Days full to the brim. . .

Yesterday morning I promised Robert that I would write a bit of a blog within 24 hours and the time is running out.

Each day in the past two weeks has been full to the brim.

Darius was unable to arrive on schedule on the 18th since he was struck with a nasty Texan flu which he said made him feel the “sickest ever”. Luckily he arrived 5 days later. As predicted, when he arrived the women erupted in LOUD choruses of song and dance which practically rocked the building.

Cox Family

We had the pleasure of having Clif, Kelly and Camilla Cox from Grapevine, Texas here for a few days. Clif is a colorectal surgeon and was able to repair a couple of abdominal hernias on our patients, as well as assist the general surgeon at the hospital with cases. Last Sunday, I accompanied them on an excursion to visit a hospital about 32 miles from Bo. On the way home, the rented Mercedes taxi broke down and we were stranded by the deserted roadside for about 5 hours. It was quite an adventure as a bush fire was bearing down on us from behind. 8 year old Camilla was an absolute champ throughout the whole adventure and it was definitely a “bonding experience”.

Broken down in Serabu

Helen and Camilla

Lungi beach walkers

The next day Darius arrived with Bob Scanlon MD from New York, George Mulcaire-Jones MD from Butte, Montana, Ray Rogers from Butte, Montana and his brother Jim Rogers from Lancaster, Pa. who were all here to teach/train at the Maternal Infant Health conference. They departed yesterday after a very successful three and a half day stint of lectures and hands on training in emergency obstetrical and infant care. The turnout was fantastic with about 80 health practitioners from all over Sierra Leone attending. They were able to hand out “Rescue Kits” complete with ambu bags, medications etc. to each institution represented. It was a terrific start to tackle the huge problem of the high (est) maternal/infant mortality rate in Sierra Leone.

Darius at conference


Dr. Vandi, Dr. Sobel & Dr. Cox

Conference Facilitators

Ray is also going to be able to help us get our new website launched which will happen within the month. Stay tuned for this very exciting development..

Jenny Bennett, a theatre nurse, from Victoria, Australia arrived with Nancy Sobel, MD from Boston the day that Darius was supposed to originally arrive which meant a trip to the airport for me. This is a 36 hour interlude. I did manage a walk to the beach and caught a great shot of women walking home. I also watched CNN news for a few minutes…such excitement! Jenny’s Aussie accent and idioms are great to hear. Both of them have been busy in the OR with Darius tackling some difficult cases with success. It’s great to have these women being operated on.

Jenny & Jackie preparing for surgery

Neonatal resuscitation training

Meanwhile, the daily challenges continue. The power at the hospital has been out almost every day for most days, except for yesterday. We found out that the President of Sierra Leone, Ernest Koroma, is coming to Bo today for a university convocation. This means that the city’s electric company is deciding to pull out all the stops and have the power on while he and his entourage are visiting. Darius et al are going to do as many cases as possible during this time. Doing surgeries under the power of the hospital generator just doesn’t cut it. It can’t handle the lights and the A/C simultaneously.

The “witch” saga escalated to unimaginable heights two weeks ago, but that is a whole book unto itself! There are ongoing management issues and just the “regular” challenges…such as trying to get things printed etc.. which are constant every day.

Now that the conference is over, the day to day should be “routine, but wait….the President is due to visit the ward today!

Also, I would like to thank all of you who sent me this link to this New York Times article about fistulas. For anyone who hasn't read it, I recommend it.

http://www.nytimes.com/2009/02/24/health/24hospital.html?_r=1&emc=eta1

Much love, Helen
Here are a few more photos:

Delivering instruments and supplies to the OR


Kumba and Feremusu carrying loads to the OR


Dog jumping from garbage can

Barack Obama Truck

Plans. . .

Apparently things are such that Helen hasn't had time to write a blog posting and even to email much of anything. She did say, however, that she wanted to post this quote from writer Wallace Stegner:

"You can plan all you want to. You can lie in your morning bed and fill whole notebooks with schemes and intentions. But within a single afternoon, within hours or minutes, everything you plan and everything you have fought to make yourself can be undone as a slug is undone when salt is poured on him. And right up to the moment when you find yourself dissolving into foam, you can still believe you are doing fine."

Feb. 9, 2009
Monkeys & 'Magic'

There’s never really a dull moment here on the job in Bo, Sierra Leone. There has been an ongoing incident since January 26th involving a recently admitted patient who has been accused of creating a general disturbance on the ward as a result of performing witchcraft and black magic. (This was actually the second time in a month a patient had been accused of this sort of thing.) Many seem to be using her presence as a scapegoat for anything that goes wrong on the ward…bad dreams, fevers, stomach aches, etc. The fact that she brought a traditional healing pot with herbs to the ward upon admission seems to be proof that she is the source of the ‘black magic and the evils of witchcraft’. After many meetings and some positive interventions (counselors and priests) it seems as though we are coming through this saga having learned a lot and the situation has calmed down. The balance of maintaining peace with the nurses, respecting cultural differences and beliefs and being an advocate for the patient(s) has been challenging.

Last weekend we took a well deserved 24-hour break from Bo and went to the Tiwai Island Nature Reserve which is only about two hours from Bo. It was WONDERFUL to be on this 12 square kilometers rain forested island in the middle of the Moa River. Yellow crested hornbills were aplenty and a first for me. Hearing these large birds take flight sounded like helicopters taking off. We managed to see four species of monkeys (Dianas, Black and whites, Red colobus and Sooty mangabeys) on an AM guided forest walk which was a treat. The troops of monkeys were swinging and leaping through the tree canopy above. Their calls were remarkable too….deep throated gurgles and hollow drum sounds with clicking and chatter. Camping out and being in the ‘quiet’ of the forest was extremely rejuvenating. We all loved it. Unfortunately the pygmy hippos for which the reserve is renowned remained elusive.

Zhao has departed after her 5 week stint leaving a huge void. Everyone loved her cheerful presence and her diligence. She accomplished a lot here including teaching family planning and reproductive health to the patients and staff and also taught a class to community health officers and nursing students with Selena at the local university. She and Selena tackled the mammoth project of revamping the website which is very exciting. We hope to have it launched by the end of the month. Stay tuned.

The days seem to blur by with a variety of tasks and meetings. We are getting a bit of a simple exercise routine going for the patients (and us) to get the blood circulating and have some fun too. The women think it’s a riot and just end up in a heap of giggles. Getting them to stand apart is tricky; they much prefer to clump together in a huddle.

Darius arrives back in Bo on the 19th with 2 volunteers…Nancy from Boston an OB/GYN and Jenny an RN with OB and OR experience from Victoria, Australia. We also have a colorectal surgeon from Texas arriving during that time, followed shortly after by a team from the US to present an obstetrical and neonatal emergency care conference in Bo for health care people from all over Sierra Leone. The calendar is full! We have at least 17 patients eagerly awaiting surgery. The cheers from the ward upon Darius’s arrival will resound throughout the whole Bo Government Hospital campus. Exciting and busy times ahead…meanwhile, one of my favourite pastimes here is to just be with the women on the ward.

On the road to Freetown




Memuna, Fatmata, & Sunkarie crocheting


Coleman, Zhao, Helen, Selena & Julia
at Tiwai Island


Hanging out in the ward


Baimba hauling laundry


Mamadu sitting on giant buttress


Tiwai Island Moa River fish trap