Two More...

The team house where most of us live. The bottom floor is where we eat together and the kitchen and laundry room. Soon we will have couches in there for a lounge as well.

I live on the second floor but I will be moving north in a couple weeks. There is a better view and a brighter room.

On the other side of the cement wall to the right, which you can't really see, is the maternity ward.

This would be why it takes so long to get anywhere. There is so much road construction and crazy drivers and unreliable cars which break down everywhere that to get anywhere is an all day ordeal.

One Photo

I've been trying to get pictures uploaded on her for the last few days. It took about ten minutes for this one. It's a start and I will try and do more later.

Here is a picture of a girl on the day of her gladi gladi surrounded by eight other patients awaiting their turn.

Burns Night

Who or what in the world is Burns night/Burns supper? I had never heard of this guy until a few days ago and tonight I had haggis for the first time, possibly the last. It's not that I didn't like it. It honestly didn't taste that bad but with every bite I had to consciously tell myself not to think about what I could possibly be eating. Jude, the manager of the clinic, is Scottish and she brought it back with her from her last trip home. It looked like a massive, massive sausage. When it was brought out it had to be walked around the table and we all stood in silence. Then Jude stabbed it with a dagger. Quite possibly the most random thing I have seen since arriving in Sierra Leone. After dinner Mikey read his poetry. Mikey isn't Scottish but I guess this is what you do at a Burns supper.

As random as this all was, this is something I really love about living in this sort of community. We all come from different places from around the globe and yet we all bring something so unique...and sometimes so strange. The funny thing is too, is that I was invited to another Burns supper/poetry reading tomorrow night. I'll have to let you know how that one goes...

Get Belly

There are two women on staff here who are trained to do advocacy teaching with the VVF women. I sat in on the first half of the day with them. Fourteen VVF women sitting in a circle talking, I felt like it was a support group, which it is in many ways. One thing I have noticed about Freetown is the large number of NGOs in the area. When you go out you can't help but pass numerous white land rovers will a different charity scribbled on the side. One of those charities is Health Poverty Action. To be honest I really don't know much about them but what I do know is that they have put together this great advocacy training program for the fistula women for when they return home. The women are taught how to advocate for other women they may find in the same situation they are in, leaking urine and alone. Not only are they taught what to do if they meet one of these women and where to send them, but they are taught what to do if they meet a woman who "get belly", is pregnant. If the woman is in labor and if they see the sun two times, one-night-two, and they still have not delivered, they must get them to a clinic or hospital where they have trained doctors.

While they were sitting in the circle, Florence had the women go around and say how long their labors lasted. I have heard these numbers before and see them daily as I enter them into the database in the computer, but to go around a circle and hear each woman say: two days, one day, three days, seven days, two days, four days, six days, ten days, three days, one day, seven days, four days, three days, two days... makes it so real. When she asked one woman how far it is from her home to the nearest health clinic of any sort, thirty miles was the answer. For most of us thirty miles isn't anything. That's a drive into Tacoma from Vaughn. Into Spokane from Coeur d' Alene. Imagine not having a car though. There is no way. And if you are in active labor...

After the training the women are given a book about Fata. It is written in simple language so some of the women can read it if they have had any schooling. Fata becomes pregnant and gets a fistula. It tells her story and it tells what needs to happen next and what could be done about it. The women can use it as a tool when they get back to their villages to help prevent fistulas.

This evening I was walking through the ward and I heard someone reading, slowly, but trying, and it was Mariama. Mariama is sixteen and only got her fistula two months ago so it is too early for her to have surgery yet. She will be with us until it is time though. She needs to be "built up" so she will be better physically for surgery. Vitamins, ensure and three meals a day will help with that. I sat with her outside for a bit this evening. I was trying to hear her story but the nurses who were translating for me got busy. I had her open her book on Fata and read instead. She speaks Mende and small small Krio but she knows her alphabet. She is slow reading but not bad. If she got to a word she didn't know she would spell it without any problem and usually figure it out from there. Such a beautiful girl. I'm sure I'll share more about her later.

Esther left today, the girl I wrote about two posts back. She wasn't able to sit in on the advocacy training so before she left I pleaded with her that if she heard of anyone with piss problems from obstructed labor to send them in. She said she would and I know she will. That girl is a strong one. So funny too. She was helping me with my Krio which is still non-existent. She is still wet but will be back in two weeks for a checkup. For now, it's back to school for her.

Tell God Tenki

One of my favorite things that happens in the morning during rounds is when the patient is asked how she is feeling. Her response, more often than not, is:

"Tell God tenki."

Tenki means thank you in krio, the local language. Tell God thank you. Even through all these women have been through, their daily response is:

"Tell God tenki."

Their response isn't:

"Why did God allow this to happen to me?"

or:

"Can you PLEASE take this catheter out!"

or:

"When can I get out of here and go home?"

or:

"When can we eat?"

it's:

"Tell God tenki."

On another note, there is a woman who had surgery yesterday and now she has three drains coming out of her. A catheter and two stents which come out from the kidneys. Those will be removed in seven days. When she gets out of bed she carries the stents around in a bed pan. Don't worry, it's super clean. But that's not what I want to share about. So today was visiting day and her husband came! That in itself is always a beautiful sight to see. So many of these women are abandoned by their husbands. But I looked over and he was bending over cutting her toenails with a razor blade. That was a tremendous picture of love! She was sitting there with a foley bag and a bed pan full of two other bags and tubes and he was lovingly cutting her toenails. I walked over to them and they both looked up at me and laughed, as did I.

Esther

This weekend when we were driving home from the beach we passed and man and his daughter selling beautiful fruit on the side of the dusty road. We stopped and for Le 3,000 I was able to get half a dozen perfect sweet star fruit then on top of that he piled that many more sour ones so I could try them. That was less than a dollar. I just ate one and it was delicious!

I walked past a patient today who was leaning over her bed digging around inside the plastic bin all the patients are given for their personal belongings. I noticed she had a stack of those composition notebooks. When I asked her if she was in school she said yes. She told me she was studying agriculture. Instead of being in school she is laying in a hospital bed trying to not leak urine. We got to talking for many reasons but it was also nice being able to talk to a patient in english. She learned english in school and spoke it very well. I opened her agriculture book and quizzed her on the difference between substance agriculture and commercial agriculture. Pretty smart cookie she was. She told me that she didn’t want to be a farmer but someday she hoped to become a nurse. At seventeen she has her life in front of her.

Here’s a bit of Esther’s story: She became pregnant about a year and a half ago and was in the midst of taking her exams when she found out she was pregnant. She decided to continue with school though. The “young man” who got her pregnant continued to help her with her school fees. When she started feeling a little pain she told someone but she told me that because she is only a child, she didn’t know what to expect from labor. She thought that when her labor started her whole belly would start moving around and everything would hurt. When this small small pain started the woman took her to the TBA, traditional birth attendant. For three days she labored. She asked them to take her to the hospital but they said they could not afford an ambulance. It would cost Le 20,000, about $4. She gave the TBA a small amount of money to call her boyfriend but they took the money and never called him. She told me the baby tried to come out but it got stuck. “It wouldn’t go up and it wouldn’t go down.” Eventually they gave in and took her to the hospital. The surgeon there said he would only do the operation for Le 200,000, money she did not have. Another day went by and that night she passed her dead child on its own.

In the hospital they inserted a catheter. She was having a small amount of urine coming out but the rest just fell out of her. By the third day nothing was coming from the catheter. It was all just pouring out. She went home.

There was a car that came to her village. It was the screening team from AWC, where I work. The nurses met her and although there were other women in the same condition, they all ran away but she stayed. Others told her to run because these nurses would eat her. She knew she needed help though. She came and had her surgery but was still wet and had to come again for another one. She had her second surgery yesterday.

Esther told me that when she went home after her first surgery, although she was still wet, she didn’t tell anyone. She dressed fine and made herself look happy because she wanted to help the other women in her village. She wanted them to see that she went and was healed. She wanted them to come as well. Even if after this surgery she is still wet, she will do the same thing. She knows she is the one who can help her friends find healing.

The Power Won't Stop Flicking Off While I Am Trying To Post This

Throughout my days I always think, I should blog about that, then I never remember what it was I was going to share.

I am settling into the routine here. Figuring out more day by day what my role is and how things work. I am training up Sia, a national nurse, to be the ward supervisor which I thought would be more challenging that it is turning out to be. She is fabulous. From day one she has been taking initiative and making sure things are getting done. I have been rearranging the wards to make things easier to get to and to have less clutter around and she has been giving ideas and jumping in to help. Last week I was teaching her how to enter patients into the database. She told me she took a computer class not too long ago but after we got past how to use the mouse, things picked up a little. She is a fast learner and I think this will be a great position for her to be in.

I am awful at learning names. I was asking someone the other day if they knew where a certain nurse was and she said she was the black woman sitting outside. I could only laugh and walk away considering the long row of patients sitting outside and I was the only white person around.

The patients are beautiful. They will stay here for close to twenty days so the opportunity to get to know them on a deeper level is something I am really looking forward to. Dr Lewis is the VVF surgeon here and she is wonderful. We have enough bed space that if a woman comes and and is malnourished, even if she is not a candidate for surgery, we will keep them on the ward to “build them up”. We will work on getting their nutrition in line and get some meat on their bones before sending them home.

This past weekend I went to another beach. It was amazing. Not only was the beach absolutely beautiful, I had my first full lobster. This beach was incredible. The restaurant we were at was inside this small bay. There was a sandbar that came out which left a small area for the ocean to come in. We would swim out to this bar and jump in the ocean and let it push us in. I felt like I was floating down the Clark Fork after being dumped in my canoe, without the fear of hitting rocks.

So far through this experience I have really been learning so much about God’s grace and goodness. At times I still wonder if this is the right place for me, if I have enough talent and leadership ability to not only do this job, but to do it well. True, I had a slight breakdown last week but who hasn’t when they start a new job. The people that are here at this clinic couldn’t be more supportive though. There is a substantial expat community in Aberdeen and Freetown. It’s been great meeting people from different NGOs and getting to know people outside of this place as well. And there are people living here from all over the spectrum but somehow it all works. Somehow in the almost two weeks of me living here I am feeling a part of this. I can’t wait to see what happens and what comes of this year here.

Papaya

A patient gave me a papaya as a gift today! It's big and smells good and I can't wait to cut into it!

A little makeup...A little screaming...

I walked onto the ward tonight at about 8pm and I could only laugh. There were two women sitting on the first bed as I walked in. One had just finished putting makeup on the other one. Her eyes were blue and her lips...outlined in thick black and colored in with a silver-type of color. She looked at me as I walked in, tilted her head back and rolled her eyes in a look-at-me type way. When she stood up she grabbed her catheter bag in one hand and held her other hand up in a sophisticated type manner. As she walked, she strutted her stuff, laughing at the same time as she paraded through all the wards. I needed that tonight.

The slight complaining I did yesterday about the house next to my window that plays the loud music, I take it back. I take it all back. About an hour ago I went to take a shower. The bathroom is on the other side of the hallway, facing the maternity clinic. As soon as I opened my door to cross the hall I could hear the screaming. It wasn't just screaming though. It was gut wrenching, horror filled agony. There is a momma in labor. Every once in a while someone will ask if I can hear the mothers from my room. No, because my room faces the other direction. I have to admit, that is something I am thankful for at the moment.

First Sunny Weekend

Outside my window, on the other side of the cement wall, is a home. I don’t know who lives there but I know they like to listen to music loud all through the night and right now they are watching a horror movie. The suspense music part is playing right now. I’m just waiting for the scream...there it is.

This weekend I have been able to get out and see a bit more of my new home and surroundings. Yesterday I went to Lakka, a beach about a thirty minute drive away, with Pete and Sonia who work in finance, and Mikey, the pediatric physician who works in the outpatient clinic. Things here aren’t very far away but with the roads in the condition they are in it takes much longer to get places. If a truck or car breaks down, it stays there until it’s fixed. The road is also being widened so a great part of the hassle comes from the construction. It’s impossible not to notice the shops along the road. It looked as though the front of the shops had all been torn off and that is exactly what happened. When they had come through to widen the road any shop which was in the way was bulldozed and for many shops that just meant the front wall of the shop was torn off, keeping the inside exposed. I was told though, that the owners were compensated for this.

One thing Sierra Leone does well are their white sandy beaches. Lakka is a large crescent cove where the beach is lined with many small places to get chop, food, and they all have wooden lounge chairs and huts to lay under. The water is pretty clean and the swimming is perfect. The shrimps I had for lunch were massive and the chips, fries, weren’t too bad either. I laid on a chair and read most of the day and watched the fishing boats come and go. It was a perfect day to breathe and take in the new sights and sounds of Sierra Leone.

The main modes of transportation here are the poda podas, large vans which you shove as many people into that you can, taxis and motorcycles. Poda podas are pretty standard throughout most places I have been in West Africa, every place just has a different name for them. The nice thing about here though, is that the rates are pretty standard and easy to figure out so you don’t have to haggle for a better price. I had thought of getting a drivers license since I’ll be here for a bit but I think I’ll be able to figure out public transport just fine. I found the supermarket but we were in a hurry to get back so I’ll save that excitement for another day.

We all just said goodbye to Anna, who I am taking over from. It was bittersweet for everyone here. I have only worked with her for the last few days but she has done a fabulous job bringing the VVF part of this clinic up to where it is. Saying goodbye to her also means here I am. The adventure of this next year is just beginning.

Sierra Leone or Bust

I’m back...to the land of VVF, heat and humidity, being tsk-ed at as I walk down the street, cockroaches, long hand shakes, sweat, urine, the unknown, dust, bars on my windows, barbed wire, ants, white sandy beaches, crowded taxis, dirty feet...I am back to the continent of Africa but to Sierra Leone for the first time. I arrived three days ago without much hassle. My luggage was underweight and it all made it! The pastor who was to meet me in the airport met me. He just walked up and said my name and we found each other easily. He helped me exchange money and get me on to the water taxi. When you land in Sierra Leone, the airport is on the other side of a bay so you have a few options: drive the five or six hours down a dangerous road to get to the city, take a helicopter, or take a water taxi. I opted for the water taxi. I had to laugh when I got in it. It was a pimped out water taxi. It was lighted on the inside with christmas lights and in the corner was a hispanic soap opera playing. There were many other expats on the taxi and we were all laughing by the time we go to the other side...a very amusing experience.

I’m here for a year. This is the longest I have been anywhere longer than seven months in the past seven years. I have my own room and if I look out to the left I can see the city of Freetown otherwise I just see rooftops. There is a beach about a ten minute walk away. That’s as far as I’ve made it beyond these walls so far. I don’t think I would swim there but it’s a nice place to walk to. The clinic is separated from the team house by a wall so I have a really short commute.

My first three days I have spent with Anna getting handover. I will be taking over her job and she leaves this weekend so Monday will be a big day. It has been, to say the least, very overwhelming, as any job seems to be when you first start. The Aberdeen Women’s Center (AWC) is where I am working. There are basically three areas to this clinic. There is the VVF side, which I will be working in, the maternity clinic where babies are delivered daily, and the outpatient pediatric clinic. Everyone I have met here has been extremely welcoming and supportive. The past three days have been trying to fill my head with every part of this place. I’m tired now. I'll have the weekend off and start fresh on Monday!