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.

Wake up world: stop tolerating harmful medical practice...

As you likely know, I am a qualified and registered medical doctor working alongside national staff in a facility that is run by a UK foundation and supported and registered by the Ministry of Health and Sanitation, providing outpatient medical care to sick children below 16 years of age. The severity of illness we deal with ranges from a child with a runny nose to a child who is unconscious due to severe malaria. Regardless of the situation, our team acts based on our training and experience. Yes, we are forever learning, but through years of training, we have been equipped to handle such situations. I cannot even begin to imagine managing critically ill children with no medical training.

I am shocked but not too surprised to read the story of Bach, who according to this article, went to Uganda as a 20 year old highschool graduate with no medical training, and ended up running a centre for children with severe acute malnutrition for five years, performing medical procedures herself. If these facts are true, this is wrong on so many levels. And sadly, stories like this are a reality in many developing countries. 

This would not be the first time a possibly well-meaning, but naïve or ignorant, individual sets out to help others but puts lives at more risk. Some might call it the White Saviour Complex. Whatever you call it, it is appalling and needs to stop. Whether it is foreigners coming in to “help” or nationals "helping" their own people, if they are working outside of their realm of expertise or doing more harm than good; STOP THEM. If the facts are accurate, it is also infuriating that Bach's friends, family and Board did not intervene but applauded from the side lines.

I don’t have more details than what is included in the article linked above, but I know this is a global issue and I believe we can and must do better. We owe it to ourselves and we owe it to those we care for. The world needs to wake up. So, here are some reminders...

Common sense: 

• Don’t do what you’re not qualified to do.
• Always make sure that what you are doing is legal.

Responsible humanitarian aid: 

• Don’t think YOU can save faulty systems or the world for that matter.  You may be able to help, but you are by no means THE solution. 
• Work alongside local authorities and nationals on a long-term sustainable and coordinated response. 
• Do not do your own thing.

Appropriate support and sponsoring:

• Know who and what you are supporting.
• Make sure the charities you support are law abiding.
• If you know that someone is working in a capacity overseas that would not be acceptable in your own country, strongly advise them to stop.
• Advise people you support overseas to work alongside nationals who know far more about their setting and context than a foreigner ever will.

Wake up call for local authorities in developing countries: 

• Supervise and monitor all of the so-called health facilities and professionals. Put clinical governance systems in place. I know that in Sierra Leone, there are “clinics”, pharmacies and healthcare workers working outside of their legal boundaries, providing potentially harmful care. Some do more harm than good and should be shut down. Why tolerate it at someone else's expense? 

Building a good health system does not only mean improving standards and ensuring high quality care but it also entails regulation, which means shutting down illegal and/or unsafe health facilities and revoking licenses of those who do more harm than good.

#wecandobetter #sierraleone #healthcare #clinicalgovernance #healthsystems #partnership #collaboration  #regulation #moreregulationneeded #ethics #healthramblings #commonsense #dogoodnotharm #supervisionandmonitoring

Ongoing journey of gratitude...

During the beginning of the Ebola outbreak, which was one of the most challenging times for me both personally and professionally, I embarked on a journey of gratitude. Everyday I paused, focused on the positive and wrote down one thing I was grateful for. I ended up with 365 moments of thankfulness. This journey helped me grow in gratitude and have a more positive outlook on life. At the start of 2019 I decided to continue this journey. Here’s week 1 of my moments of thankfulness! 

Day 1. Thankful to catch up with my friend Anna over a New Year’s dinner

Day 2. Thankful for fresh fruit, yoghurt and a blender = delicious smoothies 

Day 3. Thankful for my parents, 45 years of marriage and their ongoing commitment to each other 

Day 4. Thankful for a friend who came to visit when I wasn’t feeling well - thanks Suzanne

Day 5. Thankful for inspirational people in my life who encourage me to live and love better

Day 6. Thankful for a luxurious overnight in a hotel that was gifted to me

Day 7. Thankful that the National Emergency Medical Service (NEMS) is up & running and their ambulance was able to transfer two infants to the Children's hospital for us since our ambulance is temporarily out of service.

#2019 #makingitcount #gratitude #momentsofthankfulness #alwaysanadventure #ihaveamazingfriends #ilovemyfamily #livelovelaugh #actjustlylovemercywalkhumbly 

Happy 40th Mercy Ships...

Congratulations Mercy Ships!  40 years ago, on the 5th of October 1978, the first Mercy Ship was purchased.  As a 1 year old at the time, I was oblivious that this ship would one day become my childhood home. However, just a year later, my family joined the M/V Anastasis in Greece and I had the privilege of spending the next 14 and a half years onboard. To date, the Anastasis is still the place I have lived the longest, surpassing The Netherlands. However, Sierra Leone is catching up with 13 and a half years and counting.

I was the first child to go all the way from nursery through 12th grade onboard and although it wasn’t always easy, especially when I was the only child in my grade, I am so grateful that I grew up on the ship. What an amazing experience. From playing sticks, foursquare and sardines on the ship to swimming in the pool, playing basketball on the dock and roller-skating on the Aft deck. From sleeping outside during sails, watching dolphins swim alongside the ship, life boat drills and star gazing to having ‘fun nights’, ball room dancing, helping in the snack bar and watching movies in the lounge. I had the privilege of meeting so many people but also the heartache of constantly saying goodbye. The opportunity to visit over 40 countries was amazing, but also means some of my childhood memories are a bit of a blur in terms of where (in which country) a particular memory occurred. Being a part of community outreach including painting schools, building a playground, assisting in community clinics and spending time on the ward with patients coming for surgery, were defining moments.

Sierra Leone was one of the countries I visited as a child in 1992-1993. In our school yearbook that year I reflected on my time in Sierra Leone and ended with the following memory:

“I remember sitting down under the little palm-branch covered hut among the sick children and their hopeful moms. The sight of those children tugged at my heart. Holding a hopeless and suffering, measles inflicted child in my arms, after watching two other kids die from the same thing, made me realize how fortunate I really am. I also know that with God's strength I have something great that I can give to the dying children in the world today."

I know this was very idealistic, but that experience along with the life changing surgeries I witnessed on the ship, inspired me to pursue medicine. I was exposed to people who genuinely cared about others and one of my life heroes is still onboard, extending compassion and humility to the patients that come his way. In just a few days Dr. Gary will meet 7 patients that I am sending from the clinic I work at in Freetown to the Africa Mercy in Conakry for cleft lip/palate surgery. It is an honour to help these children on their journey and to partner with Mercy Ships. Although the M/V Anastasis was retired in 2007, the Africa Mercy and the Mercy Ships community still feel very much like home.

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