World Food Week...

World Food Day is held on 16 October each year, remembering the day in 1945 when the United Nations' Food and Agriculture Organization (FAO) was set up. The day is used throughout the world to raise awareness about those living in hunger all over the world.

With an estimated increase of 105 million hungry people in 2009, there are now 1.02 billion malnourished people in the world, meaning that almost one sixth of all humanity is suffering from hunger.

The first Millenium Development Goal is to eradicate extreme poverty and hunger by 2015. That means halving the proportion of people who suffer from hunger over a 25 year period. With only 6 years to go, the figures are still astonishing.

• 10 million people still die every year of hunger and hunger-related diseases.
• According to the UN, rising food prices may push 100 million people deeper into poverty.
• And although fewer children below five are undernourished, malnutrition still accounts for about one third of childhood deaths in Sub-Saharan Africa.

Let us reflect on these numbers and the suffering behind them. The FAO states that they have the know-how to do something about hunger and the ability to find money to solve problems when considered important. Let’s make sure this recognized as a big problem. There is a World Summit on Food Security proposed by FAO for November. Let’s hope that our world leaders come up with good solutions. And in the meantime, let’s do what we can…

“There is enough food grown in the world for everyone. And yet we remain stuck in a food crisis. Half the world’s food is lost as waste and a billion people – one in every six of the world’s poorest – cannot access enough of the other half and so go hungry every day.” – Oxfam

Psalm 23...

Lord, you are my shepherd. I have everything I need.
You let me rest in green meadows, you lead me beside quiet streams.
You give me new strength everyday.
You guide me in the right direction, bringing honor to Your name.
Even when I walk through the darkest valley I will not be afraid because You are with me.
Your rod and your staff make me feel safe and secure.
You prepare a meal for me right in front of my enemies.
You welcome me as a guest, anointing my head with oil.
I am overflowing with blessing.
I know that your goodness and love will pursue me every day of my life.
And I will live in Your house forever.

The doctor is out...

This morning I went to the doctor’s office.
As I entered, the assistant informed me that the doctor was not in.
He was called out to an emergency.
He would be back soon, but would be running behind schedule.
I was told there were 3 people waiting before me.
My response: “no problem”.

As I sat there it was interesting to hear other responses.
One lady looked at it from the view point of being the one in urgent need.
And said she would be thankful too if the doctor would attend to her right away.
Another lady was in a hurry and could not wait.
She would make a new appointment.
Someone else grumbled a bit before sitting down.

My thoughts drifted to Sierra Leone.
There, people are thrilled if they can get to a doctor’s office.
In Holland we take easy access to medical care for granted.
Everyone has a family practitioner they can go to.
It’s only a matter of calling up and making an appointment.
And even today, with the ‘extra long wait’ I was only there for an hour total.

If only people knew what it was like in Sierra Leone.
A country with 168 physicians for a population of 6 million.
Compared to Holland with 60,519 physicians for a population of 16 million.
Fathers and mothers lined up in front of clinic gates by 5 in the morning.
Waiting rooms full by 8 am with 50+ children sitting around till late in the day.
Families who get sent away without help due to lack of resources/staff.

As I sat there thinking, I realized how privileged I am.
And hoped that others too, would realize how fortunate they are.
Fortunate to have access to health care, education, water, and so much more.
It’s true, we cannot choose where we are born; in wealth or poverty.
But we can choose how we live in this world.
Let us choose to be satisfied and reach out to those less fortunate than ourselves.

The Fistula Centre...

Watch to see the life-changing surgery that women like Yeabu experience at the Aberdeen West African Fistula Centre in Freetown, Sierra Leone. Thousands of women in the world suffer from obstetric fistula. Sadly prolonged labor usually ends in the birth of a stillborn baby but too often the woman is also left with a fistula, usually a hole between vagina and bladder causing them to leak urine continuously. The centre in Freetown provides free surgeries for these women. The outpatient clinic for children where I worked is co-located in the same center. When the women were fortunate to have live babies, I would be the one to make sure their babies are healthy, during the mother's admission on the ward. Needless to say the little babies brought much joy with them. And although the women were sad and depressed when arriving at the center, most left with tears of joy as they headed back towards their villages to start a new life. I would like to credit Jenny Chu as filmmaker.

Video of Mercy Ship's Outpatient Clinic for Children...

Video by Linda May Kallestein 2008

Recently posted on http://thelegacyofhope.blog.com

Dire state of healthcare services...

Another interesting read about healthcare in Sierra Leone. And the pregnant lady who lost her baby due to lack of transportation to get to a hospital lives just outside of Freetown, the capital city of Sierra Leone. Imagine what life is like for people upcountry.

"The recently-built health centre in the Sierra Leonean village of Charlotte was shuttered. Inside were lamps without bulbs, infant scales that had not weighed any babies, an unused baby cot, boxes of surgical plaster, unopened bottles of formaldehyde, and rows of beds without mattresses...

Aminata Conteh was pregnant in January 2008. When she went into labour her pains persisted and the local traditional birth attendant was unable to treat her problem. With no other transportation, neighbours placed her in a wheelbarrow and pushed her 9km to the closest health centre in the neighbouring village of Regent. She lost the baby. "This is what happens to most of our sick people. Especially those who fall severely sick in the night - look at the road", said village leader Conteh, pointing at a dusty rocky dirt path, "How can you carry someone in the middle of the night along this road?"

Click here to read more

Clinics shut down in SL...

Sierra Leone was in the news recently; The Ministry of Health has shut down bogus clinics.

"Nearly 50 illegal health clinics in Sierra Leone are to be shut by officials amid claims that botched operations killed patients. The clinics in Freetown were staffed by people with little or no training, who offered inappropriate treatment, deputy minister of health told the BBC."

Sound shocking? Well, it's not. To be honest, I am not exactly sure what group of clinics this article is referring to, but to me this is no surprise. Over the 4+ years I have worked in Salone I often saw children who had been to other so-called clinics prior to coming to me. Mind you, a lot of these clinics did have actual signs outside the doors and unfortunately were probably legal. In my opinion, many of these clinics SHOULD be closed.

So often I would have patients coming in who had been to a so-called clinic only a day or two before. I would often be told that the 'doctor' had not even taken a history or examined a child. Sometimes the child was briefly examined but only very seldom was the blood checked. Once I had a child come in with hemoglobin of around 4 g/dL; a child clinically very anemic. And in the end due to malaria. What had the 'doctor' done for the child? Prescribed antibiotics and 'blood tonic' (a syrup with iron in it). Not very helpful obviously. Meanwhile the mother thinks she is helping the child with the medication and the child dies of untreated malaria. To say it nicely, I was often furious with these clinics. And sad that parents did not realize the bad treatment their children were receiving.

But having said that, there were also pediatricians that really got my blood flowing. Once there was a pediatrician that saw a newborn baby a few hours after birth and because the child was not doing so well decided to give the child diazepam (a sleeping drug). The next day the mom brought the child to me. The child was very floppy and dehydrated. I just couldn't believe a pediatrician would have sent this child home. And really could not believe that the child had been giving sleeping medication. But, it was right there on the prescription paper. Sad but true. Fortunately the mother came to the clinic and I sent the child on to the NGO hospital.

And then there are the prescribing habits of many doctors, nurses and dispensary workers. Almost anyone can prescribe drugs. And to be honest, you can buy practically anything in a pharmacy over the counter. Most times children will already have been prescribed 6-10 various medications, of which 3-5 are usually antibiotics. Another popular drug in the mix is phenargan (promethazine) in adult dose and blood tonic is always a very sought after item as well. The drugs are often only prescribed as a single dose or for a few days, and often in adult rather than pediatric dosages. It's a wonder there isn't more drug resistance in Sierra Leone. And it's not a surprise that many of the children are not getting better. Many pharmacies also have cots in a dark room in the back where intravenous fluids are administered for any number of ailments. If you have a bit of a cold or some loose stools and think that only an i.v. can help then just ask and you shall receive. I actually do not want to know what happens in a lot of the pharmacies.

So, Honorable Minister of Health, I beg for you to continue investigating this matter as I think there are more clinics that are not providing optimal care and need to be shut down. And at the same time, maybe you could investigate what happens in so many of the pharmacies all over the country. Maybe you can put a stop to the terrible things that occur there. And finally, health education for the public would be advised. People need to learn that they do not need a 'drip' or antibiotics everytime they are ill. What they need to do is see a well-trained doctor and follow his/her advice. Of course, this means that health care needs to be both accessible and affordable to the entire population. Thank you.

Two years ago...

I have time to think now. Think about the past, present and maybe most importantly the future. Some people tell me to move on, " don't think about the past too much". As much as I have to let the clinic go, I do think it's good to look back and reflect on the past 4+ years. The good times, the bad times, the things I would have done differently, etc. I decided to scroll through my blog a bit and I came across a blog post from September 14, 2007, written on a Friday afternoon discussing highlights and lowlights from that week. Reading it is a good reminder of common issues during my time in Sierra Leone, both things I miss and things I don't miss. Most of all, the little boy's smile still gives me a warm fuzzy feeling. I miss the kids.