Exciting transition into new role with Mercy Ships...

I’m super excited to announce my appointment as Country Director - Sierra Leone with Mercy Ships, commencing 16 September, based in Freetown!! 

What a great opportunity to represent Mercy Ships and work alongside the Sierra Leone government, health sector, partners and healthcare workers to see how the organisation can complement ongoing efforts to improve access and quality of healthcare services. 

I have a long history with both Mercy Ships and Sierra Leone. One of the ships was my childhood home for 14 years, and after studying medicine in The Netherlands, I moved to Sierra Leone, which has been my home for the past 17 years! I also worked for a Mercy Ships medical project here from 2005-2009 and have taken many patients to the ship for surgical care. It’s my worlds coming together. 

I’ll miss my AWC family and patients but I’m looking forward to this next adventure.

#sierraleone #mercyships #hopeandhealing #globalhealth #globalsurgery #partnership #equity #transformation #restoringhope #safesurgerysaveslives 
PC: Mercy Ships 

A clinic day during the COVID19 pandemic…

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

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

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

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

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

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

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

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

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

#TogetherWeCan #EndCorona #ProvidingEssentialHealthcare #ChildrenMatter

An unexpected Easter in COVID-19 times...

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

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

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

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

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

Good Friday: in the midst of chaos and uncertainty

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

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

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

Whirlwind Weeks: COVID19 confirmed in Sierra Leone

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

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

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

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

Wash your hands with soap and water frequently for at least 20 seconds.

Cough and sneeze into your elbow.

Do not touch your face. 

Avoid contact with sick people.

Keep physical distance from each other. 

Call 117 if you are sick.

Follow local health advice.

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

Another year...

Today marks the first day of another year at Aberdeen Women's Centre! Yesterday, I completed my first year working as a doctor in the outpatient paediatric clinic. There was a lot of transition at the start, including a move to a new home, resuming clinical work and starting my online Masters in Public Health and at times I wondered if I would make it to the end of the contract. Thankfully, I did and I’ve decided to stay put for another year.  

Although there are parts of my work that are frustrating and challenging, like any job I suppose, the work I do in Aberdeen is also very rewarding. I have the unique opportunity to help children get better and advise and encourage the caregivers to provide healthier environments for their children, whether it’s through nutritional advice, encouraging them to bring their children for immunisations or teaching them how to prevent illness. It’s a privilege to work alongside a Sierra Leonean team and provide healthcare that makes a difference in the lives of children and families in Freetown.

Now that the rains have started, the clinic is even busier than usual and in the past three days alone we’ve treated over 400 patients. We are seeing more diarrheal disease, respiratory disease, as well as cases of severe malaria, in children of all ages. At times it’s scary to see just how sick these children can get but on the flip side, it is amazing to see how so many of them recover. I’m hoping for ongoing wisdom and energy for our team as we strive to help as many children as we can despite the craziness and long days. Here’s to another year at AWC.  

First 24 hours...

I arrived in Freetown last night after being away for a month. I had a great time on my three country trip but it was really good to come home! 

Besides the fact that the electricity cut out at around 3am meaning my fan switched off and it got pretty warm, I slept quite well. Thankfully the power came back and my fan cooled the room down again. Breakfast today consisted of tea with a Basha donut, courtesy of my housemate who was very considerate to buy some 'welcome back donuts' yesterday. 

Within 10 hours of arriving home I walked out of the front door and out of the gate to find a taxi to take me to work. On arrival I was warmly welcomed by staff at AWC, which is always encouraging and fun, except for the comments about how I’ve gained weight because I was fed so well while on leave. This is one of those cultural things I will never quite appreciate. Is it really okay to tell someone they are fat?! I'm sure the donut this morning didn't help. ;)

There were about 45 patients waiting in the clinic when I arrived and they had probably been waiting since 5 or 6 am already. That’s the way it works here - no appointments and people come early to make sure they are seen that day. Thankfully clinic didn’t get too busy and we were able to take our time during the consultations. I even had time for lunch, which was rice with potato leaves - my favorite AWC meal.

My first patient was an infant who needed to be referred due to severe pneumonia. I also saw a child with epilepsy, a 5 year old weighing 11 kilograms and a child who had been mismanaged at a pharmacy who I diagnosed with malaria and started on treatment. I saw others with acute respiratory tract infections, skin conditions like scabies and diarrhoeal disease. It’s definitely never dull! I even had a little time left over at the end of the afternoon to update one of our protocols. 

After work I found a taxi to take me to Aberdeen road junction, walked to a supermarket to pick up a few essential items and then walked home from there, ignoring quite a few “white girl” comments on the way. Another one of those things I have never gotten used to!

I had a relaxing evening at home, which is a nice change since I usually come home and have to start studying right away. Thankfully module 3 of my MPH doesn’t start for another week. 

Alright, that’s it for a little glimpse of my first 24 hours back in Sierra Leone. More another day. It’s bed time now.

#lifeinsierraleone #sierraleone #alwaysanadventure #outpatientclinic #AWC 

Breaking news in Sierra Leone - Presidential Elections…

As of tonight, Sierra Leone will have a new President, with the swearing in taking place any time now. Congratulations Julius Maada Bio. It was a 4 week process, but we finally have an outcome. 

The first round of elections between 16 Presidential candidates was held on the 7th of March, 2018. The results were announced on the 13th of March. SLPP was in the lead with 43.3% of the votes, with APC closely behind with 42.7%. Since neither party had more than 55% or more, a run-off election was announced for the 27th March 2018. NGC had 6.9% of the votes and C4C 3.5%. The remaining 12 parties all had 1.1% or less. There was an 84% voter turnout. 

However, on the 26th March we awaited a decision by the High Court due to an interim injunction halting the runoff presidential election. Fortunately it was halted and the run-off election was allowed to go ahead, however, due to logistics that needed to be put in place, the run-off was postponed to Saturday 31 March, 2018. 

On Saturday 31 March, 2018, the run-off Presidential election was held. 2,578,271 people voted in 11,122 polling stations across the country, representing 81/11% of all registered voters.

On Monday 2 April, 2018 the tallying was halted due to a disagreement between the parties on the process used.  Later that day ballot counting and tallying continued with both parties having come to an agreement with the National Electoral Commission resolving the earlier dispute about which system to use. 

On 4 April, 2018, just after 10 pm, the National Electoral Commission announced that Bio Julius Made, having polled 51.81% of the valid votes cast on the 31st March 2018 Presidential election run-off, has been duly elected President of the Republic of Sierra Leone. 

There has been a lot of cheering, singing, whistle blowing, banging of pot covers tonight as many Sierra Leoneans are out in the streets celebrating. Let's hope for continued peace and for good conduct amongst people from various political parties. Hopefully everyone will graciously accept the election results. The people have spoken.

Congratulations Sierra Leone on conducting a peaceful, fair and transparent election. The people have decided and effected change. Let’s work together for the good of the country. Be positive. One country, one people. 🇸🇱💚

#SierraLeoneDecides #SierraLeoneElections #sierraleone #votesalone #salonevotes #keepthepeace #slppwins #onecountryonepeople

Sierra Leone election results...

Sierra Leone Election News. Freetown, Sierra Leone: The last 24 hours have been a little tense in Sierra Leone as we have been waiting for the results to be announced from the presidential election held on 7 March 2018. 

There was a lot of anticipation on the 12th of March 2018 with the hopes that the results would be announced by the National Electoral Commission (NEC). There were rumors that they would communicate at 14:00 hrs, then 16:00 hrs, then 19:00 hrs. However, the announcement did not take place and instead we were informed that ballot papers were going to be recounted at 72 polling stations in various districts. This was in addition to recounts in 82 polling stations, announced the previous day. These recounts were being conducted after deliberations with political parties. 

During the day on the 13th of March there were more rumours that the results would be announced. Finally at 16:30 hours, NEC announced that there would be a briefing held at a press conference at 19:00 hrs today. 

At 19:00 hrs today thousands of people in Sierra Leone were tuned in to their radios, waiting in suspense for NEC's announcement. Finally, at 19:46 hrs, NEC announced the election results for the presidential election with the opposition party, SLPP, leading with 43.3% of the votes and the ruling party, APC, closely behind with 42.7%. Since neither party has 55% or more of the votes, a run-off election will be held on 27 March 2018, two weeks from today.  NGC has 6.9% of the votes, C4C 3.5% and the remaining 12 parties all have 1.1% or less. 

NEC reports that the results from 221 polling stations were excluded, including stations where votes cast exceeded the number of registered voters at those stations.  Also, after deliberations with political parties, recounts were conducted in 154 polling stations, none of these results were nullified. 

There were 3,178,663 people registered to vote, of which 2,676,549 people voted (with 139,427 invalid votes), meaning there was a 84.2% voter turnout on 7 March 2018. 

Well done Sierra Leone for conducting a credible election. Let's continue to keep the peace in the lead up to the run-off and the transition of power to whoever is elected as the next President of Sierra Leone. 

National Electoral Commission results: 13 March 2018

#SierraLeoneDecides #SierraLeoneElections #sierraleone #keepthepeace #undivided #votesalone #presidentialelections #NEC #votesalone

Sierra Leone Decides...

7 March 2018, Freetown, Sierra Leone 

Today was a big day in Sierra Leone as voters went to cast their votes at the polling stations. Across the country 11,000 polling stations were open for voting between 7 am and 5 pm and according to the National Electoral Commission, 3,178,663 people were registered to vote. At some polling stations, people starting lining up at 2 am, at others it was later, but by 7 am, most of the stations were open to voters. The voters were each given 4 ballots to vote for Presidential, Parliamentary, Local Council and Mayoral candidates. Once the ballots were marked, they were immediately deposited into the designated ballot boxes. After polling stations closed at 5pm, the manual counting of the votes began.

The day was peaceful and there was a great atmosphere in the air. I was able to visit two polling centres and it was great to sense the excitement. From what I could see, and from what I’ve read, NEC organised the election extremely well, and in most polling stations, it has been reported that voting was carried out well.

It wasn’t until after 5pm that there was some commotion reported in a few different areas in Freetown. Apparently the police searched the premises of the main opposition leader, where he and his team were monitoring the elections, on allegations that they were hacking results. This intrusion led to commotion. Thankfully the former Ghanaian President, also head of the Commonwealth election observer mission, diffused the situation. It is of note that counting of votes is all done manually.

A time of waiting and anticipation has begun and many people will be listening to their radios over the coming days while the counting continues. NEC will announce initial results once 25% of the votes have been counted and verified.

Let’s wait patiently and peacefully. Amazing patriotism was shown today. Please continue to make Sierra Leone proud. Stand United.

#SierraLeoneDecides #SierraLeoneElections #sierraleonevotes #presidentialelection #sierraleoneelection #electionsinsierraleone #sierraleone #undivided #keepthepeace

It’s 2018 and I’m back in Sierra Leone after a cold but fun two week break in The Netherlands with family. I wonder what this year has in store for me. I have some hopes and dreams but I also have many questions and things to ponder. Don't we all. Some of these dreams I’ve had for a very long time...

So, 2018. What will this year hold? Am I the only one who never seems to know what I want in life? “When I grow up I want to be a...” Wait a minute I am grown up. Well, there are days that I really don’t know what I want in life and I don’t feel very grown up at all. The good thing is, we never have to have it all figured out. 

What I do know is that right now, I’m in the right place, doing the right thing. And I’m trusting that if I need to head in a different direction at some point, it will be made clear - I will know when to move on and where to move on to. For now, I am staying put. And trusting God. 

Life is busy. Work is busy. There’s an abundance of disease and never a shortage of patients. Today on my first day back I was in the clinic on my own. Seeing 54 patients. There were a surprising number with malaria and a lot with gastroenteritis. One child tested positive for HIV, while another had to be reminded of the importance of taking preventative medication due to his sickle cell disease. There’s never a dull moment. And, just to keep me on my toes, last month I started a distance learning Masters in Public Health. Yes, it’s busy. 

Let’s see where 2018 takes me...

#2018makeitcount #alwaysanadventure #actjustlylovemercywalkhumbly #sierraleone

Freetown Flooding: the landscape then and now

On 14 August 2016, I went to Regent to visit one of my colleagues at his home on the hillside. I took photos of the beautiful landscape that day. Little did we know that exactly a year later, 14 August 2017, torrential rains would lead to a mudslide down Sugar Loaf mountain, followed by unprecedented flooding and the loss of hundreds of lives. These images taken a year apart in roughly the same spot, speak for themselves. Regent is the epicentre of the disaster, but the devastation stretches much further down the valley to the Lumley area. Prayers go out to all those affected and to those responding. 

#prayforSierraLeone

Freetown Flooding: one week later

It is one week since the tragic mudslide and flooding took place at Sugar Loaf Mountain in Regent, Kamayama, Kaningo in Freetown. 492 bodies have been buried, with hundreds still missing and thousands of people displaced. The country remains in a state of mourning as people try to come to terms with their losses.

Today a mom came to the clinic with her 6 week old. With great sorrow she told us that her husband and mother died in the flooding in Kadingo. This mom is now a widow and her child will never know his father. 

On Saturday I met a lady whose family slept in their new home in Regent for the first time on the eve of the disaster. Early Monday morning the lady, her husband and their one year old went to their former house to get the last belongings. By the time they returned to Regent the landslide had taken place. Their 12 and 4 year old children died in the mudslide. They never saw them again. 

There are many sad stories. There is so much grief. Yet the resilience of the Sierra Leoneans is remarkable. Time after time they demonstrate that even in a crisis, they press on. They stand together. They smile. They are courageous. They are kind. Yes, there is a lot of sorrow, but in the midst of it, they show great strength. So many people have worked hard to make sure the victims are given dignified burials and the displaced are being provided for. The response continues. Please remember this country and pray for her people. 

#prayforSierraLeone
#SierraLeone

40 Acts of Kindness...

 

On the 8th of May I started a 30-day challenge to complete acts of kindness as one of my #40before40 activities. This challenge included a wide variety of acts and the recipients have included family, friends in Freetown, elsewhere in Sierra Leone and far away, as well as complete strangers. It’s been fun to surprise people and see their expressions of gratefulness.

In a world with so much hatred and despair it is great to play a small part in spreading kindness and joy. I would encourage anyone reading this post to pay it forward and extend an act of kindness to someone today. In a world where you can be anything: Be Kind.

One of the fun things was that my acts of kindness sometimes “backfired” on me. When I got the phone credit for one of my acts of kindness I planned to let the lady who owns the shop opposite my house keep the change, but instead she gave me my change and gifted me with a bag of popcorn. It was an act of kindness in reverse! I was also blessed when one of the Sierra Leonean doctors gave me a lift home after the SLMDA meeting. He went out of his way to drop me off. He said “we need to look out for each other.” That was much appreciated.

I loved this activity and since the focus this year is 40, I decided to extend the challenge for an additional 10 days, to allow for 40 days of intentional acts of kindness. Here’s the list:

1. Bought NPA (electricity) topup for a friend

2. Treated 3 friends to a meal at a "new" restaurant in Lumley - enjoying African cuisine

3. Made a cup of tea for my house help - it was raining and she was cold (although it was still 30 C outside!)

4. Gave a few phone credit scratch cards to one of my security guards - he was surprised, gave a big smile and said "thanks and God bless"

5. Gave cans of Coca Cola to two different taxi drivers on a hot afternoon 

6. Gave a friend a hug 

7. Gave coconut to a group of children at the beach

8. Made a donation to the organization "charity: water" in honor of my mom on Mother's Day 

9. Sent handwritten cards to friends who are on leave in the UK and Switzerland

10. Gave a card and money to a couple to go and enjoy ice cream at Gigibonta

11. Spent some time at a friend’s house to make sure that her furniture was delivered and assembled while she’s on leave in the USA

12. Helped a friend in need financially

13. Helped someone who is unable to write, write a card for a couple getting married 

14. Bought ice cream for a friend

15. Wrote a card of encouragement to a friend leaving Sierra Leone later in the day, who is moving back to the UK

16. Made lime bar treats for Bible study 

17. Donated money to the organization “Mariatu's Hope” to help with the cost of a tutor

18. Gave a new security guard some Guinea mangos 

19. Had a friendly chat with a random taxi driver and then paid double for my taxi ride

20. Donated money to the organization “Planting Promise” for their school-feeding program in Sierra Leone on World Hunger Day

21. Gave a bag of rice to my house help 

22. Baked chocolate chip cookies for the “Kings Sierra Leone Partnership” team at Connaught hospital and had them delivered to their offices the next day

23. Spent the day helping two blind patients access appropriate healthcare including investigations in other facilities

24. Spent more time with a patient to get a CT scan at a different hospital

25. Sent phone credit anonymously to two former colleagues and my caretaker

26. Packed up clothing I don’t wear anymore to take to Namina’s family in Bailor village

27. Gave chocolates to a group of children

28. Went to Murray Town with someone I just met to help her pick up her fiancé at the Sea Bird water taxi, while I was also picking up a friend

29. Paid the taxi fares for fellow passengers in two different taxis. The smiles and gratefulness expressed was so worth it. 

30. Copied and bound my study manual for the pediatric primary exam and gave it to a Sierra Leonean doctor who is planning to take the exam in a few months time

31. Bought medicine for a friend’s colleague 

32. Gave money to my house help towards her pending surgery 

33. Bought a ticket for a Sierra Leonean law student to attend the Advocaid film festival on women's rights

34. Supported the medical students talent and awards night

35. Sent gifts to my nieces in the Netherlands 

36. Sent money to a family friend who is pursuing a course in counseling

37. Sent money to Stefan, Genae and the kids to treat themselves to treats at “Menchies”

38. Sent a get well card to a dear family friend who is recovering from surgery

39. Sent a card to my parents in Haiti, via TN, to let them know I love them

40. Bought Luci lights, cool solar powered lights, for Junior’s family & Namina’s family  

#randomactsofkindness #actsofkindness #bekind #payitforward #40before40 #sandraturns40 #40isthenew30 #bucketlist #alwaysanadventure #sierraleone #sweetsalone

21. ✔A 30-day challenge - completing acts of kindness or gratefulness (8/5/17-16/6/17)