…At least not in Freetown. We’re a balmy 31oC when I’m told that Elgin in Scotland was -18oC last night. I now have an office at work. It comes with an air-conditioning unit (who paid for this I wonder? And why? Why did they not put the money into something more useful like another doctor or nurse?). Anyway, its there, so on it went. I have acclimatised enough to feel cold when it is set at 27oC…. So not sure how I would fare in the UK just now!
Apparently it’s Christmas in 3 days time. It seems to have bypassed me a bit this year. Mostly because I have already had my holidays so am now back to work. Also – its just strange being warm at Christmas. There are a few decorations about but they look decidedly out of place. The hospital’s actually pretty quiet just now – although this is a relative term (I am told that parents keep their children at home at Christmas time even longer than usual – which is saying something). Strange thinking back to this time last year when I was an Acute Reg in the JRH looking after all those bronch babies! There are actually babies with bronchiolitis here – its just that they get treated as pneumonia (i.e. with antibiotics) because according to the WHO cough + fever + tachypnoea = pneumonia. Dr Hull would not be happy. Hopefully happier to know that I go around crossing off all the steroids prescribed for them….!
I am having a happier week than some weeks. None of the children I am actively looking after have died so far. Even the boy who has been unconscious with cerebral malaria for 4 days is still alive at the moment (although clearly it will take a small miracle for him to survive). I’ve even helped to make a few patients better – if the child is better the Mums say “I tell God tenki” which means “Thanks be to God” which is so lovely to hear.
Many thanks for all your Christmas wishes. Mum told me this evening that lots of people have sent cards. Many thanks for these in advance. Unfortunately none of them have arrived! I’ll keep you posted when they do! I’m actually spending Christmas Day on the beach – hopefully having lobster for dinner!
So, from warm and sunny Freetown, I wish you all a very Happy Christmas and all the very best wishes for the New Year!
Wednesday 22 December 2010
Monday 20 December 2010
Sunday 19 December 2010
Holidays!
I’ve had a brilliant and perfect two weeks as Andy came to visit SL (and me, obviously!) I took the two weeks off work so we could spend time together, relax and see a bit more of the country.
As my facebook status said, I could have burst with excitement before he arrived! The plane was delayed unfortunately but everything else went to plan and I met him at the Pelican Water Taxi. He had brought lots of presents – contact lens solution, shampoo, conditioner, shower gel, dried herbs including basil (which you can’t get here), Worcester sauce (which you can, but is really expensive), some DVDs and nice mail and photos from people at home. Many thanks for all your gifts.
We spent the first couple of days relaxing around Freetown – visiting Lumley Beach, Big Market and other sights in the centre of town, and had some fun introducing Andy to the “interesting” public transport system here (see previous blog entries for details on this). We also got to do some fun things for me like eating out in Crown Bakery (choc croissants!) and dinner at Country Lodge (real red wine!)
Tacugama Chimpanzee Sanctuary
We stayed the night at Tacugama, in their beautiful, and romantic treehouse. It also had the advantage (for Andy) of being relatively cool. I even had to have a blanket in bed for the first time in months! Whilst there, we did a couple of walks, including to Charlotte Falls, and of course, the tour of the chimp sanctuary! It was set up 15 years ago, mainly to rescue chimps which had been used as pets; the aim being, eventually, to integrate them back into a normal chimp family. There are currently about 100 chimps in the sanctuary, in different enclosures depending on how well integrated they are. They are amazingly human-like (although much better at acrobatics than us!) and I could have watched them all day. We had a lovely evening eating a Basha chicken with rice and veg on the balcony with a half bottle of wine that Andy got from the plane.
The Hospital
I wanted Andy to see the hospital so he can picture it when I am chatting about it. We had to actually get there first! I decided it would be easier to walk from the town centre than try to get a very slow moving taxi or poda poda there so we walked through the crazy mad streets of PZ in the East End of town, opted to take the slightly longer route of Kissy Road (as it has, at least by some definition of the word, pavements! Unlike Fourah Bay Road, which has sewers where you would expect the pavements to be) and finally arrived at the hospital. I showed Andy around, introducing him to the staff while he snapped away taking photos for me. Everyone was so nice and welcoming to him and were delighted that he was visiting.
It was also Meike and Nadine’s last day at work so we went to their leaving party, held in the library. We started with Christian and Muslim prayers, then everyone feasted on cassava leave with rice and washed it down with a Fanta. Lots of snapping of photos later, then we all piled into the Cap Anamur Land Cruiser for the journey home.
Sugar Loaf Mountain
So, the adventure up the mountain. I fear that I have now had so many adventures up mountains (I’m thinking Mt Mulanje, the volcano Pacaya, Ben Lomond, only to name a few Ros!) that maybe I should stop having adventures up mountains!
I had organised for a large group of us (first two mistakes – don’t have too big a group, and don’t actually organise anything or its bound to go wrong!) to climb Sugar Loaf. Unfortunately we sort of went up the wrong path (is this sounding familiar to anyone Ros?!) and ended up bashing through the bush to actually find the correct path. By this time we had been climbing for three solid hours. So while Beth, Tash, Alex, Ollie and Marcus continued up the hill, Andy and I made the executive decision to take the all the stragglers back down to the cars. A wise decision I think as everyone made it back down safely with no broken ankles or hypothermia (not that that would really be possible here) or dehydration. And we were back in time for a brilliant Mamba Point Lunch.
Hamilton BeachAndy and I had a lovely few hours at Hamilton Beach, where on the 12th December, we sat out in the sun, swum in the Atlantic Ocean and ate fresh barracuda grilled to order on the barbeque. Andy alas got burned (sorry – I take the blame for the areas of missed sunscreen!) but we got some good photos of the pair of us for Christmas cards at home which Andy has been organising.
Tiwai Island
Following an interesting journey to get there (our hired landrover broke down and we became a tourist attraction for the kids in a small village for about 4 hours, before our driver realised – having sent a mechanic off to Bo with Le100,000 of his own money – that he could drive it in 4 wheel drive, so we carried on again – which must have looked truly bizarre to the children in the village) we finally arrived quite late at Tiwai. Its in a really beautiful spot, very jungley (actually I don’t think that’s a word, but you know what I mean). We stayed in a ready-pitched tent complete with a mattress inside – fairly luxury for camping if you ask me. There was even a working shower (although it was “dribbly” as Andy described it).
We woke early the next morning for the forest walk before breakfast. Expecting this to last about an hour, we were back for breakfast a full two and a half hours later! On the walk we were able to see three different kinds of monkeys, and a huge variety of flora which our guide expertly pointed out. Tiwai is “famous” for having pygmy hippos. They are very shy, only come out a night, and although I believe there are two in London Zoo, they are indigenous only to Sierra Leone, Guinea, Liberia and the Ivory Coast (all the top tourist destinations of West Africa then. I’m kidding obviously.) Alas we didn’t see any.
In the afternoon we had a great boat trip up the river, spotted some birds, some more monkeys, and marvelled at our guide’s command of both English and the Latin names for various trees and plants, especially as he had never been to school.
Dinner was served at a remarkably early 4.30pm (we managed to stave off till 5pm!) so then had an early night before the long (and thankfully less eventful) trip back home.
IMATT
Wonderful IMATT! I have such a lovely time whenever I go there. The one RAF officer there invited us up for dinner so he could get some air force chat. He and his wife were so incredibly hospitable; we had a wonderful meal and great company, as Frankie and Howard (ex-VSOs who stayed on) had also joined us, along with the IMATT doctor and another army officer, who, bizarrely has a cousin from Shetland who I know! It was a really great evening and was a bit like being transported back to the UK (they have a bath! With hot and cold running water!)
Back to Reality
So Andy’s just gone – he did get back by the skin of his teeth though. All the flights home since Friday have been cancelled as Heathrow is closed. So there are a number of stranded VSOs who were looking forward to going home for Christmas. Keep your fingers crossed for them that they manage to get back and enjoy time with their loved ones too. Back to beans and rice for dinner for me. Back to work tomorrow. Back to the daily challenge of getting to and from work. Back to the dying babies. Hopefully also, back to making some of them better, and training the nurses and doctors here to do the same.
As my facebook status said, I could have burst with excitement before he arrived! The plane was delayed unfortunately but everything else went to plan and I met him at the Pelican Water Taxi. He had brought lots of presents – contact lens solution, shampoo, conditioner, shower gel, dried herbs including basil (which you can’t get here), Worcester sauce (which you can, but is really expensive), some DVDs and nice mail and photos from people at home. Many thanks for all your gifts.
We spent the first couple of days relaxing around Freetown – visiting Lumley Beach, Big Market and other sights in the centre of town, and had some fun introducing Andy to the “interesting” public transport system here (see previous blog entries for details on this). We also got to do some fun things for me like eating out in Crown Bakery (choc croissants!) and dinner at Country Lodge (real red wine!)
Tacugama Chimpanzee Sanctuary
We stayed the night at Tacugama, in their beautiful, and romantic treehouse. It also had the advantage (for Andy) of being relatively cool. I even had to have a blanket in bed for the first time in months! Whilst there, we did a couple of walks, including to Charlotte Falls, and of course, the tour of the chimp sanctuary! It was set up 15 years ago, mainly to rescue chimps which had been used as pets; the aim being, eventually, to integrate them back into a normal chimp family. There are currently about 100 chimps in the sanctuary, in different enclosures depending on how well integrated they are. They are amazingly human-like (although much better at acrobatics than us!) and I could have watched them all day. We had a lovely evening eating a Basha chicken with rice and veg on the balcony with a half bottle of wine that Andy got from the plane.
The Hospital
I wanted Andy to see the hospital so he can picture it when I am chatting about it. We had to actually get there first! I decided it would be easier to walk from the town centre than try to get a very slow moving taxi or poda poda there so we walked through the crazy mad streets of PZ in the East End of town, opted to take the slightly longer route of Kissy Road (as it has, at least by some definition of the word, pavements! Unlike Fourah Bay Road, which has sewers where you would expect the pavements to be) and finally arrived at the hospital. I showed Andy around, introducing him to the staff while he snapped away taking photos for me. Everyone was so nice and welcoming to him and were delighted that he was visiting.
It was also Meike and Nadine’s last day at work so we went to their leaving party, held in the library. We started with Christian and Muslim prayers, then everyone feasted on cassava leave with rice and washed it down with a Fanta. Lots of snapping of photos later, then we all piled into the Cap Anamur Land Cruiser for the journey home.
Sugar Loaf Mountain
So, the adventure up the mountain. I fear that I have now had so many adventures up mountains (I’m thinking Mt Mulanje, the volcano Pacaya, Ben Lomond, only to name a few Ros!) that maybe I should stop having adventures up mountains!
I had organised for a large group of us (first two mistakes – don’t have too big a group, and don’t actually organise anything or its bound to go wrong!) to climb Sugar Loaf. Unfortunately we sort of went up the wrong path (is this sounding familiar to anyone Ros?!) and ended up bashing through the bush to actually find the correct path. By this time we had been climbing for three solid hours. So while Beth, Tash, Alex, Ollie and Marcus continued up the hill, Andy and I made the executive decision to take the all the stragglers back down to the cars. A wise decision I think as everyone made it back down safely with no broken ankles or hypothermia (not that that would really be possible here) or dehydration. And we were back in time for a brilliant Mamba Point Lunch.
Hamilton BeachAndy and I had a lovely few hours at Hamilton Beach, where on the 12th December, we sat out in the sun, swum in the Atlantic Ocean and ate fresh barracuda grilled to order on the barbeque. Andy alas got burned (sorry – I take the blame for the areas of missed sunscreen!) but we got some good photos of the pair of us for Christmas cards at home which Andy has been organising.
Tiwai Island
Following an interesting journey to get there (our hired landrover broke down and we became a tourist attraction for the kids in a small village for about 4 hours, before our driver realised – having sent a mechanic off to Bo with Le100,000 of his own money – that he could drive it in 4 wheel drive, so we carried on again – which must have looked truly bizarre to the children in the village) we finally arrived quite late at Tiwai. Its in a really beautiful spot, very jungley (actually I don’t think that’s a word, but you know what I mean). We stayed in a ready-pitched tent complete with a mattress inside – fairly luxury for camping if you ask me. There was even a working shower (although it was “dribbly” as Andy described it).
We woke early the next morning for the forest walk before breakfast. Expecting this to last about an hour, we were back for breakfast a full two and a half hours later! On the walk we were able to see three different kinds of monkeys, and a huge variety of flora which our guide expertly pointed out. Tiwai is “famous” for having pygmy hippos. They are very shy, only come out a night, and although I believe there are two in London Zoo, they are indigenous only to Sierra Leone, Guinea, Liberia and the Ivory Coast (all the top tourist destinations of West Africa then. I’m kidding obviously.) Alas we didn’t see any.
In the afternoon we had a great boat trip up the river, spotted some birds, some more monkeys, and marvelled at our guide’s command of both English and the Latin names for various trees and plants, especially as he had never been to school.
Dinner was served at a remarkably early 4.30pm (we managed to stave off till 5pm!) so then had an early night before the long (and thankfully less eventful) trip back home.
IMATT
Wonderful IMATT! I have such a lovely time whenever I go there. The one RAF officer there invited us up for dinner so he could get some air force chat. He and his wife were so incredibly hospitable; we had a wonderful meal and great company, as Frankie and Howard (ex-VSOs who stayed on) had also joined us, along with the IMATT doctor and another army officer, who, bizarrely has a cousin from Shetland who I know! It was a really great evening and was a bit like being transported back to the UK (they have a bath! With hot and cold running water!)
Back to Reality
So Andy’s just gone – he did get back by the skin of his teeth though. All the flights home since Friday have been cancelled as Heathrow is closed. So there are a number of stranded VSOs who were looking forward to going home for Christmas. Keep your fingers crossed for them that they manage to get back and enjoy time with their loved ones too. Back to beans and rice for dinner for me. Back to work tomorrow. Back to the daily challenge of getting to and from work. Back to the dying babies. Hopefully also, back to making some of them better, and training the nurses and doctors here to do the same.
Saturday 4 December 2010
A Photo - Hopefully!
Oops I forgot to add the photo (kindly taken by Alex) to the last blog - hopefully it will work this time!
Birthday Week
Birthday Week
Its been a good week (especially in comparison to last). It was my birthday on Wednesday; thanks to everyone for your lovely messages. I was teaching the students in the morning and they sung Happy Birthday to me! In fact I was also sung to by lots of the nursing staff. Tash and Alex had come to town to visit the hospital so we had a treat of fried chicken in bread for lunch (makes a change from laughing cow cheese in bread). I managed to do remarkably little work the rest of the day (apart from walking in on an attempted – and failed – resuscitation of a child who had come in gasping). Dying children were not what I wanted on my birthday so I avoided ER and ICU for the rest of the day.
We went to Mamba Point Restaurant for dinner – Carole and I shared a fantastic selection of prawn tempura, fish carpaccio and a Mexican salad, all washed down with a bottle of real red wine (I say “real” as we often drink somewhat dodgy but none-the-less drinkable red wine from a carton – and this was from a proper bottle). Becky had made a fantastic and very chocolaty cornflake cake with M&Ms (the most chocolate I have had in several months) which came out with huge sparklers on top. It was a brilliant evening and would just have taken my husband being there to make it perfect.
ICU
On Thursday when I arrived on ICU I asked the nursing staff if they were particularly worried about any patients. They promptly pointed me in the direction of a dehydrated and lethargic boy (who thankfully became a lot less lethargic when we started poking needles into him) and a pale and lethargic girl (also not so lethargic when she had her blood sugar checked). This was good as usually the lethargic children here are really properly lethargic – as in they are unconscious – which the next girl turned out to be. Blood sugar 0.6. Weak, thready pulse. Not responding to painful stimulus. She had been admitted the evening before and diagnosed with severe malaria (without a paracheck or malaria slide – as is usual here) and had been transfused with blood but not given any antimalarials…. Several boluses of dextrose, saline and blood (and some antimalarials…) later and in the afternoon she was sat up eating an orange. It was brilliant, especially after last week when I watched four children deteriorate and die in front of my eyes. It was terrible – one baby who had presented with a TWO WEEK history of cough and difficulty breathing – she died within a few hours of admission from severe pneumonia. Who in the UK would watch their child have severe breathing difficulty for two weeks before going to see a doctor? Its so so sad. Another child died of sepsis secondary to an infected injection site. And another two from severe malaria (presumably). I really was starting to feel like the Angel of Death last week. I ask the nurses to prioritise the sickest patients to see first on the ward rounds and spend a lot of time with those patients. Its something I’ve found mentally and emotionally very difficult, especially making the call to stop resuscitating (which of course I never have to do by myself in the UK). We obviously have no proper ICU facilities (1-2l/min of nasal cannulae oxygen is the best we can offer) so you can only get so far down the resuscitation algorithms before knowing there’s nothing else to do. Medically its not a difficult decision, but emotionally its tough.
ETAT Teaching
Also on Thursday Fred and I did some resuscitation scenario-based teaching with the medical officers. It was a good laugh and everyone participated well. Fred played the candidate while I was the instructor as a demonstration for them (scenario-based teaching not something they do much of here). We kept to simple stuff – how to triage, why to triage and that sort of thing. I have a series of interactive lectures called “Emergency Triage and Treatment Plus” which are brilliant for teaching that basic things done well can save lives. Hopefully next time the medical officers will do the scenarios themselves. I will keep you posted.
How to Really Save a Life!
So the way that our blood bank works is that the technicians will give a unit (or however-much) of blood for a pikin (child) if the family provide a donor to replace the blood that they use. A fairly sensible system (the blood is then checked for HIV etc and thrown away if positive). Unfortunately they won’t accept blood from lactating women. Many families are also scared of donating so go and find someone from the street and pay them to donate on their behalf. If it is really an emergency I sometimes send Sandra (from Welbodi) off to the blood bank with the mother, as they are much more likely to give her blood as a priority without waiting for a donor first. We did this twice yesterday (for the same child – who was still alive when I left yesterday having had two episodes of massive haematemesis), so in return Sandra and I went off to donate some blood. A very surreal experience and absolutely nothing like donating in the UK (apart from the massive needle!) He did try to check our PCVs but the centrifuge spun our samples out. He didn’t bother to ask if we were pregnant or lactating either! Anyway, we were treated to some Christmas cheesy music whilst donating and given some free water to rehydrate afterwards (no biscuit though). Cat and Becky had donated last week and Cat even got to hang up her own unit of blood for a child – who was sitting up and eating popcorn the next morning! (So anyone in Freetown reading this, come and donate blood. Anyone at home reading this, go and donate blood).
The IMATT Christmas Party
So minus my unit of blood we went Up the Hill to amazing IMATT for their wonderful Christmas Party. It was brilliant – Christmas tree, cheesy music, even some decorations floating in their swimming pool. The food was ace (barbequed lobster – oh wow!) and the company better. The IMATT people are incredibly hospitable. They live in the lap of luxury (comparatively) and think that VSOs are a bit mad for volunteering (especially as a lot of VSOs live without running water and electricity) so they like looking after us (I think they also like meeting nice young pretty girls….!) Becky and I entered in syndicate into the “Money tree” and amazingly won Le 200,000 between us! This is just over £30 and you should have seen how excited we were! A very fine night indeed.
Bliss Christmas Fair
The morning we headed to Bliss for the Christmas Fair in aid of St Joseph’s school for the hearing impaired in Makeni. Zoe and Theo were volunteering at the “guess the weight of the cake” and “guess how many skittles in the jar” stand. I pondered long and hard over how heavy the cake was in comparison to preterm babies. I guessed 1325g – and guess what! - I just found out I won! All I need now is the Spanish Air Traffic Controllers to stay at work and get my husband here tomorrow and it’ll be the perfect weekend!
Its been a good week (especially in comparison to last). It was my birthday on Wednesday; thanks to everyone for your lovely messages. I was teaching the students in the morning and they sung Happy Birthday to me! In fact I was also sung to by lots of the nursing staff. Tash and Alex had come to town to visit the hospital so we had a treat of fried chicken in bread for lunch (makes a change from laughing cow cheese in bread). I managed to do remarkably little work the rest of the day (apart from walking in on an attempted – and failed – resuscitation of a child who had come in gasping). Dying children were not what I wanted on my birthday so I avoided ER and ICU for the rest of the day.
We went to Mamba Point Restaurant for dinner – Carole and I shared a fantastic selection of prawn tempura, fish carpaccio and a Mexican salad, all washed down with a bottle of real red wine (I say “real” as we often drink somewhat dodgy but none-the-less drinkable red wine from a carton – and this was from a proper bottle). Becky had made a fantastic and very chocolaty cornflake cake with M&Ms (the most chocolate I have had in several months) which came out with huge sparklers on top. It was a brilliant evening and would just have taken my husband being there to make it perfect.
ICU
On Thursday when I arrived on ICU I asked the nursing staff if they were particularly worried about any patients. They promptly pointed me in the direction of a dehydrated and lethargic boy (who thankfully became a lot less lethargic when we started poking needles into him) and a pale and lethargic girl (also not so lethargic when she had her blood sugar checked). This was good as usually the lethargic children here are really properly lethargic – as in they are unconscious – which the next girl turned out to be. Blood sugar 0.6. Weak, thready pulse. Not responding to painful stimulus. She had been admitted the evening before and diagnosed with severe malaria (without a paracheck or malaria slide – as is usual here) and had been transfused with blood but not given any antimalarials…. Several boluses of dextrose, saline and blood (and some antimalarials…) later and in the afternoon she was sat up eating an orange. It was brilliant, especially after last week when I watched four children deteriorate and die in front of my eyes. It was terrible – one baby who had presented with a TWO WEEK history of cough and difficulty breathing – she died within a few hours of admission from severe pneumonia. Who in the UK would watch their child have severe breathing difficulty for two weeks before going to see a doctor? Its so so sad. Another child died of sepsis secondary to an infected injection site. And another two from severe malaria (presumably). I really was starting to feel like the Angel of Death last week. I ask the nurses to prioritise the sickest patients to see first on the ward rounds and spend a lot of time with those patients. Its something I’ve found mentally and emotionally very difficult, especially making the call to stop resuscitating (which of course I never have to do by myself in the UK). We obviously have no proper ICU facilities (1-2l/min of nasal cannulae oxygen is the best we can offer) so you can only get so far down the resuscitation algorithms before knowing there’s nothing else to do. Medically its not a difficult decision, but emotionally its tough.
ETAT Teaching
Also on Thursday Fred and I did some resuscitation scenario-based teaching with the medical officers. It was a good laugh and everyone participated well. Fred played the candidate while I was the instructor as a demonstration for them (scenario-based teaching not something they do much of here). We kept to simple stuff – how to triage, why to triage and that sort of thing. I have a series of interactive lectures called “Emergency Triage and Treatment Plus” which are brilliant for teaching that basic things done well can save lives. Hopefully next time the medical officers will do the scenarios themselves. I will keep you posted.
How to Really Save a Life!
So the way that our blood bank works is that the technicians will give a unit (or however-much) of blood for a pikin (child) if the family provide a donor to replace the blood that they use. A fairly sensible system (the blood is then checked for HIV etc and thrown away if positive). Unfortunately they won’t accept blood from lactating women. Many families are also scared of donating so go and find someone from the street and pay them to donate on their behalf. If it is really an emergency I sometimes send Sandra (from Welbodi) off to the blood bank with the mother, as they are much more likely to give her blood as a priority without waiting for a donor first. We did this twice yesterday (for the same child – who was still alive when I left yesterday having had two episodes of massive haematemesis), so in return Sandra and I went off to donate some blood. A very surreal experience and absolutely nothing like donating in the UK (apart from the massive needle!) He did try to check our PCVs but the centrifuge spun our samples out. He didn’t bother to ask if we were pregnant or lactating either! Anyway, we were treated to some Christmas cheesy music whilst donating and given some free water to rehydrate afterwards (no biscuit though). Cat and Becky had donated last week and Cat even got to hang up her own unit of blood for a child – who was sitting up and eating popcorn the next morning! (So anyone in Freetown reading this, come and donate blood. Anyone at home reading this, go and donate blood).
The IMATT Christmas Party
So minus my unit of blood we went Up the Hill to amazing IMATT for their wonderful Christmas Party. It was brilliant – Christmas tree, cheesy music, even some decorations floating in their swimming pool. The food was ace (barbequed lobster – oh wow!) and the company better. The IMATT people are incredibly hospitable. They live in the lap of luxury (comparatively) and think that VSOs are a bit mad for volunteering (especially as a lot of VSOs live without running water and electricity) so they like looking after us (I think they also like meeting nice young pretty girls….!) Becky and I entered in syndicate into the “Money tree” and amazingly won Le 200,000 between us! This is just over £30 and you should have seen how excited we were! A very fine night indeed.
Bliss Christmas Fair
The morning we headed to Bliss for the Christmas Fair in aid of St Joseph’s school for the hearing impaired in Makeni. Zoe and Theo were volunteering at the “guess the weight of the cake” and “guess how many skittles in the jar” stand. I pondered long and hard over how heavy the cake was in comparison to preterm babies. I guessed 1325g – and guess what! - I just found out I won! All I need now is the Spanish Air Traffic Controllers to stay at work and get my husband here tomorrow and it’ll be the perfect weekend!
Monday 22 November 2010
Hospital Life
Despite only having had my medical registration for two weeks, I had actually been “working” on Ward 1 for several weeks before that. “Working” meaning doing the ward rounds with the Sierra Leonean medical officer, reviewing patient with them, making management decisions, sending children home. Basically everything apart from actually signing prescriptions and doing procedures.
Having now got my registration I can now (ethically and legally) sign prescriptions and have managed to put in a total of one cannula (the nurses put in most of them, they just get a doctor if they’re struggling).
Ward 1
Ward 1 is for the more “stable” children. There are usually about 50 patients on the ward to see on the round, which is hard work. No one really gets a proper clerk in when they are seen in emergency…. So there is a lot of guesswork going on… The main diagnoses are “severe malaria”, “severe malaria with severe anaemia”, “diarrhoea with severe dehydration” and “severe pneumonia”. Also the occasional sickle cell crisis (accompanied by severe malaria) or “query meningitis”. Also we’ve recently had a measles outbreak. The lack of proper clerk-ins and proper history taking is frustrating. Frustrating also as, without an interpreter, I can’t do a full history (although I can get by with the basics of fever/vomiting/diarrhoea/etc). It would all be a lot easier if they got a proper history taken by whoever sees them first!
There are some great nurses on ward 1 although they’re terribly disorganised. The crazy pharmacy system doesn’t help – the doctor prescribes the medication on one drug chart, the nurses on the ward round copy this onto another bit of paper, which the doctor then signs. The nurses take this to one of two pharmacies and pick up a supply of medication, supposedly to last two days. The parents keep the drugs (and needles and syringes…) in a bag by the child’s bed so you have to check whether they’ve got enough every day. Then when the nurse actually gives the medication they write out a whole new list on a completely separate chart! Its absolutely mad and I have never come across a child yet who has had their full amount of prescribed drugs given to them. Its so sad when we do actually have the drugs here!
FrustrationsLast week I moved onto ICU. Or at least partly moved onto ICU. After we finally finished that ward round (at 2pm – the medical officer was 2 hours late…), Johnny the nurse from ward 1 came to find me and said there was no doctor on ward 1 at all and could I come to see those patients!
(Just to clarify here – I am not on the medical officers’ rota, and the idea is that I am supposed to be working WITH them and not INSTEAD of them (we’re into “sustainable” development here) – there are enough of them to cover a ward each).
It was somewhat soul-destroying and I asked him to triage their sickest patients and take them to ER to be reviewed by a doctor. The following day (a Muslim holiday) I was sure there would be no doctor covering ward 1 so went back there. Although most of the children hadn’t been seen in a shocking 4-5 days (!) thankfully most were fine and I got to send a lot of them home.
With my limited Krio it takes me much longer to see patients than the doctors here (and I’m much more thorough too – although obviously I’m biased!) so the ward rounds are soul-destroyingly long. Its really really hard work being on the wards all the time – its very hot and sweaty. I also have to do something I never have before – to check that the children are actually getting the medical they are prescribed! It’s a bizarre (and really really sad) thing, seeing quinine written up twice a day and finding they haven’t received it for 36+ hours.
I enjoy seeing the individual patients though and get the instant reward of being able to treat them and although the mortality figures are shockingly high I have been involved with a few little miracles, which keeps up the morale.
An Inspiring Afternoon
Last week the Welbodi team directors were here visiting from the UK (The Welbodi Partnership is a UK-based NGO working to improve standards of child health care in ODCH by providing equipment, training and developing the postgraduate paediatric training system). I joined them and one of the SL medical officers (Ish) for a brainstorming session on ideas to reduce child mortality. The mortality rate is currently about 13% for the whole hospital, 34% for SCBU. It was a really inspiring session and brilliant to get Ish’s point of view on everything. He has just passed the first part of his postgraduate exams and he helped to set up Welbodi, along with a British medical student (now ST1 in paeds).
We then went for a wander around the slum behind the hospital. Unbelievably grim it was. Open sewers everywhere, you really had to watch where you put your feet! Houses so tightly packed together, flies and mosquitoes all around. Lots of open fires. Its no wonder we see so much malaria/TB/diarrhoea/burns. We met with the chief and sat with him and a number of others and asked their opinions of the hospital. They had so much to say about the hospital and it was so interesting to hear from them directly. They had concerns that, even though health care is supposed to be free, they were still being asked for bribes by the nursing staff! They also felt they were not treated with respect and their concerns dismissed unless a child was in extremis. It was really interesting (and sad) to hear all their points of view and how vehemently they expressed their opinions. These people were certainly not apathetic about their children’s health and health care!
Some Interesting Stats (pulled from the WHO Sierra Leone Country Cooperation Strategy Paper 2008-2013)
Sierra Leone ranks as the least developed country in the world, based on its 2007 Human Development Report ranking of 177 out of 177 countries. The country is extremely resource poor. With a GDP per capita (PPP) of US$ 700; it ranked 102 out of 108 countries in the Human Poverty Report, with Human Poverty Index (HPI) of 51.72. Nearly half of the working age population engages in subsistence agriculture.
With an under-five mortality rate of 267/1000 live births, Sierra Leone has the highest
under-five mortality in the world, and malaria is the number one cause of deaths. For the entire population, malaria burden is very heavy: malaria cases were more than 500 per 1000 population in 2003 and about 330 per 1000 in 2007. The disease accounted for about half (48%) of all outpatient consultations, and remains a major threat to socioeconomic development. In children under five years, the disease accounted for 50%-60% of all admissions, and about a third of the children may die (case fatality rate of between 16%-33%).
HIV and AIDS are fast becoming threats to social and economic development in Sierra Leone. The national sero-prevalence survey conducted in 2005 estimated a rate of 1.53% compared to 0.9% in 2002. The highest prevalence among women occurred in the 20-24 years age group (2.0%) whereas males between 35-39 years had the highest prevalence (3.5%). Prevalence in urban areas was 2.1% compared to 1.3% in rural areas, and about 47% of the total numbers of infections were new infections.
The burden of tuberculosis is increasing in Sierra Leone. Between 2004 and 2007, the number of registered TB cases in the country almost doubled, in spite of a case detection rate of about 50% (the WHO target is 75%). This is further complicated by the recent emergence of multi-drug resistant tuberculosis (MDR-TB). The TB/HIV co-infection is also an issue of concern: the prevalence of rate TB/HIV co-infection is 11.6%. However, the defaulter rate has been declining and the treatment success rate has increased, from 83% in 2004 to 87% in 2007.
Sierra Leone is ranked as having the highest under-five mortality rate in the world, with almost one out of every three children dying before reaching the age of five.
The trend has not changed significantly in the past eight years. The three main causes of under-five mortality are malaria, diarrhoea and pneumonia and they account for
over a quarter of all childhood deaths. Malnutrition plays a significant role, as 57% of the deaths would not have occurred if the children were not malnourished. Neonatal death accounts for 20% of the overall under-five mortality rate, an indication of poor quality care during labour, delivery, and immediate postnatal period.
Having now got my registration I can now (ethically and legally) sign prescriptions and have managed to put in a total of one cannula (the nurses put in most of them, they just get a doctor if they’re struggling).
Ward 1
Ward 1 is for the more “stable” children. There are usually about 50 patients on the ward to see on the round, which is hard work. No one really gets a proper clerk in when they are seen in emergency…. So there is a lot of guesswork going on… The main diagnoses are “severe malaria”, “severe malaria with severe anaemia”, “diarrhoea with severe dehydration” and “severe pneumonia”. Also the occasional sickle cell crisis (accompanied by severe malaria) or “query meningitis”. Also we’ve recently had a measles outbreak. The lack of proper clerk-ins and proper history taking is frustrating. Frustrating also as, without an interpreter, I can’t do a full history (although I can get by with the basics of fever/vomiting/diarrhoea/etc). It would all be a lot easier if they got a proper history taken by whoever sees them first!
There are some great nurses on ward 1 although they’re terribly disorganised. The crazy pharmacy system doesn’t help – the doctor prescribes the medication on one drug chart, the nurses on the ward round copy this onto another bit of paper, which the doctor then signs. The nurses take this to one of two pharmacies and pick up a supply of medication, supposedly to last two days. The parents keep the drugs (and needles and syringes…) in a bag by the child’s bed so you have to check whether they’ve got enough every day. Then when the nurse actually gives the medication they write out a whole new list on a completely separate chart! Its absolutely mad and I have never come across a child yet who has had their full amount of prescribed drugs given to them. Its so sad when we do actually have the drugs here!
FrustrationsLast week I moved onto ICU. Or at least partly moved onto ICU. After we finally finished that ward round (at 2pm – the medical officer was 2 hours late…), Johnny the nurse from ward 1 came to find me and said there was no doctor on ward 1 at all and could I come to see those patients!
(Just to clarify here – I am not on the medical officers’ rota, and the idea is that I am supposed to be working WITH them and not INSTEAD of them (we’re into “sustainable” development here) – there are enough of them to cover a ward each).
It was somewhat soul-destroying and I asked him to triage their sickest patients and take them to ER to be reviewed by a doctor. The following day (a Muslim holiday) I was sure there would be no doctor covering ward 1 so went back there. Although most of the children hadn’t been seen in a shocking 4-5 days (!) thankfully most were fine and I got to send a lot of them home.
With my limited Krio it takes me much longer to see patients than the doctors here (and I’m much more thorough too – although obviously I’m biased!) so the ward rounds are soul-destroyingly long. Its really really hard work being on the wards all the time – its very hot and sweaty. I also have to do something I never have before – to check that the children are actually getting the medical they are prescribed! It’s a bizarre (and really really sad) thing, seeing quinine written up twice a day and finding they haven’t received it for 36+ hours.
I enjoy seeing the individual patients though and get the instant reward of being able to treat them and although the mortality figures are shockingly high I have been involved with a few little miracles, which keeps up the morale.
An Inspiring Afternoon
Last week the Welbodi team directors were here visiting from the UK (The Welbodi Partnership is a UK-based NGO working to improve standards of child health care in ODCH by providing equipment, training and developing the postgraduate paediatric training system). I joined them and one of the SL medical officers (Ish) for a brainstorming session on ideas to reduce child mortality. The mortality rate is currently about 13% for the whole hospital, 34% for SCBU. It was a really inspiring session and brilliant to get Ish’s point of view on everything. He has just passed the first part of his postgraduate exams and he helped to set up Welbodi, along with a British medical student (now ST1 in paeds).
We then went for a wander around the slum behind the hospital. Unbelievably grim it was. Open sewers everywhere, you really had to watch where you put your feet! Houses so tightly packed together, flies and mosquitoes all around. Lots of open fires. Its no wonder we see so much malaria/TB/diarrhoea/burns. We met with the chief and sat with him and a number of others and asked their opinions of the hospital. They had so much to say about the hospital and it was so interesting to hear from them directly. They had concerns that, even though health care is supposed to be free, they were still being asked for bribes by the nursing staff! They also felt they were not treated with respect and their concerns dismissed unless a child was in extremis. It was really interesting (and sad) to hear all their points of view and how vehemently they expressed their opinions. These people were certainly not apathetic about their children’s health and health care!
Some Interesting Stats (pulled from the WHO Sierra Leone Country Cooperation Strategy Paper 2008-2013)
Sierra Leone ranks as the least developed country in the world, based on its 2007 Human Development Report ranking of 177 out of 177 countries. The country is extremely resource poor. With a GDP per capita (PPP) of US$ 700; it ranked 102 out of 108 countries in the Human Poverty Report, with Human Poverty Index (HPI) of 51.72. Nearly half of the working age population engages in subsistence agriculture.
With an under-five mortality rate of 267/1000 live births, Sierra Leone has the highest
under-five mortality in the world, and malaria is the number one cause of deaths. For the entire population, malaria burden is very heavy: malaria cases were more than 500 per 1000 population in 2003 and about 330 per 1000 in 2007. The disease accounted for about half (48%) of all outpatient consultations, and remains a major threat to socioeconomic development. In children under five years, the disease accounted for 50%-60% of all admissions, and about a third of the children may die (case fatality rate of between 16%-33%).
HIV and AIDS are fast becoming threats to social and economic development in Sierra Leone. The national sero-prevalence survey conducted in 2005 estimated a rate of 1.53% compared to 0.9% in 2002. The highest prevalence among women occurred in the 20-24 years age group (2.0%) whereas males between 35-39 years had the highest prevalence (3.5%). Prevalence in urban areas was 2.1% compared to 1.3% in rural areas, and about 47% of the total numbers of infections were new infections.
The burden of tuberculosis is increasing in Sierra Leone. Between 2004 and 2007, the number of registered TB cases in the country almost doubled, in spite of a case detection rate of about 50% (the WHO target is 75%). This is further complicated by the recent emergence of multi-drug resistant tuberculosis (MDR-TB). The TB/HIV co-infection is also an issue of concern: the prevalence of rate TB/HIV co-infection is 11.6%. However, the defaulter rate has been declining and the treatment success rate has increased, from 83% in 2004 to 87% in 2007.
Sierra Leone is ranked as having the highest under-five mortality rate in the world, with almost one out of every three children dying before reaching the age of five.
The trend has not changed significantly in the past eight years. The three main causes of under-five mortality are malaria, diarrhoea and pneumonia and they account for
over a quarter of all childhood deaths. Malnutrition plays a significant role, as 57% of the deaths would not have occurred if the children were not malnourished. Neonatal death accounts for 20% of the overall under-five mortality rate, an indication of poor quality care during labour, delivery, and immediate postnatal period.
Saturday 13 November 2010
Medical Registration - Finally!
So, on Monday I finally got my medical registration. And what a shambles it was!
I left home at 7.30am in the rain and got a taxi to Aberdeen to the VSO office where I was going to meet Theresa (the VSO the health programme manager) at 8.30am (I was there by 8am) to give me and two other new doctors a lift there. Theresa and the driver were there so I suggested that we go to the hotel where the other doctors were to pick them up, seeing as they were en route anyway. It turns out that Theresa had not informed them that she was going to pick them up at 8.30am and one of them was still in bed! Bless him he got up and was ready in about 5 minutes.
So we got going across town, stopping at my flatmate Carole’s office on route because Theresa had bizarrely left the application forms for Tash and Alex there on Friday – without telling Carole or me about this….
We got to the SL Medical and Dental Council Offices, met the lovely Registrar (who had worked in Ramsgate, it turned out) and were told that, despite us having given VSO our documents and photos goodness only knows how many times, the Council had STILL not been given the required number of any of our documents. My CV had somehow gone missing in the process of it all. (In preparation for this, I had taken my USB with me…) The Registrar got very confused by the Latin on my degree certificates… but we eventually persuaded him that they were a medical and science degree!
By then it was evident that Theresa would have to go back to the VSO office to get more photos of everyone, so I went with her. I printed out my CV (again, times 3) while there and personally counted out all the copies of everything before we left.
Back to the Council. In the meantime, Tash and Alex had already been interviewed. It turns out that they then waited for the third British doctor (me) before interviewing the Philipino and Dr from the DRC…. He said it was just a formality and that he knew we were well trained, that there is a fee of $500 but that was not my problem but that the Ministry and VSO would have to fight it out between them, and thank you so much for coming to volunteer in our country. He was one of the nicest people I have met here so far. And he confirmed that, yes, I can now practice, and the bit of paper will follow in two weeks time (I’ll believe that when I see it, but anyway!)
So Tash, Alex and I thought we would head to Bliss for lunch (it was lunchtime by now). We stopped off at my house on route to pick up my laptop so that they could check their email. Bliss is up the road with all the roadworks and it took us a while to get there, only to discover – its closed on Mondays! So we went a bit further away to a place at the beach – also closed on Mondays! We finally found that Mamba Point (the place that does the films on a Tuesday night) was open, so had lunch there…. Which was v nice and well deserved we thought.
I left home at 7.30am in the rain and got a taxi to Aberdeen to the VSO office where I was going to meet Theresa (the VSO the health programme manager) at 8.30am (I was there by 8am) to give me and two other new doctors a lift there. Theresa and the driver were there so I suggested that we go to the hotel where the other doctors were to pick them up, seeing as they were en route anyway. It turns out that Theresa had not informed them that she was going to pick them up at 8.30am and one of them was still in bed! Bless him he got up and was ready in about 5 minutes.
So we got going across town, stopping at my flatmate Carole’s office on route because Theresa had bizarrely left the application forms for Tash and Alex there on Friday – without telling Carole or me about this….
We got to the SL Medical and Dental Council Offices, met the lovely Registrar (who had worked in Ramsgate, it turned out) and were told that, despite us having given VSO our documents and photos goodness only knows how many times, the Council had STILL not been given the required number of any of our documents. My CV had somehow gone missing in the process of it all. (In preparation for this, I had taken my USB with me…) The Registrar got very confused by the Latin on my degree certificates… but we eventually persuaded him that they were a medical and science degree!
By then it was evident that Theresa would have to go back to the VSO office to get more photos of everyone, so I went with her. I printed out my CV (again, times 3) while there and personally counted out all the copies of everything before we left.
Back to the Council. In the meantime, Tash and Alex had already been interviewed. It turns out that they then waited for the third British doctor (me) before interviewing the Philipino and Dr from the DRC…. He said it was just a formality and that he knew we were well trained, that there is a fee of $500 but that was not my problem but that the Ministry and VSO would have to fight it out between them, and thank you so much for coming to volunteer in our country. He was one of the nicest people I have met here so far. And he confirmed that, yes, I can now practice, and the bit of paper will follow in two weeks time (I’ll believe that when I see it, but anyway!)
So Tash, Alex and I thought we would head to Bliss for lunch (it was lunchtime by now). We stopped off at my house on route to pick up my laptop so that they could check their email. Bliss is up the road with all the roadworks and it took us a while to get there, only to discover – its closed on Mondays! So we went a bit further away to a place at the beach – also closed on Mondays! We finally found that Mamba Point (the place that does the films on a Tuesday night) was open, so had lunch there…. Which was v nice and well deserved we thought.
Sunday 7 November 2010
The Sierra Leone Medical and Dental Association 36th Annual Congress
Sandra, Fred (the Welbodi doctors) and I were invited to attend the opening ceremony of the SLMDA annual congress. We arrived at the stated time (and found out we had to pay for the privilege of being invited to attend….) and sat around waiting for another hour or so before it actually started…. It was an impressive affair. Loudspeakers boomed out Paul Simon music and we were greeted at the door by my lovely medical students. The seats were covered (as if at a wedding) and there were some impressive decorations at the “top table” where the important people sat (no bride and groom, although the chairperson did keep announcing which young female junior doctors were “available” to the young male junior doctors! )
It was certainly an "interesting cultural experience", as my friend John (an ophthalmologist) put it. The chairperson invited every Old Boy in the Network to stand up and have their own personal round of applause. To be fair, a) there were a few women and b) these are doctors who had gone abroad to do their training and then actually come back to Sierra Leone to work. I was quite surprised to see how many doctors there actually are in SL – although most of them work either in the Ministry of Health in a managerial/public health capacity or work in private practice.
The obligatory drug company sponsorship was ever present – we even got presented with a laptop bag full of leaflets advertising benylin cough mixture, various ACTs (artemisinin combination treatments) and clexane. Also included were a pen and a bottle opener/key ring in one. Sure they’ll come in handy sometime.
We had a number of different talks from various speakers including the registrar of the Medical Council – yes, the one I am supposed to register with, if anyone in either VSO or the Ministry would get around to organising it for me…. He reminded everyone present why it is so important to be registered and why it is also important to renew your registration each year. My thoughts exactly. So it turns out that most of the doctors in the country aren’t officially registered. And yes, they’re still practicing….
A few more talks later and the Congress was officially opened by the Chief Medical Officer, who was standing in for the Minister for Health. There was a musical entertainment on the programme but unfortunately they didn’t turn up…. At the end all the junior doctors who had qualified since 2007 (which included most of our doctors from ODCH) got to stand up and introduce themselves to the rest of the crowd, and get their own applause. Don’t think that would happen at the BMA annual conference somehow!
It was certainly an "interesting cultural experience", as my friend John (an ophthalmologist) put it. The chairperson invited every Old Boy in the Network to stand up and have their own personal round of applause. To be fair, a) there were a few women and b) these are doctors who had gone abroad to do their training and then actually come back to Sierra Leone to work. I was quite surprised to see how many doctors there actually are in SL – although most of them work either in the Ministry of Health in a managerial/public health capacity or work in private practice.
The obligatory drug company sponsorship was ever present – we even got presented with a laptop bag full of leaflets advertising benylin cough mixture, various ACTs (artemisinin combination treatments) and clexane. Also included were a pen and a bottle opener/key ring in one. Sure they’ll come in handy sometime.
We had a number of different talks from various speakers including the registrar of the Medical Council – yes, the one I am supposed to register with, if anyone in either VSO or the Ministry would get around to organising it for me…. He reminded everyone present why it is so important to be registered and why it is also important to renew your registration each year. My thoughts exactly. So it turns out that most of the doctors in the country aren’t officially registered. And yes, they’re still practicing….
A few more talks later and the Congress was officially opened by the Chief Medical Officer, who was standing in for the Minister for Health. There was a musical entertainment on the programme but unfortunately they didn’t turn up…. At the end all the junior doctors who had qualified since 2007 (which included most of our doctors from ODCH) got to stand up and introduce themselves to the rest of the crowd, and get their own applause. Don’t think that would happen at the BMA annual conference somehow!
Thursday 4 November 2010
Bunce Island
A couple of weekends ago all the hospital NGOs (Welbodi, Cap Anamur and VSO) hired a Pelican water taxi and went to visit Bunce Island – where the old slave fort was/still is although very run down. For those of you who have seen the film Amistad – this is the fort that the good old Brits blow up at the end of the film after the abolition of slavery. We had a great journey and then were shown around by the caretaker – in fluent Krio! Luckily Sandra could translate what we couldn’t understand. After a really interesting tour we headed back to the buzzing traffic of Freetown and off to Alex’s at Lumley beach for dinner and drinks.
Weird and Interesting things in FreetownSo the Chinese have decided they are kindly going to make the main road out the west side of Freetown into a dual carriageway. In principle this is a good idea; the traffic is dreadful and the current road is full of potholes. In practice it means they have had to knock down large chunks of walls, buildings, peoples’ front rooms, even a great restaurant has been knocked down! (we are reassured that it will open again soon as the kitchen is still standing!) So now there are piles of rubble all over the place by the road and the West side of Freetown looks like Beirut. Or maybe people in Beirut would say that their city looks like Freetown (meaning I shouldn’t make judgements on places I haven’t been – as so many people make judgements on SL – like thinking there’s still a war going on – which there isn’t and hasn’t been for 8 years!)
I was in a supermarket earlier in the week and saw some imported magazines and newspapers! I stood astonished for a moment, then realised that The Sunday Times was actually from August! And cost the equivalent of £5. I think I’ll make do with the BBC webpage to keep me updated from time to time…
Another weird thing was probably us! Beth (another VSO) is a qualified yoga instructor. She arranged a class for us last Sunday so some of us did yoga on the beach as the sun was going down. It was just so relaxing, but also really funny as we had crowds watching us, and a few people also who joined in!
A couple of weekends ago all the hospital NGOs (Welbodi, Cap Anamur and VSO) hired a Pelican water taxi and went to visit Bunce Island – where the old slave fort was/still is although very run down. For those of you who have seen the film Amistad – this is the fort that the good old Brits blow up at the end of the film after the abolition of slavery. We had a great journey and then were shown around by the caretaker – in fluent Krio! Luckily Sandra could translate what we couldn’t understand. After a really interesting tour we headed back to the buzzing traffic of Freetown and off to Alex’s at Lumley beach for dinner and drinks.
Weird and Interesting things in FreetownSo the Chinese have decided they are kindly going to make the main road out the west side of Freetown into a dual carriageway. In principle this is a good idea; the traffic is dreadful and the current road is full of potholes. In practice it means they have had to knock down large chunks of walls, buildings, peoples’ front rooms, even a great restaurant has been knocked down! (we are reassured that it will open again soon as the kitchen is still standing!) So now there are piles of rubble all over the place by the road and the West side of Freetown looks like Beirut. Or maybe people in Beirut would say that their city looks like Freetown (meaning I shouldn’t make judgements on places I haven’t been – as so many people make judgements on SL – like thinking there’s still a war going on – which there isn’t and hasn’t been for 8 years!)
I was in a supermarket earlier in the week and saw some imported magazines and newspapers! I stood astonished for a moment, then realised that The Sunday Times was actually from August! And cost the equivalent of £5. I think I’ll make do with the BBC webpage to keep me updated from time to time…
Another weird thing was probably us! Beth (another VSO) is a qualified yoga instructor. She arranged a class for us last Sunday so some of us did yoga on the beach as the sun was going down. It was just so relaxing, but also really funny as we had crowds watching us, and a few people also who joined in!
Sunday 24 October 2010
A Week of Musical and Cinematic Entertainment
Tuesday evening I really needed some escapism from the world of the hospital so went to Mumba Point Restaurant with the other VSOs – they have a film club there and this week were showing “Letters to Juliet” – an big cheese-fest starring the girl from Mama Mia. It was just what I needed and we were all laughing hysterically at the cheese factor. Mumba Point is also (apparently) the only restaurant in Freetown where you can get sushi – they fly it in from Belgium – so comes at a price. I had some rather good humous and flat bread instead. Howard and Freya shared the biggest pizza I have ever seen so I will definitely be back there to sample one (pizzas being a rarity in SL)!
An SL Ceilidh (sort of)!
On Wednesday evening the Ballanta Music School put on an evening of Sierra Leonean Music and Dance. This was held at the British Council and was the largest gathering of white people I had seem for a long time (until the following night – see below!) It was a brilliant mix of traditional music – ranging from a group who improvised instruments using a stool, a saw and a battered looking table (this came from slave times we were told), to a large group of boys who danced around in a circle playing a cross between a vuvuzela and a didgeridoo, accompanied by a whistle and a bass drum. They looked a bit like football hooligans and I wondered what Simon Cowell would have made of them… The best group were led by the oldest man I have seen in SL so far who had the largest smile I have ever seen and was dressed in a rather fetching outfit in the colours of the SL flag – blue, white and green. They were followed by a fantastic bunch of boys and girls dancing (some were so thin I thought they should go to TFC…) The two youngest looked about three years old but were clearly developmentally older and they were hilarious doing cartwheels and backflips across the stage (hilarious because they very cutely kept accidentally banging into one another and knocking themselves over).
“Cow” for dinner
Before the show Becky and I got something to eat at the British Council – we were offered some cous-cous. Becky asked if there was any meat in said cous-cous; we were told that, yes, there was “cow” with the cous-cous. Becky asked if they would kindly take the cow out of hers’. I said, yes I would love to have some cow with my cous-cous. And very nice it was too!
How the other half live….
Thursday evening and all British Nationals in SL had been invited to IMATT (the British army base here) for a concert put on by the Well Cathedral School choir. We got all dressed up to go out and had a lovely evening. I felt like we had been transported back to Oxford – the choir girls were those Oxford preppy types with crazy hair all over the place and terribly posh voices (I’m allowed to say this because I live in Oxford….). They were amazing singers and musicians though and I had tingles down my spine as they sung The Flower Duet (the BA advert music). There was also a flautist (who has just been made principal flautist for the British National Orchestra), a trumpeter, a saxophonist, a number of pianists and a girl who hula-hooped to some African drumming.
The evening was held in the Officer’s Mess so I also got some military chat and met a really nice RAF regiment couple who have just arrived. IMATT is in a fantastic location up the hills overlooked by the American Embassy. They have a beautiful outdoor pool and a gorgeous view from the balcony of the Mess (not that I’m jealous of course…) All in all it was a thoroughly nice evening – a Very British Evening. (Margaret and Roger – I also met Anthony – Roger’s counterpart here in SL – so it was great to finally meet him!)
An SL Ceilidh (sort of)!
On Wednesday evening the Ballanta Music School put on an evening of Sierra Leonean Music and Dance. This was held at the British Council and was the largest gathering of white people I had seem for a long time (until the following night – see below!) It was a brilliant mix of traditional music – ranging from a group who improvised instruments using a stool, a saw and a battered looking table (this came from slave times we were told), to a large group of boys who danced around in a circle playing a cross between a vuvuzela and a didgeridoo, accompanied by a whistle and a bass drum. They looked a bit like football hooligans and I wondered what Simon Cowell would have made of them… The best group were led by the oldest man I have seen in SL so far who had the largest smile I have ever seen and was dressed in a rather fetching outfit in the colours of the SL flag – blue, white and green. They were followed by a fantastic bunch of boys and girls dancing (some were so thin I thought they should go to TFC…) The two youngest looked about three years old but were clearly developmentally older and they were hilarious doing cartwheels and backflips across the stage (hilarious because they very cutely kept accidentally banging into one another and knocking themselves over).
“Cow” for dinner
Before the show Becky and I got something to eat at the British Council – we were offered some cous-cous. Becky asked if there was any meat in said cous-cous; we were told that, yes, there was “cow” with the cous-cous. Becky asked if they would kindly take the cow out of hers’. I said, yes I would love to have some cow with my cous-cous. And very nice it was too!
How the other half live….
Thursday evening and all British Nationals in SL had been invited to IMATT (the British army base here) for a concert put on by the Well Cathedral School choir. We got all dressed up to go out and had a lovely evening. I felt like we had been transported back to Oxford – the choir girls were those Oxford preppy types with crazy hair all over the place and terribly posh voices (I’m allowed to say this because I live in Oxford….). They were amazing singers and musicians though and I had tingles down my spine as they sung The Flower Duet (the BA advert music). There was also a flautist (who has just been made principal flautist for the British National Orchestra), a trumpeter, a saxophonist, a number of pianists and a girl who hula-hooped to some African drumming.
The evening was held in the Officer’s Mess so I also got some military chat and met a really nice RAF regiment couple who have just arrived. IMATT is in a fantastic location up the hills overlooked by the American Embassy. They have a beautiful outdoor pool and a gorgeous view from the balcony of the Mess (not that I’m jealous of course…) All in all it was a thoroughly nice evening – a Very British Evening. (Margaret and Roger – I also met Anthony – Roger’s counterpart here in SL – so it was great to finally meet him!)
Saturday 16 October 2010
Hospital Goings On
So…. Perhaps not surprisingly, I still don’t have my medical registration yet. Its getting a bit ridiculous really…
In the meantime – I have finished doing my lectures - another on genetics and two respiratory, although the students also asked me to cover neonatal tetanus (cause I’m the world’s leading expert on that… not!), childhood obesity (in Sierra Leone! I am still pondering on why!), seizures (okay that’s important – a lot of children come in with “convulsions” or “shake shake” but I’m never sure if this is a seizure, a rigor, or what, as the history taking is… somewhat deficient….) and “birth asphyxia”. HIE is fairly common here and as a good proportion of my students want to be obstetricians one day I have tried to instil that “prevention is better than cure”. So thanks to James and Dr Anthony for sending out the slides! The students are away doing obs and gynae lectures for three weeks before coming back to us for clinical teaching.
We had an M&M meeting on Thursday. A lot more mortality than morbidity…. Its only the third M&M they have had here so everyone’s still getting used to the fact that its not a place to fight about whose fault the death was – the doctor’s for not reviewing them enough or changing the antibiotics, the nurses’ for not giving the said medication or not doing observations, the mothers’ for not taking them in soon enough or for discharging against medical advice, the maintenance people for not sorting out any running water, the ministry of health’s for not providing any equipment or the government’s for not educating the population… the list goes on….
Anyway, it was an interesting meeting – most children (apparently) die from severe malaria and severe anaemia. I say apparently because although we actually have access to blood films and rapid antigen tests, no one actually does them… So there is no way to really tell what they die from.
I feel I’m being critical when there is a huge amount of good stuff happening. Some of the nurses are fantastic – they put in all the cannulas – and the triage is great. It was Global Handwashing Day (yes, without running water in the hospital….) on Friday so Becky and Gibril (one of the SL nurses from the observation ward) had organised an education day for the staff and parents. It was so much fun going around the wards. Some of the nurses from the Therapeutic Feeing Centre had made up a skit and then sang Krio songs to get the message across. It was a lot of fun and all the better that it was done mostly by the Sierra Leonean staff.
I’ve been writing for a while… so… more later! I'll try to get up some photos at some point too, now that Matt the vodaphone photographer has fixed my camera!
So…. Perhaps not surprisingly, I still don’t have my medical registration yet. Its getting a bit ridiculous really…
In the meantime – I have finished doing my lectures - another on genetics and two respiratory, although the students also asked me to cover neonatal tetanus (cause I’m the world’s leading expert on that… not!), childhood obesity (in Sierra Leone! I am still pondering on why!), seizures (okay that’s important – a lot of children come in with “convulsions” or “shake shake” but I’m never sure if this is a seizure, a rigor, or what, as the history taking is… somewhat deficient….) and “birth asphyxia”. HIE is fairly common here and as a good proportion of my students want to be obstetricians one day I have tried to instil that “prevention is better than cure”. So thanks to James and Dr Anthony for sending out the slides! The students are away doing obs and gynae lectures for three weeks before coming back to us for clinical teaching.
We had an M&M meeting on Thursday. A lot more mortality than morbidity…. Its only the third M&M they have had here so everyone’s still getting used to the fact that its not a place to fight about whose fault the death was – the doctor’s for not reviewing them enough or changing the antibiotics, the nurses’ for not giving the said medication or not doing observations, the mothers’ for not taking them in soon enough or for discharging against medical advice, the maintenance people for not sorting out any running water, the ministry of health’s for not providing any equipment or the government’s for not educating the population… the list goes on….
Anyway, it was an interesting meeting – most children (apparently) die from severe malaria and severe anaemia. I say apparently because although we actually have access to blood films and rapid antigen tests, no one actually does them… So there is no way to really tell what they die from.
I feel I’m being critical when there is a huge amount of good stuff happening. Some of the nurses are fantastic – they put in all the cannulas – and the triage is great. It was Global Handwashing Day (yes, without running water in the hospital….) on Friday so Becky and Gibril (one of the SL nurses from the observation ward) had organised an education day for the staff and parents. It was so much fun going around the wards. Some of the nurses from the Therapeutic Feeing Centre had made up a skit and then sang Krio songs to get the message across. It was a lot of fun and all the better that it was done mostly by the Sierra Leonean staff.
I’ve been writing for a while… so… more later! I'll try to get up some photos at some point too, now that Matt the vodaphone photographer has fixed my camera!
Transport Fun
So there are several methods of transport in Freetown – ranging from poda podas (minibuses) to taxis (shared or chartered) to lifts with friends (a VSO favourite!) or walking. There are also okadas (motorbikes) but I have no intention of ever getting anywhere on one of these.
Walking is a full on assault of the senses – there are very few pavements in Freetown so you always have to be on your guard not to fall down a pothole or sewer. There are constantly people saying “Hello how are you?” or “White Girl!” or “I love you”. Taxis and podas tend to enjoy driving nearly into you as they assume you want a lift somewhere. You could buy any number of things while walking around ranging from peanuts to bread to plumpinut or Starter F75 (the nutritional supplements for malnourished children which are provided free by Unicef…)
I’ve only been in a few podas. They tend to have almost no space in and I’ve always been fairly dubious that they would EVER pass an MOT.
Shard taxis can also be a challenge. You have to shout in the window where you want to go as they drive past, and if they’re going that way, they might stop. I’ve been in a few taxis which say they’re going one way, and then suddenly change their mind half way there….
Getting lifts with friends is happily how I’ve mostly been getting to work. The wonderful Becky from Welbodi has been bereft of colleagues for the last few weeks while Sandra is away so she and her driver Usman come to get us most mornings. Usman is a legend. He knows his way around Freetown like the back of his hand and has a lot of tricks to get through the notoriously slow Freetown traffic.
Walking is a full on assault of the senses – there are very few pavements in Freetown so you always have to be on your guard not to fall down a pothole or sewer. There are constantly people saying “Hello how are you?” or “White Girl!” or “I love you”. Taxis and podas tend to enjoy driving nearly into you as they assume you want a lift somewhere. You could buy any number of things while walking around ranging from peanuts to bread to plumpinut or Starter F75 (the nutritional supplements for malnourished children which are provided free by Unicef…)
I’ve only been in a few podas. They tend to have almost no space in and I’ve always been fairly dubious that they would EVER pass an MOT.
Shard taxis can also be a challenge. You have to shout in the window where you want to go as they drive past, and if they’re going that way, they might stop. I’ve been in a few taxis which say they’re going one way, and then suddenly change their mind half way there….
Getting lifts with friends is happily how I’ve mostly been getting to work. The wonderful Becky from Welbodi has been bereft of colleagues for the last few weeks while Sandra is away so she and her driver Usman come to get us most mornings. Usman is a legend. He knows his way around Freetown like the back of his hand and has a lot of tricks to get through the notoriously slow Freetown traffic.
Beaches and Football
I’m just back from the beach – again? I hear you say. I went this afternoon to Lakka Beach with some of the lovely people from The Mercy Ships hospital. We had a lovely swim, walk and some ace barracuda with chips and rice for lunch. We left just in time before a tropical downpour. The Mercy Ships have a maternity ward, an obstetric fistula clinic and a children’s outpatients clinic. It was nice meeting up with a couple of their doctors and some midwives.
The Football
So…last Sunday afternoon, we went to see the football. At least we attempted to see the football. We (Cat and I) went with our lovely neighbour Joe to see if we could get tickets for the SL vs South Africa game for the knockout stages of the Africa Cup of Nations. So.. getting the tickets was the easy bit. We got into the ground and were just going into the stadium but it honestly looked like hell on earth actually inside the stadium. There were FAR more people there than the stadium was clearly designed for. My phone and purse were expertly pickpocketed (luckily there was only about 50p in the purse and the phone was only worth £3.50, and I’ve already got the same number back, along with most of my credit – I just had to pay to get another phone unlocked. I was very impressed with the mobile phone company). So we wandered around for a bit trying to see if there was anywhere we could go that wasn’t totally packed. Crowd control was clearly NOT on the agenda of anyone there, apart from some policeman using their truncheons to get people to stand back.
Being crushed was not what I had in mind for today. We decided to leave. The lovely Joe got some nicer policemen to escort us out of the stadium. The policemen were most surprised that we didn’t want to stay and watch the game!
The Football
So…last Sunday afternoon, we went to see the football. At least we attempted to see the football. We (Cat and I) went with our lovely neighbour Joe to see if we could get tickets for the SL vs South Africa game for the knockout stages of the Africa Cup of Nations. So.. getting the tickets was the easy bit. We got into the ground and were just going into the stadium but it honestly looked like hell on earth actually inside the stadium. There were FAR more people there than the stadium was clearly designed for. My phone and purse were expertly pickpocketed (luckily there was only about 50p in the purse and the phone was only worth £3.50, and I’ve already got the same number back, along with most of my credit – I just had to pay to get another phone unlocked. I was very impressed with the mobile phone company). So we wandered around for a bit trying to see if there was anywhere we could go that wasn’t totally packed. Crowd control was clearly NOT on the agenda of anyone there, apart from some policeman using their truncheons to get people to stand back.
Being crushed was not what I had in mind for today. We decided to leave. The lovely Joe got some nicer policemen to escort us out of the stadium. The policemen were most surprised that we didn’t want to stay and watch the game!
Sunday 10 October 2010
So now I am a lecturer...
So I am now a lecturer…
I have given my first three lectures this week – two on cardiology and one on genetics. They seem to have gone down well. They are a nice bunch of students – 27 of them all in fifth year (out of six). In fifth year they only do paediatrics and obs and gynae! Thankfully they are responsive to answering questions and are good at listing off the things by rote (things which I can no longer remember…). They were all very grateful when I sent them off half an hour early on Tuesday too. Next week I have one more genetics and two on respiratory paeds. Thanks to everyone in Oxford whose presentations I have “borrowed” in order to make my lecture slides.
Evenings Out
I had a lovely evening out at Frankie and Howard’s house on Wednesday. They are ex-VSOs and are now the honorary aunt and uncle of all new VSOs. We had some lovely food including an amazing chilli con carne. I was most excited as this is the first mince I have seen for a while. Apparently you can buy it in Monoprix (the fab, but expensive, supermarket - £3 for a jar of peanut butter (of which I am eating a lot), over a pound for a tin of beans). It was good to meet up with everyone and chill out. Howard also gave lots of tips of things to do in SL – so anyone coming to visit (Ella) I have lots of info for you!
I also visited the Mercy Ships for an evening service last Sunday – it was really nice and again, good to meet up with other people. The Mercy Ships have an obstetric fistula clinic and paediatric outpatients. The set-up there is so…. Organised…. In comparison to the hospital.
On Friday evening we had Beth, Theo and Alex round for dinner – I made bean stew with rice and potatoes and Cat made pancakes for pudding. Beth had bought some nutella which made a perfect topping to the pancakes! I get excited at small things!
And to the beach…
Yesterday we had a lovely day – a bit of a lie in, then over to Beth and Theo’s. There we met Tash and Alex (the VSO Dr’s in Makeni). It was great to see them and exchange tales of woe from the hospital. If I think its bad in Ola During, it’s a thousand times worse in Makeni. The parents have to go out and BUY the cannulas there. At least in ODCH we have a ready supply of them, along with fluids and IV antibiotics and antimalarials to go through them.
Anyway, Tash and Alex dispatched themselves to buy a car. The rest of us, meanwhile got a taxi out to Lakka beach, where we had three hours of pure heaven. I had a couple of long swims in the warm Atlantic (nice to get some exercise after a lot of sitting around in cars) and a long walk along the beach. It was absolutely beautiful, and hardly anyone there and no hassle. Bounty beaches indeed (the SL beaches were used in the Bounty ads in the 80s).
We finished the day by watching sunset from a taxi as we drove past Lumley Beach then a lovely dinner at The Bamboo Hut.
I have given my first three lectures this week – two on cardiology and one on genetics. They seem to have gone down well. They are a nice bunch of students – 27 of them all in fifth year (out of six). In fifth year they only do paediatrics and obs and gynae! Thankfully they are responsive to answering questions and are good at listing off the things by rote (things which I can no longer remember…). They were all very grateful when I sent them off half an hour early on Tuesday too. Next week I have one more genetics and two on respiratory paeds. Thanks to everyone in Oxford whose presentations I have “borrowed” in order to make my lecture slides.
Evenings Out
I had a lovely evening out at Frankie and Howard’s house on Wednesday. They are ex-VSOs and are now the honorary aunt and uncle of all new VSOs. We had some lovely food including an amazing chilli con carne. I was most excited as this is the first mince I have seen for a while. Apparently you can buy it in Monoprix (the fab, but expensive, supermarket - £3 for a jar of peanut butter (of which I am eating a lot), over a pound for a tin of beans). It was good to meet up with everyone and chill out. Howard also gave lots of tips of things to do in SL – so anyone coming to visit (Ella) I have lots of info for you!
I also visited the Mercy Ships for an evening service last Sunday – it was really nice and again, good to meet up with other people. The Mercy Ships have an obstetric fistula clinic and paediatric outpatients. The set-up there is so…. Organised…. In comparison to the hospital.
On Friday evening we had Beth, Theo and Alex round for dinner – I made bean stew with rice and potatoes and Cat made pancakes for pudding. Beth had bought some nutella which made a perfect topping to the pancakes! I get excited at small things!
And to the beach…
Yesterday we had a lovely day – a bit of a lie in, then over to Beth and Theo’s. There we met Tash and Alex (the VSO Dr’s in Makeni). It was great to see them and exchange tales of woe from the hospital. If I think its bad in Ola During, it’s a thousand times worse in Makeni. The parents have to go out and BUY the cannulas there. At least in ODCH we have a ready supply of them, along with fluids and IV antibiotics and antimalarials to go through them.
Anyway, Tash and Alex dispatched themselves to buy a car. The rest of us, meanwhile got a taxi out to Lakka beach, where we had three hours of pure heaven. I had a couple of long swims in the warm Atlantic (nice to get some exercise after a lot of sitting around in cars) and a long walk along the beach. It was absolutely beautiful, and hardly anyone there and no hassle. Bounty beaches indeed (the SL beaches were used in the Bounty ads in the 80s).
We finished the day by watching sunset from a taxi as we drove past Lumley Beach then a lovely dinner at The Bamboo Hut.
Sunday 3 October 2010
Two Weeks in Freetown
The Exciting News
So the exciting news of this week is that I now have the internet at home. At least I’m paying for the internet at home. It jumps between being fairly reliable and quick to completely dropping out when I am mid-trying to do something. A bit frustrating.
The other news of this week is that we started in the hospital. I’d say we started working in the hospital but as I still don’t have my medical registration I can’t really do any proper work…
The Ministry of Health and Sanitation
So on Monday we (me and various other VSO health volunteers) were taken to meet the Chief Medical Officer (of the country) along with various other high hidyins (?spelling). After the meeting I was interviewed on tape by the press officer who asked what was my background, what was I going to do and wasn’t it wonderful that there is now free health care for under 5’s and pregnant and lactating women.
Ola During Children’s Hospital
We were driven over to the hospital in a Ministry of Health and Sanitation jeep and were shown around by Nadine, a German nurse working with an NGO called Cap Anamur. Within about half an hour of arriving I had witnessed the deaths of a set of preterm twins in SCBU. Very sad.
I have spent the rest of the week attached to various medical officers on their ward rounds. The wards are: the ER and “ICU” (for those of you with any sort of medical background, this bears no resemblance whatsoever to any PICU I have ever been in), Ward 1 (supposedly for more stable children), Ward 3 (with a TB unit), an isolation ward, a separate measles ward, a therapeutic feeding ward (actually although this is full of emaciated children it is the happiest place in the hospital), and a SCBU (which they call S-C-B-U which I find terribly confusing!). This also bears almost no resemblance to any SCBU/NICU I have ever been in apart from the fact that there are some incubators!
I have spent most time in ER and ICU this week but actually its difficult to spend much time there. I’ll go into more details in another blog but its fairly upsetting. Its frustrating not being able to do anything without my registration.
So I am now a Lecturer…
What I HAVE achieved this week in work is meeting Professor Tamra. She is an amazing woman, she is a Nigerian Prof of Paediatrics and is working for the UNFPA and helping to set up a Sierra Leone postgraduate paediatric course. She is in charge of the medical student teaching and has asked me to become involved in this. So I have now become a cardiology, respiratory and genetics lecturer…. My first lecture is tomorrow morning and is scheduled to be a TWO HOUR lecture on cardiology. Followed by a further TWO hours on Tuesday (also cardiology). Not sure I can actually talk for that long. Not really sure I even know that much about cardiology… but I have scraped together 129 slides for the two lectures…. Wish me luck!
The Weekend
It’s now the weekend. Cat and I had a most productive day yesterday. We went out with a list of things to do and achieved them all! We changed some money in the supermarket (the rate is Le 6200 to the pound – not bad at all). We got a taxi to take us into town. We got slightly lost while looking for the Zain shop. We found it. Wer registered our mobile phones so that we don’t get cut off. We found the Sierratel shop after a bit of searching around. We spent 45 minutes in there and came out with dongles and two months supply of dodgy internet connection. We found Crown Bakery. We had a COFFEE and a CROISSANT! It was lovely. And there is a HAND DRYER in the toilet! My new favourite place in Freetown (apart from our balcony). We got a poda poda back home. We bought some onions at the market and some bread from the bread man. We then couldn’t connect to the internet so one phonecall to Beth (our resident IT VSO person) and we were invited to dinner. Theo had cooked all sorts of lovely Sierra Leonean food which we washed down with some boxed Spanish wine. And I managed to speak (very briefly mind you) to my father-in-law on Skype!
Its now Sunday and I’m sorting out my genetics lectures for later in the week. This evening I’m off to the Mercy Ships to meet with some friends of friends of friends from Shetland to an evening service.
PS
The internet is so slow and unreliable I am sorry I can’t reply to all emails but thank you for all your messages and thoughts. Love and miss you all! Andy has my phone number if you want to text me (its very nice getting texts from home and apparently it only costs you lot 17p per text – hint!)
So the exciting news of this week is that I now have the internet at home. At least I’m paying for the internet at home. It jumps between being fairly reliable and quick to completely dropping out when I am mid-trying to do something. A bit frustrating.
The other news of this week is that we started in the hospital. I’d say we started working in the hospital but as I still don’t have my medical registration I can’t really do any proper work…
The Ministry of Health and Sanitation
So on Monday we (me and various other VSO health volunteers) were taken to meet the Chief Medical Officer (of the country) along with various other high hidyins (?spelling). After the meeting I was interviewed on tape by the press officer who asked what was my background, what was I going to do and wasn’t it wonderful that there is now free health care for under 5’s and pregnant and lactating women.
Ola During Children’s Hospital
We were driven over to the hospital in a Ministry of Health and Sanitation jeep and were shown around by Nadine, a German nurse working with an NGO called Cap Anamur. Within about half an hour of arriving I had witnessed the deaths of a set of preterm twins in SCBU. Very sad.
I have spent the rest of the week attached to various medical officers on their ward rounds. The wards are: the ER and “ICU” (for those of you with any sort of medical background, this bears no resemblance whatsoever to any PICU I have ever been in), Ward 1 (supposedly for more stable children), Ward 3 (with a TB unit), an isolation ward, a separate measles ward, a therapeutic feeding ward (actually although this is full of emaciated children it is the happiest place in the hospital), and a SCBU (which they call S-C-B-U which I find terribly confusing!). This also bears almost no resemblance to any SCBU/NICU I have ever been in apart from the fact that there are some incubators!
I have spent most time in ER and ICU this week but actually its difficult to spend much time there. I’ll go into more details in another blog but its fairly upsetting. Its frustrating not being able to do anything without my registration.
So I am now a Lecturer…
What I HAVE achieved this week in work is meeting Professor Tamra. She is an amazing woman, she is a Nigerian Prof of Paediatrics and is working for the UNFPA and helping to set up a Sierra Leone postgraduate paediatric course. She is in charge of the medical student teaching and has asked me to become involved in this. So I have now become a cardiology, respiratory and genetics lecturer…. My first lecture is tomorrow morning and is scheduled to be a TWO HOUR lecture on cardiology. Followed by a further TWO hours on Tuesday (also cardiology). Not sure I can actually talk for that long. Not really sure I even know that much about cardiology… but I have scraped together 129 slides for the two lectures…. Wish me luck!
The Weekend
It’s now the weekend. Cat and I had a most productive day yesterday. We went out with a list of things to do and achieved them all! We changed some money in the supermarket (the rate is Le 6200 to the pound – not bad at all). We got a taxi to take us into town. We got slightly lost while looking for the Zain shop. We found it. Wer registered our mobile phones so that we don’t get cut off. We found the Sierratel shop after a bit of searching around. We spent 45 minutes in there and came out with dongles and two months supply of dodgy internet connection. We found Crown Bakery. We had a COFFEE and a CROISSANT! It was lovely. And there is a HAND DRYER in the toilet! My new favourite place in Freetown (apart from our balcony). We got a poda poda back home. We bought some onions at the market and some bread from the bread man. We then couldn’t connect to the internet so one phonecall to Beth (our resident IT VSO person) and we were invited to dinner. Theo had cooked all sorts of lovely Sierra Leonean food which we washed down with some boxed Spanish wine. And I managed to speak (very briefly mind you) to my father-in-law on Skype!
Its now Sunday and I’m sorting out my genetics lectures for later in the week. This evening I’m off to the Mercy Ships to meet with some friends of friends of friends from Shetland to an evening service.
PS
The internet is so slow and unreliable I am sorry I can’t reply to all emails but thank you for all your messages and thoughts. Love and miss you all! Andy has my phone number if you want to text me (its very nice getting texts from home and apparently it only costs you lot 17p per text – hint!)
Thursday 30 September 2010
Blog 1 – One week in Freetown
Its Saturday afternoon; I’m sitting on my balcony looking at a gorgeous view over the ocean towards Lungi. I’ve been in Freetown almost a week. In-country training is done.
We arrived very late on Sunday night (the plane was delayed as we stopped on route in Malaga to refuel (probably due to everyone’s luggage limit of a massive 40kg – which I for one was very glad to have). We were met at the airport by some VSO staff and taken by water taxi to Freetown.
I am living a really nice VSO house near a big roundabout called Congo Cross. I have a big double room with an en suite! My shower doesn’t work alas but I do have a working toilet and sink. There is another shared bathroom with a working shower (cold water – but that’s not a problem!) We also have remarkably good electricity. A hydroelectric dam has just been opened which provides power to most of Freetown. The lights are a bit dim sometimes and occasionally we have a power cut lasting a few hours but in general much better than I was expecting.
We have had in-country training this week at the VSO office (in Aberdeen). Lots of info about how the VSO programme works in Sierra Leone, about the social, political, and economic context of development here and a bit about how to survive in Freetown. We also got to learn a bit of Krio. One of the new volunteers was born in Freetown and speaks Krio so it was fun practicing with her.
VSO have just been back in SL since 2005 (the war ENDED in 2002) and the health programme started in 2008. There has just been a big influx of health volunteers including me, another paediatrician, a GP, an ER doctor (who will work as a clinical tutor in a medical school) and a paediatric nurse.
We’ve had a tour around Freetown today, driving by Lumley Beach, around the hills and up to the British High Commission and US Embassy. That is to say, we drove past them. The views are incredible. We had lunch down town (I was adventurous enough to have “plasas”; a cassava leaf stew with a variety of fish, chicken and unidentified meat, served with rice. A bit hot, but pretty nice anyway. We had a wander around town, including “Big Market” the touristy market selling baskets, jewellery and lovely clothes.
Now back on the balcony relaxing before the VSO party this evening!
Its Saturday afternoon; I’m sitting on my balcony looking at a gorgeous view over the ocean towards Lungi. I’ve been in Freetown almost a week. In-country training is done.
We arrived very late on Sunday night (the plane was delayed as we stopped on route in Malaga to refuel (probably due to everyone’s luggage limit of a massive 40kg – which I for one was very glad to have). We were met at the airport by some VSO staff and taken by water taxi to Freetown.
I am living a really nice VSO house near a big roundabout called Congo Cross. I have a big double room with an en suite! My shower doesn’t work alas but I do have a working toilet and sink. There is another shared bathroom with a working shower (cold water – but that’s not a problem!) We also have remarkably good electricity. A hydroelectric dam has just been opened which provides power to most of Freetown. The lights are a bit dim sometimes and occasionally we have a power cut lasting a few hours but in general much better than I was expecting.
We have had in-country training this week at the VSO office (in Aberdeen). Lots of info about how the VSO programme works in Sierra Leone, about the social, political, and economic context of development here and a bit about how to survive in Freetown. We also got to learn a bit of Krio. One of the new volunteers was born in Freetown and speaks Krio so it was fun practicing with her.
VSO have just been back in SL since 2005 (the war ENDED in 2002) and the health programme started in 2008. There has just been a big influx of health volunteers including me, another paediatrician, a GP, an ER doctor (who will work as a clinical tutor in a medical school) and a paediatric nurse.
We’ve had a tour around Freetown today, driving by Lumley Beach, around the hills and up to the British High Commission and US Embassy. That is to say, we drove past them. The views are incredible. We had lunch down town (I was adventurous enough to have “plasas”; a cassava leaf stew with a variety of fish, chicken and unidentified meat, served with rice. A bit hot, but pretty nice anyway. We had a wander around town, including “Big Market” the touristy market selling baskets, jewellery and lovely clothes.
Now back on the balcony relaxing before the VSO party this evening!
Wednesday 29 September 2010
I've got here!
This is a very quick message as the internet is so slow!
Hope you are all well. I am fine. I have tried to write a blog and copy and paste - but even THAT isn't working just now!!
I have had one week of in-country training and now just started in Ola During Children's Hospital.
More when I get my own internet....
This is a very quick message as the internet is so slow!
Hope you are all well. I am fine. I have tried to write a blog and copy and paste - but even THAT isn't working just now!!
I have had one week of in-country training and now just started in Ola During Children's Hospital.
More when I get my own internet....
Saturday 18 September 2010
Thinking of the Sound of Music and the Terminator movies
So long, farewell... but also - I'll be back!
Well that's it, I'm off tomorrow. With my huge bags (very pleased about the 40kg baggage allowance - I would NOT have managed with the 25kg that VSO allows!)
The next time I post I'll be in Freetown! All very exciting. Sad too - its been a sad week of farewells. We've had a nice relaxing time of walking into town, nice dinners and into London to visit the British Museum and Imperial War Museum and have some dim sum.
Last night tonight - off to watch X Factor for the last time - although we have to go to James and Jo's to watch it as our TV is on the blink - good practice for me!
Well auf wiedersehen, goodbye! See you all soon xxx
Well that's it, I'm off tomorrow. With my huge bags (very pleased about the 40kg baggage allowance - I would NOT have managed with the 25kg that VSO allows!)
The next time I post I'll be in Freetown! All very exciting. Sad too - its been a sad week of farewells. We've had a nice relaxing time of walking into town, nice dinners and into London to visit the British Museum and Imperial War Museum and have some dim sum.
Last night tonight - off to watch X Factor for the last time - although we have to go to James and Jo's to watch it as our TV is on the blink - good practice for me!
Well auf wiedersehen, goodbye! See you all soon xxx
Wednesday 8 September 2010
I can't believe its actually nearly here - I'm off in 11 days! Nothing packed yet but its all laid out in the spare room.
I've got two weeks of training with VSO in Freetown when I arrive before starting in the hospital. It will give me a chance to acclimatise and meet up with the other VSOs.
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