Advent: cling to hope...

“For unto us a Child is born, unto us a Son is given; and the government will be upon His shoulder. And His name will be called Wonderful, Counselor, Mighty God, Everlasting Father, Prince of Peace.” (Isaiah 9:6) 

Today is the first day of advent: a time of waiting and expectation, preparing for, and reflecting on, the coming of Jesus. In this season, while physically preparing for Christmas, with trees, lights, carols, family traditions and delicious foods, we also prepare our hearts, contemplating the hope, peace, joy and love that Christ is. 

 

In the 12^thCentury, Bernard of Clairvaux emphasized Christ’s coming in three ways: in Bethlehem as a baby in the manger, in the second coming at the end of the age and in His presence in our lives every day. 

 

HOPE. 

 

Hope is more than wishful thinking. It is not simply a feeling. It goes beyond mere optimism. Hope is confident expectation. In the New Testament there was a confident expectation that the Old Testament prophecies of a Messiah would be fulfilled through the birth of a Saviour. 

 

As believers, we have a confident expectation that we are saved by grace through faith in Jesus. We confidently expect that this child who was born in Bethlemen will come again to reconcile this world. We confidently expect the gift of eternal life. 

 

How can we hold on to this hope in a world filled with disease, death, despair, division and injustice? 

 

It seems inevitable to lose hope. However, without hope, life loses its meaning and purpose. We must cling to hope. Jay Y. Kim describes hope as follows: “It doesn’t ignore fear, anxiety, and doubt; it confronts them. It holds steady, clinging to peace in the midst of chaos. Through life’s many treacherous storms … hope is buoyed by something greater that has happened and something greater that is going to happen again.” (from: Hope: An Expectant Leap)

Hope requires a trust placed in a loving and merciful God who is the same yesterday, today and forever, who knows the beginning from the end and who keeps His promises. Hope in the one who has come and who will come again. Hope in the one who is present in our lives, whose Spirit dwells within us. 

 

St. Augustine prayed the following: “How much you have loved us, kind Father! If your Word had not become flesh and had not dwelt among us, we would have had to believe that there was no connection between God and humanity and we would have been in despair.” 

Our hope is in God alone. 

"But the Lord watches over those who fear him, those who rely on his unfailing love. He rescues them from death and keeps them alive in times of famine. We put our hope in the Lord. He is our help and our shield. In him our hearts rejoice, for we trust in his holy name. Let your unfailing love surround us, Lord, for our hope is in you alone." (Psalm 33:18-22)

 

Cling to hope. 

O Come Emmanuel. 

Happy Thanksgiving...

 

Happy Thanksgiving!

This evening I’ve enjoyed delicious food and some time to reflect. Basically, I’m incredibly grateful for the people God has put in my life - whether for a season or forever - whether near or far - they constantly teach me how to live, laugh and love. They remind me of the importance of self-worth and courage, letting go and moving forward, patiently waiting and chasing my dreams.

I’m forever grateful.

And yes, I put my Christmas tree up a few days ago. It's 2020. It's allowed.

#ihaveamazingfriends

#ihaveanamazingfamily

#livelaughlove

#alwaysanadventure

#begratefulalways

It takes as long as it takes...

The last few months have been challenging on a personal/relational level and it’s taking some time to process. I feel like I should be, or am expected to be, further along in this journey but I was reminded recently that “it takes as long as it takes”. 

A friend encouraged me to remember the 3T's: tears, talking and time. And to be kind and patient with myself during this process. So, onwards I go, for however long that takes. Some days are easier than others as I continue to walk a fine line between hope and reality.

Ups & downs seem to be a bit of a theme these days for everyone, especially in this COVID19 era. From issues at work, to travel restrictions, to personal matters. It's a bit of a rollercoaster ride. If you’re going through a challenging time, be kind to yourself. Be gentle on yourself. Give yourself time. Embrace joy and gratitude.

A clinic day during the COVID19 pandemic…

It’s 6:45 am on a Monday. As I head out the door, I put on a cloth mask and make my way to the paediatric outpatient clinic at the Aberdeen Women's Centre. Unlike many places in the developed world where outpatient services have switched to telemedicine, here in Sierra Leone due to limited connectivity we are still doing in-person consultations. It is the only way to keep essential health services going, which is vital in a country with some of the highest maternal, child and infant mortality rates in the world. 

It goes without saying, safety is our priority: personal safety, colleagues’ safety and that of the patients and caregivers. This is not an easy task and takes considerable planning and resources. Hand hygiene, screening, personal protective equipment (PPE) and social distancing occupy my mind throughout the day. Psychologically it is challenging. Everyone I come into contact with potentially has COVID19. 

On arrival I wash my hands and go through the screening process. Once screened, I enter the hospital compound and make my way to the children’s clinic. I wash my hands. After changing into my scrubs, I wash my hands again before I don personal protective equipment (PPE): head cover, mask, apron, face shield, gloves. Now I am safe, as long as I don’t touch my mask or my face and I wash my hands frequently.   

I walk out of the clinic’s side gate and meet the line of patients waiting to be seen. Our first priority is triage and screening. Triage to ensure that the sickest children are seen first, and screening to identify any potential COVID19 cases to isolate them for testing. During this process we have to ensure that patients are socially distanced and masked up. Although it is made somewhat easier due to painted markings on the sidewalk and chairs placed at least a meter apart, it can be chaotic, requiring a lot of patience. 

Screening takes time but eventually the patients enter the clinic; all wearing face masks. Next, one of the nurses does a health talk, using the time to educate the caregivers about corona virus and how to prevent it. Meanwhile I attend to very sick children in our observation room or, if there aren’t any emergency cases, I prepare my consultation room; disinfecting the table and chairs and making sure I have gloves and hand sanitizer. Finally, I start the general consultations. 

Consultations are carried out as usual except that I consider every person to be a suspect case. Although we screen at the gate, we will miss cases, in particular asymptomatic caregivers. So, I make sure the caregiver and child are sitting at least a meter away from me and I keep my mask and face shield on, using gloves for every patient contact followed by hand hygiene. This process repeats itself until every patient has been seen, either by my colleagues or myself. 

After all of the patients leave, I remove my face shield for disinfection and reuse, wash my hands and attend to administrative tasks, trainings and meetings. My mask is kept on, because even those I work with are suspects. Anyone could be an asymptomatic carrier. 

It’s time to clock out. I doff any remaining PPE, wash my hands, change my clothes, put on a cloth mask and make my way home. On entering my compound, I wash my hands before heading indoors. The workday is done and I can only hope that I kept myself safe today. 

All across Sierra Leone, healthcare workers continue to provide essential health services, as well as COVID19 care. Please pray for courage, safety and perseverance. 

#TogetherWeCan #EndCorona #ProvidingEssentialHealthcare #ChildrenMatter

An unexpected Easter in COVID-19 times...

I am writing to you from mandatory quarantine; all is well. I am currently healthy. Spending time in isolation has given me the opportunity to reflect and although this Easter has not gone as planned, it is probably one of the more meaningful Easter’s I’ve had. 

Over the past few weeks, the following words have become all too real to people all over the world. Isolation. Chaos. Confusion. Fear. Death. Suffering. Loneliness. Pain. Hurt. Loss. Doubt. Distress. Uncertainty. Despair. We are confronted with the reality of separation, disease and death. Our world feels like it has been turned upside down. Maybe it’s not so crazy that this pandemic happens to coincide with Easter.

The moments leading up to Jesus’ death were full of turmoil. Jesus was distressed and troubled in the garden of Gethsemane. One of his very own, Judas, betrays him. Peter disowns him. Soldiers mock him. Those who pass by the cross hurl insults at him. And at noon, complete darkness fills the land. Jesus cries out “My God, my God, why have you forsaken me?” How many of us have asked where God is in the midst of this COVID-19 pandemic? The earth shook. The temple curtain split in two. Unprecedented. A day like no other.

The good news is, resurrection Sunday came. The angel said to the women, “Do not be afraid, for I know that you are looking for Jesus, who was crucified. He is not here; He is risen, just as he said.” (Matthew 28:5-6)  Death did not hold Jesus. The darkest moment in history transformed into the greatest love story the world has ever known. Amazing grace. Through His death and resurrection, we are brought out of the darkness and into the light.  He does not promise us an easy life but He promises us a life with Him. In the middle of our current unexpected storm, He is our anchor. He is our light and our strength in these dark times. He is our peace. Hope is not lost. 

Christ is risen! Let’s rejoice today as we celebrate our Lord and Saviour – our hope and our strength! May you have a deeper awareness of His love and peace today. 

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