Update with A-lo

I guess it has been a while since I’ve written about work related happenings… Working in a health facility in rural Sierra Leone continues to be a roller coaster ride. Some days are great and I really feel like we are helping people and making a difference in the community, and other days it is so incredibly frustrating on so many levels.

Probably my greatest daily challenge is a lack of diagnostic resources. On top of having no doctor at the clinic, it is extremely trying to not have diagnostics to aid in the decision with your diagnosis. There are two labs in town, however, they are quite questionable in terms of reliability of staff and equipment, and only are able to do a handful of tests. It is also difficult to tell a woman who has just walked 10 miles with her children to come for treatment that she now has to walk another 2 miles across town to get a lab test done, in which afterwards must walk back with the results so that we can treat her or her child or whomever. I knew before coming here that I would have to “make do with what we have”, however from a professional practice standpoint, this has proved to be much harder than I suspected. As you can imagine, many times you don’t know what the problem is, so you look at the three or so options that you think might be the problem, pick the most likely one and tell them to come back if they don’t get better. This sounds like malpractice, I know, but what other options are there?

One really cool thing is that I have developed a solid relationship with a local doctor who I mentioned before – Dr. Samura. He is one of the only two doctors in all of Kabala and runs a private inpatient/outpatient clinic out of his home. He is an amazing person and doctor. I am so happy to have him because I can confidently refer difficult or acute cases to him, knowing that the person will receive good care. Whenever I see him or take a patient to him, I ask him a million questions that have been piling up in my brain over the last while, and we have some great talks.

Along with seeing patients, I have taken on/been appointed the task of “developing the professionalism and standards of practice” at the clinic (I love these fancy titles). I can now say that we have a fully functioning filing system. The main challenge was how to go about arranging patient files considering that virtually everyone has the same names. For example, there are five students in class 5 at CRC School with the last name “Kamara” – three of which have the same first name. Anyway, after doing some research at other health care facilities and talking with our staff, we developed our own system to track patients according to date. Having a filing system has proved to be incredibly valuable with follow up cases and returning patients. As well, we now have a nurse in our waiting room doing the registration as well as vital signs on each patient, and keeping an eye on acutely ill people who need to be treated first. The patients seem to really like this as well.

Organizing. I have been doing a lot of this since I arrived. For whatever reasons, much of our donated supplies were not unpacked and organized. Myself, along with an American volunteer who is with us for a couple months, have spent the last couple weeks unpacking boxes, sorting items, and arranging them accordingly on the shelves (Jeanette, the label maker is getting worked into the ground between this and the filing system☺). Doing this, I have learned that in the future I will be more selective in what I chose to donate. I think people have this notion that “I can’t use this, but someone in Africa will want it”. I won’t go into specifics, but we’ve gone through a lot of random, unusable junk like half used expired prescriptions. But yes, some really great stuff too.

New Staff. We just hired a new nurse and an Agriculturalist. Our nurse’s name is Mariama and she is great! Young, super knowledgeable, eager to learn and learns quickly, organized, etc. She is also in charge of the maternity unit at the Government Hospital of Kabala. It’s been really interesting for me to be on the administrative side of things. Being involved in hiring and training processes is, yet again another first for me here. We are also hoping to hire Lansana, our nurse volunteer, in March if the funds are available. Having more staff around has been so helpful as our patient numbers seem to be steadily increasing. I think the community is hearing positive things about our clinic and really trusts the care they are receiving from us. However, the new clinic is still not finished and with increasing patients, staff, and volunteers, space in the current clinic is really tight.

Cleaning. I am so incredibly delighted that our request to hire a cleaner is in the works! Besides sweeping a couple times a week, the clinic has not been getting cleaned. This coming Thursday we are doing interviews for an official cleaner. We want to hire someone young and hardworking who has graduated from Secondary School, and wants to attend college but is unable due to financial constraints. Hopefully, they can work with us for a year or two, and then have the money to go. As you can imagine, I have prepared a detailed list of daily, weekly, and monthly duties, and I cannot wait to train this person! They will also be able to assist with running errands and assisting patients in the waiting room.

What else… Last week I helped deliver a baby. Theresa called me early one morning and said I should come. I got to her house around 7:00 a.m. and the baby was born at 7:52 a.m. She was fully dilated when I arrived so things moved pretty quickly. Thank the Lord that everything went extremely smoothly without complication and both the mom and baby boy were healthy. The entire process was quite interesting considering that when I arrived an enema was being given through a funnel with some tubing attached to try and stimulate stronger contractions. As well, shortly after an IM injection of Oxytocin was given because, “we need to get things going – we must be at the clinic by 9 o’clock.” Despite some “cultural” differences, the experience was amazing and has provided yet another area of nursing I am interested in.

Next Monday I will be venturing out into an entirely different area of work for one week. CES (Christian Extension Services) – the NGO that is closely linked with the school Joe works at – is doing an impact evaluation of their Micro-Credit Program. This program is aimed at building the capacity of women economically and socially in the society by giving small increment loans in three phases. They have asked me as “an outsider with a non-biased opinion” to help with the evaluation. Sooooo, I will be leaving this Monday with an EXPERT (I have to stress this so that my parents won’t be surmounted with fear for my life) motorcycle driver traveling 86 miles to three different villages. In these villages I will be facilitating one-on-one interviews with the program beneficiaries and community leaders, as well as facilitating group discussion. My job will be to ask the questions and record the answers with the help of a translator. I know this sounds very far removed from what I came here to do and what I really am trained to do, but I think it will be a really cool experience on so many levels. E.g. learning about micro-credit programs, working with an other NGO, seeing more of the country, experiencing villages life, etc.

So, that’s about it for now. Please continue to pray for safety and good health, especially in this upcoming week. We are getting so excited for my mom and dad to be coming in just over a month!!!

Bye for now.
Missing you all.
Adrienne