Saturday, 30 July 2011

Sidiatu Jollah

Fatmata sat quietly in the Admissions tent cuddling her sixteen-month-old daughter in her lap. She had been searching for over a year for someone to give her some hope that little Sidiatu might have a normal life. Born with congenital cataracts in both eyes, the baby’s blindness required her mother’s undivided attention. Fatmata’s nine-year-old daughter watched the baby when her mother had to go to the market to sell her home-made soup. Like so many other families in Freetown, Fatmata’s husband is currently out of work.

Fatmata had taken Sidiatu to a local hospital for cataract surgery, but it was not successful. A second hospital couldn’t help, either. Finally, she found a local doctor who referred her to an eye screening with Mercy Ships. After the ophthalmologist examined Sidiatu’s eyes, Fatmata received the precious appointment card for her daughter to have cataract surgery on the Africa Mercy.

Sidiatu had the surgery to remove the cataracts on both eyes. Very active and curious, the little girl kept trying to remove the protective bandage. The nurses wrapped her hands to ensure that the protection remained in place.

Early the next morning, the doctor removed the bandages. Those in the ward held their breath as the little girl surveyed the world around her – for the very first time. Anxious to grasp a balloon, she suddenly stopped. Sitting perfectly still, she stared straight ahead in an effort to take it all in. Then, quickly, she closed her eyes. The doctor said that this was a normal reaction. The child’s senses were overwhelmed, and she was returning to a place of comfort – the familiar darkness.

Soon, Sidiatu opened her eyes again. A toothbrush was set before her, and then a toy that was just out of reach. She stretched out her hand to grasp the red and blue truck. A low gasp was audible in the ward. It was obvious – she could see! Tears welled up in the eyes of those who were privileged to witness this miraculous moment. The doctor grinned. A single tear ran down Fatmata’s left cheek.

About an hour later, Sidiatu was dressed and ready to go home to a life that was now in glorious color. Sidiatu’s young life was forever changed. Her loving mother’s hope had been fulfilled.

“It has taken a long time to find a solution,” said Fatmata. “I walked around to many hospitals to find help. I am very, very happy. Mercy Ships is a very good place. They take care and encourage you. Nothing bad about that.”

Story by Elaine B. Winn

Wednesday, 27 July 2011

NYT reports on Sierra Leone

The New York Times have written an article about maternity care here in Sierra Leone. Free healthcare is making a huge difference for pregnant women and babies, but as they hint at in the article there are not really enough staff in place in many places to cope with the increased demand for care.

(you have to click through to the 2nd page at the bottom)

Wednesday, 20 July 2011

some things you never get used to

Well maybe not never, but six months is really not much in terms of getting used to African midwifery, even though Africa is not new to me. Yesterday was just another routine day in antenatal clinic in most respects, but a few things always remind me that this is Africa.

First thing in the morning we all had a good laugh about at shift handover - one of the midwives handed over that one of the woman had a baby boy in the night, to which one of the other midwives said 'are you sure its a boy - its this baby on my lap' and there he was kitted out in bright pink top, bottoms and matching bright pink hat. So we looked and confirmed that he was in fact a boy, probably now with a complex as we all discussed his clothing. That made us all smile, obviously there is kind of unwritten rule here about pink being a girls colour just like elsewhere in the world, I wouldn't have been sure otherwise if they hadn't have said about it!

One of the ladies I saw came into the unit for her second antenatal check - her notes said she was 28 weeks pregnant. I couldn't quite match her size with this information and was unable to find a fetal heart beat. Another midwife came and checked and couldn't find it either. The lady said the baby had not been moving yesterday - so we had a fair number of warning signs that all was not well. We are blessed to have an Obstetrician here at the moment so she took her for a scan wondering if the baby had died- only to discover - she wasn't pregnant (and hadn't been)!! I confirmed this by pregnancy test, just in case we were missing something somewhere but it was negative, so we had to explain to her that there was actually no baby. Quite a bizzarre finding, especially as it wasn't even her first check up!!

Two of us couldn't find a fetal heart beat on another lady, but had she assured us that the baby had been moving about (usually a good sign of the baby being fine). Our Obstetrician did a scan and sadly confirmed that the baby had died and any movement felt was probably related to there being a lot of fluid swishing about. What I can't get used to is that there is no privacy here, there is just not the space for single rooms or anything. We called this lady's family to come and support her, they sat outside with a bunch of other pregnant women waiting for their checks. Later we admitted the lady to the ward to start an induction of labour, and she was just sat on the bed, looking completely shocked, while next to her other Mums were looking after their beautiful babies. I can't really get used to the different way women show emotion here, how there is the expectation that they have to be strong and quiet when things go wrong. Not that I really want them wailing around the unit, given its small size, but it still suprises me that they are not.

One thing that is very different here to in the Uk is that women don't always come the day you ask them to for their antenatal checks. Sometimes maybe for good reasons - some of them have to work hard to earn enough for that days food, some of them because of it being difficult to travel to us, sometimes it just seems like they just decide to come on a different day or at a random time and expect that to be fine. I learnt a lesson the hard way though about not always judging women for coming late. I joked with a woman that she was two months late and her reply was that her three year old had died from convulsions and she had been busy. And that was not the answer I was expecting. I'm not sure how long it will take me to really understand the difficulty women have living here and just how fragile life is.

One lady I met was in her fifth pregnancy, this would be her sixth child. She was very unusual here in that all of them were alive. Looking at women's obstetric histories is actually quite heartbreaking when you see just how many have lost children, but we have to remind ourselves that the unit I am working at is so much better than other's around. It has had many good outcomes with live babies for women that have had two or three stillbirths previously and this is really a reason to be positive amidst it all. Anyway, we are currently able to offer sterilisation (they type where they tie the tubes so that women won't get pregnant again) free of charge so I gently talked with this lady about whether she would want to consider this. I suggested she talked with her husband to see if it was something they would want to consider and that I could give her the paperwork next time. She told me how hard life was, how difficult it was caring for and providing for her 5 children and how she really didn't want any more after this one. She said her husband would be overjoyed to know that this option would be possible and that Praise God, He has answered her prayers - there is a solution to her keep getting pregnant that she didn't know about. She was ready to sign there and then! That made me smile, but I assured her there was plenty of time and that next time would be fine once she had talked to her husband!

Sorry that these thoughts and encounters with women at work are all a bit random and disjointed - much of clinic is pretty dull and I get fustrated with the numbers of women coming. For most of them it is just the same checks, the same medicines, the same advice.... But it is through good, regular antenatal care that we are able to promote better health and pick up any warning signs along the way. I have to remind myself that it is just as important as being a good birthing midwife and when it is my turn run clinic with a smile anyway, just with less jokes about women who come late.

Thursday, 14 July 2011

palliative care

Harriet is a friend who also works off the ship, doing a job most people really wouldn't want to do. She travels out and about supporting families of people who we couldn't help surgically, often because of advanced cancer. She writes about her work, plus earlier in the year had lots of blogs with pcitures from her driving around so it is a great one to check out and see a different aspect of our work here.
 Her latest blog is my favourite though, and this will take you directly to the story of one family Harriet has become friends with

Friday, 8 July 2011

Summer programme

For a few weeks out of the summer holidays the boys are entertained by the summer programme. Our friends from two years ago, the Zupke family, are leading the team and have all sorts of fun happening. Each week they have a day out somewhere, the first week they went to the beach and then last week the chimp sanctuary and a waterfall. They do a ton of crafts, scavenger hunts, pool trips and all sorts. The older children (well all except the pre-school kids) are also spending time each week at the HOPE centre (as mentioned in our previous post) and also on the wards here on the ship. I would love to be a fly on the wall watching them interact with our patients. Tom says they have been doing crafts with them and I found a few pictures of them (taken by the ship photographer as crew are not allowed to take pictures in the wards) in action:
 So many families have left or are away this is all the kids in summer programme this year, ranging from Josh (in his stripey Ghana top) and his pre-school friends up to the junior high school
 Tom helping with craft work on the ward
 This is the other Josh in the school playing Jenga with patients
 Josie and Jessica building bricks
Shaun and his friend showing the finished craft work

the Zupke family posted some different pictures:

You can also check out their other blog posts as the summer programme progresses to see what our boys are up to:

Wednesday, 6 July 2011

Missing Sam and Amy

Sam and Amy (Sarah's brother and Sister in Law) left the ship a few weeks ago. We just found these photos on our camera.
 This was just before they left the Ship. We REALLY want to hear if Sam is ever brave enough to ever wear these trousers anywhere outside Africa so let us know if you see them!
 This is one we took for Amy - on July 4th we had a BBQ on the dock, (complete with balloons) to celebrate withour American crew! We spent July 4th with Sam and Amy in Texas in 2008, in Benin in 2009 and in Chicago in 2010. We missed them this year!

Friday, 1 July 2011

HOPE centre

You may remember us describing our previous off-ship housing in the 'hospitality centre' in both Benin and Togo. This year we have an off ship facility just a couple of minutes walk from the Ship, they changed it's name from Obama City to the HOPE (Hospital Out Patient Extension) centre. The idea of this is that people who travel a long way to come to us can be housed off ship for a night or two while they wait for surgery or in between their outpatient appointments after their surgery. With limited hospital beds on board, this allows us to use the hospital beds for those who really need them, rather than having people stay in them for weeks on end. The HOPE centre has a/c sleeping areas with beds under mosquito nets and those who stay get to eat local food cooked on site. When our family went last week there was some basic health teaching given to the adults while we were playing play dough with the children. The boys found some other boys to play football with and they all had a good time (despite the combination of Toms competitiveness and his opponents being on crutches which we thought might not be the best combination).

A picture of Tom's summer programme group on the way to the HOPE centre on here:

Some pictures of patients at the HOPE centre by one of our photographer friends when he was here: