Ebola: my role...

Ebola. It's a hot topic. For now, Sierra Leone is still Ebola free but it may only be a matter of time. We need to prepare. Just in case.

At the Children's hospital we are not yet ready for a potential outbreak. Don't worry, we have starting preparing but we need to speed it up a notch. Yes, we have the case definitions up on the walls, but once the patients are identified, what next? It's time to allocate an isolation room, get it set up, train staff, ensure we have protective gear, etc. That's on the agenda for tomorrow.

Why am I involved?
Well, it's not in my job description, but it won't be in anyones. This is one of those situations in which everyone needs to pull together and that includes me. I would like to work with hospital staff to make sure the hospital is ready and people feel safe and confident. I won't be the one dealing with the cases, but I do want to make sure that those who do are well prepared.

If the hospital is not ready, it would be a disaster; that's what we need to avoid. So that means I spend some of my time doing various Ebola related things:
- Laminating and posting case definitions.
- Discussing a plan with the medical superintendent.
- Whatsapping numbers for surveillance officers in the district to house officers.
- Testing the Ebola hotline phone number.
- Attending an Ebola meeting at the Ministry with senior doctors
- And more will follow like attending the Ebola Task Force meetings, setting up the isolation area, possibly help with staff training but at least getting experienced people in to train, etc.

My prayer is that Ebola is contained and dealt with in Guinea and Liberia and that it never reaches Sierra Leone. But if it does, I pray we are ready.

Ebola: fascinating and terrifying...

Ebola. Ebola. Ebola.

For the past 2 weeks Ebola tends to come up in most conversations. At the hospital, in the office, at home, in transport, at international church, etc. Years ago (1995) after seeing the movie 'Outbreak' I remember being fascinated by Ebola. Now I think it is fascinating when reading about it in Central Africa, but when it could potentially cross my border, it's terrifying.

In some ways it really is a fascinating disease - what a powerful virus! There is so much we do not know about it. However, the fact remains that this particular strain (Zaire) has a case fatality rate of up to 90% and that makes it terrifying.

Thankfully to date there are no confirmed cases in Sierra Leone but the numbers in Guinea and Liberia continue to increase. We need to do what we can in Sierra Leone to prepare for what may come our way. 

Preparation is key in managing a potential outbreak. We need the healthcare providers to feel safe and confident. We don't want anyone abandoning their posts and we want excellent safety measures to be put in place. I am hoping that experienced NGOs and partners will ensure that this is the case for all health facilities. I feel very much out of my depth in even being a part of this, but all of us need to play a role. I will do what I can and pull in the experts where I can!

(map from April 3, 2014)

Milestone in Child Health Reached: Welbodi Announces Accreditation of the Children's Hospital...

Welbodi Partnership is pleased to inform you that the long awaited news of accreditation has reached the shores of Sierra Leone. Accreditation means that for the first time ever, doctors in Sierra Leone can pursue paediatric residency training without leaving the country.

The accreditation status of the Ola During Children's Hospital was officially announced during a meeting held on Wednesday 22 January 2014 at the Ministry of Health and Sanitation in the presence of the Honourable Minister of Health, Ms Miatta Kargbo, and other representatives from the Ministry of Health and Sanitation, the Ola During Children’s Hospital and the Welbodi Partnership.

After a brief overview of the accreditation process from 2010 to date by Dr. Abiodun, the news on the accreditation status of the hospital was announced and the official documentation was handed over to the Acting Chief Medical Officer, who in turn handed it over to the Minister.

The official letter from the West African College of Physicians stated that “The Council at its meeting held in Abidjan, Cote D’Ivoire on Wednesday 6th November, 2013 approved that your institution [Ola During Children’s Hospital] be granted temporary accreditation for 2 years, to train membership residents for paediatrics. The accreditation is for 2 years from 6th November 2013.”

The Minister addressed the audience by thanking those involved for their hard work in making accreditation become a reality. She highlighted the importance of this milestone and encouraged those present to continue their efforts in ensuring that postgraduate training will be delivered at a high standard.

Establishing in-country postgraduate training has been a core focus of Welbodi Partnership’s support to the Ministry of Health and Sanitation and Ola During Children’s Hospital for the past five years. We have invested resources to support doctors to take the primary exam, to provide key upgrades to infrastructure and equipment (including the development of a state-of-the-art digital x-ray department), to cover the cost of accreditation visits, etc. We are grateful to our donors and partners who have enabled this to happen.

Accreditation for the Children’s Hospital is excellent news as it means that in-country paediatric training can commence and doctors no longer need to be sent abroad to do their paediatric residency training. This will boost the health services and human resource status in Sierra Leone and be of great benefit to the many children in the country in need of high quality paediatric specialist care.

We would like to congratulate the Ministry of Health and Sanitation and the Ola During Children’s Hospital staff in achieving this important milestone.

Welbodi Partnership will continue to support the Ministry and hospital staff to ensure that a high quality residency-training programme is developed and delivered and hope that together we can work towards achieving full accreditation in 2015. 

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Pictured above: Dr. Sarian Kamara, Acting CMO and Honourable Minister Ms. Miatta Kargbo

The Annual Medical Conference...

From the 13^th-15^th of November the Sierra Leone Medical and Dental Association held their 39^th Annual Congress and Scientific Meeting. This years theme was: “Achieving the Millennium Development Goals in Sierra Leone: A Critical Look at the Health Workforce”. I attended the event which allowed me to network with other doctors in the country as well as listen to the various scientific sessions about research being done in Sierra Leone at this time. During the opening ceremony the Minister of Health highlighted the fact that there are very few specialists in the public sector; for example there are only two Sierra Leonean paediatricians in government service. The Minister said that much work lies ahead to address the problems in the health sector and the next phase in the journey has just begun. She stated: “we now have an opportunity to adequately address the human resource crisis by actively pursuing accreditation and continuing to support students overseas”. Currently 8 Sierra Leonean doctors are pursuing their postgraduate training in paediatrics in West, East and South Africa. Hopefully by the end of 2014 some of them will be ready to return back to Sierra Leone to support training in country. The need for in-country postgraduate training was highlighted once again, which is something Welbodi has been focusing on over the years. Hopefully with support from the Ministry of Health, tertiary hospital staff and NGOs, in-country postgraduate training will become a reality in 2014.

No name for 2 weeks...

Coming from a background where parents often name their child before he/she is even born, it still comes as a surprise to me at times that in Sierra Leone children are not named at birth. 

Traditionally in Sierra Leone when a child is born they are not given a name. Generally, once a child is a week old, there is a 'pull na door' ceremony. Literally this is when the child is 'pulled out of the door' or brought out of the house to be presented to the family/community members. At this time, the child's name is announced. This is otherwise known as a naming ceremony.

I've been thinking about it and I think part of the reason is because in a country with one of the highest infant mortality rates in the world, people just aren't sure if their child will be 'lucky' enough to make it through the first week. So people are cautious, and once the child has made it through that first week, the families are confident to give the child a name. I think that naming a child makes everything more real - their is ownership, relationship, a sense of belonging.

Today I saw a new cleft lip/palate patient. She is two weeks old and the parents have not named her. Why? Because of her birth defect. They are not sure what to do with the child. I wonder if they are questioning whether or not the child will survive, or if they are trying to distance themselves from the child. Maybe for as long as the child does not have a name, she doesn't seem real, she's not a part of their lives and they do not need to love her. It's sad. I don't know why this happens. 

So what did I do? I encouraged the family that this child's problem can be solved. She is not a devil child. It is not the mother's or father's fault. God made this little girl and what she needs is a lot of milk, love and affection. I suggested naming her because I think that by giving her a name, her mother will realize that she is a very real little human being that needs to be loved and cared for. By giving her a name maybe they will realize she is theirs and that they need to do their best to make sure this child survives. Maybe by giving this child a name her chances of survival will increase because she will start receiving the care that she needs. I hope the parents will discuss it. The grandmother on the other hand is very willing to give the child her own name. You have to love grandmothers!

Note to self: I'm doing this for the children...

"People are often unreasonable and self-centered. Forgive them anyway. 
If you are kind, people may accuse you of ulterior motives. Be kind anyway. 
If you are honest, people may cheat you. Be honest anyway. 
If you find happiness, people may be jealous. Be happy anyway. 
The good you do today may be forgotten tomorrow. Do good anyway. 
Give the world the best you have and it may never be enough. Give your best anyway. 
For you see, in the end, it is between you and God. It was never between you and them anyway.”
~Mother Teresa

I am thankful to a friend for sending me this quote today. This weekend has not been easy since a few people have treated me unfairly and have been negative about my work. Unfortunately this all happened through email correspondence. Thankfully, most people are happy with what I am doing in the hospital and that is what I can hold onto. More importantly, as Mother Teresa says, it's between me and God. I am not here to please people, I am doing this work for Him. As long as I know I am making life better for the vulnerable children in Sierra Leone, I know I should continue this work. That is what I have been called to do and I will not let people bring me down. I want to work as a team and I'm not in this to make a name for myself. I really do want to see child health improve in Sierra Leone. 

I'm very thankful for an amazing team and friends here in Sierra Leone and elsewhere and family - Osman, Heleen, Margaret, Kate, Dickya, Anna, Matthew, Toyin, Tom, Suzanne, mom and dad - thank you so much for your support and encouragement! I couldn't do this without people like you backing me up. Here's to doing more work at the Children's Hospital, to make it a better place.

Goodies and Breast Pumps...

I know, I know, it's only July, but when people come with so many gifts, it feels a little like Christmas. Friends of mine who used to live here sent me an email a few weeks ago  to let me know they were coming and  did I need them to bring anything. Well, I knew I needed a bunch of C batteries for the otoscopes at the hospital and I always 'need' chocolate. Slowly the list grew. I actually forgot what I requested and was thrilled to see the goodies - M&Ms, granola bars (including chocolate chip), chocolate chips, hot chocolate, smoked almonds, baking pans and tortillas. Awesome. And then of course, the peptobismol tablets which are useful here when stomachs can get a bit dodgy, and yes, a breast pump - two actually. 

A breast pump is probably the most bizarre thing I have requested and it might be even more bizarre that I'm pretty excited about it. Do you know why? It means that Kumba can now use a pump to express breast milk in order to feed her 11 day old baby girl who was born with a cleft lip and palate. This will make Kumba's daily life a bit easier and hopefully it means that this little girl will be exclusively breast fed so that she will be strong for surgery in about 6 months time. Kumba is dedicated already and I am happy to be able to make things a little easier for her. It's tough enough in Sierra Leone to be mothering a baby with a deformity so any help is welcome. Thanks Marty for bringing this out for Kumba! Here's to the growth of her little one and more zeal for Kumba.

Willing & Abel Medical Board...

I accepted the invitation to be on the Willing and Abel Medical Board. I will be one of a team of medics who will review potential cases from various countries for surgery and make medical recommendations to the W&A trustees. I'm excited to be a part of W&A more formally and to continue helping children in developing countries who require specialist surgery. I see a number of children at the hospital that struggle to get the surgery they need and it's great to know that W&A can help. 

Children that I have helped with the assistance of W&A to date are children like Namina (cancrum oris, needing multiple reconstructive surgeries on the Mercy Ship), Junior (cleft lip and palate) and some of the hydrocephalus cases I sent to Guinea for shunting. Up until now, I've been able to take most of the children to the Africa Mercy for surgery and so the costs have mainly been related to border crossings, documentation for the vehicle, transport costs, food, etc. With the Africa Mercy going to Congo for the next outreach, I may need to look at other options. Praying that God will direct. Junior will need a palate repair towards the end of the year/early next year and I have two new cleft lip/palate cases needing surgery.

I'm pleased to know Abi, who founded W&A, and also Benita, one of the trustees who was in Sierra Leone for a year. It's fun to be collaborating more with friends and helping children at the same time! For more information about Willing and Abel go to: http://www.willingandabel.org.uk

In the meantime things remain busy with my Welbodi Partnership work at the Children's Hospital and I'm still on the Enable the Children Board of Trustees. Enough to do!