lizards on the beach

 Tom helped his Daddy take pictures of lizards this weekend while we were waiting for a ride. Now we have ten times as many pictures of lizards as we might really want and some random ones of African dogs lying in the shade. It kept him happy while we waited though, while Josh made a new friend and played games on her phone!

on the beach

 These are some views from where Grace Community Church had their baptism service on Sunday.

 We had to hop over the wall you can see and then we were on the beach by the sea

It was a bit grey and overcast which was a blessing. None of us turned into lobsters despite a few hours outside.

baptisms on the beach

 We were invited to the beach this weekend to join friends at Grace Community Church for their first ever baptism service - and it was in the sea! Baptism is an outward sign that people have become Christians and want to follow Jesus. Going under the water is symbolic of death and then having new life in Jesus.

We weren't the first or last church group to be having a baptism that morning! And there were tons of people on the beach enjoying their Sunday, as you can see here, some just floating by the action!

driving around

 These were a couple of shots I took last week while Tommy was driving. This is a two way road believe it or not. I thought about doing a video of driving like we did in Benin, but the speed of traffic is so slow it would be pretty dull, you hardly move anywhere!

Although a little quieter further on there are still people everywhere! There are big ditches on each side of the road too hidden by the people.

Screening

Screening has gone really well. Tommy finished work early on Friday to go with the security team on Friday afternoon to set up the lines and came back aboard on Saturday after working the night.

By 10pm on Friday night there were already a couple of hundred people in line, with many more having been sent away who we were unable to help. People kept arriving, and continued to be pre-screened to send away people we can't help. The security team worked hard all night walking up and down the line to make sure that everybody was calm and kept informed. Tommy had a great time interacting with the many people he met, both those we could and couldn't help. He saw some heartbreaking conditions that we don't have surgeons to help with and hundreds of hernias when our hernia list is already full for now. By the morning there were a couple of thousand people in line and the nurses in the screening team began to screen around 7am. The line was so calm and moved so smoothly that the line was gone by around 8:30 and everybody we could help was in the compound beginning the long process that results in an appointment for surgery.

It was a very long day for Tommy, but also a very enjoyable one. It was a fantastic opportunity to see a different side of the Sierra Leoneon peole than what we saw at the Stadium screening. Alongside the desperation, this time we were able to bring hope that with an orderly line we would be able to see everybody in the line.

screening again

Tomorrow is the repeat patient screening day that so many have been waiting for -many people from around the country have stayed in Freetown since the last screening because it would cost too much to travel a second time. There have been people returning regularly to the stadium in the hope that we would be there again, and people outside the dock every day hoping someone will help. We hope the right people will come tomorrow and get the slip of paper to come back and have surgery. Please pray for a successful and calm day. Please pray that people will have heard which problems we can and can not help. Even this week I still met a lot of people on the streets who asked me about screening and when questioned about their health problems reported general back pain or heart problems and things we can't help or just wanted medication for something. Tommy left at 2pm today (after finishing work at 1.59pm), along with Sam and some other crew to set up the lines before it gets busy with people arriving. It might be a long night for them, but we hope that an early coordination of the lines of people, helped by local police will mean a calm night for the desperate people waiting.We'll write more soon.

On another note here is an article about the ship:
http://www.telegraph.co.uk/health/expathealth/8355009/Floating-hospital-arrives-in-Sierra-Leone.html

fun times travelling

Yesterday I went to the Maternity clinic for a few hours of meeting staff and orientation prior to starting working there next week. Trying to get there involved some fun and games, but this is Africa after all, and some things you just expect to be different. The taxi driver I phoned said leaving at 8am was too early so we found one who agreed to meet me at nine. He had assured me that he was nearly there just after nine so I explained that I would walk out of the Port to try and meet him the other side of all the trucks lining to road down to our Port Gate. I spent the next hour meeting the whole of Freetown, or so it seemed, advising them about which day to come to have their teeth sorted out, telling women with goiters and men with hernias to come to screening on Saturday, explaining to people that I really did not have any bread or sodas on me, and fending off lifts to all sorts of places from all sorts of people heading around Freetown who thought I might like to go with them. Having white skin sure makes you stand out in a crowd, although somehow the taxi driver manages to walk past me and get to the port gate on foot. He had arrived shortly after 10am, but his car was parked somewhere else because of the container trucks all trying to get in the Port. So his first suggestion was to get a taxi to his taxi (!!) but then we decided to walk it. So we finally set off about half past ten heading towards Aberdeen at the usual painfully slow speed in Freetown. So other than being a little bit hot and bothered all was well until the car cuts out. Actually the first time it cut out and wouldn't turn back on the driver just called some men over and they pushed it so he could restart it so that wasn't too much drama. The second time was more fun as he kept asking people and they all said no, yelling something at him, I think because he was holding up the traffic. It involved people waving arms and hitting the car until finally someone did come to our rescue. The other times it cut out we were on downhill stretches and got it going again. One other thing to mention is they don't have traffic lights here, they generally just have traffic police at every junction, who direct you and pull you over at random (or so it appears to me). My driver had to show his documents to one policeman, then was asked to get out of the car at another junction and had a chat with the police lady, about the passenger tyre or something, anyway in the end he told her he was late, and so off we went again. We finally did arrive in one piece and the journey home was uneventful, he had apparantly sorted out the problem with the starter plugs, or whatever it was and the traffic was actually not too bad considering the time of day. Next week though we're testing whether he will actually arrive at 6am to get me to work by 7am, should be fun!!

you should read this blog

I will be working at the Aberdeen Women's Centre this year alongside a fantastic midwife called Kate and by the sounds of it a really great team - a couple of other international midwives and 10 or so local midwives. They started a birthing centre at the fistula hospital last year which they really want to become a centre of excellence in the area. Since they started they have had over 700 births and not a single maternal death - and yes, by the average numbers in Sierra Leone they should have had a fair few by now. If you read the blog it does sound like an incredibly challenging place to work yet in a different league in terms of care to some of the other units locally, they have up to date policies and protocols in place and are actively striving to be practicing the best possible care within the limitations they have. I'll keep you posted once I have started there, but until then it is really worth reading stories from Kate:
http://blogs.news24.com/KatieChristie

up and running

This week saw the start of surgery in the hospital, the start of eye screenings and eye patients being seen and the first full week for the dentists. Screening was done in the North of the country before the ship arrived and a few hundred people were scheduled for surgery and a few hundred more on a waiting list, so while the next local screening is being planned we still have plenty of work to get us started here in Sierra Leone. The dentists had a very busy week, seeing over 400 patients and extracting about 1100 teeth! The dental and eye screenings are going to be weekly, so although they are busy they are much smaller than the mass screening that took place at the stadium and there has not been any trouble. There is a lot of need here, I was out a lot last week and every time I walked backwards and forwards to the hospital just 10 minutes walk away I was stopped by at least one, usually a couple of people to ask about screening and sharing details of their health problems. We are planning another screening event soon, please specifically pray that the people who come will be those who we can help. There are so many conditions that sadly we are unable to help with and we don't want these people to come hopeful that we can help, just to go away disappointed. The local radio stations will be giving the details of the screening along with some details of what the ship is and is not able to help, so pray that people will take this on board.

beach frisbee against a local team

Yesterday we loaded up a few cars and headed for Lumley Beach to meet a bunch of guys who wanted to play frisbee. They were a youth team, incredibly fit, really good natured and won every game, but our players had a lot of fun anyway! The little boys played in the sand and the sea with some friends from the Ship and some other bigger boys who they met on the beach. I bought a couple of necklaces from the mobile craft market. A few women just walked up, almost buried underneath all the things they were carrying, they didn't say anything to us but just simply unpacked and laid out all their crafts on the sand and then sat down and waited to see if we wanted any. Later on we met the beach security and lifeguards came and said hello, and then another craft seller who gave the boys bead necklaces in the Sierra Leone colours. I was with my friend Natalie, who was dressed in long sleves and longish trousers, at the time reading a book with a t'shirt over her head to protect her skin from the sun. When our new friend discovered she does not yet have a husband he was quite sure she would find one in Freetown and then told her he liked what she was wearing!! This is quite a common event here - being asked about your husband and then having a proposal if you admit not having one yet, but we did laugh afterwards because of Natalies 'highly attractive' attire.

 frisbee on the beach...

 ...while the little ones splashed...

 ...and dug holes...

 ...then we had lunch - while wearing the necklace my new friend (and Natalies future husband) gave Tom...

  ...we watched a ton of people pull this boat out of the water and all the men from our group push a car out of the sand...also a few people walking past with fruit in baskets on their head and the same craft laden ladies come past...and we waited for our lunch, remembering that we are truly back in West Africa and nothing happens very fast around here...

midwifery conference pics

 The midwives are in the pink and the anaethetists and anaesthetic nurses in the orange

 The midwives use songs to teach health promotion, so they sang some for us

 The antenatal clinic where we had some lectures - the buildings were actually in pretty good condition

And the midwifery school where we had most of the midwifery sessions, they had a small computer room, a clinical skills lab with dummies to practice on and a classroom, sadly no running water or flushing toilets though

Academy West African themed art

 This is the current display outside our cabin door

 Toms West African artwork

 Pre-school pictures

Joshua's picture of him and his Daddy

happy red nose day!!

For more info on red nose day see http://www.rednoseday.com/
We hope you all have fun being generous for a good cause. 

Thanks Nanny for our red noses :-)

meeting local midwives

Health care for pregnant women and children under 5 has been free for almost a year now. I have just spent three days with about 30 local midwives at a local conference and have really enjoyed learning from them about the challenges and fustrations of working here. Some of the challenges they face must make working very difficult - it seemed that doctors will often not attend a woman when called, drugs might run out or be locked away somewhere, they are lacking good, knowledgeable role models who are prepared to challenge existing poor practices. It would appear that small changes have been made - the partogram (chart used for a visual summary of clinical information in labour) has recently been introduced and the midwives have some understanding of how to use it. Since the introduction of the free healthcare initiative pregnant women are attending an average of four antenatal appointments, I think this is a big improvement from what was usual previously, although the midwives find this a challenge as it has significantly increased their workload.

I think one of the biggest challenges to improving the midwifery care here is getting the midwives to believe that they can make a difference, that maternal and infant mortality can be reduced, not just by better equipment and fancy resources, but by being more diligent in the basic care of women. Much of the care described to me was based on the idea of 'this is what we have always done and what we all do', rather than what is actually the best care practice. They laughed at ideas of women kneeling to give birth and looked skeptical about the idea of reducing their episiotomy rate on primips. I am excited to be working as a midwife this year, but anticipate that this is the start of a steep learning curve, not only about the practice of midwifery here but how practice is influenced by the wider culture and beliefs.

One for Roger...

I really love our location here in Sierra Leone. Sarah has done a good job of showing you what our berth is like. We have a great view of the Lion Mountains from which Sierra Leone derives its name. We also have some good local wildlife - particularly a number of kites(?) that spend a lot of time near to the dock. I am keen to get some good pictures of them - these are from my first few attempts. Hopefully over the next 9 months I'll get better ones.

Tommy.

Screening update

This is the press release on the Mercy Ships blog about the patient screening that took place yesterday. The crew involved are shaken up, especially those outside seeing what was going on. Tommy and Sam were involved in the security in front and behind the gate and are still processing it all.

"Posted by Mercy Ships staff on Mar 07, 2011 at 12:11 pm

Mercy Ships is deeply saddened by the tragic events that occurred today during medical screening at the Freetown National Stadium when a crowd stormed the gate resulting in several injuries and one life lost.

Mercy Ships personnel working at the site attended the injured and accompanied them to local hospitals.

"Our hearts and prayers are with the individuals and families of those affected by today's events. The occurrence of this incident in the course of activities intended to restore lives is tragic. We move forward with tremendous sadness, but great determination, to assist as many people as possible in the next ten months," stated Mercy Ships Founder, Don Stephens.

Mercy Ships exists to serve the forgotten poor and has served Sierra Leone five times over the past two decades, also helping establish two land-based health care facilities. For the next ten months, Mercy Ships will be providing surgeries for qualified patients while working alongside the Sierra Leonean Government to support its five-year healthcare plan and strengthen the functions of the national health system.

Please keep the people of Sierra Leone and the Mercy Ships crew in your prayers, not just today but in the months to come"

There is an intensly personal account of the day from one of the nurses at the screening on her blog here.

Screening day

Today is screening day - please remember our crew today as they see the many people who will come in the hope they will be scheduled for surgery in the coming weeks and months. The screening is at the stadium in Freetown a little distance away from the ship.  Tommy was assigned to the security team and so was *lucky* enough to be up before 3.30am to arrive first to facilitate some kind of queueing. The high school students and almost all the teachers have the opportunity to go again to help with entertaining the children with bubbles, balloons, balls and colouring. The little ones are in school on board as usual, I am helping with pre-school today as their teacher is at screening so it should be a fun day. We'll let you know what happened at screening soon, but be praying for the crew today, they will need much endurance for the long day and the intense heat and wisdom to know who to schedule for surgery. Thanks.

slideshow of our arrival in SL

check it out here:
http://www.mercyships.org/blog/entry/the-africa-mercy-arrives-in-sierra-leone