01:00

Website Article: Visit to Sierra Leone of Her Royal Highness, The Princess Royal

Just after lunchtime on Wednesday a small crowd gathered at Lungi to bid a fond farewell to Her Royal Highness The Princess Royal at the finale of an historic royal visit to Sierra Leone. Her Royal Highness, accompanied by her husband Vice Admiral Sir Timothy Laurence, had spent the past two days in Freetown to mark the 50^th anniversary of independence and recalling the visit of Her Majesty the Queen back in 1961.

Arriving late on Sunday night, the Royal couple’s first taste of Sierra Leone was crossing the bay from Mahera to Freetown, a truly unique airport arrival experience. They awoke the following morning to the bustling sights and sounds of Wilberforce and then wound down Hill Cot Road for a call on His Excellency President Ernest Bai Koroma. During their meeting, the Princess and President discussed the depth and breadth of the historical links shared between Sierra Leone and the United Kingdom and enjoyed a lively conversation about the strength of the 21^st century relationship. This built on a similar conversation during the recent visit of Henry Bellingham MP, the UK’s Minister for Africa.

Keen to experience more of Sierra Leone and to meet its people, the Princess undertook a busy schedule of visits throughout the peninsula. Talking with businessmen and women she learned that British and Sierra Leonean companies are working well together across a range sectors, nearly doubling trade between the two countries during 2010. This dynamic partnership will contribute so much to the prosperity of both countries.

The Royal Family strongly supports development and human rights work around the globe and the Princess is no exception. She was keen to use her first visit to the Sierra Leone to see for herself the progress made in health, education and equality since the war. Staff at the Princess Christian Maternity Hospital (PCMH) described for her the significant role that the UK’s development assistance continues to play in helping to build Sierra Leone’s future; especially through the Free Health Care Initiative. The Save the Children Fund showed her their work with vulnerable groups at Kroo Bay. The Princess is President of SCF’s UK chapter and was pleased to feel a personal connection to the ongoing work of British aid organisations and volunteers in Sierra Leone.

The Princess rounded off her stay in ‘Sweet Salone’ by taking the time to explore her diverse culture, environment and history, visiting Bunce Island and spending an enjoyable afternoon amongst the wildlife at the Tacugama Chimpanzee Sanctuary. Both of which highlight the potential for a vibrant tourism trade in Sierra Leone; bringing further investment, jobs and development.

The British High Commission was keen to document this visit and proposes to share it with as many people as possible. We will be putting more information, including many photographs, onto the High Commission website, flickr and Facebook pages. If you are interested in finding out more about the visit or were lucky enough to have been at the events please check theses out, you may even be in one of the photos!

Taken from: http://ukinsierraleone.fco.gov.uk/en/

Beaches in Sierra Leone...

2011-10-29T22:31:00.003+02:00

The beaches here never cease to amaze me. These photos were taken at Bureh last weekend.

Football...

2011-10-29T22:17:00.004+02:00

Football. An international sport. Fun to watch & fun to play. These were taken at Bureh beach last weekend. The little guy that was goal keeper did an excellent job. He wasn't to be reckoned with. :)

Namina's second surgery...

2011-10-28T22:21:00.002+02:00

Last week Wednesday Namina, her mother and her older brother came to see me at the hospital. They arrived in Freetown as planned for Namina's admission on the Africa Mercy the following day. To my surprise, Namina showed up in her school uniform. She looked adorable. The family seems to be doing well and are coping with the loss of little Ibrahim. As hard as it is to have lost him, they are looking to the future.

A few weeks ago I received a call from Namina's brother saying she was sick: fever and vomiting. I arranged for her to be seen by a doctor (who I had never met) and she was diagnosed with malaria and admitted overnight. She tolerated the medication well and within a few days she had recovered. I was thankful that a friend connected me with the doctor and amazingly he treated her for free even though she is above the age of 5. I was also relieved that she got better quickly because I certainly did not want anymore drama for a family who had recently lost a child to malaria.

So now, 5 months after her first surgery onboard the Africa Mercy, the time had come for surgery number 2. The surgery took place on Friday (a week ago) and the plan was to put another skin graft under her left eye to ensure that her eye is not as exposed. A few other techniques were performed and I am happy to say that the surgery went well. I saw Namina last Sunday and she was as cheerful as ever and getting into trouble already. That's a good sign. I hope to see her again this Sunday and expect she'll be heading home by the end of the week. Back to Lungi and back to school. I'll go and visit them in their village again before Christmas.

Lumley beach in September...

2011-10-28T21:59:00.003+02:00

A September walk on Lumley beach. It really is beautiful, despite the (medical) waste and seaweed that washes up now and then. I should really go down there more often. After all, it's only a 15 minute taxi ride. I always hope to go for a run but usually end up getting home too late to venture down there by taxi, run and make it back before dark. Must keep trying. It's maybe not the most beautiful beach in Sierra Leone, but for being right in Freetown I'd say it's amazing.

Good things...

2011-10-17T15:33:00.000+02:00

On a day like today I need to count the good things that occur.

I woke up in good health.

We had running water in the house.

The Land Rover started this morning.

Amara Kamara who was admitted in ICU with meningitis three weeks ago has been discharged today. I remember the first few days he was with us, with his persistent fits. We were afraid for his life. Today, before leaving he gave me the cutest smile ever. I am very thankful.

The city waste management came to take away a truckload of trash from the compound. That’s a good thing.

The Internet is working in the main building of the hospital.

I was able to arrange a free CT scan for an 11-year-old girl with severe headache. Hopefully it will help in reaching a diagnosis and potentially treatment for her.

A patient of mine has been admitted on the ship for surgery tomorrow.

I just had a very cold bottle of Coca Cola.

It’s the good things that matter today, no matter how small they are.

Another Friday...

2011-10-14T22:17:00.001+02:00

I'm so glad it's weekend. It was another crazy day today. It was one of those interesting days at work in which I ended up doing so many things that probably someone else should have done...

I went to the ward to sort out two patients only to find out one of them disappeared. Instead of waiting for a referral letter (as instructed) for an echocardiogram they decided to go elsewhere for a blood test that needed to take place at some point but which was much less urgent! No one knew where she went at 6 am! Anyway, all said and done, they returned mid-morning and echo is re-scheduled for Saturday.

The second patient has been in hospital for a month and needs anti-tuberculosis medication. Unfortunately the country is out of anti-tuberculosis medication (can you believe it?) and has been for the past month. The child also has an infection in his leg and so I sent him for a second opinion elsewhere. Mom's a trooper cause when I walked in to town later in the afternoon to go to a meeting I met mom on a busy street on her way to the hospital after buying some anti-tuberculosis drugs from the pharmacy. One of the three meds was not right, so we ended up going to the pharmacy together to sort it out. Her child will finally receive anti-tuberculosis treatment now. Question is, will this be sustainable? Let's hope the national TB program's drugs come soon so that there is a continuous and free supply!

Speaking of drug supply, I ended up having to find anesthetic drugs for the maternity hospital today. They were on their last few vials while waiting for a shipment to be released. We found out the drugs will be cleared on Monday so, to tie them over, we arranged a loan of drugs from an NGO hospital. I'd hate to think of what would have happened to the women coming in needing emergency surgery (C-sections, ruptured uterus, etc). Oh Salone. Oh agencies.

Another mom cornered me as I was leaving the ward. That's what happens: you go in to see a patient and arrange something and before you know it, you're asked by another mom to come and see her child. This was a boy I knew from ICU. He was diagnosed with meningitis and is on i.v. Ceftriaxone. He needs to be on i.v. treatment for a while but unfortunately the supply ran out today. I won't go into details because the whole supply/re-stocking is very complicated but it means his treatment will be interrupted. So sad. Fingers crossed he'll make a full recovery. Unfortunately he does have some right-sided weakness but I'm hoping physiotherapy will help! Let’s hope for i.v. Ceftriaxone again on Monday.

I had a meeting today about radiography training and am hopeful about the prospects. Not for me of course, but for the trainees and for the children in the health facilities who will finally have access to x-rays! Let's hope this kicks off in the next two months. Fingers crossed. In the meantime, we need to try to source an x-ray machine, some equipment to go with it, consumables, etc. Toes crossed too.

This evening after we got home from work I went out again to go and visit my driver. He fell down this morning and wasn't able to make it to work. So, a friend and I drove up. He's okay but will probably need some rest and painkillers for a few days. Unfortunately I haven’t been able to convince him to stay away from injections. Almost everyone here loves injections.

When we brought the car back to the office I went inside to download some documents that were sent to me this afternoon. Financial documents for a meeting I have tomorrow. Better late than never? Well, I was a bit frightened by what I saw and decided I would need to stay in the office for a few hours to go through the spreadsheets/documents. So, here I am: in the office, with a cup of tea, looking through spreadsheets (and blogging). In an hour a friend will come to pick me up (and bring some bread) and I’ll head home to sleep. In the morning I am taking the Land Rover to IMATT for inspection and then going to my accounting meeting. I'm definitely taking next weekend off!

Bailor town shots...

2011-10-08T23:52:00.002+02:00

Condolences in Bailor town...

2011-10-08T23:46:00.001+02:00

On hearing about Ibrahim’s death on Tuesday I decided I needed to visit Wara, Namina, Saidu and family in Bailor town to express my sympathy and encourage them. Osman kindly agreed to drive me there, which was great since he is also a friend and knows the family too.

For some reason I was nervous about the trip. I was not sure how the family was doing and unsure what was expected of me. However, I knew I had to go. I prayed for wisdom, sensitivity (knowing culturally what was okay) and safe travels. Osman is a great driver but his car, ABJ, is not the most reliable. I love and hate that car! Also, it was middle of rainy season and the roads and bridges had been damaged. There was a possibility that we would have to take a detour. Only time would tell.

We had an early start on Saturday. The drive to the ferry was fine. The ferry crossing was perfect. We met up with Saidu in Lungi and had breakfast. We then continued on to Bailor. We had to stop at a checkpoint, which was troublesome last time but we made it through quickly without any problems. Saidu said that the bridge had been fixed and was better than last time and so we thought we would try the usual route. Thankfully, the bridge was intact. After the bridge we drove through a mud pool and that didn’t stop us either.

When we arrived in Bailor town people surrounded us within seconds, mostly children. We were taken to the landing outside of the house and I waited for Wara to appear. As soon as she came out I got up to meet her. As I embraced her, she started to weep. Her deep sorrow was so apparent. This woman has been through so much in the last few years. She has sacrificed a lot for her family. And now she was in need of comfort. And that is all I could do. I had the chance to talk to her a little later to encourage her. She’s an amazing woman and I hope that she will sense His peace and comfort.

Namina was in great form and quite cheerful really, which was good. I wondered what was going through her mind though. I spent some time playing and doing some crafts with her and her brother in Saidu’s room. It was nice to have some quality time. I also ended up doing a consultation for an aunty. She had been unwell for a few days. I had come prepared with a stethoscope and some medications for children, but had not expected to see an adult. There wasn’t a whole lot I could do. For the rest I spent time playing with children, went around the village with an aunty to meet ‘everyone’, watched the end of a football match in the ‘cinema’ with Osman and Saidu, waited while the aunty bought fish from the fishermen on the beach, had some coconuts, etc. I didn’t want to take many pictures because this visit seemed a bit different, however, the children kept asking, so just before leaving, I took out my camera. They loved it.

I have to say it wasn’t an easy trip. It was tiring. I fell asleep on the ferry back to Freetown. But it was a good trip. It was the perfect time for me to visit Namina and her family again. And I was worried for no reason. Everything went as planned. Besides a few awkward moments (being stared at by like 20+ people) it was a perfect day.

The day Ibrahim died...

2011-10-08T22:54:00.003+02:00

Tuesday, September the 13^th started off like any other day. Before leaving the flat, I went to the balcony to watch the sunrise. It was pretty amazing. I then headed down to the office on spur road where we park our vehicle. Our driver was slightly delayed due to transport issues, but came soon enough. After a 30-minute journey to the hospital, I started work. Work mostly consisted of firefighting; little issues here and there. And I spent a good portion of the day trying to resolve a conflict between various staff members.

Then I received a phone call. It was from Saidu, Namina’s brother. I thought they were probably just calling to say hello. But no, this time it was different. Saidu called to tell me some bad news. The line was not good and I had to have him repeat the message a few times. I don’t know if it was the connection or if I just couldn’t believe what I was hearing. Saidu was telling me that his little brother Ibrahim died that morning. Silence.

I didn’t know what to say. Osh ya, the Krio phrase for ‘sorry’ is all I could think of. I wanted to speak to Wara, Namina’s mom but she was too distraught. Saidu asked if I could come to the funeral but it was to take place in just a few hours. There was no way I could get to Bailor town on time. I had to say no. Instead, I said I would meet them on Saturday. I still found it hard to believe that Ibrahim was no longer with them. Just two weeks earlier he had been in my office with Wara and Namina, looking like a healthy one-year old. They had just come to visit.

It sounded like Ibrahim had been sick for just two days. Enough I guess to cost him his life. My guess is malaria. His symptoms were fever and paleness. They took him to a ‘hospital’ and he received a couple of injections. That’s all Saidu told me at that time. I knew Ibrahim had not received appropriate treatment and I wished they had come to Freetown. After all the times they had come just to visit, this would have been the crucial time to come. If only.

I know I work at a place where death is a daily occurrence but when it's a little child you know and have come to care for, it hits home a little harder. When you see the pain the family is going through, it is all so much sadder. I can’t change what happened. I can only continue to support this family. And that’s what I did when I went to Bailor town just a few days after Ibrahim’s death. And that is what I will continue to do.

Attention, attention...

2011-10-08T21:51:00.002+02:00

This sign was posted at various sites around the hospital several months ago. It is still there. I've thought about taking it down but I don't want to upset whoever put it up. I am, to be honest, intrigued by this sign. I love the spelling, for one. Secondly, I am so curious as to what kind of herbs are used to treat a sickle cell attack. And interesting that it is free of charge. I guess that should be expected, after all this is the era of free healthcare at the Children's Hospital and Maternity Hospital. However, I almost wish it wasn't free, I'm slightly concerned about easy access to this treatment for patients who could be in critical condition! I wonder if anyone has called the number yet. Should I try?

Internet & Water...

2011-10-08T19:51:00.003+02:00

Here I am at Bliss. And, thankfully, internet is working. And it's fast. It's funny how easily we take things like internet for granted at home. Not having internet at home has been a bit of a challenge. To be honest, I've gotten used to it. But, having said that, it has meant that I have not kept in touch with family and friends much. And, it makes it hard (very expensive) to actually talk to people back home. I have to admit I have done poorly on the blogging front lately. I have so many things I could write about. Soon, soon. Hopefully at some point, we may have internet at home. We do have a usb dongle, which usually works for my colleagues, but it doesn't seem to like my mac. It tends to freeze my computer every time I try to use it. Sometimes it lets me use the internet for twenty minutes or so, but usually it cuts me off before that. All this to say, I am happy to finally have access to fast internet! And I may come here more often. The desserts are definitely a pull as well!

Speaking of taking things for granted. Even here in Sierra Leone I tend to take it for granted that I usually have water running from the tap. Since Thursday we have been out of water in the flat and so it's back to using water from 5 gallon containers. It's not great, but I just remind myself that that is what my neighbors water supply is like all the time. I really can't complain. However, it would be really nice if they can sort out the water at the flat. Apparently the pump to pump the water from the reservoir to the tanks on the roof is broken. The plumber has been twice already. Now that the rains are ended, we may have a water supply problem anyway. Due to road works the Guma pumps in Wilberforce have been locked since September. We're probably going to have to get water delivered every two weeks. We'll see and we'll manage for the time being. Hopefully it doesn't take two months to sort it out like it did last year at this time. Fingers crossed.

Encouragement...

2011-09-24T17:16:00.003+02:00

"God is not unjust; he will not forget your work and the love you have shown him as you have helped his people and continue to help them. We want each of you to show this same diligence to the very end, so that what you hope for may be fully realized."

Hebrews 6:10-11

Rainy Friday...

2011-09-23T07:39:00.000+02:00

Rainy season hasn't ended yet. A lot of people seem to think it should have been done in September, but I always remember it to have rained in September. It's not over yet. To be honest, the rains haven't even been too bad this year so maybe it will be a bit more drawn out than usual.

This morning I left the house at 645 am to meet up with my driver to handover the car key. He needed to go and pick someone up. Off I went, raincoat on and umbrella in hand. I reached the office by 7 am and fortunately the driver appeared a few minutes after I did!

So, I am now at the Spur Road office, using the internet and writing a few documents while waiting for an 8 am meeting. After that, it's errands in town (getting colleagues registered, visas sorted, etc) and last but not least, the hospital. I have to say I'm happy it's Friday. I do have some work to do this weekend...and an Enable the Children Board meeting, but it'll be nice not to have to wake up early and sit in an office all day! And, maybe I'll find some time to blog about my Engineering experience, my trip to Bailor town, the community survey etc.

Hope for Sierra Leone...

2011-09-14T19:10:00.002+02:00

I was pleased to catch a glimpse of the sunrise yesterday. It was a good reminder of the beautiful world we live in. I have to say the last few weeks have been tough. And in tough times in can be hard to see the beauty in anything. Yes, there have been good times, but there have been a lot of difficult and challenging times. Children dying unnecessarily. Colleagues refusing to work together. Lack of motivation for people to do their work. Working in a healthcare system that just does not function as it should. We are trying, but it's not easy. At times it is hard to discern whether or not we are making a difference. However, I am not going to give up. I have invested far too much to give up now! Despite the difficulties, I do love this place and the people and know that with time things will continue to improve. I know that in the middle of the suffering and injustice that takes place, there is still hope. Hope for a better place. Hope for a brighter future. Hope for the children of Sierra Leone. Here's to HOPE.

A hectic Tuesday...

2011-09-06T18:05:00.000+02:00

Whereas yesterday was nice and quiet, and very productive, today was very noisy and hectic. Yes, I was at the hospital again and even though our new office is further removed from the wards, people still come in and out. That is of course absolutely fine, but just means it’s hard to get a lot done.

First of all, I sent our driver to town to buy some NPA (national power) credit and find out our bank balance. Then a colleague came to create and discuss his work plan. During our meeting a lab technician came to report that the hemocue is reading an error. I took the opportunity to teach him how to dismantle and clean it. Then someone from Mercy Ships called about a team of engineers arriving today to do a full assessment of the hospital’s infrastructure. After my meeting I went to Special Care to check on progress there. The work seems to be completed. There are 14 beds for the mothers and they seem very happy. Unfortunately in the neonatal bit, I only saw 2 nurses instead of 6, which meant a trip up to matron’s office to find out what is going on. I then returned to the office to do some printing for a survey we’re conducting. After that I met with the head of the hospital to talk about a few of the SLICH projects that have been delayed. I am not sure if we actually came to any conclusions! From there I went to the head of maintenance to let him know that the engineers are arriving today. On my way, I found a father in tears, who had thrown himself to the ground. He just lost his child. Soon the mother came out and in floods of tears they tried to console each other. I had to try hard to fight back the tears. I then went up to ER and ICU to see how things were. ER was so full and only a house officer; a few medical students, a few nurses and many student nurses could be seen. I am not sure how they will cope today. ICU was a bit calmer, but still there were some very sick children there. I wanted the nurses to check a blood sugar but they told me the glucose strips are done. I asked for them to go and get a new supply. From there I went back to the office. It’s not even noon yet. There’s still a lot to do.

The afternoon ended up being a primarily clinical afternoon, which is sometimes welcome, but definitely not something I planned for today. I was passing through the ER and overhead a conversation about a patient. Meanwhile I noticed that said patient was gasping and so started ventilating with a bag and mask while others were deciding on a plan for fluids. After 40 minutes of ventilating we were a bit stuck: there was still a heart beat but the pupils were fixed and dilated, telling us that the brain has been starved of oxygen and continuing was futile. After another five minutes of bagging, we stopped and within a minute the heart stopped beating. I explained to the mom what had just happened and watched as tears streamed down her face. I was ready to get out, but two more admissions showed up, and no one else was around. While stabilizing the first one, one of my colleagues walked in. I left soon afterwards; back to the office. Later in the afternoon I had to go back to Special Care to see how many nurses were on late shift and walked right in on resuscitation. I helped where I could. Unfortunately it was another failed attempt.

On my way back to the office at 4 pm I ran into the Engineering team. It was good to chat with them a bit and attempt to explain the complicated water system we have here at the hospital! It’s taken Welbodi 3 years to try and figure it out, so hopefully they’ll be much more successful in the week they’re spending here. I’m looking forward to the recommendations they’ll make. Just after 5, we decided to head home. Another day come and gone. Lots done, but very little crossed off of my to-do list! C’est la vie…

A quieter Monday...

2011-09-05T18:03:00.000+02:00

I think today might have been the first time that I waved my colleagues off to the hospital and stayed behind at the Spur Road office on the West side of town. I realized that in order to move forward with Comic Relief, I would need to spend a good chunk of uninterrupted time on it and for today that meant staying away from the clinical world and hiding from the many people that come in and out of the office at the hospital.

So, at 7 am I started work in the office and it was nice and quiet until about 11 am when some others arrived. Fortunately everyone did his or her own thing and my productivity level remained at a high. Internet then cut out, which was annoying, but not a surprise and to be honest, didn’t effect what I was doing anyway. Oh, except for the fact that I was supposed to have a Skype call with one of the Welbodi Director’s. She ended up having to call my phone for a good hour and a half conversation about Comic Relief.

After the Comic Relief call I got a taxi to Connaught Hospital to meet with a radiographer about the ongoing need for a radiology facility at the Maternity and Children’s Hospital. Unfortunately, little progress had been made in the past month or two and our hands are kind of tied. It gave us the opportunity to call up some people in the Ministry to see where they are at with things. Let’s hope there’s progress soon. I was then able to catch my colleagues in the Welbodi car on the way home, which was convenient. And I headed back to the Spur Road office to finish up some work. I was hoping to download a number of documents from googledocs onto my computer, but of course, as soon as I started with the first document, Internet cut out. Go figure. By that time it was 6:30 pm. Time to call it a night!

I spent the evening cooking pasta and pesto, talking to my mom and watching an episode of ER with my colleague. It was in the end a productive day, and I’d say it’s probably worth repeating a day at the Spur Road office in the near future. But tomorrow, it’s back to Ola During...

Another Sunday Summary...

2011-09-04T22:15:00.000+02:00

Today was a good day. Actually, this weekend was a good weekend. The fact that I hardly did any work probably helped, although I did spend a fair amount of time getting the car sorted. At least a friend did most of the work and we had fun chatting while getting the job done.

Saturday afternoon I went to a bridal shower for a friend who is traveling home to get married. It was good fun and it was a special time with some long-term friends here. Fortunately it wasn’t a goodbye since she will come back with her husband-to-be in January. Yay.

Sunday school today was amazing. For the first time we split the children into three classes: 2-5 years, 6-10 years and above 10 years. Georgiana and I will be teaching the 6-10 years olds and I have to say, what a brilliant class. I taught them for the first time today and I have to say it was very pleasant teaching a group of children that listened and joined in. Up until now I taught the 2-8 year olds, and that was just too big of an age difference. The small children rarely sat still throughout the class, and every 5 minutes another child was asking to be excused to go pee or get a drink of water. It was nice not to have so many distractions today! We are a bit further away from the church, which means less noise and distractions, and we meet on a big soccer field, which means more space to play! I led them around the field with their eyes closed as we made our way through an obstacle course of chairs. We then had an interactive talk about trusting God and others. It was great. We then did a craft and seeing as we had no idea how the service was progressing, we ended up playing games until we realized people were walking up the road meaning church was out. The kids taught me how to play a Sierra Leonean game called ‘Basket’ which involved quite a lot of jumping. I might need to alter my church attire when teaching Sunday school! Anyway, I am excited about this new class and the potential to teach these children. Plus I think we’ll have a lot of fun too.

After church I walked to a junction about 20 minutes away and met up with a friend and taxi driver Farah. His taxi is in the garage, but he said he’d walk with me up to the next junction where I had arranged to meet Alusine, the Welbodi driver. So, Farah, his son Michael and I trekked up the hill and met up with Alusine about 10 minutes later. We then continued with the 4 of us for another 20 minutes or so down a rocky road to Alusine’s house, a pan body. Much to my surprise, Alusine’s son Momoh ran up to me when I arrived. I was surprised because up until today he had been afraid of me! Maybe the fact that he knew I was bringing him a little toy car helped. It was fun to spend some time with them. I even drank some ‘atya’, which is actually green Chinese gunpowder tea with quite a bit of sugar added to it. I hear that some people even add marijuana to it but was assured this tea had no additives! After another two hours of sitting and chatting about Islam, gardening, and school for the children, etc, it was time to set out. We ended up climbing the hill up to SS Camp, which was a good 20 minutes climb up a rocky path. This is a walk that Alusine makes every morning in order to get a taxi to meet us in Wilberforce where the car is parked. After reaching the top, I said farewell and hopped in a taxi down to Wilberforce.

After a few hours at home, I again got in a taxi and headed to Aberdeen for the monthly international service. It was a nice service followed by a good potluck dinner. And now, it’s 10 pm and I am ready for bed. I have to be up at 6:20 am.

Views from Wilberforce...

2011-08-31T07:41:00.000+02:00

Third blood donation...

2011-08-30T18:45:00.003+02:00

Yes, it has been 4 months since blood donation #2. On Saturday the 20th of August I went to the blood bank at Ola During Children's Hospital to give another 450 mls of blood. Since my regular partner in crime has left Sierra Leone (still miss you Shona!), another friend joined me this time. It was his first time to donate (well done Grant!). First things first, we started off with a cold bottle of coke. Then, we headed to the blood bank where we needed to check our own hemoglobins to make sure we were fit to donate. As usual, my Hb was on the low side: 11.2 g/dL. Slightly too low to donate, but I convinced the technician that I was happy to donate at my own risk. He allowed it. He then proceeded to check my friend's Hb. The machine read: error. He tried again. Same thing. He tried another machine. Both read: error. I asked when the machines were last cleaned. It had been a while. He said he would do it now. After a 5 minute search for a special hemocue cleaner, I suggested I get a cleaner from my office. The technician liked that idea so off we went to pick up a cleaning package. The tech then proceeded to clean the machine. However, he wasn't able to dismantle the machine to get to the optic lens, which is the part that needed to be cleaned. He graciously asked if I could help. To be honest, I have done it before, but never quite remember how I dismantle the machine. I did manage however, and cleaned both hemocue machines. Who would have thought I'd be put to work when going to donate blood? Only here. My friend's Hb was much better than mine and so we were ready to donate. We headed over to the donation room, got our weights and ages noted and got settled on the exam tables- one of which is propped up by a box. The process took longer than usual, due to slow running blood through my veins and a dislodged needle in my friend's arm meaning he needed to be stuck a second time. All ended well, and we both donated. It was, once again, a unique experience.

If you would like to donate at the Children's Hospital, let me know! I know the experience sounds a bit crazy, but really it's fine. World Health Organization Standards and all around good staff. No need to worry. And, the offer of an escort and free coke still stand. Come and donate - it's a great way to contribute to saving lives...

A story with a good ending...

2011-08-27T18:04:00.001+02:00

Thursday did not start off well. I was showing a visiting doctor around the hospital and the first place we went to was ward 3. I think that’s my favorite ward. The patients are for the most part stable, but the cases are varied. There are general cases as well as children with tuberculosis, HIV, Burkitt’s lymphoma, etc. I thought it would be a good place to start the tour, but I was wrong. As soon as we walked in, I noticed a nurse removing a cannula from a child on the examination table. It only took seconds to realize that the child had died. What a terrible introduction to the hospital. Face to face with reality.

Later, on our way to ward 1, I noticed a mom walking into the building with a child on her back. The child was totally covered by her lappa and by the look of the bundle it looked like the child wasn’t breathing properly. I asked the mom to remove the child. The child was gasping. I found out it was a new patient and the mom had been looking for the registration area. To make a long story short and skip some of the frustrating parts – I carried the child up to the Emergency Room and we proceeded to treat the child.

Alongside me were a couple of nurses, one of who used to work in Aberdeen and is now doing her RN training. I was thankful to have her by my side. While putting the child on oxygen (with some delays), we checked the blood sugar, which was LO. We were struggling to get a cannula in and so in the meantime I grabbed the ambubag as a precaution. Finally one of my colleagues managed to secure a line. We gave 30 mls of Dextrose 10% and waited. And after just a few minutes the child’s breathing normalized, the child was alert and the child even started fighting the nurses. Thank God I ran into this child and got her to the Emergency Room. And thank God for Dextrose!

I have to say that it is one of the most amazing recoveries to witness. A child that comes in unconscious, often gasping, receives dextrose and then comes back to life as it were. I made it a point to use the moment as a teaching opportunity and talk to the (student) nurses about hypoglycemia and the importance of recognizing it and treating it and, once corrected, monitoring it. I think that the nurses were also amazed at the child’s response. Everyone was very aware that any more delay would have cost the child’s life.

This morning, two days later, I was on one of the general wards and saw the child and mom. The child is doing much better and the mom was very thankful. I am grateful for happy endings.

Denial, blame and lying...

2011-08-26T18:01:00.000+02:00

While checking up on a few things today, I was reminded again how easy it is for people to deny issues, blame someone else, or blatantly lie about something. And unfortunately, it happens all the time using phrases like:

"I don't know anything about that."
"It wasn't me, it was..."
"Nobody told me."
"Ask so-and-so."

For instance, I notice a child that hasn't had vital signs taken since the previous morning. I ask one of the nurses why this has not been done. The response: "the early shift was supposed to do it". I react by saying that all shifts are to blame since it has been more than 24 hours since they were done. I end with: can you please do it now?

I ask someone if they have decided on where specific items should be moved to for storage while some reconstruction is taking place. They respond by saying "I know nothing about that". I remind them that I had discussed it with them two evenings ago when leaving the hospital. I end with: Can you please let me know by Monday morning?

I notice one of the pieces of lab equipment is not being used and find out someone has taken out the batteries (which are supposed to last for 5 years). I ask who did it. No one knows. And no one cares. "It wasn't me."

I stand at my gate, knocking for 10 minutes before a guard comes to open it and let me in. I tell him he shouldn't be sleeping. He says, "I wasn't." I give up as I walk past his mat and a second guard sleeping under the staircase and hurry up to my flat.

I can go on with examples, but it would only continue to frustrate me. I just don’t buy it that everyone comes to work for their salary without caring at all about what they do. I just can’t imagine that would be the case. Yet, sometimes it looks that way. Yes, there are some very dedicated and hard-working people here but there are many people who do not seem to be very active at all. Why do they even come? And this is not only a problem in the healthcare sector. It’s a problem in many sectors. Why is that? And, more importantly, how can it be changed?

How can you instill a sense of responsibility in people?
How can you convince people that it is there duty to do their job to the best of their ability?
How can you make people realize that even if someone else was supposed to do something but forgot or neglected to do so, they should do so in order to do their job the best they can?
How do you change something that is so engrained into the culture?

Unfortunately I know that there is no clear answer and that this way of thinking and behaving will take years to change. I suppose all I can do is to try to be a good influence. I can encourage people and mentor them. And hope that they see that doing your job to the best of your ability pays off. If anyone has any answers, let me know!

Wednesday Bible Study...

2011-08-24T23:00:00.001+02:00

After a overwhelming first half of the week, it was great to be able to go to the Wednesday night house group and discuss 2 Corinthians 6 with friends. I was encouraged.

God reminds us, “I heard your call in the nick of time; The day you needed me, I was there to help.” Well, now is the right time to listen, the day to be helped.

“Our work as God's servants gets validated—or not—in the details.
People are watching us as we stay at our post, alertly, unswervingly...
in hard times, tough times, bad times;
when we're beaten up, jailed, and mobbed;
working hard, working late, working without eating;
with pure heart, clear head, steady hand;
in gentleness, holiness, and honest love;
when we're telling the truth, and when God's showing his power;
when we're doing our best setting things right;
when we're praised, and when we're blamed;
slandered, and honored;
true to our word, though distrusted;
ignored by the world, but recognized by God;
terrifically alive, though rumored to be dead;
beaten within an inch of our lives, but refusing to die;
immersed in tears, yet always filled with deep joy;
living on handouts, yet enriching many;
having nothing, having it all.”

Challenging Monday...

2011-08-22T20:15:00.000+02:00

I don’t really know what it was about today that made it so challenging. I suppose it was a combination of things.

All day long I felt as though I was on the go. There was a lot of chasing up to do. A patient that had not received medication, a form that was not available on the wards to request for ceftriaxone, data that had not been collected for the monthly report, a lab result that had not yet been looked at. In other words, there were a lot of little things that ended up taking time to sort out or getting someone else to sort it out. Things I don’t mind doing, but that keep me away from my ever growing ‘to do’ list.

The reconstruction of the Special Care Baby Unit took up quite a lot of time today. From checking the mosquito screens (and having the contractor re-do some of them), to making sure the floor and cots were cleaned, to moving in incubators, to organizing the cots in the bays, to making sure the incubators work, to discussing the need for shelves for monitors etc. We are nearing the time when the babies can be moved into the new ward and need to make sure we are ready. Needless to say, it meant many trips back and forth to SCBU to cross the T’s and dot the I’s. Obviously, this needs to be done, and it is great to be a part of the process, but it takes up quite a bit of time. And, some of the aspects bring on their own frustrations.

All of the above meant that I didn’t do much of what I had hoped to do. I think part of today’s problem was realizing how swamped I am. I had hoped to finish the finance documentation, plan a team meeting, get approved projects underway, arrange meetings with SLICH Board members, read Comic Relief documentation, sort out contracts, call people about various registrations, chase up an audit, etc. It just wasn’t possible. And that got to me. I know I can only do so much, but being hit in the face with my limitations throughout the day was tough. Every time I looked at a clock, it was a few hours later than I expected. The day was flying by and I still had so much to do. I realized again that I need to acknowledge the fact that I will not be able to accomplish everything. I am one person, trying to do a job that is bigger than I can do at the moment. Hopefully, that will improve a bit over the next few weeks. For now, I’ll just have to manage. In Sierra Leonean style: ‘A go manage.’

To top it off, we now seem to be collecting rainwater inside our house! Our roof has a hole in it and the water is dripping into the corridor by the kitchen. There’s never a dull moment here. It’s go, go, go.

Another Sunday Summary...

2011-08-21T23:11:00.000+02:00

My weekend was quite busy. Saturday was spent at the hospital overseeing some of the work in the special care baby unit. The place needed to be fumigated, which was scheduled for 9 am and finally took place at 3 pm. I then donated blood, which was an adventure as usual. For the rest, I did a mixture of work and surfing the Internet. It was nice to be in a place with electricity for the day! The evening ended out with a steak dinner, to replenish my iron stores.

On Sunday I went to church. Although I was not on the schedule to teach, I did end up with the Sunday school kids because there were so many of them. I can’t say I minded. I also ended up seeing a sick child and referring him to a clinic.

After church I spent a few hours at home before hopping in a taxi to Aberdeen to meet up with Sarah for a run. We headed down to Lumley beach, and after catching up with friends who have just returned from their holiday we were off. Seeing as we’re just starting up, we didn’t run very far, but it was long enough for us. We continued walking until we reached the amputee football team playing a football match. Within seconds, an expatriate came up to us and before we knew it we were discussing laboratory services and medical care in Sierra Leone. Networking. Not what I would have expected to be doing on a Sunday afternoon, but it’s potentially a good contact to have. We then walked further down the beach before turning around to go back to the center. After a shower (with great water pressure) I left the center and went to meet another friend. On my way out, I ran into a mom who was waiting to register her child for the clinic the next morning. To make a long story short: the child needed to be admitted and so I sent the child to the Children’s Hospital for a blood transfusion. My friend ended up meeting me in Aberdeen and we walked the whole stretch of the beach to Lumley. I can definitely say I got my exercise for the day!

It was another good weekend come and gone. I can’t say I had the chance to rest much this weekend, but maybe I can make up for it during the week. Probably not!

Okon...

2011-08-20T14:06:00.003+02:00

Five-year old Okon was admitted in July and discharged on the 11th, the day Comic Relief was at the hospital to do our grant approval 'reveal'. On that day Okon and his mom were full of smiles, because after being treated for malaria for four days, he was well enough to go home.

Today, when I came to the hospital, I saw a man and child sitting on the bench outside my office door. The child looked very familiar. It was Okon. Everything about him was the same, except for the smile. He was no longer smiling. For some reason, he is sick with malaria again and it has made him very weak. He has had two blood transfusions in the past two days. I hope he gets better quickly. And starts smiling again.

It makes me wonder how many children get sick again shortly after being discharged from the hospital. And why? And how many of them do not come back? And how many of those die? It would be sad to know that we aren’t fully curing patients. I have thought about this a lot in the past because I know that despite free health care, not all of the drugs are free to outpatients. While a patient is admitted everything might be free, but when they are discharged they may need to pay for some of the medication. Does that happen? Or do they go home partially treated, only to get sick again within a few days or weeks. Or do we treat one condition and overlook another. I suppose it is all possible but I sincerely hope we are treating all patients well the first time around.

In Okon’s case there are a lot of questions that can be asked. Did the doctor prescribe the right medication on discharge? Did the nurses dispense it to the mom? Did anyone explain to the mom how to give the medication? If mom had the medication, did she give it to him properly? Does he sleep under a bed net? I don't know the answers. Let’s just hope that he gets better quickly, and that when he is discharged it will be clear to all what needs to happen.

Friday facts...

2011-08-19T18:00:00.000+02:00

I paid for Namina’s school fees this week so she can start primary school in September.
It rained 2 days straight on Wednesday and Thursday, so I was happy to see the sun again today.
Cleft lip babies in Sierra Leone are often labeled as ‘devil children’ and left in the bush to die.
There is a Sunday Times article (in the Magazine supplement) coming out THIS Sunday covering Mercy Ships, which may or may not include Namina’s story.
According to the Central Intelligence Agency Sierra Leone is 60% Muslim, 10% Christian and 30% Indigenous beliefs.

Ramadan...

2011-08-18T17:59:00.000+02:00

It’s the month of Ramadan right now during which Muslims fast during the light hours of the day.

It has been very interesting to observe the fast month and to talk to some of my friends who are Muslim. Most of them are very devoted and go to the mosque to pray multiple times a day. This time of year is very important to them. They refrain from food and drink throughout the day and then around 7:15 pm (when it is dark here) they break the fast (in different ways) and then share a meal with family and friends. It actually sounds quite nice. The idea of refraining from something to focus more on God sounds great. And the fact that it is something that is shared with family and friends is appealing as well.

However, as with Christian fasting, I always wonder how many people fast because it is ‘the thing to do’ and how many people are really spending extra time thinking, praying and reading. I think there is a lot of social pressure here, especially when it comes to what is expected of you while fasting. You either need to cook food for a large number of people or you have to bring gifts to the person cooking for you. I know it is about good gesture and respect, and I can appreciate that. However, when someone has little income but is expected to buy an elaborate dress for his granny, it seems strange to me. Social pressure is huge. Expectations from relatives are huge. Maybe this is a part of the sacrifice.

Another thing that surprised me is that although no one eats or drinks during the day, some people actually end up eating more in a 24 hour than they would normally. I know a family who ends up cooking twice as much in the evening, and so, spending twice as much money on food during the fast month. I know they can’t afford this. I don’t understand why this is necessary and to me it seems to contradict the whole idea of a fast. Maybe that’s just me.

It’s also interesting to think about how the fast could be considered to be easier or more difficult depending on where you are in the world. I think in Sierra Leone people can be thankful that they only have to fast for 12 hours. The sun rises at 6:45 am and sets just after 7 pm. In Iceland, the longest fast was on August 1^st and lasted 17 hours and 59 minutes. That’s incredible. To be honest, I am not sure I could even do the 12 hours. Not eating, fine, but not drinking anything would be difficult and I’m sure I’d pass out.

I always wonder what kind of impact Ramadan has on the health of children. Not really in terms of fasting, because the children do not fast for the most part, but more in terms of caregivers not bringing them to the hospital, caregivers not wanting to donate blood because they are fasting, etc. I wonder how our patient numbers will compare to the previous month, bearing in mind that the rains are also at the worst this month – meaning, more illness, but more difficulty in patients reaching the hospital.

It has been insightful to experience Ramadan from the sidelines and I’m sure I’ll have many more conversations with my friends here about this. In honesty, it has been a good reminder to me to make sure I spend time focusing on God, whether fasting or not fasting.

Short Sunday summary...

2011-08-14T22:37:00.000+02:00

Rain, rain and more rain. That pretty much sums up the weather. I knew it would be a struggle to get to church if it was pouring rain so I chose an easier option and asked Farah, a taxi driver, to pick me up. It was much more convenient. During the service the rain stopped and I was able to teach Sunday school, which takes place outside. Today I taught fifteen children between the ages of 2 and 8. I was happy I picked a good craft that kept them all busy and out of too much trouble! As of next week we are splitting Sunday school into three groups: 2-5 years, 6-10 years, 11 and up. I will be teaching the 6-10 year olds which I am really looking forward to. However, it looks like it means teaching every other week instead of every third week. Things are just getting busier.

I spent the afternoon at home and ended up taking a nap curled up on my bed wearing a sweater. Yes, it really does get a little chilly in rainy season. I love that aspect of the rains. There wasn’t any power (there hasn’t been all weekend) and so there wasn’t much else I could do. Late afternoon I headed to the port to visit friends on the Africa Mercy. On my way I stopped at a friends house to say bye, since she is leaving Sierra Leone for good. There are a lot of people leaving this summer. That’s one of the aspects of life here I don’t like so much! My visit to the ship was fun. It was great to catch up with friends and I enjoyed the service. After a hot chocolate (with a shot of mint) in the Starbucks café it was time to head home. It’s now nearly 11 pm and time for me to go to bed. It’s going to be an early start tomorrow since I have to be out of the door by 6:50 am. I’m hoping for a productive and smooth week.

Back in SL: the first 72 hours…

2011-08-13T22:34:00.000+02:00

I returned to Sierra Leone 72 hours ago and it’s been great so far, with mostly ‘ups’ and very few ‘downs’.

I had a good trip back especially since I travelled with my new colleague. We had plenty of time to chat and get to know each other and the six-hour trip went by quickly. From Lungi we made it to Freetown in record time by way of a minibus and water taxi. When we reached Aberdeen, our driver picked us up and took us to the flat. Over a cup of tea, I caught up with my colleagues before heading to bed.

On Thursday morning we went to our little office on the west side of town (near the flat) to catch up a bit. Of course, as predicted, I hit the ground running. Not only am I taking on all of the Comic Relief stuff (which kind of doubles my work load) but I am also taking over a few of the tasks from a colleague who left last night – like overseeing the reconstruction of the neonatal unit and sorting out vehicle issues! Oh, the joys. If I am honest, it is a bit daunting, but really, I will manage. I just need a few days to catch up with what has happened over the last few weeks (finances etc.) and then I can move forward with some big assignments!

In the afternoon we went to the hospital and I showed my new colleague around. It was great to catch up with hospital staff, although the place was a little empty due to Ramadan (people out for prayers). We ended up leaving after 5 but fortunately traffic wasn’t too bad. In the evening we went to Independence Bar ion the beach for barbeque dinner (groupa fish and potato salad) and it was wonderful to sit on the beach, feet in the stand, listening to the sound of the waves and seeing the stars in the sky. Sierra Leone really is a beautiful place.

After a meeting at Connaught Hospital on Friday, we went to the Children’s. I spent the day catching up on a few things, seeing more hospital staff and spending some time chatting to some of the doctors, which was fun. One of the downs was the confrontation again with how sick children are here. There was a child in ICU on the verge of death and at various times I heard the sound of a wailing mother down the hall. It’s tough but I guess that is why we are here: to improve care.

On Friday evening we went to a place called Big Brother as a farewell for my colleague. After volunteering with Welbodi for 10 months he is moving on and he’ll be missed. A few of us saw him off at the water taxi which ended up being delayed a bit when a severe rainstorm came out of nowhere. Even though we were all under cover, within seconds, we were wet. Horizontal rain. Love it!

Today is Saturday and I met up with a good friend from Aberdeen for brunch. Afterwards we headed to town for some shopping. Our first stop was the ‘big market’ – a large covered market with carvings, jewelry, bags, blankets, fabric, etc. It’s rainy season and the evenings/nights are actually a bit chilly, so I bought a blanket at Big Market. When I bought my blanket I didn’t even bargain. The lady’s first price was Le 120,000 (20 Euros) and I told her my first and last price was Le 60,000 (10 Euros) since that is what I have paid in the past. She tried to get me to pay Le 75,000 but I told her Le 60,000 was my final price. Sold! We then strolled along Malama Thomas Street and picked out some fun fabrics. We then walked to the bus station and took the bus to the West side of town.

I spent the rest of the day unpacking my suitcase, cleaning, putting things away and basically enjoying a quiet afternoon and evening at home. I feel I have had some time to relax and come Monday, I’ll be ready to go! Full steam ahead. I hope.

Friday facts...

2011-08-12T22:32:00.001+02:00

After spotting a triangle of laughing cow cheese on my food tray on the plane, I knew I was heading back to Sierra Leone: land of laughing cow cheese.
I put water in the kettle first thing in the morning and switched it on, only to realize that there was no electricity.
There are still a lot of dogs outside our compound and annoyingly enough, they all start barking at various times throughout the night, in unison.
Due to Ramadan I hear the call to prayer a couple of times in the night. Fortunately it’s pretty soft and I fall back asleep again.
I went to the supermarket yesterday to change money. I handed over two bills and in return I got a whole wad of cash.
I had a Vimto (soda/soft drink) at Independence Bar in honor of my friend Mikey, who left Salone a few weeks ago.
Lunch at the hospital is a choice between bread with either: laughing cow cheese, luncheon meat, baked beans, boiled egg or sardines. I rotate my choice between luncheon meat, cheese and egg.
Sierra Leone started a new bus system within Freetown a few months ago and it is a success.

Holiday shots...

2011-08-11T21:51:00.003+02:00

Back to Salone...

2011-08-08T23:03:00.001+02:00

Tomorrow I start my journey home. First to London, with an overnight at a friend's house and then on to Freetown the following day. It'll be good to be back, sleep in my own bed and get back to work but I wish I could see my family more often. C'est la vie. It really has been nice spending time with them in both the USA and the Netherlands. I enjoyed having a bit of a break too, with less responsibility and few frustrations. And of course it's been great playing with my nieces and nephew! It was fun to run around the yard with Porter flying planes and rolling down a hill with Zoey and Esmee. Good times! When I get back, I think I'll hit the ground running, especially since we discussed and planned a lot during the recent Welbodi Board meeting. It's time to put it into action. I think I'm ready...

Top 7: Things I miss from Sierra Leone...

2011-08-07T09:31:00.000+02:00

I have two full days left in Holland, then a day with travel to the UK and meeting up with my good friend Shona, and then a day of travel to Freetown. I will definitely enjoy my remaining time at home. However, I thought I'd let you know what it is I've missed about Freetown:

1. My bed. During my holiday I slept on airplane chairs, airport benches, air mattresses, beds, foam mats, garden chair cushions, etc. I will have slept in 7 different rooms. I have to say, there is nothing like my own bed. I am excited about sleeping in it on Wednesday, mosquito net and all.

2. Krio. 'Ow de bodi?' 'A de manage.' 'Ow yu sleep?' 'Tenki.' There’s nothing like speaking with everyone in Krio. From chatting to people on the street in the morning when I’m on my way to work, to colleagues at the hospital, to taxi drivers in town, to street vendors. Love it. Happy to return to the Krio speaking world.

3. Friends. Of course I miss my friends in Salone: my colleagues at the hospital, friends in Aberdeen, friends on the ship, flat mates, friends from international bible study, etc. There are some great people in Freetown! Sadly, two of my very good friends will not be there when I get back. I’ll definitely miss having them around. Mikey and Shona – come back to visit sometime!

4. ODCH. It’s not the easiest place to be but definitely an amazing place to work. There’s always something going on. Whether good or bad. I kind of miss the challenge of solving problems. Don’t worry, all too soon I’ll be right in the middle of it all again. What I miss the most is the smiles and giggles from the children and the friendliness of hospital staff. It’ll be great to see everyone again.

5. Beaches. I have missed the ocean. And best of all, swimming in the ocean with the mountains as a back drop. There’s nothing quite like it. Not to mention the hot sun, although, it was nice in Colorado to have a dry heat, rather than being all hot and sweaty. I’ll be returning to the peak of rainsy season, so who knows when the next beach trip will take place.

6. Transport. As crazy as it sounds, I do miss taxi’s and poda poda’s. Bizarrely, Freetown public transport actually makes sense and is really easy to use (once you get used to it). It’s pretty convenient and not expensive. Mind you, I’ve not missed hectic Freetown traffic.

7. Barracuda. I have had some excellent food while being away, but I am looking forward to fresh fish from the sea when I return. Yum!

Holiday top 7…

2011-08-06T23:05:00.000+02:00

Although Sierra Leone is pretty much home for me now, it's still nice to go 'home' - to the Netherlands/USA (read: where family is) - for a break. It is true that when I am in Sierra Leone I am pretty content and have learnt to deal with various issues in daily life. However, once I'm 'home' I must say there are things I love about being 'home'. Here's my top 7:

1. Family. Siblings, siblings-in-law, parents, nieces, nephew. Need I say more?

2. Electricity. All day and every day. I can actually charge my phone and laptop at anytime. And I’m not getting electrocuted!

3. Running water. Excellent showers without having to kneel due to poor water pressure or use a bucket due to no water at all and I can drink water straight from the tap.

4. Different fruits. Fruits in Salone are great, but I have really enjoyed fruits that we don’t have there such as strawberries, cherries, (orange) oranges, plums and blackberries.

5. Peaceful neighborhood. No barking dogs or house parties at night and I can walk around town without being hissed at, shouted ‘white man’ at, etc. I can walk in silence and no one will feel offended and sometimes that is just really nice.

6. Dairy. Delicious milk, yummy yoghurt, real cheese (as opposed to laughing cow) and ice cream.

7. Friends. I didn’t get to see very many of you due to my short visits, but have definitely enjoyed seeing some of you again. There’s nothing like getting together with friends after being away for months and picking up where you left off. I'm thankful for deep friendships!

A successful quiz night...

2011-08-05T22:51:00.004+02:00

On Friday the 15^th of July, Welbodi Partnership held a fundraising quiz night, hosted by IMATT in Freetown. Just one week after sending out invitations we had generated more interest than we could cope with. After asking IMATT to agree to 100 participants, rather than the originally planned number of 80, we started putting additional names on a waiting list. Needless to say, we saw this as a sign that the night would be a success.

The Welbodi team, and a few honorary Welbodies, spent the next week planning and preparing for the night. Quiz questions were thought up, spectacular raffle prizes were arranged, raffle tickets were created, emails were sent back and forth, lists of names were submitted, the hall was set-up, etc. We were determined to make this a spectacular event.

On the evening, as people entered the room, they paid their entrance fee and were encouraged to buy raffle tickets to make a chance at winning some amazing prizes, raising more money for Welbodi. Prizes were varied and included winning 5 movie tickets, a night at the Chimpanzee Reserve, a day’s vehicle hire on the peninsula, a trip to the Africa Mercy to tour the ship and enjoy Starbucks, Splash cash and last but not least meals at various restaurants like O’Casey’s, Roy’s, Atlantic, Independence Bar and Crown Express.

The quiz rounds soon began and teams did their best to come up with the right answers to questions. Rounds varied from questions about sports, science & nature, history, entertainment, general knowledge and world, to picture rounds including popular locations within Freetown and a music round including lyrics in Krio, which was by far the most popular round.

At the end of the night, while the points were tallied, the raffle was drawn. Unplanned, one raffle prize ended up being auctioned off which was great fun with some high bidding taking place between two individuals. Finally, the winners were announced and the first prize went to the team “4 Nations”.

The fundraiser was a huge success and with everyone’s help we were able to raise Le 4,370,000, which is just over one thousand US dollars! This money will be used to continue improving child health care in the Children’s hospital. Welbodi Partnership would again like to thank IMATT for hosting, the prize givers for donating prizes and those individuals who made this event a success. Thank you.

To those who were not ableto make it, hopefully you can come to one of our events in the future. In the meantime, you can test your knowledge with the following quiz questions:

1. What is the capital of the newest country in the world?

2. What is the color of hippo milk?

3. What quintessential salone (food) product comes from the Jura region of France?

4. At the end of the 19^th Century, European powers had occupied and ruled over all but 2 African countries. Which two?

5. What is the exact date when Sierra Leone became independent?

(Answers are in the comments)

Finally, if you would like to host an event to help raise money for the Welbodi Partnership please let us know. It’s easy, fun, and a great way to contribute to our work in Sierra Leone. Make your own free fundraising website in minutes at JustGiving http://www.justgiving.com/welbodipartnership, and contact us at info(at)welbodipartnership.org if you need information or materials to help make your event a success.

At the airport...

2011-07-29T18:46:00.003+02:00

I'm at Denver airport, waiting to board a plane to Dallas. Yay for free wi-fi. After a three hour lay-over at DFW I'll be boarding another plane to London. Nine hours later I'll arrive at Heathrow and make my way to the underground. Three underground trains later I should be at Emily's house, where we'll be having the Welbodi Board meeting. I'm ready for a bit of work, and then excited about another week of holiday, in Holland.

My time in Colorado was great. It was fun to spend time with family. My niece and nephew are both adorable. I had a lot of cuddle time with Finley and lots of play time with Porter. Favorites were playing airplanes in the backyard (Porter's planes on the left, mine on the right), running away from the wormies that were trying to catch us, catching Porter, playing soccer, collecting bugs and racing cars. The trip to the zoo yesterday was a lot of fun too, as was our 'hike' to Boulder falls. As always, it was sad saying goodbye...I think the little kids make it harder for all of us! And the fact that none of us know exactly when we'll see each other again. In a month's time we'll be spread out over 4 countries again: Netherlands, USA, Haiti and Sierra Leone. I love what I do, but this is definitely one of those sacrifices that is difficult to make. Let's just say I'll focus on the time spent in Colorado and look forward to the week in Holland with more family.

See you on the other side of the pond...

Ola During Children's Hospital...

2011-07-20T23:08:00.001+02:00

Photos taken with permission from the caregivers.

Happy to say that Okon, Kumba and others are well and discharged home.

A tennis promo video...

2011-07-20T22:37:00.004+02:00

I was tipped off by a friend today that I'm on a new Mercy Ships Tennis Promo video which will apparently be aired in Switzerland. Thanks to speedy wi fi at Lungi airport I watched the clip and sure enough 21 seconds in there I am. Footage from 2006 I believe, but it is me in Sierra Leone. I was working in the outpatient clinic in Aberdeen at the time. Anyway, for those interested you can watch it at:

36 hours to go...

2011-07-20T18:55:00.004+02:00

The 36 hours have begun. I can't say I am excited about the actual traveling that will take me to my family but hey, it's the only option and they are well worth it. At least there are some good things about the travel.

Good news: There is free wi-fi at Lungi Airport! Granted it's a little slow, but I can't complain as even schiphol doesn't offer free internet.

Bad news: I've already spent an hour waiting at the water taxi 'terminal' and two hours at the airport prior to check-in. I have another hour to wait before I can check in and then another 5 hours before boarding.

Good news: There's food upstairs. I'm looking forward to dinner from the Lungi restaurant. I think I'm that hungry. And, I am sure it will be better than pot noodles (Ramen noodles) which seems to have become my staple diet over the past few weeks. I know, I know, that's not going to help my hemoglobin any. But, it's quick, fast, cheap and pretty tasty.

Bad news: The flight will be really full (but at least I'll be on it). Hopefully I'll sleep a bit.

Good news: Although I have a long lay-over in Heathrow (5+ hours) at least I can do some shopping. I'm looking forward to browsing in book shops, eating some yummy chocolate and drinking some milk!

Bad news: I then have another 2 flights to go including another 4 hour lay-over in Chicago. Oh, the joys of traveling.

Good news: Once I arrive in Denver, I'll be picked up by my brother and on my way to re-unite with Genae and Porter and meet my niece Finley. I am very excited about that.

So, 36 hours to go...but in true Salone style, I'll manage! Right now I am sitting with two travel mates in the cafe while my small suitcase is left unattended in the middle of the hall. It's saving my spot in the line. I should be within the first ten to check in! I will be on that flight. In the meantime, I'm finally going to catch up on blogging. You can expect some more posts over the next few weeks.

36 hours past...

2011-07-20T18:49:00.000+02:00

The past 36 hours have been rather crazy. Yesterday I ran a lot of errands and made good use of my driver! I think he enjoyed a day’s worth of driving. I started at the Ministry of Health and Sanitation at 8 am to pick up some letters. I was hoping to deliver the letters, but most offices were still closed so I headed out. First stop, the Electricity House, to buy more credit for our NPA (national power authority) meter. Then I went to the bank to cash a check. After that I went to the Sierra Tel office to extend our Internet dongle services. And then I went to a shop in town to check on an order of plastic buckets with built in taps, which will go to the wards in the hospital. They weren’t ready yet.

The next 5 hours were spent at the hospital, doing what I usually do, which ends up being a bit of everything. At 3:30 pm I left the hospital and headed to a meeting. I have a wonderful meeting with one of the senior pediatricians in town. What a humble and gracious man. If only there were more people with such dedication. I then made the trek back to the Ministry and met up separately with the deputy chief nursing officer, the director of hospitals and the director of reproductive and child health. They were all brief but good meetings. Sometimes it’s just good to have a bit of an informal catch up! I then backtracked to Connaught Hospital to meet with a radiographer there concerning the radiography-training program that we are trying to get off the ground. The good news is that funding is nearby and the project might actually be underway in the next two months. Great!

After Connaught we drove to Aberdeen to check the times for the water taxi. I heard earlier in the day that BMI downsized their plane and not everyone can get on the flight today. So, it sounds like instead of the 7 pm water taxi I will have to take the 2 pm water taxi. The flight is not until 11 pm so that means a LONG wait in Lungi. Oh well. Right now, I just want to make sure I’m on the flight. From the water taxi I went to the Women’s Centre to pick up a power adapter for my Mac book. Yeah, means I can use my computer during the long journey to the USA! I reached home at about 630 pm, in time to head out again at 730 pm to meet good friends at Mamba Point. It was a fun yet slightly sad occasion as it was the last time that Mikey, Shona and I will be together in SL. They’re both leaving while I’m away. They’ll be missed.

After a great meal out I came home to do some packing, cleaning and finish up some work. By 130 am I thought it was time to get some sleep before being woken up by my alarm clock at 620 am. Wednesday was going to be another long day, marking the start of a probably 36-hour journey.

Welbodi Quiz Night...

2011-07-07T21:35:00.002+02:00

Come and support Welbodi Partnership at a quiz night at IMATT on the 15th of July starting at 7pm.

The cost is Le 50,000 for dinner and the quiz (drinks available for purchase).

Come and enjoy the IMATT experience and support Welbodi Partnership.

Money raised during the night will be invested by Welbodi Partnership, in collaboration with hospital management, in projects at the only Children's Hospital in Sierra Leone with the aim to improve paediatric care.

Come and enjoy a fun night out! Rain or no rain, we'll be there.

Please RSVP by Monday! (yes, this means you have to commit - but it's for a good cause!). Drop me a line, e-mail, facebook message, send a text, whatever. Just make sure your name is on the list by Monday.

See you there!

For more information about Welbodi Partnership go to: www.welbodipartnership.org or visit our blog at: www.welbodipartnership.blogspot.com

Busy Welbodi...

2011-07-07T20:16:00.003+02:00

The past 2 weeks have been really busy. They have flown by. One of our directors was here last week and we kept ourselves occupied! We met the American Ambassador, met the Minister of Health, held team meetings, discussed a number of issues etc. It was a very productive week. This week we've kept up the momentum. We have a team of lab experts who have come from the UK and the Gambia to train the national lab staff at the Children's Hospital. We're in the process of purchasing a new Welbodi car that can seat 7. The reconstruction of the Special Care Baby Unit is slowly getting started. We're preparing for a Welbodi Quiz night up at IMATT as a fundraiser. And we have some special visitors coming in tomorrow for a few days. More on that later! It's encouraging to see so many things happen. Of course, there is still a lot that needs to be done but every step forward brings us closer to our goal of delivering high quality paediatric care to the children of Sierra Leone. Let's keep going...

Lab training...

Getting ready for the reconstruction of this ward into the Special Care Baby Unit!

Starbucks in Africa...

2011-07-04T10:41:00.002+02:00

YEAH! I finally managed to get Becky and Fred on the ship for Starbucks. Just over a week ago now, the three of us and a VSO friend headed across town to pay a visit to some of my friends on the ship and to enjoy some of the luxuries (in our eyes!). We had dinner in the canteen (spaghetti with meat in the sauce!) and then hurried off on the tour. I know to the crew, a tour is not so exciting, but to us Freetowners, the ship is amazing. Normal things have become luxuries to us. Television, internet, meals cooked for you, automatic hand sanitizers on the walls, washing machines and dryers, air conditioning (some rooms are like freezers!), hoover back-packs, a lovely library (with an amazing couch), swings on the deck, a kitchen for the crew with 6 ovens, multiple kitchen aids (!), a state of the art hospital, a functioning x-ray machine, a well-equipped lab, a list of blood donors, a snack bar and last but not least - Starbucks! We finished the tour just in time for the evening meeting after which we quickly moved towards the Starbucks. Finally! It took me 4 months to get Becky there! But I did it. And we enjoyed. I'm not much of a coffee drinker myself, but I do enjoy the occasional flavored coffee and definitely enjoy a mint hot chocolate. Good times. Thanks Allison and Maggie for hosting!! I owe you one. The funniest part was probably the Ghurka chasing us off of the ship. All fun and games.

Enable the Children...

2011-06-26T14:57:00.000+02:00

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...

2011-06-23T20:00:00.002+02:00

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...

2011-06-22T22:17:00.000+02:00

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?

2011-06-13T21:19:00.001+02:00

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...

2011-06-13T09:42:00.002+02:00

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...

2011-06-12T18:12:00.002+02:00

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...

2011-06-02T19:07:00.002+02:00

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...

Coordination and clinical work...

2011-05-31T18:16:00.002+02:00

A lot of the work the Welbodi Partnership does is to coordinate and facilitate projects and training programs within the hospital. Our aim is capacity building – helping others to improve their skills rather than coming in to solely provide patient care. We believe that in the long run more patients will receive high-quality treatment and have better outcomes if we focus our current efforts on improving the services delivered in the hospital. That is why we have engaged in projects like electricity and water supply, the medical records/data collection and reporting system, the laboratory services, nursing care, the triage and emergency process, and training for the doctors.

This does mean that my job as a medical coordinator, although diverse, does not leave much room for clinical work. As I am trained as a doctor, that is not always easy. Fortunately, for my own professional development and to see how hospital systems are or aren’t functioning, I try to do some clinical work. However, usually my role as coordinator keeps me so busy, I don’t make it to the wards. If I do make it, it’s usually just to see a few patients. I decided that for now it is best not to do ward rounds on a ward because it is unlikely that I will be available to the nurses and patients for the rest of the day due to meetings and other responsibilities.

The last few weeks have been so busy, I have really only been able to see a few patients on the ward adjacent to our office, so it has been good to be able to be involved with patients a bit more on other wards.

It started one evening when I happened to be at the hospital and ran into a family with a very sick child looking for the Emergency Room. The child was admitted and stabilized but unfortunately remained in a very critical condition. Sadly, the infant died in the course of the following day. I was again hit by the reality of the mortality figures in this country. And I realized again that although it can be very rewarding to do clinical work, it is also pretty tough.

I was also involved in the case of an infant admitted a few days ago. With a hemoglobin of 3.5 g/dL, the child needed blood urgently. Fortunately there was a relative who was able to donate and the child received blood soon after admission. After that it was a waiting game. Thankfully, the next day the child looked much better. However, unfortunately the child had not received all of the prescribed medication within the first 24 hours of admission because something went wrong with the supply. So, I wrote a prescription for the missing medication and later checked up on the child again again. The child was stable and I expect will make a good recovery. Now, if I can only convince the mother to stop giving the child hot water and encourage her to exclusively breastfeed I will be really happy!

I love the clinical work and honestly do miss it, but I also have to admit that it can be quite frustrating. Yes, there have been many improvements over the last few years, but there is still a long way to go. I think all of the clinicians in the hospital would agree that clinical work in the hospital is challenging. The patient numbers can be high, working hours can be long, (once a week when on-call overnight the doctors work for about 30 hours straight) and the cases coming to the hospital are often quite severe, which means that on a daily basis one is faced with children dying. For doctors and nurses alike this can be very demoralising. Yet somehow, everyone must continue. Despite the frustrations, spending time on the wards gives me more insight into how the various systems (pharmacy, lab, blood bank, nursing, medical records, doctors) work (or not) and how they have improved (or not) over time. The barriers and delays to achieving good patient care become more apparent. This information can in turn re-start the thought process and refinement of how Welbodi continues to work alongside hospital management and other partners to improve systems within the hospital with the overall aim to improve pediatric care. And that is when I put my coordinating hat on again!

First posted @ http://blogs.bmj.com/bmj/2011/05/31/sandra-lako-coordination-and-clinical-work/

Random Freetown photos...

2011-05-28T18:23:00.002+02:00

Astonishing Freetown traffic...

2011-05-26T20:37:00.004+02:00

WOW! Traffic has been amazing the last two weeks. Today I managed to get from the hospital to my house (including parking the car on Spur Road and walking back home) in an hour. It's amazing. March and April were terrible months- and it would often take 2 1/2 hours to get home. Fortunately the average is usually about an hour and a half. But, for the last two weeks it's been round about an hour. I am NOT complaining. Hopefully I won't jinx it by writing this post. Tomorrow is Friday however, so you never know.

Post from two months ago...

2011-05-26T18:50:00.003+02:00

This post was written 2 months ago and gives a glimpse of a more clinical day for me (which are far and few between).

*****

Today definitely had its good and bad moments. I loved the fact that I could do some clinical work but disliked the fact that I was doing it because someone else didn’t do it in the first place. I was annoyed to see nurses sitting around complaining they were to busy on one ward but happy to see nurses elsewhere eager to learn and help re-assess patients. It was a long day. Leaving the house at 6 am and arriving back at 9 pm. Here’s a glimpse…

Early morning ward check: At 6:30 am Becky and I arrived at the hospital to do a surprise early morning check. This is the check we do 4 times a month to monitor overall ward performance. It’s not very popular with the nurses, but needs to be done. Unfortunately this morning it was not particularly good as a number of patients either did not receive medication on time or it was not documented correctly. It can be discouraging but we need to keep trying to bring about change. It’s all about motivation and attitude!

Administration and trip to town: I spent the next hour doing some administrative work. I then went to town in order to try to meet an accountant because one of our accounts needs to be reviewed/audited. Unfortunately he was in meetings all morning and I was told I would be called. This never happened. Fortunately I managed to get the accountant’s direct line and talked to him later in the evening. I went to the bank to request a money transfer and withdraw cash. It’s funny how it doesn’t really faze me anymore to withdraw 5 million Leones. Then, since I was close by, I brought back lunch from Crown Bakery, as requested by my colleagues. Needless to say, I had a very tasty lunch.

Two ship patients: Earlier this week two patients showed up at my door – one needing plastic surgery, the other maxillofacial. Yesterday the little girl needing plastic surgery was at my door again and I found out that the mother, the 3-year-old girl and her 1-year-old brother were sleeping outside on the hospital compound. I decided that while waiting to contact the ship, I would ask if they could stay in ward 3 since there was a lot of space. The superintendent agreed and I took mom to the ward. Only to find out that the brother was sick- high fever and quite pale, which needed to be sorted out first. So I took the family down to triage to get him registered and that is how my afternoon of clinical work began.

Feeding Centre: While waiting for the 1 year old to get registered, a student nurse came by to say she was looking for a specific doctor, but couldn’t find him. She disappeared again, only to come back a few minutes later. She still hadn’t found a doctor and so asked if I could see a child. I said sure and followed her into the feeding center only to find a nurse attempting to resuscitate a child. Seeing as there was no ambubag or glucometer I decided to transfer to the emergency room where we resumed CPR. However, it was too late. There was nothing left to offer the child.

More clinical: I ended up in the Feeding Centre again later in the afternoon and saw another very sick child, in need of oxygen. I got that sorted and then went on my way again. I made sure the 1 year old got his blood transfusion. He did and thankfully he improved. Towards the end of the afternoon I went back to the Feeding Centre once more and ended up transferring the very sick patient to the Intensive Care Unit for better monitoring.

Namina: At 6:30 pm I walked to the ship, hoping to meet Namina and family on the ward, only to see that another patient now occupied her bed! I was informed that she had been transferred to the Hope Center, which is the off-ship hospitality center. So, I walked back out the port and up the road. I was happy to see Namina and her mom and brother there. It’s always great to spend time with them.

Re-assessments: After returning from the Hope Center I went back to the hospital and checked up on various patients. Some were still quite critical but at least in the intensive care unit. Seeing they were all being taken care of, I decided to head home. It had been a long day.

The run...

2011-05-25T21:46:00.000+02:00

I’m sure you are familiar with the term ‘love-hate relationship’. Well, that is kind of what it is like with me and running. I love it and I hate it. So, as much as I wanted to start running again, it took some effort to convince myself that it was the right thing to do this evening. It had been months since I last ran, and it was high time for some exercise. And, since I was home by 5:30 pm for once, there was no excuse.

Seeing as I had to get down to the beach first, I thought I should wear running clothes that are more modest – as in, no shorts, but Capri’s. This meant, however, that I would have to forego the zip pockets and make do with one small pocket. I decided for safety purposes not to take anything with me – no phone, no iPod, basically nothing. I would only take some money and one key. So, I put 5,000 Leones (just over $1) in my pocket, and 5,000 Leones in each shoe, just in case I lost the money out of the pocket or someone decided to steal it! I then took another Le 1,300 with me for my transport money, so that I wouldn’t have to run with change jingling in my pocket! The 5,000 bills were for the way home: one to use for transport and two for contingency. I then took my apartment key and tied it onto my Capri cord tie. I was ready.

So, off I went. I headed down the stairs with a bag of water (yes, a 500 ml bag of water) in my hands, because I thought it would be wise to hydrate myself before the run. On my way from the house to the roundabout, which is about a 7-minute walk, I was slowed down a bit by multiple people asking if I was going to jog. Yes, I replied. As soon as I got to the roundabout there was a taxi waiting and we headed towards Lumley. Fortunately traffic was not bad and 15 minutes later I was at the Lumley roundabout. From there I walked to Atlantic and that is when my run began. A run from Atlantic to Roy’s.

I loved the initial part of the run, like maybe the first 5 minutes. I then quickly started hating it! I think there were times in between that I liked it again, but for the most part, I didn’t love it very much. Once I was done however, all of the hatred was gone and I was satisfied!

The things I loved were being on the beach, hearing the ocean, watching the sunset, knowing I was getting some exercise and greeting others on the beach. But I throughout the run I hated being out of breath, feeling like I couldn’t continue any longer and getting a stitch in my side. So, the verdict is out, do I love it or do I hate it? I think it really is a bit of both. Now, if only I can get to the beach more often (before it gets dark) to run, then maybe I will improve my condition and not feel Iike I am going to die while running!

Of course, it does take some effort to get to the beach and back as well. I think half of the time I was out was spent in transport. Once I reached Roy’s I walked for about 10 minutes and then ran again towards Family Kingdom. Once there I walked up to the Aberdeen roundabout. I managed to get a front seat on a poda poda but felt bad because I was getting the seat all sweaty! I suppose it happens all the time. When we reached Congo Cross I got out in order to take a taxi up to Wilberforce, got out at Cemetery road and then walked the last 5 minutes home.

So, the run was worth it. And hopefully I’ll be able to go for a run again soon. I’ll have to be creative and think of a way to make it easier to get down there and back in less time. Or, I suppose I can start running in Wilberforce and run all the way down Spur Road to Lumley. After all, it’s downhill. I’ll keep you posted.

Busy but good...

2011-05-25T16:25:00.001+02:00

The last two days have been busy and diverse. It’s been good but I constantly felt like I was being pulled in different ways. I guess I was. I finally put my phone on silent today because it was ringing so often – it’s seems less intrusive if it just vibrates! So, to give you an impression, I’ll give you an overview of the last 48 hours.

Discussed the re-wiring of the laboratory with one of our maintenance guys in order for the lab to be connected to the back-up generator.
Arranged a meeting between Mercy Ships, Children’s Hospital, Maternity Hospital and Welbodi.
Sorted out the patient charts needed for the morbidity and mortality review on Thursday, which meant spurring the medical clerks into action.
Conducted a (2-hour) ward check with one of the in-charge nurses on all of the wards, checking whether or not the wards are clean, if patients received medications, if observations have been done, etc.
Checked up on the little girl that was admitted on Sunday evening, who was still in critical condition.
Involved with the admission of a 4-week-old twin, who was very anemic.
Escorted the father of the above child to the blood bank to make sure the child received blood urgently.
Chased down one of the administrative staff to ask why there are no charts available on the wards for new patients.
Took a lab request form to the lab to ask them (again) to come and do some blood tests on the little girl admitted on Sunday.
Took a call to discuss the plan for a cleft palate patient on TB medication that left the hospital due to family/social issues.
Met with one of the Welbodi directors and a colleague to plan for a meeting on Saturday.
Checked up on the twin from yesterday and found out he had not yet received a dose of gentamycin so wrote him a prescription for that.
Tried to arrange for a 1-year old boy with cerebral palsy to meet with the physiotherapists.
Talked to a communications person from the ship concerning a potential visit form a team from the ship later this week.
Met with a donor organization to discuss potential funding for the reconstruction of the neonatal unit.
Discussed a few cases with the person in-charge of infant feeding on the ship.
Delivered the hospital data (statistics) to the Hospital Manager and discussed the Quarter 1 report briefly.
Helped one of the doctor’s crop pictures and insert them into a power point presentation for a lecture he was giving.
Took a call from a doctor at the Aberdeen clinic concerning a patient they referred to us, who unfortunately died later this afternoon.
Attended a lecture by a WHO consultant on the issue of influenza surveillance.
Went back to find the twin to see if he had received the medication as prescribed (unfortunately not) and encourage the nurses to do so.
Sent some emails.
Helped admit a 5 year old child, putting him on oxygen, making sure his hypoglycemia was corrected, going to the blood bank for urgent blood and handing over to the doctor on call.
And maybe I did a few other things in between.

So, that was it for Monday and Tuesday. Like I said: “busy but good”.

Sunday evening encounter in triage...

2011-05-22T22:45:00.000+02:00

This afternoon I took a poda poda from Regent village, where my church is, to Siaka Stevens street. From there, I walked through town to get to the eastern side of the city where the Children's Hospital is located. After cooling down from the hot and sweaty journey, I spent a couple of hours working on statistics and then went to the Africa Mercy to meet up with some friends from the IOC for dinner. After a good meal (it’s so nice not to have to cook!), tea, homemade peanut butter cookies and a good chat I headed to the lounge for the evening service, which was really good. This was followed by a quick visit to Starbucks before it was time to head home.

Unfortunately the driver that was going to pick me up called to say his car broke down. Fortunately some friends from the Aberdeen Center were onboard and could give me a lift part of the way home. However, I had to stop at the hospital on the way to pick up my laptop, bag, etc. I told them it would take about three minutes to run up to the office, get my bag and come down, but of course I was delayed, as often is the case.

While entering the hospital I noticed a group of people standing in triage; there was a lady holding an infant, surrounded by 3 or 4 others. I asked if the child was sick and they said ‘yes’. At the same time the lady holding the child told the man next to her (her brother) that she knows me. She then asked if I remember her. As I look at her face, she says ‘It’s me, Zainab.’ And sure enough, I do remember her. She is a former VVF patient who I have seen and spoken to many times in Aberdeen. She used to live near the center and come by to visit. I haven’t seen her in years.

Knowing they came with a sick child I looked at the child’s condition. It was bad. There were obvious signs of respiratory distress. Apparently she has been sick for 4 days. I quickly walked them up to the Emergency Room and alerted the nurse and house officer. We went about checking the blood sugar (which was fine) and getting the child some oxygen. Unsurprisingly, there was no connecting piece for the oxygen concentrator and so I ran up to the office to get one. It still seemed to take a long time to sort it out so I looked around at the other concentrators to see if any of them already had two connections. Sure enough there was a machine with two connections but only one patient actually connected. I asked who the second set of tubing belonged to (as not to steal another child’s oxygen) and was informed that the child that had been connected to that point died earlier in the evening. This is the reality at the hospital. Children die. And I knew that if this new infant didn’t get oxygen soon, the same fate would be hers. We moved her closer to the concentrator and got her connected right away. Meanwhile the house officer was getting a history from the father. I am not sure what will happen to this little girl tonight. I suspect she has severe pneumonia, severe malaria or sepsis.

So that was my Sunday evening encounter in triage: an unexpected reunion with a former patient who was bringing in a new patient. I left the hospital happy to have met up with Zainab again, but sad to see one of her relative’s children in such a bad condition. It is now 1-½ hours since I brought the little girl to the Emergency Room and I find myself wondering if she is still alive. I can only hope and pray that I will see her in the morning. I hope this child survives. And hopefully I will meet up with her aunt Zainab again as well.

Back to Namina's village...

2011-05-22T17:16:00.003+02:00

From top L to bottom R: Juliette, Saidu, Ibrahim, Wara, grandson, Isatu, me, Koleh, Musa, Namina

11 weeks ago I went to Namina's village for the first time. That is when I told her that she had been scheduled for surgery in March. Since that visit, she had surgery and spent a further 8 1/2 weeks admitted on the ship and at the Hope Center. During that time I saw her regularly. On Friday the 13th of May she came to the hospital to tell me she had been discharged. It was time to go home.

So, a week after her homecoming, I thought it would be nice to visit her. So, off I went with two of my friends - Osman, a driver, and Juliette, nurse I worked with in the Aberdeen clinic. It was a great day, full of smiles and fun and some adventure. We had a great time with Namina, her siblings, and her mother (Wara), and the rest of the village! It was great to see Namina settled again and playing with her friends. Her life has been changed. And so has her family’s. More details and photos to follow…

Mercy Ships Connections video: May 2011...

2011-05-20T11:13:00.003+02:00

This is the latest Mercy Ships Connections video which includes some footage from the screening that took place earlier this year. I was asked to say a few words and the interview appeared on this video (towards the end). Just thought I'd share.

I have been able to refer a number (around 50 by now I believe) of patients to the ship including patients with cleft lip, cleft palate, lipoma, noma, clubbed feet, micrognathia (no lower jaw), contractures, hernias, bowed legs, and more. I have also been able to contact surgeons onboard for advice on various cases, which has been helpful.

Sometimes the never-ending knocks by strangers on my office door get a bit annoying, especially when it's yet another person with a goiter or hernia or something else that cannot be treated onboard. Also, the walks to and from the port are not always as convenient and it's definitely made my work busier, but in the end, it is a pleasure to be able to help both the children and adults in Freetown. For many of them this is a once in a lifetime opportunity. And of course, for patients I've have known for years, like Namina, this is what we have been waiting for. Mercy Ships has been a huge part of my life (14 years living onboard, 4 years working for them in Aberdeen), that I have to say it is only natural for me to stay involved. And it's a privilege. Of course, the perks are great too. I have to say that although I have never lived or worked on the Africa Mercy, the simple fact that it is a Mercy Ship still makes it feel like home to me. I think it's the familiarity of community life, and the familiar faces too of course.

#4 Photo of the week...

2011-05-17T18:37:00.002+02:00

“Ward 3 - Ola During Children’s Hospital”

Namina's admission on the Africa Mercy...

2011-05-16T00:01:00.000+02:00

My connection with Namina began over two years ago, on the 21^st of January 2009, when she came to the Aberdeen clinic for the first time. To be honest, when I first saw her I doubted that there was anything I could do. (see post: Tears for Namina) I was wrong. It was true I would not be able to fix the large hole in the left side of her face but together with my nurses we were able to stop the infection, clean out the wound and get the healing process started. The process had its ups and downs. Namina often cried during the wound care, and her mom often did as well. It was hard for Wara to see her daughter suffer so much. (see post: Monday's thoughts) However, after intensive wound care, multiple days a week, for a number of months, as well as providing nutritional support, the tissue settled down and the hole began to close. Seeing as the hole would never fully close on it’s own and she could no longer open her mouth due to damage to her jaw, surgery was still needed. So, Namina and her mom waited, patiently, until they heard in 2010 that the Africa Mercy would be arriving in Freetown in 2011.

Finally, on the 27^th of February the ship arrived in Freetown and I was able to make arrangements for Namina’s admission and surgery. Then on the 5^th of March I traveled to Namina’s village, to let her know the surgery had been scheduled, and she was to be admitted the following week! The entire family was delighted. This is the news we had all been waiting for, for over two years. Finally, on Monday the 14^th of March Namina, her mother and her younger brother, Ibrahim, made their way from Bailor town to Freetown and came to the Children’s Hospital. The time had come. We were excited and a little nervous as we headed off to the ship for Namina’s admission. I felt privileged to be a part of the admissions process and I think Wara appreciated it as well, and she was happy to send me off to the lab with Namina for her blood tests! Having built up a relationship with Namina and Wara over the years, it was amazing to be a part of this important moment in their lives. With a thankful heart I left them onboard, and walked back to the Children’s Hospital. In two days, I would be back to watch her surgery…

Waiting in the lab

Pre-operative blood testing.

A balloon to make up for the finger stick.

Wara's fingerprint for consent for Namina's surgery.

Wrapping up the admissions process.

Namina's mom, Wara, and her little brother, Ibrahim.

Another weekend, come and gone...

2011-05-15T23:23:00.001+02:00

It’s Sunday night and I’m not sure I’m ready for Monday morning just yet. I had a lovely weekend and wish it wasn’t over!

Friday night, movie night...When I lived in Aberdeen, we used to have movie nights on Fridays. They were always good fun and very relaxing after a busy workweek. This past Friday, Sarah and I decided to get together for a movie night. So, I headed down to Aberdeen and we ended up watching ‘The Bucket List’. Afterwards, while waiting for a friend to pick me up, we made up our own verbal lists of things we still want to do in life! I realized there is still a lot I want to do.

Meeting by chance...Months ago I tried to meet up with someone from a certain organization but unfortunately I called him the day before he was leaving so we never met. About a week ago my driver friend, Osman, told me that a doctor he knows was coming to Freetown for a week and he was to pick him up from the water taxi. It wasn’t until Friday morning that I realized this was the other doctor working for the organization I wanted to connect with So, I told Osman that at some point I’d like to meet this doctor. Little did I know that we would end up meeting late Friday night at the Aberdeen Women’s Centre since Osman had just picked him up and had planned to give me a lift home. We talked about the work he is doing at Connaught and the work I am doing at Children’s and it was interesting to hear about the similarities of what we’re doing. Anyway, Osman and I dropped him off at a hotel, and then Osman dropped me off at home.

Saturday breakfast...Sarah and I decided we would meet at Montana’s for breakfast at 9 am. Little did we know that Montana’s is not open until 10:30. Oops. Needless to say, we enjoyed an early morning walk along Lumley beach and then took a taxi to Bliss and had a lovely brunch there. It was a fun way to spend the morning.

Meeting a newborn...In the afternoon I went to Tengbeh town to meet a friend's newborn baby. He is only 4 days old and I’ve decided he’s adorable. I held him for a long time and at one point he started sucking on his hand. It was a first, so of course out came mom’s camera. The fact that my friend had him in Freetown is pretty incredible. As her colleague noted: Sierra Leone used to be called ‘White Man’s Grave”, so this baby being born in Freetown is pretty significant and a sign of hope for many.

Alusine and family...In the evening Osman drove me up to Alusine’s house. Alusine is the Welbodi driver and drives us to and from work everyday. His wife was very sick last week and his son was sick on Saturday. So, I wanted to make sure they were okay and that his son was on the right medication. He wasn’t. We stayed for about an hour and then headed back to Wilberforce, stopping at a pharmacy along the way to pick up the right malaria medication.

Church...Before heading to church I called Alusine to ask him to meet me at the Regent junction so that I could give him the medicine he needs for his son. Fortunately by the time I reached the Regent area, Alusine was at the correct junction and I could handover the medication while staying in the taxi. I then continued on to church. I was excited about listening to Pastor Michael teach today as I didn’t have Sunday school but ended up having to watch an 11 month old whose mom was teaching Sunday school. He wouldn’t keep still for the first part of the sermon, so I ended up outside anyway. Fortunately he got tired and fell asleep on my lap and I was able to listen to the second half of the sermon!

Ship...From church I went to my flat to drop off a bag of mangoes I received as a gift and from there I took a taxi to Congo cross, a poda poda to Regent road and then walked down to the port. I had arranged to meet up with a new friend, Allison on the ship. After a few minutes onboard, we headed off the ship again and walked around in town for a bit. After a coke and fanta at Mem’s cookery we walked back to the ship. I enjoyed a lovely dinner of roast beef, mashed potatoes, veggies (beans and mushrooms!), salad and a tangerine followed by a nice chat on deck 8, We then went to the evening service (which was great) and ended the evening with a caramel macchiato at the Starbucks café. It was a great visit! Thanks Allison.

Bed...And now it’s time for bed. I have a buys week ahead. Lots of work to do and I have the next four evenings planned – dinner tomorrow with the doctor I met on Friday night, meeting up with my friend Ans on the ship on Tuesday evening, International Bible study on Wednesday evening and women’s group on Thursday evening. It’s no wonder the time flies here…

Second blood donation...

2011-05-15T00:41:00.008+02:00

After a four-month wait, I was finally allowed to donate blood again at the Children's Hospital. I still think it's crazy that women have to wait 4 months, while men can donate after 3 months but rules are rules. Anyway, after lunch on Good Friday (great day to donate and reflect on the blood Jesus shed for us!), Shona and I headed to the blood bank to donate. Last time we enjoyed Christmas music, this time we enjoyed an Independence song serenade by yours truly: Omar.

I have to say, the whole process is quite amusing every time we donate. My Hb was 12.3 g/dl this time I believe, which is not bad considering I hardly eat meat these days. And I lost 3 kilograms since the last time I donated. I won’t complain about that either. So, Hemoglobin fine, weight fine, ready to donate. And that’s when my least favorite part comes in- the big big needle needs to be inserted into my arm. Ouch. And unfortunately this time, shortly after the needle was in place, the blood stopped flowing. After some slightly painful maneuvering, the blood still didn’t want to come out and so we decided to give it another go. This meant a second needle stick. Fortunately this time, the blood flowed quickly into the collection bag. And there was a fresh bag of blood, waiting to help one or more women or children.

I love the thought of helping others in such a tangible way. And what does it cost me? A little time and a little blood. Oh, and two needle sticks this time. I would again encourage everyone in Freetown to come and donate blood at the Children’s Hospital; every 3-4 months please. And really, if you come, I’ll buy you a coke!

Sunset over Lumley beach...

2011-05-15T00:19:00.002+02:00

13 May 2011: By far the best sunset view yet from my balcony! Stunning!

Trip to Namina's village...

2011-05-14T23:21:00.005+02:00

On Saturday the 5^th of March I woke up at 6 am. I had a big trip planned- a visit to Namina and her mom in their village. Farrah, a taxi driver friend of mine came to my house at half past 6 and after loading up a huge bag of rice and some other gifts for the family, we headed towards town. On the way we picked up one of my former colleagues, Ramatu, who used to work with me as a nurse in the Aberdeen outpatient clinic.

By 8 am we were on the ferry, heading towards Lungi. From Lungi we were told it would be a 15-minute drive to Bailor town, Namina’s village. Wrong. We picked up her older brother Saidu, to show us the way and after 25 minutes we found ourselves in a remote area, driving in and out of very small villages. Saidu kept saying we were almost there. We came to a bridge and wondered if we could cross it. Saidu said taxis do it all the time. So Farrah braved it. The crossing was very noisy as the loose planks were moving about under the tires of the car. I loved watching Farrah’s face as he was driving across the rickety bridge. He was happy to make it to the other side and already dreaded having to cross the bridge again on the way back!

After 75 minutes we reached Bailor town; a peaceful village on the beach surrounded by palm trees. The people were friendly and of course Namina and her family, including her granny, were thrilled to see us. Many children crowded around fairly quickly to get a glimpse of us. I was happy to see Namina and Wara again, and loved the fact that I was able to get a glimpse of their lives.

With all of the children in tow, we walked to the beach and enjoyed picture taking and refreshing sips of coconut water. There was laughter all around. It was great to see Namina in her own environment. We walked further down the beach and then turned back up to the village and back to Namina’s house.

A few hours later we were served food. Culturally, the guests are given food and everyone else waits to eat at a later time. So the three of us were served a wonderful meal while everyone else remained busy in the kitchen or in the house. I would have loved to sit down and eat with everyone, but I know this was a way for them to show their appreciation and respect. Their hospitality meant a lot.

When we realized we would miss the two pm ferry, we sat around and talked some more and then left in time for the 4 pm ferry. Of course, we had to cross the bridge again. And this time, we actually got into trouble- the tire slipped through the planks and was stuck in between the metal bars of the bridge. After trying various tactics, we managed to get the car tire out. We went on our way again, thinking we would miss the 4 pm ferry but in the end, there was no 4 pm ferry and had to wait for the 5:30 pm ferry. I think we were home by 7:30 pm.

The visit was eye opening and I will treasure the memories. I was happy to see where Namina and Wara live and grateful for their hospitality. I think what I was reminded of most from the trip is Wara’s commitment to her daughter. Wara’s husband died a few years ago and she is now the sole caretaker of 7 children (of which two are above age 16). I thought about our journey to Bailor town and back – the cost, the time, the distance, the effort, the challenges. And I thought of Wara making that same trip every single week to get Namina to the clinic in Aberdeen for her wound care. They would take the ferry on a Monday, stay with relatives in Freetown, come for Namina’s appointments and then head back to Bailor town on a Friday evening. And Wara did this for months on end and never complained. Wara was determined and dedicated and I can certainly learn from her. It is her perseverance that pulled Namina through. And after months of follow-up and more months of waiting for the ship, it was a delight to be able to take Wara and Namina to the ship for Namina’s admission. I feel privileged to have played a part in Namina’s story and am glad that I will continue to be involved in their lives.

Sierra Leonean lanterns...

2011-05-14T15:24:00.001+02:00

The Sierra Leonean lanterns are still around in town. The first one is from Aberdeen, the second one is from Tengbeh town. And, the picture may not show it, but the Independence ship was pretty impressive on the night of the parade. As stated in my blog post about the lantern parade: Sierra Leonean lanterns are not actual lanterns, but floats!

Petrol crisis in Sierra Leone...

2011-05-11T09:47:00.001+02:00

A week ago I was caught in a heavy downpour just after finishing up a meeting in town. I called a friend to see if he could pick me up. He could, so I found a bit of shelter under a tarpaulin and waited.

He arrived about 30 minutes later and we headed towards the West side of town. We did however need to get some petrol. This sounds easy, but it being only 4 days after the increase of the petrol price, we knew this would not be the case. For a few days many of the petrol stations had been closed, selling petrol for only a few hours everyday. Long lines of cars appear outside of petrol stations, waiting for station to open. Numerous jerry cans were lined up outside of stations, waiting to be filled. No one was happy.

The price of petrol used to be Le 17,500 for a gallon of petrol. Seeing as one UK gallon is 4.55 Liters, this means the liter price used to be Le 3,846. The new price is Le 5,000 per liter. For some reason, they have now started selling petrol per liter instead of per gallon. Maybe they’re hoping people won’t realize how big the increase in price was. If you look at the gallon price now it is Le 22,750 per gallon. This is quite a significant increase in price especially in relation to the average income in Sierra Leone!

My friend and I found a petrol station that looked like it might open soon. There were about 20 cars lined up outside so we joined the line. About 30 minutes later, the petrol station opened. We continued to wait, moving forward every few minutes as cars in the front of the line moved on. Of course the unthinkable happened. There were only two more cars in front of us and at that moment the station manager decide to stop selling. By this time we had been there for over an hour. And that is what happened to many people over the course of a week. It was not pleasant. Fortunately we made it home with the small amount of petrol left in the tank. I still don’t know why petrol stations were not selling for most of the day. Did they really have a short supply? Or was this all a power play? Were they trying to make a statement because in reality they were hoping for more of an increase in price? I hear it is even worse upcountry where they are charging up to Le 8,000 per liter!

So now taxi and poda poda drivers need to spend more on petrol. This means that transport prices have gone up from Le 1,000 to Le 1,300. In the meantime, salaries don’t change and so people spend a higher percentage of their salary on transport costs, leaving less money for living expenses. Prices of commodities are guaranteed to go up, to compensate for people’s loss of money (money now going to transport). As you can imagine, people are not so happy. But there is nothing that can be done about it. So, people will manage. They will need to manage with what they have. And I can again be thankful that I don’t need to worry about where my next meal comes from. I am privileged.

Help AdvocAid in Sierra Leone...

2011-05-10T20:16:00.003+02:00

"In 2005, a young woman in Sierra Leone was sentenced to death for a murder she did not commit. Her purported crime was the killing of a 6-month-old baby, the daughter of her husband's second wife. The infant died after its father sat on it, but the young woman, whom we know only by her initials M.K., took the blame – and even told police that she had killed it. "I said that I was guilty because my husband told me to," M.K. says. Her husband told the police that she had poisoned the baby, and they believed him. M.K. ended up on death row in Sierra Leone's notoriously grim Pademba Road Prison in the capital city of Freetown, far from her home village. Forgotten by her family and unable to read, write, or pay for a decent lawyer, M.K. was confined to a small, dirty cell for nearly six years. But then she met Sabrina Mahtani, the founder of AdvocAid, a nonprofit group based in Freetown that provides free services for women who find themselves inside Sierra Leone's prisons. Ms. Mahtani got to know M.K. and was moved by her story. Mahtani offered to help..." For more on this story: click on this story about Sabrina and AdvocAid.

AdvocAid is a great organization set up by Sabrina who has dedicated her time to helping women in prison. It is far from easy to do the work that she does day in and day out but she does it. One of the quotes that strikes me the most in the above article is that "it's not about numbers, it's about impacting individual lives." That is exactly what Sabrina and her team are doing. Helping one woman at a time. They are changing lives. And to do this, they need our support. Finding funding for this type of work is not easy. Will you join with AdvocAid today and help the women and children imprisoned in Sierra Leone? Donate through paypal or through AdvocAid's justgiving page today!

Sick small...

2011-05-02T08:02:00.000+02:00

So, since June 2005 I have actually only been sick once – sick as in, needing to stay home type of sick. That was within my first two months here when I came down with some serious shigella, became dehydrated and fainted. After 48 hours I was on the go again. Fortunately that was just before clinic opened.

I like to think I’ve become immune to a lot of the pathogens floating about the hospital, Freetown etc. People here get sick all the time and I’ve managed to avoid illness altogether, except for the occasional bout of diarrhea which is never severe enough to keep me at home. Unfortunately Friday evening, my stomach started acting up and I realized I would need to stay close to facilities. There went my planned weekend beach trip! It was bad enough to keep me in bed most of the next day and I decided that the remedy would be lots of fluid and no food. I figured if I don’t eat anything, nothing can come out. I did venture out after 24 hours, hoping that water, coke and ORS would keep me upright. I enjoyed a bit of the lantern parade and went to church in the morning. I think a 30 minute walk in the hot sun due to a transport crisis did me in yesterday but some ORS revived me again. After 24 hours without food I got pretty hungry and thought I better eat something – soup and crackers it was. It seemed to go well, except for a bit of nausea afterwards. In the evening I decided to try oats and so far so good.

I’m at work today and besides a splitting headache and a teensy bit of nausea, I’m fine. I’d hate to say I’m actually sick…maybe ‘sick small’. As long as my stomach doesn’t explode, I’ll be fine. We’ll see what the day brings! I guess I’m not as immune as I thought, but I have to say that getting sick only twice in 6 years is pretty impressive, especially considering there are a huge variety of pathogens in my work place! To the rest of my friends out there who are unwell (there’s a lot of illness in Freetown right now) – get well soon!

Independence Lantern Parade in Sierra Leone...

2011-05-01T21:15:00.000+02:00

I was not expecting to see the lantern parade on Saturday night because my plan was to stay overnight at Tokeh beach, however, a 24-hour bug kept me at home on Saturday. Since I hadn’t eaten all day my stomach settled a bit by the evening and so around 10 pm when a friend said she really wanted to go and see the lanterns, I joined, seeing as it was the last of the Independence celebrations! (Plus I was going a little stir crazy having been in the flat for over 24 hours!)

Off we went at 10 pm trying to find transport, forgetting that there would be hundreds of people trying to get transport at that time and of course the petrol crisis made it all the more difficult. We finally found a taxi and it took us right into town for Le 2,000 each (USD 0.50). Surprisingly, the taxi was able to drive us right to the end of Pademba road, very close to the Cotton Tree, where the event was happening. Bearing in mind that the event was scheduled to start at 7pm we were surprised to see at 11 pm that, although busy, not that much was happening as far as a parade. We met up with some other expats and stood chatting and waiting for the lanterns to come by. So far, my friends who had already been there for 2 hours had not spotted a lantern. This was true Salone time.

Finally, at midnight the first lantern approached the Cotton Tree. This was both exciting and fun but honestly, I am not sure why they are called ‘lanterns’. I think a cultural float is a better description. Most of them were basically massive puppet shows on flat bed trucks; some with puppet soldiers, one with a puppet lion who’s head was bobbing up and down, one with puppet street cleaners, some with live music to add to the effect, some designed as ships. They were definitely entertaining, to say the least. Unfortunately I don’t have any pictures to show you; I didn’t want to take a chance with my camera!

In the next thirty minutes we didn’t see another float so we thought we would move around and try to find them! Seeing as none of us felt like staying out till 4 or 5 am, which is when the lanterns were likely to reach the Cotton Tree for judging, we thought we would make a move.

We attempted to walk down Siaka Stevens street but the masses quickly made us change course. We went back down Pademba and then took a right down the second side street ending up by the Electricity House. We walked along Siaka Stevens street and after some minutes a large group of young men ran past us. This surprised us and we quickly jumped to the side of the road. Within seconds a lantern appeared behind the group of men. A second lantern spotted. After walking a bit further we felt like the crowd was too rowdy and turned up to Pademba road again only to later return further down on Siaka Stevens where we saw the third float. Seeing as it was really busy, and time was ticking along, we thought we would call it a night. We decided to head home, but of course, with the busyness, transport would be hard to get.

We started walking down Pademba road and sure enough, just as we were wondering where the lanterns were hiding, a lantern turned onto Pademba road. The crowd behind it was massive and so we waited on the side of the road. It was definitely intriguing and entertaining to watch the crowd pass by. I assume most of them had been following the lantern from Tengbeh Town, which is the community that built this particular float. It was by far the best float: a ship with helicopter and all. The crowd seemed very proud of it and we were all impressed. After a good twenty minutes we could finally move towards Campbell Street. There we saw a couple more lanterns. So, all in all, we couldn’t complain.

We ended up walking to the stadium due to lack of transport and in the end got into someone’s personal vehicle to Congo Cross. Three of us then got out and took a taxi the rest of the way home. It was a late night but it was worth it and fortunately my stomach coped! I would definitely watch the lanterns again but maybe I would go to bed early and then wake up at 5 am and go to the Cotton Tree to see the final parade of all the lanterns at once! Actually, I hear they park the lanterns at the Youyi building, so another option is to go and see them there. However, I’m not sure the experience would be quite the same without the masses of people, the search for the lanterns and the sounds on the street.

Queens Day 2011...

2011-04-30T20:06:00.005+02:00

Today is Queens Day in the Netherlands. But I am in Freetown and I'm afraid there's not much going on here in the way of Dutch celebrations. It's still full on Independence here. So, I'm thinking of my friends and family having a great time back home - decked out in orange and enjoying the festivities outdoors.

It's quite funny this year with Sierra Leone's independence, the British Royal Wedding and Queens Day all being within a few days of each other. Makes me realize how patriotic people can be. And although I didn't care too much about the royal wedding, I did enjoy seeing a glimpse of the procession in one of the doctors offices yesterday. And I am reminded today of how excited I was last year to be within meters of Queen Beatrix in my hometown.

Anyway, I hope all of my Dutch friends have fun today. I am hoping I'll feel a bit better this evening to catch a glimpse of the lantern parade here in Freetown - the final Independence event I believe.

(see post from last year: Koninginnedag 2010...)

Independence Day at Charlotte Falls...

2011-04-30T10:53:00.002+02:00

I decided to spend Independence Day with friends at Charlotte Falls. Actually, our first stop was halfway up the road to the Chimp Reserve for a quick hike up the ‘Butterfly trail’. It was a lovely walk but there were not a whole lot of butterflies! It was so peaceful though.

We then continued to Charlotte village. My friend decided we should take the second turnoff- supposedly less steep than the first turnoff. Well, it was still pretty steep and it was all loose rock. After getting stuck, we switched drivers. After a few minutes, when it seemed the land rover might just tip over, those of us in the back got out. The problem was that there was a deep crevice in the road, filled with some loose rocks. While trying to get the back tires out of the crevice, the vehicle kept sliding, lifting the back left tire about a foot off of the ground as the right tire went deeper into the crevice. It looked pretty scary but the driver continued to maneuver her way down hill- slipping and sliding over the rocks. Finally, the land rover made it to the bottom. When we reached the bottom on foot, we heard that part of the problem was that the handbrake was left on. No wonder they slid all the way down! It’s yet another story to tell.

We were quickly joined by Akim, our guide and headed to the falls. On our way we passed the chief’s house where they were having a big Independence celebration. Everyone was wearing green, white and blue, music was blaring, and people were enjoying food and drinks. Perfect.

The falls were great, even though there wasn’t a whole lot of water flowing. That’s what happens towards the end of dry season. There was still plenty of water in the pool though and we enjoyed a quick swim after our picnic. We were later joined by people from the local TV network who wanted to film us and talk about development. We were maybe too honest in saying we didn’t want the place to develop further – we liked the fact that we were in the middle of nature! Charlotte falls really is a beautiful place.

Friday...

2011-04-29T15:48:00.001+02:00

It's Friday, 2 pm. This is exactly what I feel like doing.

A few hours to go and I'm heading back to the West side.

I'm looking forward to a weekend away!

Independence Eve in Sierra Leone...

2011-04-27T00:20:00.002+02:00

The plan for the night (according to the schedule) was Carnival and Fireworks at Lumley beach, starting at 9 pm. I assumed that the festivities would start around 9 pm like they did on Sunday night and that the fireworks would kick off at midnight.

So, my colleague and I headed down to Lumley beach decked out in green, white and blue. We were ready for a party. The plan was to head to Montana’s on the beach and meet up with some more friends and then join in with the Saloneans to celebrate.

Well, the night did not quite go as planned. We ended up sitting at Montana’s with about 30 expatriates, waiting. Surprisingly, beach road was not crowded at all. The road was not blocked off like it was Sunday night which actually made it easier for everyone to get transport. However, I actually quite liked the street festival vibe on Sunday evening and was hoping tonight would be even more spectacular. There must have been a party elsewhere that someone forgot to tell us about!

My colleague’s friend was due to arrive tonight from the UK and so at 10:30 pm we headed to the water taxi to pick her up. We walked along Lumley beach road, which was still really quiet. No partying going on, but again, this meant we easily found a taxi. The friend arrived at 11:15 pm and decided that instead of heading back to the beach, we would head home. After all, it seemed more and more unlikely that there would actually be fireworks. And if there were, we would see them from our house.

It is midnight. HAPPY BIRTHDAY SIERRA LEONE!!

I never did see fireworks tonight, and it didn’t sound like much partying was going on, but it was still an enjoyable evening. People must either be partying elsewhere or getting geared up for the 7 am parade tomorrow! Of course, on our street, the music has piped up and the party has started. I think the music may just go on all night. For me, it’s time to sleep. I’ll continue the Independence Day celebrations tomorrow! And I am sure that tomorrow there will be a lot going on…

World Malaria Day 2011...

2011-04-25T22:10:00.001+02:00

Today is World Malaria Day and unfortunately, although a preventable disease, malaria still kills many people in the developing world. At the children's hospital I work at, we see malaria cases everyday. Some cases are very severe; the children are literally on death's doorstep and other cases are mild and improve with oral medication. As you can imagine, the disease has a major impact on child health in Sierra Leone.

In November of last year, we had 999 inpatients in the hospital and in that month (as often is the case) malaria was the most common reason for admission, followed by chest infections, diarrheal disease and anemia (unrelated to malaria). Sadly, children die at the hospital on a daily basis. In November, 54% of the hospital deaths were attributed to malaria. In November 67 children died at the Children’s Hospital as a result of complicated malaria. We obviously have our work cut out for us. Having said that, I do believe that the staff at Ola During is working hard to do their part in combating malaria. The staff, management and partners of ODCH and the Ministry of Health and Sanitation must be commended for their ongoing efforts to improve healthcare. The laboratory has definitely improved and more blood smears are being examined for malaria. Thanks to one of the partners in the hospital, malaria treatment is readily available. Improvements in the triage and emergency system mean that children receive their treatment more promptly. There is still a lot to be done, but progress is being made.

The theme for the fourth World Malaria Day is Achieving Progress and Impact. The theme recognizes the international community's renewed efforts to make progress towards near zero malaria deaths by 2015. We’re not there yet, but I like to believe that things are improving. Hopefully the country of Sierra Leone can tackle issues like: distribution and use of insecticide treated nets, prompt diagnosis, appropriate treatment, etc. Various barriers play a role, such as: cultural/traditional ideas impacting use of nets and quick presentation of child to a health facility, lack of experienced laboratory technicians, lack of rapid diagnostic tests, inconsistent supply of ACT medication or quinine, etc.

Hopefully, health education in the communities, training in health facilities (lab and medical staff), and improved supply chain will decrease the number of deaths related to malaria in Sierra Leone. The day that there are near-zero malaria deaths in the country will be a day to celebrate for sure. Count me in…

(see: http://www.worldmalariaday.org)

Beach road festivities...

2011-04-24T23:01:00.000+02:00

Lumley beach is apparently the happening place this week. Last night they had a massive party there. When I went to the beach this morning at 6 am for an Easter sunrise service there were hundreds of people walking from the beach towards Aberdeen. I guess a lot of people didn’t sleep last night!

This evening, after dropping off my colleague’s parents at the water taxi, we headed to Lumley beach. I was curious as to what the atmosphere would be like. We went to Roy’s for a drink. Initially the beach wasn’t too busy. However, the road was blocked off just past the helicopter road turn off and no vehicles were allowed onto the main part of beach road. That is, no vehicles except for the occasional VIP, or ‘someone who knows someone’ type of vehicle and of course the Ambulance. The ambulance drove up and down the road with siren on for no apparent reason. Patrolling? Driving around VIPs? Picking up people who have fainted? Who knows? It seemed like ‘a lot of noise, but little action’. And I almost hate to say it, but that sometimes seems like a common theme. Anyway, it was great to have a whole road to walk on, except for dodging the occasional okada (motorcycle).

After Roy’s we decided we would venture a little further to see what was happening at Montana’s- where we had seen a pretty big stage the day before. Sure enough there was a bigger crowd there. And actually, the road was much busier with people too. I have to admit that there was a great atmosphere there. Everyone seemed happy and friendly. There were many stalls on the side of the road selling drinks, biscuits, street meat etc. It really resembles a street festival at home. I ran into a former patient and his mom, as well as a former lab technician of mine. It’s fun to run into familiar faces. When we reached the stage there was again a lot of noise from the stage and little action – Airtel; one of the mobile networks was doing some kind of promotion talk. People seemed fine with it though. We stayed for a bit and then headed back. We took a fabulous taxi from beach road to Congo Cross with a built in DVD player/screen and watched Michael Jackson video clips during our journey home. We changed taxis at Congo Cross and then walked the last bit up Cemetery Road to our house. It was an enjoyable evening.

Rumor has it that Tuesday’s events will include live bands and fireworks. That’s Independence Eve folks and I think we’ll try to be there. Of course, there will be hundreds of people there, and so to the concerned ones out there, don’t worry; we’ll do our best to stay safe. If the crowd gets out of control, we’ll head home. It’s just hard to pass up the 50^th Anniversary celebrations.