Money well spent. . .

Jan. 28, 2009

Last week, Abigail our skills training teacher, normally fairly reserved and shy, came rushing into the office carrying her limp 2-year old daughter Mariama. Abigail was frantic and borderline hysterical knowing that her daughter was very ill and that she had no means to pay for any medical care. It was a very heart wrenching moment to put myself in her situation, imagining the terror and helplessness to see your beloved baby slipping away. Of course, I reassured her that I would help her out with the finances and anything else.

Mariama was hard to rouse, her belly round and her conjunctivae were white….most probably a combination of anemia, worms, malnutrition, generally weakened by a recent case of malaria and an overdose of over-the-counter remedies at home.

Luckily we managed to track down one of the community health officers at Bo Government Hospital and he tended to her rapidly. Realistically, this was mainly because she was accompanied by a “pumoi” (white person). Blood tests were done and luckily it was determined that Edmund, another teacher, was a proper match for a blood transfusion. Finding a donor for blood is the family’s responsibility. There is no blood bank system here to due poor refrigeration because of the inconsistent supply of power.

In Sierra Leone, families of patients admitted to hospital have to go and purchase all medicines and supplies for the hospital stay; including gloves, syringes and in this case, the bags and tubing required for the blood transfusion prior to treatment. These are often not available and results in a stressful wild goose chase around town resulting in the loss of precious time. Families also have to bring in food and bed linen. The nursing care is a pretty bare bones operation too. One gets a pretty good idea why the infant mortality rate in this country is 16% for children up to one year of age. Thank goodness for programs like MSF (Doctors without Borders) which provides free and professional care.

Mariama and Abigail were in the pediatric ward for 4 days. I would check on them several times a day and with each visit I saw a progressive improvement in Mariama. Upon discharge she was looking like another child. Such a relief. I was glad I was able to help them…I have never spent a more worthwhile $12.

Zhao, Helen and Selena with

Abigail and baby Mariama being discharged

Check out this link to http://thacher.org the website of Julia’s former high school, where they have posted a bit of a story. Click on the right side where it reads, ‘(Long Distance) Calls to Service’.

Some Recent Photos. . .

Bo Marketplace

Baby returns for 3 month follow-up check

Annie's WAFF sign installed

Aminata becoming a computer whiz

Morning watering in the garden

Vero explaining the solar cooker

Sundu and Doctormaggi

Kadiatu and Wuyata basking in the morning sun

Julia's chicken gift

January 27, 2009

EVOLVING. . .

The days are developing a more steady rhythm and routine. It’s good to have the opportunity to take walks in the neighbourhood and also through the rabbit warren of market stalls in Bo. It’s amazing to be in the middle of it all, seeing all the colours of fabric, plastic buckets, chilis, plastic flipflops all within a few feet. A bunch of sweet bananas costs 500 Leones (about 15 cents) and is one of my favorite purchases along with home ground peanut butter from freshly roasted nuts.

Right now we are beginning to really gear up for a big month in February. Dr. Maggi will be arriving as well as a colo-rectal surgeon from Texas. Later in the month two other physicians from the USA are coming to give a workshop which will integrate training, discussion and hands-on practice to improve the level of training and delivery of emergency obstetrical and newborn care for health practitioners from all over Sierra Leone. Combined with the arrival of other volunteers, it promises to be a full, exciting and productive time as the programs all begin to evolve.

Last week’s discharge ceremony was the usual tearjerker, complete with raucous singing and dancing. We also have many new admissions and have some patients who have returned for their 3 month follow up visits. It’s great to be part of the reunions as well as the goodbyes.

The veggie garden is progressing well with Coleman and Julia’s attention, despite a visit from some local goats. The women are very involved too and are eager to supervise, lend advice and take on watering duties every evening.

The solar cooker HotPot donated by my friend Lee Curtis in Yungaburra (www.SHE-Inc.org) has proven to be a great success. Coleman has been researching how to make one from basic available-in-the-local-market materials, such as inner tubes from car tires and window glass. We hope to make them so that every woman can have one to take back to her village upon discharge. The advantages are so many…less deforestation, less smoke, less wood gathering and hauling and of course, more economical. We demonstrated its use yesterday and the women were all very pleased and excited.

Last week Zhao and Selena completed a week of Family Planning and Reproductive Health, teaching at the local university to community health workers and nurses, as well as on the ward. This was very well received. They report that all the students are very thirsty for knowledge. This week we have really started revamping the website…a long overdue project. It’s coming along and we hope to announce its launch soon. Computer training for staff and some patients has also begun.

Julia has had a busy past four days, going on an outreach and sensitization trip to Kabala in one of the northern districts. She continues with her role of acting administrator and is always doing her best to streamline logistics and budget issues.

It’s great for me to watch the new programs integrate and unfold as envisioned. I have had the opportunity to show a few visitors around and they all comment on how much the fistula ward vibrates with good energy and a strong sense of community. There’s much to be done, but we are off to a great start.

Helen

BYE-BYE BUSH. . .

Jan. 21, 2009

Obama’s inauguration was historic and definitely a global event. Being in Bo was proof of this phenomenon. We were given an invitation to watch the inauguration at, our landlord, Mr. Idriss’s house. This was a very special invitation since TVs in private residences are very few and far between.

We departed the office at the hospital at 3PM and picked up some drinks and snacks for the occasion at the “Downstairs” mini market. Julia, Selena, Coleman, Zhao and Helen (“pumoi” (white) people) and our driver Kabba arrived by 4 at the house. On the way over we passed many people gathered around radios and we were listening to the BBC radio updates in the car. The excitement in the air was palpable. Bars and little shacks with TVs were advertising the event and charging 10,000 Leones to watch (about $3USD).

Being up to 32 years older than my companions, I realized that other than 9/11 and the Iraq war starting, they had not really experienced any other days that fit in the category of “a-day-in-which-you-will-always-remember-where-you-were-when-it-happened-days”. However, being here in Bo, Sierra Leone for Barack Obama’s inauguration was going to be one of those days for everyone.

We all had front row seats at the Idriss household and we were gathered with about 15 people. We cheered, clapped, wept and laughed together. The closing of the final prayer was great “…black will not be asked to get back, when brown can stick around, when yellow will be mellow, when the red man can get ahead, man, and when white will embrace what is right.”, was especially poignant as we represented most of the color spectrum in that room.

Watching Bush depart in the helicopter was grand. I usually cry at farewells, but not this time! When anyone departs from the ward, there is a chorus of “Bye-Bye”, so this time it was “Bye, Bye Bush!”

Driving back to the guest house there were throngs of people lining the streets as spontaneous parades formed with people dancing and playing music in the back of pick up trucks. Pretty wild and crazy. . .

Waking up to the morning prayers from the mosque in the predawn hours was a bit different this morning. The call seemed less mournful and definitely tones of joy. It’s such a relief to feel the hope of new leadership.

Love from, Helen
(a.k.a. “Obama Mama”…my nickname from WAFF staff)

January 18, 2009
Bo, Sierra Leone

Time flying. . .

The two weeks since returning to Bo have flown by. All is going along pretty well. It’s gratifying when plans actually work out, especially considering all the potential pitfalls with transportation, general organizational and timing hassles in this part of the world.

Friday night I was standing on the “border” between the arrivals and departure sections in Lungi Airport, where absolute chaos prevails with masses of people coming and going. My right eye was waiting to see Selena Gerace from Mt. Shasta, California appear while with my left I was watching Annie, Jenn and Melinda in the departures queue. It worked out that Selena arrived in time to meet them for a tiny bit of crossover time. Jenn said,” We have two ears and one mouth, so we should listen twice as much as we talk.” This is certainly great advice for everyone everywhere.

Jenn and Melinda were able to collect a lot of interviews with women, nurses, staff and community members, including a health councilor with the Bo City Government and a traditional birth attendant. They were able to return with Alice, one of our discharged women, to her village for an emotional homecoming. Alice had suffered from the miseries of fistula for 15 years and now has been cured. Her testimony at last week’s discharge ceremony had everyone weeping. (I challenge anyone not to cry!) It will be exciting to see their footage. On this trip they were also able to pick up another girl who was brought to them by her father. People were certainly drawn to them and were willing to share their amazing stories in depth.

Annie finished working on the mass grave memorial, repainted a sign and also helped in the garden. She did some paper cutting design and paper box making with the women (some had never used scissors), played cards, did puzzles and hung out with them which they adored.

Jenn, Melinda and Annie all made a positive impact on the program and it was wonderful to have them here. They’ll all be missed.

Meanwhile, Coleman has been teaching first aid and working in the garden, including putting in an irrigation system. Zhao has been making fabulous posters for Family Planning and Reproductive Health classes and teaching. She’s also been training Aminata, one of the nurses, on the computer. It’s exciting how fast and eager Aminata is with her learning. Though she still does lots of administrative work in the office, Julia has been working in the garden too which is a great change for her.

I continue to coordinate and keep the lines of communication open. I love that every day is different with this work. Sunday’s are generally pretty low key and laid back. Today I went and hung out in the ward with some of the women. One young woman, Kadiatu, is particularly eager to learn how to read. It’s so fun to witness her soaking things up like a sponge. Today I taught her quite a bit of geography which was really fun. We did all sorts of puzzles, world map ones of varying degrees of difficulty and an African one. The puzzles have been a huge success with all the women.

Some rather out–of–the-ordinary and ordinary bits of the work days have included:

• Dealing with some fallout in the ward as one of the patients was accused of being a witch. The situation seems to be quelled and she is accepted now.

• Getting our patients and staff vaccinated for yellow fever and witnessing the mass immunization clinics. There were two cases of yellow fever reported in the Bo District recently and the goal of the 5 day yellow fever campaign throughout the district was to immunize 528,000 people.

• Not in the “out-of-the-ordinary” category, but certainly rewarding was to help Sundu, one of our patients (she was admitted several months ago pregnant with a pre-existing fistula and delivered a healthy son was delivered by C-section) with breastfeeding. Her babe’s name is “DoctorMaggi”. He’s appears to be pretty robust and a great ‘mothersucker’!!! It’s so sweet watching her care for him.

• Delivering the graduation speech at the discharge ceremony. The five women looked so beautiful in their new dresses. Poised, scared, sad, happy and excited all at once. Three came to receive their presents and hugs, sobbing.

• One of our staff members, John, is now off for a few days on simultaneous bereavement and paternity leave. One of his wives delivered a baby girl on Boxing Day in Bo and the baby died Thursday. Friday AM his other wife delivered a baby boy in Freetown. Her first child was stillborn. His quote of the day was, “In Africa you have to lose one or two children before you can start a family.”

• Being interviewed on radio

• Continual networking with locals and people abroad to improve and sustain the program

• Taking a tour of the impressive MSF facility with the volunteers.

• Dinner table and end-of-the day conversations with volunteers about insights and experiences

• Constant hassles with the internet connectivity

• Attempting to teach the staff why anticipation of problems is crucial to achieving good work

• Meetings, meetings, meetings. . .

• Watching Bo get ready for Obama festivities. Banners across the main streets and radio advertisements for parties. Tuesday will be a big day here and we have an invitation from our landlord to watch the inauguration on his TV. Very exciting.

The staff will all be wearing their Obama shirts!

I continue to feel lucky to be immersed in this rewarding and challenging work.

Helen

Going away presents from Benjamin

Selena and Fatama

Big night out !

Zhao dancing

Some recent photos:

Discharge ceremony

Uma Hawa Bah at ceremony

Post ceremony

Five discharged women

Sama's hairdo


Puzzle Queens

Helen & Annie

Cole teaching CPR

Cole & Annie in new garden

Annie with Julia & Kumba


Annie painting new sign on memorial


Interviewing Martha with Benjamin


Woman on bridge

Melinda & Jenn on sunset hill

Team for Outreach on bridge

RETURN TO BO. . .
January 5, 2009
Sierra Leone

New Year’s Day departure from Boston with frigid wind chill sub zero temps seems light years away as I write from the guest house for WAI/WAFF volunteers in the steamy evening heat here in Bo.

We all rendezvoused at Heathrow per plan which was quite miraculous considering all the snowstorms we managed to dodge. It’s exciting that we are the first “batch” of volunteers for the program and to see the vision unfolding. “We” comprises, Melinda Binks from Jackson, Wyoming (www.fallcreekproductions.com) a cinematographer who will be working with Jenn Barton, a writer from Wiscasset, Maine to produce a film about the WAI program and the obstetric fistula women’s stories. They were high school friends and hadn’t seen each other for ten years prior to Heathrow. It’s great to watch them in action. Zhao Han is from Gainesville, Florida, a premed student here to teach family planning and reproductive health. Coleman Griffith, an EMT from Fort Collins, Colorado, will teach first aid to the hospital staff and in the community. Annie Strachan (Helen’s daughter), a student at Lewis and Clark College majoring in international studies, will help in all aspects of the program including helping get the garden project launched and teaching the women.

After the chaotic scene at baggage claim and getting through customs it was wonderful to be greeted at the Lungi Airport by Poppa and Julia Robinson. Julia from Ojai, California has been here since September and has been acting administrator. Her presence and hard work has been a tremendous asset for the program as everything gets “settled”. She’s a “VV”…veteran volunteer.

Poor Julia had had a rather harrowing day prior to our arrival. Our long term arrangements for accommodation at the Lungi Airport Hotel fizzled at the last minute due to being bumped by Qadafi and his Libyan entourage! The Libyans have been in Sierra Leone to dedicate an enormous mosque on the outskirts of Freetown. Julia had to scuttle and make other bookings. We appreciated her efforts and had a good first sleep SL at the Lucia Guest House.

After the usual ferry queues and delays in the AM we managed to hit the road for Bo about 1PM. The road is much improved since I was here in September which was a treat not hitting miles of pot holes and corduroy ruts. Upon arrival it was grand to reunited with the community of staff and friends here and introduce everyone all round. A real homecoming.

We’ve had a full two days since arrival. Sunday we went to Taiama and visited with Samuel Pieh and his family after attending the morning/afternoon church service (four hours!!!). The afternoon entertainment comprised of cultural dancing and a tightrope acrobat. It was very festive and fun.

Monday AM was spent in a series of courtesy calls to community dignitaries and officials…the mayor, the paramount chief, the district chairman, the police chief and the provisional secretary.
It’s been wonderful just seeing how the ward has come together since all the renovations in September. Currently there are 27 patients and many will be part of the discharge ceremony slated for next week. One woman has just had her catheter removed and she is dry after 15 years of dealing with fistula. Imagine the change in her life!

At an impromptu staff meeting today I introduced all the volunteers and distributed the donated Barack Obama T-shirts. There were many hoots and hollers of delight!

So we are getting into a bit of a routine with our planned work activities and it’s a very homey atmosphere with everyone in the guest house. We have wonderful meals provided by Safula who Julia has hired and trained.

Waking up in the AM to the call to morning prayer is a favorite moment for me. This place really gets under one’s skin and it feels like another home. It’s exciting to think of what lies ahead for the next few months.

Some photos:

Local Police and Waff

Unpacking at guest house first night

Cole, Julia, Annie & Zhao

Jenn, Uma Hawa Bah & Melinda

Kadiata doing Africa puzzle

Interviewing Sundu in the back

Planting first seeds

Annie & friends cleaning memorial

Mende lessons

Hair braiding time

The Obama gang!