Ignorance? Neglect? Cluelessness?...

Sometimes I really wonder why people do what they do here.
What are they thinking?
And why?
How can they take so much risk with the lives of little children?
I am shocked by the number of children abandoned by their parents here.
And frustrated that they sit at home so long with sick children.

Today I saw a 4 year old boy in the clinic.
He came with an aunt.
He was abandoned by his mother 1 year ago.
And now lives with his granny.
When I saw him today, he weighed 14 kg.
He looked like a skeleton.
And had a very sad expression on his face.
He had skin changes, brittle hair and oral thrush.
I was shocked to hear that his condition was pretty much like that for the past year.
Why had they not taken him anywhere?
Could they not see that his condition was only getting worse.
Apparently the granny was giving him traditional medicine.
Well, now he is acutely ill too, with a temperature of 39.3 Celsius.
Are they now thinking that with one visit to the hospital he'll get better?
I tried to make it clear that I would do what I could, but that they need to take responsibility.
Giving medication, feeding him properly, doing further tests, coming for follow-up visits.

I wonder what will happen to this child.
He is to go for further tests tomorrow.
And to come and see me again on Monday.
Will his family follow through?
Will they make this child's health a priority?
Will this child, after a year of being sick, finally get better???
I'll find out soon enough...

Saved by the guard...

I was very thankful to find out this evening that the security guard had already opened the valve on the water tank. Thank you guard. He spared me another trip up the steep steep ladder.




This is a picture of our gazebo on the left, main house on the right and my appartment block straight ahead with visibility of 2 out of 4 of the water tanks on my roof. It's the one on the left that is causing so much trouble. Fortunately I found out this evening that from standing at this point I can actually see the blue valve at the bottom of the tank- and see the position it is in - so I won't be making any unnecessary trips up the ladder!!!

Acrophobia...

Due to very random Sierra Leonean plumbing one of the four water tanks on my roof overflows regularly: every 3 or 4 days, usually between 8-10 pm. Seeing as the water tank is right above my room I am usually the first one to notice; it’s kind of hard to ignore the sound of a magnificent waterfall! Lots of water gets wasted and someone has to go onto the roof to close one of the many valves. Then, in the morning the valve has to be turned on again.

What does this have to do with acrophobia? Well, like I said, the water tank is on the roof of my building. It is very high. I’ve climbed onto our generator roof many times, but it’s not nearly as high. And I just haven’t been brave enough yet to climb up onto my roof. The ladder is very steep. Yes, I’ve always been a little afraid of heights, unless there’s a railing or something to hold on to. But with our maintenance man going on holiday I had to bite the bullet. Someone had to be told what to do in case of an overflowing tank (which was bound to happen). So, on Thursday evening before it got dark, up we went. He went up, I followed. He showed me the valve. I looked around a bit. I got a little nervous climbing down. Made it to the ground. Survived. No problem.

This evening, when I came back from a lovely dinner out, the guard told me the tank was overflowing. This happened to be the 1 guard (out of 3) that was not shown which valve to close. Ugh. You know what that means. I was the one that would have to go up and solve this problem. My options were: 1) brave it, climb up, pray I don’t slip, close the valve, and climb back down or 2) leave it, waste lots of water, and not get any sleep because of the loud sound of the waterfall. Basically, there was no option. Up I went.

With my sneakers on, flashlight in my pocket, I climbed up the steep ladder in the dark, making sure the guard came up with, so that he would know what to do next time this happened. And I figured if I freaked out and couldn’t climb down, or fell off of the ladder, etc. at least someone would know and could call for help : ) Well, I made it to the top, dodged the flowing water, closed the valve, showed the guard, and was ready to go down. I wanted to wait for a minute to make sure the tank stopped overflowing because there was no way I wanted to climb up again. As the guard climbed down and I stood on the roof looking at the ladder I thought ‘what if I panic and can’t get down’. I told myself to stop thinking and get moving. And climbed down.

Never a dull moment. Always something to do. And hopefully this will help me overcome my fear of heights a little! I guess in the morning I’ll have to climb up again to open the valve, because we’ll be out of water!

Lunsar, Joshua, Beach, Chinese and more...

This week has been great. Busy, but good. A satisfying week. And it's not over yet!

Tomorrow I am heading out to a place called Lunsar- about a 2 1/2 hour drive from Freetown. I am going to an NGO run hospital to visit some patients I referred. Children with a specific tumor called Burkitt's Lymphoma. Fortunately the hospital there runs a special chemotherapy program for them! It's the only place in the country with affordable treatment. I think it's only available in 2 other places, but very expensive. I am looking forward to a brief trip upcountry, connecting with the doctors there and hopefully seeing 2 of my patients responding to chemo.

Afterwards I will be picking up Joshua David - who is now 6! And he'll be spending the weekend with us. I'm excited about that. He's always fun to have around. It's been a little while since I've seen him (February). His caretaker/granny is very sick and so we've been asked to look after him for the weekend. It'll be good for my Krio!

And then Saturday we'll be celebrating my birthday a bit more. A possible beach trip (weather permitting...it's rainy season!) and going out for dinner to a very posh Chinese restaurant.

All in all...a fun filled weekend! Hope you enjoy yours too...

Busy birthday...

Another birthday come and gone. This one was busy; filled with patients, 4 songs, 5 desserts, phone messages/calls and friends. A great day!

It started at 6am...with a text message from home.
Then b-day wishes from my house mates.
A happy birthday song in the car on the way to work.
Then more singing by my mom and Terri in their office.
Followed by yet another song from my staff in the outpatient clinic.
Then the work started; lots of follow-up cases.
A roll of chocolate cookies that appeared on my desk! : )
Very busy, no time for lunch (but ate the cookies) and finally done at 4pm.
Satisfying day with the patients.
I had hoped to take staff out for ice cream at 3, it was 430 instead.
We piled into the landcruiser and went to Montana's.
I happened to meet a friend there who had just bought me a little cake.
She was going to drop it off at work. How thoughtful!
After ice cream I headed to my parent's place.
We talked, I opened some gifts, we shared the little cake I had received.
And after 30 minutes it was time to head off again.
Only then did I hear my mom had made a cheesecake! (we'll eat it tomorrow!)
Rushed home, ate dinner, had a shower and headed out again, to Bible Study.
Seeing as that's where my friends would be, it seemed like a logical place to hang out.
Mind you, I did hop out at one point because my brother called from the States.
After Bible Study I was surprised with more dessert...not 1 but 2, and more singing.
One friend made a chocolate cake, another made a killer mint-chocolate pie!
Delicious!
By this time it was almost 10pm...but it's never too late for chocolate.
I ended the day spending some time on skype- talking/chatting with a good friend
And reading emails and facebook messages.
It was definitely a great birthday!

Mother listens to advice...

A mother came to the clinic with her 2 year old today.
He had been sick for a week.
With the standard history of fever and cough.
They were the first in line when I went out to the gate this morning.
Arriving at 530am waiting for clinic to open at 8am.
When I checked the child, he looked very pale.
So I gave him an ORANGE priority ticket even though he was first in line.
Because I was sure we would prioritize more children and I really wanted to see him first.
15 minutes later, after checking all of the kids in line, we all went inside.
While the nurse checked the boy's vital signs, I took his history.
Then we went off to the lab (just around the corner).
Hemoglobin, malaria smear, glucose.
I hung around to see the first results.
Glucose 8.8 mmol/L = good.
Hemoglobin 4.4 g/dL = not good.
I already knew I would have to refer the child for a blood transfusion.
We then walked back to my office, for me to examine the child.
After which we got the results for the malaria smear: positive.
Malaria and Anemia.
A frequent combination.
A frequent killer.
Time to refer.
Meaning time to make some phone calls.
Unfortunately, the NGO referral hospital was out of beds.
So I had to once again refer to the government-run Children's Hospital.
Which meant money was needed.
Le 15,000 ($3) to see the doctor (compared to Le 1,000 at our place)
Le 30,000 ($10) for a blood tranfusion.
And money for medication.
These are vast amounts of money for the average person here.
Fortunately the mother had been given a decent sum of money from the uncle.
This would cover most costs, but not all, so I topped it off a bit.
It sounded like this mother would actually take her child there for admission.
Only time would tell.
Fortunately she had a had a phone number we could call, which we later did.
When we called, the mother told us they had just started transfusing the child!
So, he had been seen by a doctor and was on treatment already.
Good news.
He is on the road to recovery.
I'm happy to post a happy ending to a consultation this time.
A mother that takes our advice and goes where we tell her to go.
Many times it's these initial steps that are so difficult for them to take.
Due to financial constraints, traditional beliefs, family pressures, etc.
Hopefully this child will get well quickly.

Sierra Leone drug issues and latest bust...

Cocaine-filled plane ditched at Sierra Leone airport

July 13, 2008 - FREETOWN, Sierra Leone - A passenger plane loaded with 1,540 pounds of cocaine was found abandoned at Sierra Leone's main airport Sunday, police said. Airport officials discovered the craft, which was registered to a South American country, along with a handful of guns apparently left behind by a two-man crew before dawn, said Francis Munu, a police official in the capital. Munu said police had organized a search party to try to find the pilots of the plane. With cocaine prices in Europe surging ahead of prices in the United States, drug smugglers in South America are increasingly ferrying cocaine to West Africa, from where it is parceled out to hundreds of individual traffickers who carry it north. Major seizures have been made in Guinea-Bissau and Ghana, and it is widely believed that other countries along the coast are also being used by drug runners. AP article

Also: How the drug trade operates in Sierra Leone

Unknown ending...

On Thursday a mother came to the clinic with her three week old child. Her firstborn. She came into the consultation room just after 9 am. Her child had started convulsing. Guido and I stopped the work we were doing to tend to this child. Fortunately within minutes the convulsion stopped on its own before needing to give diazepam. The child was not febrile or hypoglycemic, so we couldn't find an immediate cause for the convulsion. We decided that a neonate who has just had a convulsion should not go home, but rather be observed in hospital. We don't admit. So it meant referring. The NGO hospital was full. So it meant government hospital. We wrote a referral letter, talked with the mother, she said she would go and off she went. What happened next? Unfortunately the child was not at the hospital on Friday. No one had seen her. Did she go there? Was she sent home? Did she go home directly from our clinic? Who knows. Hopefully her baby is alright. This is another one of those cases without an ending...