Saturday, November 26, 2011
Thursday, November 17, 2011
Thursday, October 27, 2011
Yes, again it has been awhile since I last updated on here. Sorry-o. I am now home in the USA. I will say it is nice to be home but in all honesty, it was very hard to leave. Many tears were shed and my heart hurt as I got in the water taxi to go to the airport Wednesday night. I'm still not fully home. One more flight to take me to Spokane and to bed.
One of the reasons I haven’t written on here in so long is honestly because I didn’t have time. The last month in Sierra Leone was c-r-a-z-y! You could say it did not end how I had hoped it would or in the way I had imagined. When the thought came up of me coming home early, I should have come home in January, I knew it was right. I had trained up a national nurse to be the ward supervisor and I had full confidence she would do a great job. I knew I could leave knowing she would be fine and the other nurses looked up to her and respected her. I felt like I had accomplished what I went there to do.
About two weeks ago this all changed very quickly when it was found out that many drugs were missing from the pharmacy and she was the reason. To say I was devastated would be an understatement. After learning this, more lies just as horrible were brought to light as well. I felt like the last six months I had spent training her were all of a sudden a lie. Like the work I had been doing was a waste of time. I don’t believe that now but it was a huge struggle for me for a time. After this all came out I laid in bed and went through every conversation we had and wondered if all we talked about and all she shared with me was a lie as well. When we realized medications were missing I told people it wasn’t her. I couldn’t believe it could be. I felt completely let down but I know my nurses did as well. They all trusted her as much as I did and I know this all came as a shock to everyone who worked at the centre.
God really is so good though. As I was training this nurse, I was training up another nurse along side her as well. She did not have as much training with me as this first nurse but I really do believe that she will do a fabulous job. The areas she struggles in are areas where she will have much support from others at the centre. Computers, paperwork, those lovely things.
Many people have asked me in the last week what I will miss about Sierra Leone: the patients, the nurses, my friends, beautiful Sierra Leone beaches, Thursday and Friday lunches (groundnut and rice and beans and rice), the sense of community in the ward where the women take care of each other, VVF women who come back to have their babies at the centre-- just to name a few. I do find comfort in knowing that come January I will be headed back to Africa, Niger this time, to open the fistula centre at Danja. I am so thankful that my time working with VVF women has not come to an end although my time in Sierra Leone is done. I have learned so so so so much this year and I know I can take most of that with me next year.
My current plan is that I will be in the states now until mid January before I leave for Niger. I will write a post soon about what that is all about. I will be home visiting family and friends and doing fundraising. Back at it! Thank you all for your prayers and support during my time in Sierra Leone. In all honesty, I don’t know if I would have survived without all your prayers and support during the past ten months.
Oh, and my bruise is much better. It’s still there but now it just looks like a large birthmark on my back. Still tender to touch it but I know that will get better with time.
Friday, September 30, 2011
Before I start this post, I want to say that I am ok.
Yesterday (as in three weeks ago when I started writing this) I went to my room to eat lunch. After lunch I grabbed my umbrella and headed back to work. It had just started raining. I opened my umbrella and started down my steps. Crocs on, umbrella open, carrying my water bottle and empty bowls. I made it down the first set of stairs then turned the landing and as I started down the second set of stairs my feet went out from under me and I proceeded to hit every step on my way down. Cement stairs covered with tile. My left flank and left elbow hit every step on the way down.
When I got to the bottom I could only swear. I could move and feel my legs but I knew I couldn’t get up. Luckily I had my phone in my pocket and I called Jude, my boss. I told her I was hurt and told her where I was. My umbrella landed right over the top of me so I was able to stay mostly dry. She came quickly. I couldn’t get up. Dr John and Maggie and Simon and everyone else showed up out of nowhere. I was told they were going to get the stretcher but I kept saying that if I just sit for a few minutes I would be ok. Deep down I knew that wasn’t true. Any movement and I started crying. The decision was made that Simon would pick me up from behind and someone else get my legs like a fireman hold and get me in a chair. From there they would carry me up the stairs to an empty room. The pain was unbearable and only got so much worse when they tried to put me in the chair. I couldn’t sit. The stretcher showed up and I was laid on it. When my tears came they couldn’t stop. The pain, the embarrassment, everything that started running through my head about being in Sierra Leone and what could go wrong.
They carried me on the stretcher to Orange Ward which was empty. I told them to just put me on the bed on the stretcher but they wanted to get me off it. Profanities ran like a river out of my mouth. I could only lay on my right side. Esther showed up and I realized that things that are said that annoy me so much, annoy so much more when I am hurt. I really dislike it when I am told not to cry when you know that crying helps so much to get the emotion and even pain out. To tell someone that you will be fine or that Jesus will heal me so I don’t need to cry or worry about anything. You don’t know if I will be fine. You don’t know if I will be ok, will need surgery, or if I broke something. You don’t know. Jesus does heal. Miracles happen. God can deliver you from your pain. Does He do it for everyone? No. That is His choice, not mine. I know I shouldn’t worry because God does have a plan, but don’t tell me that God will heal me and I won’t need surgery and I shouldn’t cry. I know she was trying to help and just doing her best to comfort me. A clash of cultures which wouldn’t be the only one of the day.
Jude and Dr John decided pretty quick that I needed X-rays. The ship has a machine but they wouldn’t be able to be read until a day later. I looked up and Dr Lewis came in and told me I was going to Emergency Hospital. I cracked a smile, thinking she was joking. Emergency Hospital is the hospital we send our VVF patients to if they have an RVF. A local hospital which is run by the Italians. When I heard I was headed to Emergency, I have to admit, I got scared. I would have preferred the comfort of the ship where I know people. Where I have friends. Dr Lewis’ husband works at Emergency as a surgeon. She was confident that this was the best place to be seen. There is an orthopedic surgeon there and she was certain this was the place for me to go.
Back onto the stretcher. More tears. More language. Out of the heart the mouth speaks. I was loaded into the back of an Aberdeen Women’s Centre car. All the long ones were out so when I was put in the shorter one, the doors wouldn’t close fully. The back doors were tied closed with wire.
The trip to Emergency was unbelievably painful. Every pothole and every bump was felt and received with tears. Dr John was sitting next to me and held my hand the way there. It was comforting. I felt like a little kid continually asking if we were there yet. I could tell where we were at times. I knew we were on the long stretch of road that passes right in front of the ocean when it felt like we were driving over a cheese grater. We were in Lumley when I saw the colorful umbrellas from the sellers in the market. Laying down in the back I could see full taxis and busses passing. Babies carried on backs and women with large baskets on their heads.
When we arrived at Emergency I was taken out of the AWC vehicle on the stretcher and I felt like I was dumped onto the Emergency stretcher. They wanted me to lie on my back and straighten my legs. Ow. No fun. It’s a very vulnerable position to be in when all you can see are the people pushing you into the emergency room and the white ceiling.
Although the pain in my back was excruciating, the pain from my full bladder was increasing. HR 106, BP 140/80. Yes, I do remember this. I don’t remember when I so aware of what was going on. Needing to know what was happening. I was laying against the wall with the air conditioning unit right above me, dripping water from the unit collected in a bucket below and every now and then I would get a drop on my face or arm.
The doctors were Italian and the nurses were from Sierra Leone. They were all so good to me. After the doctor examined me I was finally given diclofenac IM. That helped with some of the pain. The worst was yet to come though. X-rays were needed. I was wheeled into the hallway and parked there to wait my turn. The pain was already returning. I was crying as I pounded my hand against the wall. At this point I think it finally hit me that this wasn’t a good situation to be in. If something was broken, what were my options? Would I have surgery here or be evacuated? Why the heck did I fall? How ridiculous was this?! I knew it wasn’t good. Every small move brought forth a pain I couldn’t stand to bear. It was finally my turn in radiology. The men were very nice but to turn onto the hard boards was not something I enjoyed doing. This was the worst pain yet. After it was finished, about an hour later, more x-rays were needed to back in I went and more pain had. After the x-rays were done, I was taken back into the emergency room, the large open room, and my wet x-rays were brought and hung on the IV pole at the end of my bed with the chemicals dripping down onto me.
While I laid there waiting for the results, some interesting patients were brought in. Like I said, this was an open room. No curtains. Nothing to separate you from the patient next to you who broke his wrist. Three doctors surrounded this calm looking man and as two pulled traction and the other casted, the man screamed and screamed and screamed. I couldn’t help but watch. My stretcher was the table for the bandages. When that was done another man was wheeled in. His mud house fell in on him the day before. He was unable to move his arms or legs since. He was taken to a local healer who poured boiling water down his back in an attempt to heal him. This is not uncommon here. I looked over when he was rolled onto his side and the skin was all burned off his back. A woman came in who had fibroids which needed to be removed. I guess they can do them at Emergency. I wish I would have known that earlier. I was always told no where in Sierra Leone could this be done. We get so many women here in Aberdeen with this and no where to send them.
The docs finally came to look at my X-rays after giving me a shot of tramadol. That is great stuff! They finally said I had a broken iliac wing. Three Italian docs looking at my many films all decided this. Dr John and Jude were finally allowed back in to see me and we decided I would head to the Africa Mercy to recoup there.
When I got to the ship there was a good amount of people waiting for me. The tramadol stayed in my system for hours it felt so the ride there wasn’t bad. It took just over an hour or so to get there with the traffic. When I arrived, the side door opened and I saw Jane, a wonderful friend there who worked to get things situated for me to arrive. When the back door opened there were four big Ukrainian guys ready to carry me up the gangway on the stretcher. I will say this many times, but this was the most humbling experience of my life.
To speed up the story now...
When I got to the deck 3 hospital, I was taken to C ward where my friends had made me up a bed with a bright green apple comforter. I was taken first to get new x-rays of my pelvis and left elbow which had a great tunnel formed in it. My films from the ship were sent to the orthopedic doc who comes to do the ortho surgeries on the ship and to another radiologist in Canada. The ortho surgeon said I had broken my pelvis and I had a funny looking SI joint which I would need a CT scan to fully see if it was broken, and the radiologist in Canada said everything looked fine. All I knew was that any movement and I was in excruciating pain. The iliac wing fracture which was my diagnosis at Emergency Hospital turned out to be a smudge on the films. Kind of funny to look at now and see this smudge which brought me so much anxiety a few hours earlier...
For seven days I was on bed rest on board the Africa Mercy. If the ship was not here I would have been airlifted to Europe somewhere for scans and treatment. Finally on the seventh day I had a CT which showed nothing was broken. Seven days later it still hurt so much to bend or move certain ways but the pain was improving. Those seven days in the hospital I was shown such love. The friends I have here are incredible. I never ate a meal alone. We had picnics for lunch and dinner where friends would bring me food from the dining hall. We celebrated two friend’s birthdays while I was there with cake and watching Planet Earth. Documented my bruise which grew and changed to the prettiest blues and purples. They came and watched movies with me. Brought me a fake plant to brighten the room. Talked. We figured out how I could turn a bit so they could wash my hair. They listened to me and advocated for me and listened more to my frustration as I knew I was going to have to cancel my flight home for my brother’s wedding. All such amazing women.
On day seven, after the CT results, physical therapy came to get me out of bed. Jane helped as well as I first stood and walked with a walker then crutches. After I could do this, I moved to a guest cabin and saw rain and sunlight for the first time in seven days. I spent another week in that cabin sleeping mostly and moving more.
I’m now back in Aberdeen. It’s amazing to hear all that has happened in the last three weeks. The week before I fell I had to fire two nurses. Esther hired two more while I was away. I wasn’t expecting this at all. She told me the questions she asked and reasons for not hiring certain nurses who interviewed. I am very impressed with her and proud.
Now it is slowly getting back into work. On the 8th we will be launching a hotline for VVF throughout Sierra Leone. A toll free number where people can call if they think they know someone with VVF. It should be a wonderful day. Please pray for this opening that it goes smoothly and women hear about this centre who need to.
Thursday, August 18, 2011
Wednesday, August 17, 2011
Tuesday, August 16, 2011
Monday, August 15, 2011
Saturday, August 13, 2011
What a great Saturday! It started with me walking to the roundabout to get a taxi to Bliss to meet Sandra for lunch. I somehow got a free ride from someone I didn't know. Olga, but there is the Sierra Leone hospitality for you.
Friday, August 12, 2011
Thursday, August 11, 2011
Wednesday, August 10, 2011
Yes. It has been a long while since I posted on here. So much has happened and so much has changed. My attitude being one, but more on that later.
I went home for four weeks from mid June to mid July. I actually had known since about two weeks before I arrived that I would be coming home. I wanted to make it a surprise though so no one knew. It was wonderful being back on familiar soil for a bit. It came at just the right time as well. To tell you the truth, when I left I didn’t know if I wanted to come back. So much was happening and I was struggling to keep my feet under me. Rest came at a perfect time.
Home was great. I spent four weeks with my sister and her family and was able to see all my nephews and niece. Many friends came to visit as well. I ate a lot and slept. Celebrated the 4th of July. Cooked on a campfire. Canoed. Hiked in the forest. Went fishing. Stocked up on some goodies for friends back here. It was great, to say the least.
I have been back a few weeks and honestly, it has been great being back. Having a time of rest, of real rest, renewed my strength. It helped too, that when I returned back here, nothing but good reports came from when I was gone. Bernadette and Esther, the two Sierra Leoneans I have been training to be the ward supervisors have been doing such an amazing job. Truly. It couldn’t have gone better. There was a visiting surgeon who came while I was away and he did 22 surgeries in a week. That is double what can be done on a good week, which we don’t see too much, but all my nurses pitched in and did a fabulous job. They told me that now that I am back, they can slack off. I told them absolutely not! And they haven’t. They are really showing me what they can do. It’s been great for me because I have been able to do more teaching and more detailed things to encourage and really try to get things right into place for when I leave in December. I pray this all continues.
Updates from the ward:
You wouldn’t believe it. So there was a woman who showed up with her sister and her daughter-in-law. All with VVF. The daughter-in-law has already gone home. Her injury was too extensive and there was nothing Dr. Lewis could do for her. The other two, sisters, both had their surgeries yesterday. Both are dry and doing great! More to come on them in the future...
Seibatu. The visiting surgeon attempted her again. Her third VVF. When I came back she still had her catheter in and was becoming wet. I decided to leave her catheter in longer than normal because she had said that her wetness was improving. The first thing I had noticed when I returned was that she still had her colostomy! She was soposed to get it reversed the day I returned home, four weeks before. Nope. They saw she still had a small hole so they left it longer. She was given another appointment at Emergency Hospital where she was going to get her reversal and last week she did!!! Two days ago I went to visit her so I could change her catheter but when I showed up they said she wasn’t having any urine from it so I just took it out. Her surgery failed, once again. Dr Lewis will examine her again this week and see if there is anything more she can try. Her colostomy reversal was a success though! Her RVF was closed!! The good news is that Seibatu has pooped! This is such a victory! For the last year it has all been coming out of her vagina and now, with the colostomy giving her bowels time to heal after her RVF surgery, she has pooped, three times! Every time is a victory for her! Chances are she will go home soon. After six months, she needs to go home and visit her children and husband and family. She told me she will not go if she is not dry. It will be hard to see her go but sometimes there is nothing more that can be done here.
It is Ramadan. In a country where you are either Muslim or Christian, this is a big thing. I have had old patients call me and ask if I am fasting. Nurses taking time in their day to pray. Breaking their fast in the evening. Having a VVF patient find out she is pregnant and the only question she has for us is if she can still fast. It’s a different world here sometimes...
This woman who found out she was pregnant, I was in tears. We do pregnancy tests on all our women. She came back positive. The obstetrician did an ultrasound but couldn’t see anything, so she did a vaginal one and yes, I got all choked up. So tiny on the screen. About six weeks along and you could see the tiniest little flutter of a heartbeat. It was incredible. She was given an appointment to return to have her baby here.
Oh, and last week we had such an overflow of patients that one night two beds were pushed together and three women shared and the next night an mattress had to be put on the floor! A full week this week and next week we already have a full OR schedule as well!
Last week Jane stayed with me for a bit for her vacation time. One night we were walking down the street and passed the side gate to the centre. There were five of my women there staring out and said they wanted groundnut. Jane bought them groundnut and we shared with all the patients. Now everyday they say, ‘Sarah, I want groundnut.’It makes me laugh whenever I hear this.
More stories to come. Off to bed for now though!
Friday, June 17, 2011
It is hard to know Seibatu’s age. She has a very thin frame despite our attempts to fatten her up. She carries her perfect apple cheek bones without any trouble and she has had five pregnancies. I would put her into her mid to late twenties, although she could not confirm nor deny this. Here is Seibatu’s story…
Seibatu has been here at the centre for 153 days. Yes, you heard me right, 153 days. Her first surgery took place on January 19, 2011, but I am getting ahead of myself. Like I said, Seibatu has had five pregnancies. From those five, she has four daughters which I am sure are as beautiful as she. Zainab, Fatmata, Isata, and Jariatu. It was during her fifth pregnancy that she came into trouble. She went into labor at home. For three days she labored before she went to the nearest government hospital to her home. There she had her child without a caesarean section. The baby was born alive. A boy. Within one day he died. The next day Seibatu noticed she could not control her urine and one month later she realized she could not control her bowels either. She had both a VVF (vesico-vaginal fistula) and an RVF (recto-vaginal fistula). This happened ten months ago.
Soon after her problems started another woman in her village returned from Freetown where she became dry after having this same problem. Seibatu was taken to the Paramount Chief of her village by her in-laws to seek help. He told her to go to Aberdeen to get help like this other woman had done. She was brought by her husband, Umaru, a very thin man like Seibatu but with the same infectious smile. At home they work together as farmers: cassava and rice. Since Seibatu has been here they have not been able to farm. Umaru travels between home and Freetown to visit Seibatu and care for his family. He has been seen on the ground here cutting her toenails and taking care of her, a beautiful sight to behold.
January 19, 2011 Seibatu had her first VVF surgery. She came out of surgery with two stents and a foley. Quickly we noticed her surgery did not work as her bed was still wet. After she had time to recover from this first surgery, on March 1 she was sent to a nearby hospital to have a colostomy placed. When the colostomy was placed, her RVF was closed. To give her body time to heal she would need to keep this colostomy for three months. Three weeks ago she went back for a check up and it was noticed that the RVF was only the size of a pin point! This Sunday she will return to have the colostomy reversed. The first step to full healing. Her RVF is closed!
May 18 she went back in to have her VVF attempted once again. Again it failed. Seibatu does not have a lot of healthy tissue to use to close her VVF. The greater part of the VVF was healed though. That was great news. Next month another surgeon will be visiting the centre and hopefully he will be able to do the final part of her healing, to finally close her VVF once and for all.
I asked her how she feels about being here for so long. She said she is happy. She wants a ‘well body’ to take home. She desires healing so much. There have been many tears shed on behalf of Seibatu by her, by myself, by the nurses. Seibatu has come so far and we can only pray that she will leave here completely healed and she would go home dancing.
Thursday, May 26, 2011
Wednesday, May 25, 2011
Tuesday, May 24, 2011
My name is Hawa Sheku. I am twenty five years old. I live in Gborbu Yawee chiefdom, Kailhaun district. I attended the Methodist primary school, Malayma Yawae. I stopped at class three when the war broke out in my village. That was the end of my schooling. I am a farmer and housewife but I want to learn a trade like hairdressing or dress maker, seamstress.
I am married to Sheku Ngebga. I was fourteen years of age when we got married. I became pregnant at fifteen and was happy. I have been pregnant twice and the second pregnancy gave me this VVF.
The start of the labor pains came for some time and bleeding followed. That was the time my family traveled with me to Kenema Government Hospital. I spent one night in labor pains and I was operated on for caesarean section by the doctor. I was in labor for two days overall. My husband did his best to bring me to the government hospital to save the life of my baby and myself but it was rather unfortunate that we lost the baby. He was alive for three days and on the forth post-operative day, I lost my baby. Also, that was the time I realized I had urine incontinence. At that moment I told my husband and we explained to the nurse who told the doctor. The doctor now explained to me what brought my problem, that during my prolonged labor the pressure of his head compressed my urethra and damaged it. He told me it was not his fault. He also told me about a hospital where they could fix it. It was only urine leaking from me, not feces.
My husband felt so bad because of the constraints, pain, finances and the loss of our son. My family members felt bad for me and since that day they have been having sympathy for me. My husband and my family supported me fully. I have had this problem for six years. The only problem now is that I don’t have a living child. I have never attempted VVF surgery before. This is my first time.
I heard about the Aberdeen Women’s Centre through the radio and a team from the centre picked me up and brought me here. I’ve been here for twelve days. When I came I was afraid I would not be healed. How was it going to work?
Now I know I am cured because since after my surgery I’m dry and observed no wetness. I am really cared for by the doctor, nurses, international staff, teacher and the other patients. My best friend here is Massah Saffa.
My husband will be very very happy. My relatives will also be happy. Some of my friends will be happy. Yes, they will welcome me.
I will be very happy to reach my home healed because I came sick.
Thursday, May 19, 2011
Tuesday, May 17, 2011
On rounds today, Dr Lewis decided it was time for Seibatu to have her follow-up appointment from her first VVF surgery since it has been about three months. Her first surgery was big. The hole she had from her VVF was really, really large. There is still a hole but hopefully Dr Lewis will be able to close it. She decided she will take her back to surgery TOMORROW! She is so happy. I almost broke out in tears in the office. She has been here so long and we all desire so much for her to be dry! Please pray for her surgery tomorrow that she will have no problems. That Dr Lewis will be able to complete the repair which has been started and that Seibatu will be dry! In the photo, Seibatu is the one touching my back, second from the right.