taken on our compound...

Latest update...

Many of you may wonder what life is like here. Is it different? Having been here for 5 months, some things do start to seem normal, however, life here is probably anything but ‘normal’, at least compared to life as most of us know it. Can you identify with the following daily happenings???

“Women washing their clothes by hand in front of their homes. Naked kids playing on the streets. Stand pipes along the road for people to collect water. Rusty broken down vehicles on the side of the street or turned over in ditches. A wall surrounding the compound. Street vendors everywhere. A child walking with a bucket of water on her head. Dogs barking throughout the night. Children bathing on the side of the road. Razor wire along the top of the wall. Huge piles of trash on the side of the road. Water filters in the kitchen. A gate with the following painted on it - ‘entrance, do not urinate here’. People digging through dumpsters to find items to sell or re-use. Laundry drying on the ground. Coming home to hear we need to conserve water as the tanks are almost empty. 20+ people trying to cram into a minivan. Guards patrolling the property. People walking around with live chickens in their hands. Enormous potholes on the red dirt roads. A panic button on my night stand so I can trigger the alarm system if necessary. The constant sound of the generator at night.”

If you want to read more about my life here in SL click on the following link for my latest newsletter…
http://lakomission.org/cms_exodus/images/stories/sandra/sandraaug2005.doc

To sleep or not to sleep...

I love sleeping, so I would choose ‘to sleep’ any day. However, circumstances here in Freetown often seem to opt for the option ‘not to sleep’; I either can’t get to sleep, or wake up multiple times throughout the night or wake up way too early. Noise pretty much is the cause of this, although the Lariam pills might help a hand! Let me explain in more detail where this noise comes from...

Our neighborhood is pretty lively with frequent soccer matches that take place on the soccer field, right next to our compound. I’m convinced that the whole neighborhood shows up for the game; it certainly sounds like everyone is out there with all of the music and cheering I hear. If there’s not a soccer match then there’s often a party - again with loud music, people talking through megaphones etc. This can last up until 3am! And if it’s not for the party, the dogs do their best to keep me awake- not only do they lie/sleep in the middle of the street while we are trying to drive up or down it during the day, but they manage to stay awake and bark throughout the night.

Then there’s noise that’s closer to home, right next door to me - my flat mate closing our very loud steel door as she goes to the kitchen (sometimes at 5am – mind you she does try to keep it quiet) or my parents doorbell announcing the arrival of the bread man or the guards who need more diesel for the generator. Speaking of the generator- that is another source of noise on our compound, but fortunately it’s not so close to my room. I do live close to the Hunter’s room however- and they happen to have a very noisy AC unit- so I hear the constant humming of their unit throughout the night. Then there are the guards that patrol the compound, with their walkie talkies on of course (volume on high)! Actually I wish at times that I would hear more from them- then at least I know they are awake.

And last but not least…the rain. Especially now that the rainy season is here the rain can get quite loud! And actually, if it’s the rain that wakes me up, I usually peek out of my window and am amazed at the amount of water that falls to the ground!

Birthday in SL

Yes, this past Saturday I celebrated my 28th birthday. The fun actually started on Friday morning when I walked to my office and noticed a fully decorated door- with balloons and a poster - my nurses and receptionist came in early to decorate. They later surprised me with a gift- a real African outfit! In the afternoon I decided to take them out for ice cream; there’s a local ice cream shop 5 minutes from the ACFC, with great home made ice cream (and it hasn’t made me sick yet!). On Saturday I woke up way too early- but couldn’t get back to sleep, so much for sleeping in. My parents spoiled me with various gifts- including yet another African outfit and a tie-dye skirt. Later in the morning Gisela, my parents and I went to Crown Bakery- a great bakery in town that I had not yet been too. We enjoyed a great brunch there. In the afternoon I spent time making cookies. It was a bit rainy- but not a problem since I wasn’t planning on going anywhere anyway. In the evening the New Steps gang came over and joined all of us at our team house for dessert. Gisela made me the most amazing chocolate cake! And my mom made a delicious apple pie. Plenty of sweet stuff to go around! It was a very enjoyable day. It felt very much like a birthday- and it was nice to once again have some family around to celebrate with. Thanks to all of you that remembered my b-day and made the day special!


birthday treats!

Laundry is an art...

Doing laundry can be an art and a challenge...fortunately we have a washer and dryer- and we have managed to figure out how to use the dryer without overheating the generator :) Doing laundry when we have national power can be interesting (during weekends)- national power can switch on, and then switch off again after an hour...and then an hour later come back on again- that means laundry can take a number of hours and a bunch of trips to the laundry room :) I am very thankful though that we have good facilities!

Down time...

Some of you have asked what we do for down time. Sierra Leone is a beautiful country with beautiful beaches. A group of us often try to go to a beach in the weekend...to spend some time relaxing and enjoying our surroundings!


River no. 2 - a gorgeous beach! ..... Lakka beach - with a great pool too!

The first 'marklate' day...

Up until Wednesday the out patient clinic was primarily focused on cure (besides the health teachings given in the clinic and on the wards). Well, that has changed. On Wednesday we held our first "MARKLATE" (Krio for 'vaccination') day- children could come for their childhood vaccinations- for Free!

A few weeks ago we met with some of the community leaders to let them know of our plan and to make sure they would communicate it with the rest of the community. Letters were read in the churches and mosques, announcing the vaccination day. Later we heard that the 'town crier' had walked the streets of Aberdeen village, ringing his bell, telling people to take their children to the clinic for their 'marklates'!

The turn-up on Wednesday morning was a bit disappointing. There were about 7 mothers with children. It was a start...but not good enough. The frustrating thing was knowing that some vaccines (measles, yellow fever, BCG) could only be given if a certain number of children would be vaccinated. The 9 month measles vaccine for example is a 10 dose vial and can only be kept for a maximum of 4 hours, or the vaccine will spoil. The government (who supplies the vaccines) told us that 40% wastage for the measles vaccine would be acceptable...no more. That meant we needed to have 6 children present in order to open the vial! Well, there were 3 present that needed the measles vaccine. I was hoping for the best and decided to have the patients wait awhile, and to open the vial at noon and start vaccinating. I figured that would give us until 4pm to find more children so that we would vaccinate at least 6 kids and not get in trouble for vaccine wastage! So, the nurses started vaccinating. Of course, there was a lot of noise coming out of the clinic that day- a few crying kids sure makes it sound really busy! Fortunately with time more children came in, but still not enough for the measles vaccine. (DTP and oral polio are multi dose vials and don't spoil easily). At 3pm I had one of my nurses go across the street to a compound called 'The National Dancetroop' (apparently a lot of the occupants are national dancers!). I wasn't sure what to expect...but sure enough at 330 she showed up with about 4 more children for the measles vaccines and a bunch more for some of the others. So in the end it worked out well. We were able to vaccinate 27 children in total- a good turnout for a first day!

We will definitely keep the vaccinations as part of our out patient clinic program; hoping to hold vaccination days twice a month. Maybe before the next time we'll walk the streets ourselves with a megaphone...to make sure enough people know about it!

Mother comes back to say thank you...

A few weeks ago a lady came into the clinic with her 3 year old daughter who had a high fever and was very weak (lethargic) – not even able to sit up. Right away I knew that she was very sick and would need referral. At a time like that it is very difficult to decide whether or not to go ahead and get some lab work done or to refer her right away. I decided to check her blood sugar and do a rapid test for malaria…within a few minutes I had the results- malaria! The next decision was whether or not to start treatment or get her to the referral center as quickly as possible. A call to the doctor at the referral center confirmed my idea- to send her their way immediately. So while I gave medicine to reduce the fever, someone else was waving down a taxi and negotiating the price. Soon the mother was in the taxi with the child and I continued the clinic. During clinic I was of course wondering if she made it to the referral center...on time. After clinic that day I called the referral center and heard that the little girl had made it, and iv treatment had been started. Two days later I went to visit the little girl- she had been improving initially but had now slipped into a coma. That was very discouraging. The mother was sitting next to the bed, happy to see us, but without hope in her eyes. We could only tell her that we were hoping for the best. Looking at the little girl lying there in a coma made me wonder if I could have done anything more for her at the clinic. Leaving there, I knew we had to pray for the best. Five days after visiting the girl, I called again, not knowing what to expect. And amazingly enough the doctor told me that the little girl was doing well. She had pulled through! She ended up staying at the referral center for another 5 days until she had fully recovered. A couple of days after the child was discharged her mom brought her back to our clinic…to say thanks. I told her I was very sorry that we weren’t able to do more for her; since all I really did was refer the child. The mother said that she was grateful that we were able to help the way we did; even if she didn’t get the treatment at our clinic, we helped to get her to the right place. It was great to see her daughter walk into the clinic with a big smile on her face. Sometimes I still get frustrated because I want to be able to do more for patients, and I guess I need to realize that even though at times it may seem like I am not doing much, I am doing something…and something can make a lot of difference.


follow up visit...child doing well!