Anesthesiology Conference
Consultant Anesthetist Dr. Keith Thomson, a Mercy Ships International Board Member and a regular short-term crew member from the UK, recently arranged the Second Anesthesiology Conference at the Princess Christian Maternity Hospital in Freetown,Sierra Leone. The three-day conference was locally organized by Dr. Michael Koroma, who heads the Anesthesia Department at Sierra Leone’s Department of Health and Sanitation, and Sister Florence Bull. Dr. Matt Walters was the UK coordinator of programs.
This refresher course for nurse anesthetists drew forty trained nurse anesthetists from hospitals around Sierra Leone. In addition to more than a dozen local trainees, a team of hand-picked health professionals traveled from the UK to help facilitate the program which was held in tandem with the conference for midwives.
The opening ceremony included an announcement of an essay competition with a monetary prize. Anesthetists and midwives met together for the morning session on the second day and then split into small workshops in the afternoon session. Workshops and demonstrations were held to assist health professionals in Sierra Leone to better utilize their current medical facilities and equipment. Attendees took part in demonstrations of possible situations, with trainers praising correct responses, correcting incorrect ones, and leading the group analysis of all responses. These hands-on workshops encouraged participation and demonstrated effective approaches to problems. Practicing the correct order of procedures ensures successful responses in real emergencies.
Subjects covered during the training included airway management, fluid and drug calculation, critical incidents for children, estimating blood loss, assessment of critically ill patients, circulation, coping with chest trauma, and utilizing team work to improve outcomes. On the third day of the conference, Dr. Thomson spoke on the job of an anesthetist, highlighting challenges.
At the closing ceremony, Dr. Sahr Kpakiwa, considered to be the “father” of anesthesia in Sierra Leone, distributed certificates to all delegates. In addition, all attendees received a DVD of all presentations and a bag of disposable medical equipment.
The team facilitators/anesthetists from the UK included Dr. Keith Thomson, Dr. Ruth Broadbent, Dr. Steve Morris, Dr. Paul Theron, and Sister Dr. Sarah Davidson. The team facilitators/midwives were Louise Emmett, Rhiannon Grindle, Harriet Ivey, and Ruth Morris. Dr. Thomson’s daughter, Rebecca Thomson, a paramedic, assisted with administration. Mercy Ships Programs Director Keith Brinkman coordinated the team logistics.
Sponsors of the event included Mercy Ships, the Association of Anesthetists of Great Britain and Ireland, The Shalimar Trust, and The Squirrels Trust.
Story by Elaine B. Winn
Photos Debra Bell
Thursday, June 9, 2011
SIERRA LEONE-MIDWIFERY CONFERENCE-HELP SAVE NEWBORNS
The three-day Anaesthesiology and Midwifery Conference in Freetown, Sierra Leone, was held at the Princess Christian Maternity Hospital, beginning March 14, 2011. The conference was founded and hosted by Dr. Keith Thomson (MB BS, DRCOG, FRCA Consultant Obstetric Anaesthetist). This event attracted a total of 107 local participants and offered refresher medical training for common anaesthesiology and midwifery practices.
Conference facilitators consisted of a group of British medical staff comprised of anaesthetists, pediatricians, obstetricians and midwives. The midwifery team (Louise Emmett, Rhiannon Griddle, Harriet Ivey and Ruth Morris) from the United Kingdom’s Basingstoke & North Hampshire Hospitals Foundation Trust (BNHHFT) were joined by Dr. Shona Johnston, a pediatrician working with VSO (Voluntary Services Abroad) and Dr. Jenneh Kpakiwa, a second-year obstetric trainee in Bremen, Germany.
The conference was funded by The Association of Anaesthetists of Great Britain and Ireland, The Shalimar Trust, and The Squirrels Trust. Local arrangements were made by Dr. Michael Koroma and Sister Florence Bull. Mercy Ships supported the event by providing accommodation and transport for the conference team.
Dr. Matthew Walters and Matron Louise Emmett, organizers of the conference content, opted for a practical approach – short introductory slideshow lectures from the UK doctors, followed by a series of role-playing workshops. This format developed understanding and knowledge of the best medical practices to follow in different medical scenarios, enabling the delegates to implement the procedures in their workplaces.
Participants also enjoyed fun motivational exercises to aid learning, such as an essay competition to write a job description for an Anaesthetist Nurse. The valuable prize was $20 (more than a respectable week’s wages in Sierra Leone).
Contrary to conferences organized in western countries where attendees pay a fee to attend, the reverse is true in Africa. Attendees are paid to visit the conference. For this event each attendee was offered $20 to cover expenses and to provide an incentive for participation.
Dr. Keith Thomson’s longstanding interest in Africa, including 20 years of involvement with Mercy Ships and various other conferences, was the inspiration for this event. He investigated the optimal format for this initiative through many years of lecturing at conferences across Europe. The first conferences he attended as a guest lecturer on anaesthesia were in Eastern Europe in 1996. In 1998 he hosted his first midwifery-themed conference in Lithuania. This led to a childbirth conference in The Baltics in 2006, closely followed by a midwifery event in Uganda, Africa, in 2008. Now he has combined anaesthesia and midwifery – a unique combination – as a joint topic in Freetown, Africa.
This fundamentally ground-breaking initiative by Dr. Keith Thompson recognized the commonality of patients who were generally not being prepped sufficiently or who evidenced symptoms which indicated a high risk for anaesthetic to be administered – especially when a caesarean section was considered.
Statistics reflect the alarming truth that there are minimal facilities available for childbirth in Sierra Leone. One in eight mothers die during childbirth. Unfortunately, detailed mortality statistics are not collated, so the situation may be significantly graver than the general statistics indicate.
To date, there are only three qualified anaesthesiologists for five million people. Therefore, emergency caesarean section procedures are a rare option. The sobering statistics also indicate challenging circumstances for midwives in Sierra Leone.
On many occasions when there are complications during labor, the midwife is guided by a doctor’s instructions on the phone. Generally, the communication is poor between the medical staff, and the communication to the patient is aptly described by Dr. Keith Thomson as “emotionally blunt.” In most cases, the medical care is a humiliating experience for mothers who are already in an emotional and vulnerable state during labor. This is clearly evident in reports of patients being laid on the operating table in a crucifixion position and stark naked.
The conference was designed with these issues in mind and focused on optimizing treatment – using the equipment, medical staff and facilities commonly available in Sierra Leone. Many lives will be saved if this training is implemented in the field.
In the midwifery workshops, the basic principles of how to deal with infection and hemorrhage were the main topics for role-playing and group discussions. The highlight was a demonstration of teamwork during the management of obstetric hemorrhage, including airway management and fluid and drug calculations. There was detailed explanation about identifying the source of blood loss leading to the symptoms for various types of critical conditions. Overall, the conference encouraged planning ahead – including maintaining adequate inventory of equipment and supplies – in order to be prepared if a patient’s condition declines.
Although information about best medical practices was provided, advice was also given about what to do when there are no options available to meet best-practice criteria.
The factor that raised the most concern was the poor and minimal communication between medical staff and the mothers in labor. In Sierra Leone, it is a normal occurrence for medical professionals not to speak with their patients. In referring to local medical professionals, Dr. Jenneh Kpakiwa observed, “I think they were relatively capable for the most part ... what all of them seemed to think unimportant was communication. I got the impression (in our role- playing episodes) that patients are not really informed about anything at all.”
This is a terrifying prospect for the mothers in labor. The role-playing scripts demonstrated the type, quality and timing of essential information to relay to the patient – critical training in order to save lives.
Overall, the conference offered many benefits. First, the delegates had an opportunity to network with other local medical people in their field of work and with highly experienced medical staff from the U.K. Second, the knowledge provided to enhance assessment skills and earlier diagnosis will help prevent complications during monitored childbirth. Third, this increased success will, in turn, increase confidence in implementing best-practice procedures. This is important because the delegates will likely serve as trainers for the inexperienced staff in their workplaces. This transfer of knowledge will be easier thanks to the practice in effective communication offered during the role-playing workshops.
Of course, the most important benefit of the conference training is that more lives of mothers and newborn babies will be saved.
The conference was very well-received by the local medical professionals. Dr. Shona said, “I had a great time at the conference – it was a lot of fun! I really enjoyed the two sessions that I helped with (ABC sick kids and neonatal resuscitation).”
Dr. Keith Thomson realizes that more young professional midwives are required to implement and sustain long-term training through conferences in Africa. If practicing midwives in other countries have roots or connections with Sierra Leone, there is an urgent need for them to return and set up clinics. This will provide more resources and raise the standard of medical care during childbirth.
In the meantime, Freetown embraced this valuable opportunity. Hopefully, the implementation of the knowledge from this conference, training offered by future conferences, and the desired arrival of international midwives will help improve the mortality rate of newborn babies in Sierra Leone.
Story by Claire Ross
Photos by Debra Bell
Conference facilitators consisted of a group of British medical staff comprised of anaesthetists, pediatricians, obstetricians and midwives. The midwifery team (Louise Emmett, Rhiannon Griddle, Harriet Ivey and Ruth Morris) from the United Kingdom’s Basingstoke & North Hampshire Hospitals Foundation Trust (BNHHFT) were joined by Dr. Shona Johnston, a pediatrician working with VSO (Voluntary Services Abroad) and Dr. Jenneh Kpakiwa, a second-year obstetric trainee in Bremen, Germany.
The conference was funded by The Association of Anaesthetists of Great Britain and Ireland, The Shalimar Trust, and The Squirrels Trust. Local arrangements were made by Dr. Michael Koroma and Sister Florence Bull. Mercy Ships supported the event by providing accommodation and transport for the conference team.
Dr. Matthew Walters and Matron Louise Emmett, organizers of the conference content, opted for a practical approach – short introductory slideshow lectures from the UK doctors, followed by a series of role-playing workshops. This format developed understanding and knowledge of the best medical practices to follow in different medical scenarios, enabling the delegates to implement the procedures in their workplaces.
Participants also enjoyed fun motivational exercises to aid learning, such as an essay competition to write a job description for an Anaesthetist Nurse. The valuable prize was $20 (more than a respectable week’s wages in Sierra Leone).
Contrary to conferences organized in western countries where attendees pay a fee to attend, the reverse is true in Africa. Attendees are paid to visit the conference. For this event each attendee was offered $20 to cover expenses and to provide an incentive for participation.
Dr. Keith Thomson’s longstanding interest in Africa, including 20 years of involvement with Mercy Ships and various other conferences, was the inspiration for this event. He investigated the optimal format for this initiative through many years of lecturing at conferences across Europe. The first conferences he attended as a guest lecturer on anaesthesia were in Eastern Europe in 1996. In 1998 he hosted his first midwifery-themed conference in Lithuania. This led to a childbirth conference in The Baltics in 2006, closely followed by a midwifery event in Uganda, Africa, in 2008. Now he has combined anaesthesia and midwifery – a unique combination – as a joint topic in Freetown, Africa.
This fundamentally ground-breaking initiative by Dr. Keith Thompson recognized the commonality of patients who were generally not being prepped sufficiently or who evidenced symptoms which indicated a high risk for anaesthetic to be administered – especially when a caesarean section was considered.
Statistics reflect the alarming truth that there are minimal facilities available for childbirth in Sierra Leone. One in eight mothers die during childbirth. Unfortunately, detailed mortality statistics are not collated, so the situation may be significantly graver than the general statistics indicate.
To date, there are only three qualified anaesthesiologists for five million people. Therefore, emergency caesarean section procedures are a rare option. The sobering statistics also indicate challenging circumstances for midwives in Sierra Leone.
On many occasions when there are complications during labor, the midwife is guided by a doctor’s instructions on the phone. Generally, the communication is poor between the medical staff, and the communication to the patient is aptly described by Dr. Keith Thomson as “emotionally blunt.” In most cases, the medical care is a humiliating experience for mothers who are already in an emotional and vulnerable state during labor. This is clearly evident in reports of patients being laid on the operating table in a crucifixion position and stark naked.
The conference was designed with these issues in mind and focused on optimizing treatment – using the equipment, medical staff and facilities commonly available in Sierra Leone. Many lives will be saved if this training is implemented in the field.
In the midwifery workshops, the basic principles of how to deal with infection and hemorrhage were the main topics for role-playing and group discussions. The highlight was a demonstration of teamwork during the management of obstetric hemorrhage, including airway management and fluid and drug calculations. There was detailed explanation about identifying the source of blood loss leading to the symptoms for various types of critical conditions. Overall, the conference encouraged planning ahead – including maintaining adequate inventory of equipment and supplies – in order to be prepared if a patient’s condition declines.
Although information about best medical practices was provided, advice was also given about what to do when there are no options available to meet best-practice criteria.
The factor that raised the most concern was the poor and minimal communication between medical staff and the mothers in labor. In Sierra Leone, it is a normal occurrence for medical professionals not to speak with their patients. In referring to local medical professionals, Dr. Jenneh Kpakiwa observed, “I think they were relatively capable for the most part ... what all of them seemed to think unimportant was communication. I got the impression (in our role- playing episodes) that patients are not really informed about anything at all.”
This is a terrifying prospect for the mothers in labor. The role-playing scripts demonstrated the type, quality and timing of essential information to relay to the patient – critical training in order to save lives.
Overall, the conference offered many benefits. First, the delegates had an opportunity to network with other local medical people in their field of work and with highly experienced medical staff from the U.K. Second, the knowledge provided to enhance assessment skills and earlier diagnosis will help prevent complications during monitored childbirth. Third, this increased success will, in turn, increase confidence in implementing best-practice procedures. This is important because the delegates will likely serve as trainers for the inexperienced staff in their workplaces. This transfer of knowledge will be easier thanks to the practice in effective communication offered during the role-playing workshops.
Of course, the most important benefit of the conference training is that more lives of mothers and newborn babies will be saved.
The conference was very well-received by the local medical professionals. Dr. Shona said, “I had a great time at the conference – it was a lot of fun! I really enjoyed the two sessions that I helped with (ABC sick kids and neonatal resuscitation).”
Dr. Keith Thomson realizes that more young professional midwives are required to implement and sustain long-term training through conferences in Africa. If practicing midwives in other countries have roots or connections with Sierra Leone, there is an urgent need for them to return and set up clinics. This will provide more resources and raise the standard of medical care during childbirth.
In the meantime, Freetown embraced this valuable opportunity. Hopefully, the implementation of the knowledge from this conference, training offered by future conferences, and the desired arrival of international midwives will help improve the mortality rate of newborn babies in Sierra Leone.
Story by Claire Ross
Photos by Debra Bell
SIERRA LEONE HEALTH ED-TRAINING FOR LIFETIME
In a paradise of rolling hills with luscious green vegetation and rich terracotta soils, there is a formidable enemy – death. Tragically, children are its most vulnerable targets.
This is Sierra Leone, with a population of 4.7 million, primarily threatened by hopelessly poor sanitation and inadequate medical facilities, combined with lack of knowledge of basic hygiene. Sadly, the most common cause of death is diarrhea as a result of swallowing harmful bacteria – bacteria often associated with poor sanitation.
The logical conclusion is that maintaining good hygiene and nutrition is the key element in protecting lives. This is especially important in consideration of the limited medical facilities available. According to the World Health Organization, there are only five main hospitals. There are a handful of satellite hospitals in the towns, supported by twelve district hospitals in the provinces.
The realities of these statistics have become increasingly evident during many of the previous Mercy Ships Field Services. There have been numerous occasions when medical crew extended their roles in order to provide basic health care advice to patients. On a floating hospital ship that relies on professional volunteers, every second counts in bringing hope and healing to the West African nations. Therefore, it was quickly recognized that health education was a valuable need, and an off-ship Health Education Program was designed for patients. The program’s coordinator is Becca Taylor.
The program takes a preventative approach to health by promoting an understanding of a variety of topics – hygiene, nutrition, causes / treatment of diarrhea, basic first aid, malaria prevention and common diseases such as measles.
Considering the minimal and often desperately poor medical facilities available in Sierra Leone, this basic health education offers a lifeline – especially for the children. The 2010 report from the World Health Organization stated that one child out of five does not reach his or her fifth birthday.
The hospitality unit at the HOPE Centre provides pre-op and post-op patient care, and it is the chosen location for the health education training. Often the patients are not immediately aware of the importance of the lessons. They are usually motivated to attend due to curiosity or their relationship with the trainer. Thus, it is very important that the class format is designed to keep them engaged and focused.
All the training consists of basic information relayed through informal presentations, demonstrations and activities. The practical element is critical for the patients’ involvement as this will teach them skills to implement at home. Adding fun and laughter to an interactive approach motivates the patients to listen and learn.
For instance, one training session used the shower rooms to demonstrate how to use the water to wash bodies and clothes, as well as advice about hygienic toilet training for small children. This training was aided by pictures on the wall and fun props such as a brightly colored shower cap (an item not widely available locally).
Another session presented the importance of cleaning hands, including the concept of transferring germs. One presenter dipped his hands in flour and started touching objects and shaking the patients’ hands. The doughy white-powdered handprints were a visual illustration of the transference of germs when people forget to wash their hands. The presentation closed with a demonstration of the hand actions required to wash all the germs away accompanied by a hearty rendition of the song “Tenki Papa God” (“Thank You, Father God”).
Then the fun escalated as the practical activity began. The patients were required to wet their hands, plunge their hands into a large bowl of flour, and then tour the garden to leave white handprints on colored paper in various locations. After the tour, they lined up at the garden tap to give their hands a good scrub with soap to remove the half-dried, sticky flour mixture – again while singing a 20-second verse of “Tenki Papa God.” The activity closed with a group photo of arm-waving, laughing participants.
This positive communication and interaction will help patients remember the valuable lessons. Then they can take their new-found knowledge home and apply it to their families. In this way, they can prevent or minimize illness . . . or maybe even contribute to saving the life of a loved one!
Story by Claire Ross
Photos by Debra Bell
This is Sierra Leone, with a population of 4.7 million, primarily threatened by hopelessly poor sanitation and inadequate medical facilities, combined with lack of knowledge of basic hygiene. Sadly, the most common cause of death is diarrhea as a result of swallowing harmful bacteria – bacteria often associated with poor sanitation.
The logical conclusion is that maintaining good hygiene and nutrition is the key element in protecting lives. This is especially important in consideration of the limited medical facilities available. According to the World Health Organization, there are only five main hospitals. There are a handful of satellite hospitals in the towns, supported by twelve district hospitals in the provinces.
The realities of these statistics have become increasingly evident during many of the previous Mercy Ships Field Services. There have been numerous occasions when medical crew extended their roles in order to provide basic health care advice to patients. On a floating hospital ship that relies on professional volunteers, every second counts in bringing hope and healing to the West African nations. Therefore, it was quickly recognized that health education was a valuable need, and an off-ship Health Education Program was designed for patients. The program’s coordinator is Becca Taylor.
The program takes a preventative approach to health by promoting an understanding of a variety of topics – hygiene, nutrition, causes / treatment of diarrhea, basic first aid, malaria prevention and common diseases such as measles.
Considering the minimal and often desperately poor medical facilities available in Sierra Leone, this basic health education offers a lifeline – especially for the children. The 2010 report from the World Health Organization stated that one child out of five does not reach his or her fifth birthday.
The hospitality unit at the HOPE Centre provides pre-op and post-op patient care, and it is the chosen location for the health education training. Often the patients are not immediately aware of the importance of the lessons. They are usually motivated to attend due to curiosity or their relationship with the trainer. Thus, it is very important that the class format is designed to keep them engaged and focused.
All the training consists of basic information relayed through informal presentations, demonstrations and activities. The practical element is critical for the patients’ involvement as this will teach them skills to implement at home. Adding fun and laughter to an interactive approach motivates the patients to listen and learn.
For instance, one training session used the shower rooms to demonstrate how to use the water to wash bodies and clothes, as well as advice about hygienic toilet training for small children. This training was aided by pictures on the wall and fun props such as a brightly colored shower cap (an item not widely available locally).
Another session presented the importance of cleaning hands, including the concept of transferring germs. One presenter dipped his hands in flour and started touching objects and shaking the patients’ hands. The doughy white-powdered handprints were a visual illustration of the transference of germs when people forget to wash their hands. The presentation closed with a demonstration of the hand actions required to wash all the germs away accompanied by a hearty rendition of the song “Tenki Papa God” (“Thank You, Father God”).
Then the fun escalated as the practical activity began. The patients were required to wet their hands, plunge their hands into a large bowl of flour, and then tour the garden to leave white handprints on colored paper in various locations. After the tour, they lined up at the garden tap to give their hands a good scrub with soap to remove the half-dried, sticky flour mixture – again while singing a 20-second verse of “Tenki Papa God.” The activity closed with a group photo of arm-waving, laughing participants.
This positive communication and interaction will help patients remember the valuable lessons. Then they can take their new-found knowledge home and apply it to their families. In this way, they can prevent or minimize illness . . . or maybe even contribute to saving the life of a loved one!
Story by Claire Ross
Photos by Debra Bell
SIERRA LEONE - ISATU BLOOMING FLOWER
Isatu Konteh (Kondeh)
For the better part of a day, Isatu sat on her hospital bed staring at the reflection of her face in the small mirror in her hand. Despite the three thin strips of translucent bandage, she could see that the volunteer doctors on the Africa Mercy had corrected the cleft lip that had kept her isolated from people her whole life. She was amazed! She could hardly grasp the fact that she would now smile like everyone else.
Isatu was born with a cleft lip that created an unpleasant, even angry, expression on her face. It disrupted her upper lip and front teeth . . . and her entire life.
Isatu had spent her thirteen years at home, helping her mother keep house for the family, which included a sister and two brothers. Since West African culture views deformities as a sign of a curse, the cleft lip prevented Isatu from making friends and going to school. Would she ever be able to have a real life?
Then hope appeared in the form of a radio advertisement. A Mercy Ship was coming to Sierra Leone, bringing surgeons who could fix cleft lips. Isatu was delighted.
At the Mercy Ships medical screening, Isatu’s father described her as a very friendly girl who is a big help at home. But she sat expressionless as he spoke. Her father answered all questions for her. Quiet and withdrawn, she did not speak to anyone – a defense mechanism learned from years of being shunned.
Isatu was the first patient to receive the priceless appointment card for cleft lip surgery in the Sierra Leone Field Service. And what a difference the surgery made in her life! Almost overnight, she was transformed from a very somber young lady to one who giggled about everything. She bloomed like a lovely flower, making friends among the patients recuperating in the ward. The successful cleft lip surgery gave her a whole new perspective on herself and on her life . . . evident in the beautiful new smile she generously bestowed on everyone.
When Isatu’s brother arrived to take her home, his delight with Isatu’s successful surgery was obvious. He hugged her, and she reveled in his attention. He even revealed that because of the difference the surgery made, Isatu’s father plans to enroll her in adult education classes, followed by training to become a seamstress. Isatu beamed as she realized she would soon be preparing for a productive life.
With pride and affection, her brother said, “Now she can get married and have a family.” Getting married and having children is of prime importance to young women in Sierra Leone – a goal previously prohibited by Isatu’s cleft lip.
It is no wonder Isatu’s first words after surgery were, “I’m happy now.”
For the better part of a day, Isatu sat on her hospital bed staring at the reflection of her face in the small mirror in her hand. Despite the three thin strips of translucent bandage, she could see that the volunteer doctors on the Africa Mercy had corrected the cleft lip that had kept her isolated from people her whole life. She was amazed! She could hardly grasp the fact that she would now smile like everyone else.
Isatu was born with a cleft lip that created an unpleasant, even angry, expression on her face. It disrupted her upper lip and front teeth . . . and her entire life.
Isatu had spent her thirteen years at home, helping her mother keep house for the family, which included a sister and two brothers. Since West African culture views deformities as a sign of a curse, the cleft lip prevented Isatu from making friends and going to school. Would she ever be able to have a real life?
Then hope appeared in the form of a radio advertisement. A Mercy Ship was coming to Sierra Leone, bringing surgeons who could fix cleft lips. Isatu was delighted.
At the Mercy Ships medical screening, Isatu’s father described her as a very friendly girl who is a big help at home. But she sat expressionless as he spoke. Her father answered all questions for her. Quiet and withdrawn, she did not speak to anyone – a defense mechanism learned from years of being shunned.
Isatu was the first patient to receive the priceless appointment card for cleft lip surgery in the Sierra Leone Field Service. And what a difference the surgery made in her life! Almost overnight, she was transformed from a very somber young lady to one who giggled about everything. She bloomed like a lovely flower, making friends among the patients recuperating in the ward. The successful cleft lip surgery gave her a whole new perspective on herself and on her life . . . evident in the beautiful new smile she generously bestowed on everyone.
When Isatu’s brother arrived to take her home, his delight with Isatu’s successful surgery was obvious. He hugged her, and she reveled in his attention. He even revealed that because of the difference the surgery made, Isatu’s father plans to enroll her in adult education classes, followed by training to become a seamstress. Isatu beamed as she realized she would soon be preparing for a productive life.
With pride and affection, her brother said, “Now she can get married and have a family.” Getting married and having children is of prime importance to young women in Sierra Leone – a goal previously prohibited by Isatu’s cleft lip.
It is no wonder Isatu’s first words after surgery were, “I’m happy now.”
SIERRA LEONE - BABY BARBRA
Baby Barbara Receives Life
Chapter 1
Babies born with deformities in West Africa start life as victims of the West African superstition that abnormalities are signs of a curse. When Barbara was born with a cleft lip that extended up into her nasal cavity, her father pronounced that she was a “demon child.” He ordered his wife to take the tiny infant into the bush and leave her for dead.
Barbara’s brave mother, Aminata, refused to abandon her child. As a result, she was thrown out of her house and moved in with her sister. Without a way to support her family, Aminata was forced to separate her four other children and send them to homes of other relatives.
Broken and devastated, Aminata had reached her darkest, lowest point. Then God stepped in and brought a ray of light. One day Aminata met a woman who said that Barbara was not a “demon child.” She also said that Mercy Ships would arrive in Sierra Leone in just a few weeks. Volunteer surgeons onboard the Africa Mercy could fix the baby’s lip – for free!
Barbara’s weight was drastically low because her cleft lip prevented her from getting the nutrition she so desperately needed. In fact she weighted less than 4 kilograms (8.4 pounds). On top of that, she had contracted tuberculosis and was placed on a TB program at a local hospital.
Shortly after the Africa Mercy arrived in Sierra Leone, Barbara was accepted for cleft surgery. However, because she was below the acceptable weight for surgery, she was enrolled in the Infant Feeding Program. Nurse Melissa Davey, of Philadelphia, was able to teach Aminata a different feeding method to ensure weight gain for the tiny child.
Currently, Baby Barbara comes to the ship for weekly check-ups. She is slowly gaining weight, despite all her problems. Soon she should be ready to meet the surgeon who will repair her cleft lip – and “erase” her curse – and give her a beautiful new smile!
Chapter 1
Babies born with deformities in West Africa start life as victims of the West African superstition that abnormalities are signs of a curse. When Barbara was born with a cleft lip that extended up into her nasal cavity, her father pronounced that she was a “demon child.” He ordered his wife to take the tiny infant into the bush and leave her for dead.
Barbara’s brave mother, Aminata, refused to abandon her child. As a result, she was thrown out of her house and moved in with her sister. Without a way to support her family, Aminata was forced to separate her four other children and send them to homes of other relatives.
Broken and devastated, Aminata had reached her darkest, lowest point. Then God stepped in and brought a ray of light. One day Aminata met a woman who said that Barbara was not a “demon child.” She also said that Mercy Ships would arrive in Sierra Leone in just a few weeks. Volunteer surgeons onboard the Africa Mercy could fix the baby’s lip – for free!
Barbara’s weight was drastically low because her cleft lip prevented her from getting the nutrition she so desperately needed. In fact she weighted less than 4 kilograms (8.4 pounds). On top of that, she had contracted tuberculosis and was placed on a TB program at a local hospital.
Shortly after the Africa Mercy arrived in Sierra Leone, Barbara was accepted for cleft surgery. However, because she was below the acceptable weight for surgery, she was enrolled in the Infant Feeding Program. Nurse Melissa Davey, of Philadelphia, was able to teach Aminata a different feeding method to ensure weight gain for the tiny child.
Currently, Baby Barbara comes to the ship for weekly check-ups. She is slowly gaining weight, despite all her problems. Soon she should be ready to meet the surgeon who will repair her cleft lip – and “erase” her curse – and give her a beautiful new smile!
SIERRA LEONE - QUEEN SALLY
“Sometimes, I would just sit down and cry,” said Sally with great emotion. For seventeen years, people laughed at her and mocked her because of her legs – horribly misshapen and knock-kneed. The constant verbal abuse made her feel ashamed. Walking was difficult and tiring, so she didn’t go to school. She just stayed at home in her misery.
The problem was caused by an automobile accident when she was only ten years old. A witch doctor blanketed her legs with a native concoction of boiled leaves. Splints of wooden sticks were tied to her legs for three months. But nothing changed; she returned home with bent legs. Without money for surgery, she had to learn to live with her disability.
Three years ago, Sally’s parents died. Since she had no siblings, she went to live with a friend. Her friend found a mentor to teach Sally to sew, and she eventually went to work at a dressmaker’s shop. In fact, she hopes to own her own shop some day.
A new friend at work told her that a Mercy Ship, offering orthopedic surgeries at no charge, would soon be in Sierra Leone. She encouraged Sally to go to the screening. The volunteer surgeons on the Africa Mercy surgically repaired her legs and put them in casts.
When she awoke in the ward, she was delighted to see that her legs were both straight in the casts. But when her casts were changed, she was ecstatic. “I could SEE my legs were straight!” said Sally with a brilliant smile. “It’s like a dream, and I’m an angel that can walk on straight legs!”
While Sally was recuperating from surgery, she received some very special guests – the wives of the President and Vice President of Sierra Leone! The moment was captured by a photographer and printed in the local paper. This was a highlight for all the patients in the ward, who dubbed her “Queen Sally.” She had never received such recognition before and thoroughly enjoyed the reflected glory of the event. It was a great start in helping Sally think of herself in a new and more positive light.
Another bonus of the surgery is that her straightened legs add height to her physical stature. When she walked on her bandaged legs for the first time, she exclaimed, “I’m so amazed! I used to be a short somebody. Now, I’m tall!”
A free surgery revolutionized the life of this young woman with the bubbly personality. Sally already knows what she will do first upon being released from the hospital ship. “I want to give my testimony at church of what Mercy Ships did for me,” she states firmly. “If it were not for Mercy Ships, I was going to die with legs like that, because I had no money. I was mocked every place I went. I’m thanking God for what He has done for me, and I’m asking Him to bless you people.”
Story by Elaine Winn
Photos by Debra Bell
The problem was caused by an automobile accident when she was only ten years old. A witch doctor blanketed her legs with a native concoction of boiled leaves. Splints of wooden sticks were tied to her legs for three months. But nothing changed; she returned home with bent legs. Without money for surgery, she had to learn to live with her disability.
Three years ago, Sally’s parents died. Since she had no siblings, she went to live with a friend. Her friend found a mentor to teach Sally to sew, and she eventually went to work at a dressmaker’s shop. In fact, she hopes to own her own shop some day.
A new friend at work told her that a Mercy Ship, offering orthopedic surgeries at no charge, would soon be in Sierra Leone. She encouraged Sally to go to the screening. The volunteer surgeons on the Africa Mercy surgically repaired her legs and put them in casts.
When she awoke in the ward, she was delighted to see that her legs were both straight in the casts. But when her casts were changed, she was ecstatic. “I could SEE my legs were straight!” said Sally with a brilliant smile. “It’s like a dream, and I’m an angel that can walk on straight legs!”
While Sally was recuperating from surgery, she received some very special guests – the wives of the President and Vice President of Sierra Leone! The moment was captured by a photographer and printed in the local paper. This was a highlight for all the patients in the ward, who dubbed her “Queen Sally.” She had never received such recognition before and thoroughly enjoyed the reflected glory of the event. It was a great start in helping Sally think of herself in a new and more positive light.
Another bonus of the surgery is that her straightened legs add height to her physical stature. When she walked on her bandaged legs for the first time, she exclaimed, “I’m so amazed! I used to be a short somebody. Now, I’m tall!”
A free surgery revolutionized the life of this young woman with the bubbly personality. Sally already knows what she will do first upon being released from the hospital ship. “I want to give my testimony at church of what Mercy Ships did for me,” she states firmly. “If it were not for Mercy Ships, I was going to die with legs like that, because I had no money. I was mocked every place I went. I’m thanking God for what He has done for me, and I’m asking Him to bless you people.”
Story by Elaine Winn
Photos by Debra Bell
SIERRA LEONE JOSEPHINE STONE FREE
JOSEPHINE-GOD NEVER SLEEPS
Two-year-old Josephine inhaled something that affected her breathing. Her parents, David and Judith, could hear the rattle with every struggling breath. They took her to a local clinic which sent them to an emergency hospital . . . which sent them to a government hospital . . . which sent them to a satellite clinic . . . which sent them back to the government hospital. After five days in the government hospital, specialist Dr. Karim Kabineh told them that Josephine was so tiny that she would die if he performed the necessary operation. He needed a pediatric anesthetist, anesthesia equipment, and a critical care unit with 24-hour nursing care – all unavailable at that hospital.
After eight days of hopeless searching for help, the desperate parents took Josephine to the office of the Minister of Health, where David hoped to plead his case and find someone who could help. At that moment – in the miracle of God’s timing – Ann Gloag, a member of the Mercy Ships International Board who is well-known for her charity work in Africa, was meeting with the Minister.
As this compassionate woman walked by the family sitting in the reception area, she heard the labored breathing of little Josephine. She put in a call to Dr. Gary Parker, Chief Medical Officer onboard the Africa Mercy, the hospital ship docked a short distance away in Freetown Harbor. After explaining to him what appeared to be the problem, arrangements were made to use an ambulance to transport Josephine, her parents and Dr. Kabineh to the ship.
Dr. Gary examined Josephine, took x-rays and discovered a small stone lodged in the little girl’s bronchus. A virtual think tank was begun to find a way to remove the stone from her tiny body. Dr.Gary approached engineering to see if a medical device could be fashioned that would be the right shape to fit into the bronchoscope and retrieve the stone. Every plausible idea was examined and eventually rejected.
Dr. Gary and Dr. Kabineh worked for five hours trying to remove the stone without success. Dr. Gary called Ann back to explain that what Josephine needed was a cardiac thoracic surgeon, and there wasn’t one on the ship. David was devastated. Mercy Ships was his last hope. But crew member Clementine Tengue encouraged him, saying, “God will find a way.”
Josephine was admitted to the intensive care unit with 24-hour care. About 3:00 am, ICU Nurse Melissa Warner was working the night shift when Josephine lost her breathing tube. Her vital signs were crashing. Dr. Michelle White, the pediatric *anesthetist/ anesthesiologist, was paged, but it would take her several minutes to respond. “In my mind, I said ‘I need help!’”Melissa said. “And when I looked up, there was Corina Buth standing in the doorway in her pajamas!” Corina, a pediatric ICU nurse from the Netherlands, had been restless and couldn’t sleep. Corina did CPR, and Josephine’s vital signs returned to normal. Then Dr. Michelle arrived and replaced the breathing tube.
Josephine’s condition was rapidly deteriorating. Analysis was made of the hospitals nearby. Ghana had the required surgeon, but he was absent at that time, and the travel expense to South Africa was prohibitive.
Meanwhile, Ann had phoned a professor friend of hers in Nairobi and explained that she needed a pediatric cardiac thoracic surgeon who could fly to Sierra Leone right away. The professor knew just the right man – Dr. James Munene, head of cardiac surgery at Nairobi’s Kenyatta National Hospital. Although it was quite late, he phoned Dr. James, explained the problem and asked him to go to Sierra Leone to operate on Josephine.
“Wait!” Dr. James said, rather forcefully. “I don’t know what you’re talking about!”
“Just talk to this lady,” the professor responded.
Ann called a few minutes later and told the doctor he needed to fly immediately to Freetown where his skills were urgently needed.
“I was a bit reluctant,” said Dr. Munene. “I had never heard of Mercy Ships. I had no information on this case, and it was the middle of the night!”
Ann called back with information on his flight. “Be at the airport at 6:00 a.m.,” she said.
“It was a little difficult to say no to the lady. I told my wife, ‘I guess I’m going to Sierra Leone in the morning,’” Dr. Munene said.
Then Dr. Gary called to say he was emailing information and x-rays of Josephine.
“I was thinking, ‘It’s not happening! It didn’t sound real!’ But by 1:00 a.m., I had the ticket and all the necessary papers ... and there I was at the airport at 6:00 a.m..,” explained Dr. James.
This confident specialist with the gentle demeanor landed at Lungi Airport, not yet totally comprehending the situation. And he still had to endure the bumpy boat ride across the bay to Freetown. “It was surreal!” he admitted.
Dr. James was overwhelmed by the Africa Mercy, the more than 400 crew members volunteering from 35 different countries, and the concept of bringing hope and healing to the forgotten poor. He couldn’t believe such a mission could have been in operation for so many years, and he didn’t know anything about it.
Teaming with Dr. Gary, Dr. James operated on Josephine, fishing the stone out of her bronchus with ease. Because Josephine was so tiny, it was a vital requirement to have a pediatric anesthetist as part of the team. Dr. Michelle White was serving in this capacity at the time and was a vital part of the team. “Working with such a tiny body, I wouldn’t have proceeded without her,” said Dr. James.
Josephine awoke shortly after the surgery and sat up on the gurney all the way to the Intensive Care Unit, looking around and asking for a glass of water. To everyone’s surprise, she was anxious to eat right away. After a few days of recuperating in the ICU – and enjoying the attention of the nurses and other crew members – the little girl and her grateful parents left the ship
In reviewing this story, it is amazing to see the many things that had to happen for this tiny girl to survive. Her parents had to keep her alive for eight days after she inhaled the stone. Ann Gloag had to be visiting the office of the Minister of Health at the same time that David, Judith, and Josephine were there. Dr. James Munene had to agree to perform a surgery for an organization of which he had never heard; and Nurse Corina had to be drawn to the ICU because she couldn’t sleep. This incredible timing and all of these wonderful people were part of the miracle that allowed Josephine to grin happily as she left the Africa Mercy as a healthy little girl.
Dr. James was captivated by the mission and hopes to return to volunteer his services. “Really, it’s a privilege to come and see what people are doing while others are sleeping and doing nothing,” he said.
And God never sleeps – miracles still happen every day. Sometimes we are blessed to be a part of them.
Story by Elaine B. Winn
Photos Debra Bell
Two-year-old Josephine inhaled something that affected her breathing. Her parents, David and Judith, could hear the rattle with every struggling breath. They took her to a local clinic which sent them to an emergency hospital . . . which sent them to a government hospital . . . which sent them to a satellite clinic . . . which sent them back to the government hospital. After five days in the government hospital, specialist Dr. Karim Kabineh told them that Josephine was so tiny that she would die if he performed the necessary operation. He needed a pediatric anesthetist, anesthesia equipment, and a critical care unit with 24-hour nursing care – all unavailable at that hospital.
After eight days of hopeless searching for help, the desperate parents took Josephine to the office of the Minister of Health, where David hoped to plead his case and find someone who could help. At that moment – in the miracle of God’s timing – Ann Gloag, a member of the Mercy Ships International Board who is well-known for her charity work in Africa, was meeting with the Minister.
As this compassionate woman walked by the family sitting in the reception area, she heard the labored breathing of little Josephine. She put in a call to Dr. Gary Parker, Chief Medical Officer onboard the Africa Mercy, the hospital ship docked a short distance away in Freetown Harbor. After explaining to him what appeared to be the problem, arrangements were made to use an ambulance to transport Josephine, her parents and Dr. Kabineh to the ship.
Dr. Gary examined Josephine, took x-rays and discovered a small stone lodged in the little girl’s bronchus. A virtual think tank was begun to find a way to remove the stone from her tiny body. Dr.Gary approached engineering to see if a medical device could be fashioned that would be the right shape to fit into the bronchoscope and retrieve the stone. Every plausible idea was examined and eventually rejected.
Dr. Gary and Dr. Kabineh worked for five hours trying to remove the stone without success. Dr. Gary called Ann back to explain that what Josephine needed was a cardiac thoracic surgeon, and there wasn’t one on the ship. David was devastated. Mercy Ships was his last hope. But crew member Clementine Tengue encouraged him, saying, “God will find a way.”
Josephine was admitted to the intensive care unit with 24-hour care. About 3:00 am, ICU Nurse Melissa Warner was working the night shift when Josephine lost her breathing tube. Her vital signs were crashing. Dr. Michelle White, the pediatric *anesthetist/ anesthesiologist, was paged, but it would take her several minutes to respond. “In my mind, I said ‘I need help!’”Melissa said. “And when I looked up, there was Corina Buth standing in the doorway in her pajamas!” Corina, a pediatric ICU nurse from the Netherlands, had been restless and couldn’t sleep. Corina did CPR, and Josephine’s vital signs returned to normal. Then Dr. Michelle arrived and replaced the breathing tube.
Josephine’s condition was rapidly deteriorating. Analysis was made of the hospitals nearby. Ghana had the required surgeon, but he was absent at that time, and the travel expense to South Africa was prohibitive.
Meanwhile, Ann had phoned a professor friend of hers in Nairobi and explained that she needed a pediatric cardiac thoracic surgeon who could fly to Sierra Leone right away. The professor knew just the right man – Dr. James Munene, head of cardiac surgery at Nairobi’s Kenyatta National Hospital. Although it was quite late, he phoned Dr. James, explained the problem and asked him to go to Sierra Leone to operate on Josephine.
“Wait!” Dr. James said, rather forcefully. “I don’t know what you’re talking about!”
“Just talk to this lady,” the professor responded.
Ann called a few minutes later and told the doctor he needed to fly immediately to Freetown where his skills were urgently needed.
“I was a bit reluctant,” said Dr. Munene. “I had never heard of Mercy Ships. I had no information on this case, and it was the middle of the night!”
Ann called back with information on his flight. “Be at the airport at 6:00 a.m.,” she said.
“It was a little difficult to say no to the lady. I told my wife, ‘I guess I’m going to Sierra Leone in the morning,’” Dr. Munene said.
Then Dr. Gary called to say he was emailing information and x-rays of Josephine.
“I was thinking, ‘It’s not happening! It didn’t sound real!’ But by 1:00 a.m., I had the ticket and all the necessary papers ... and there I was at the airport at 6:00 a.m..,” explained Dr. James.
This confident specialist with the gentle demeanor landed at Lungi Airport, not yet totally comprehending the situation. And he still had to endure the bumpy boat ride across the bay to Freetown. “It was surreal!” he admitted.
Dr. James was overwhelmed by the Africa Mercy, the more than 400 crew members volunteering from 35 different countries, and the concept of bringing hope and healing to the forgotten poor. He couldn’t believe such a mission could have been in operation for so many years, and he didn’t know anything about it.
Teaming with Dr. Gary, Dr. James operated on Josephine, fishing the stone out of her bronchus with ease. Because Josephine was so tiny, it was a vital requirement to have a pediatric anesthetist as part of the team. Dr. Michelle White was serving in this capacity at the time and was a vital part of the team. “Working with such a tiny body, I wouldn’t have proceeded without her,” said Dr. James.
Josephine awoke shortly after the surgery and sat up on the gurney all the way to the Intensive Care Unit, looking around and asking for a glass of water. To everyone’s surprise, she was anxious to eat right away. After a few days of recuperating in the ICU – and enjoying the attention of the nurses and other crew members – the little girl and her grateful parents left the ship
In reviewing this story, it is amazing to see the many things that had to happen for this tiny girl to survive. Her parents had to keep her alive for eight days after she inhaled the stone. Ann Gloag had to be visiting the office of the Minister of Health at the same time that David, Judith, and Josephine were there. Dr. James Munene had to agree to perform a surgery for an organization of which he had never heard; and Nurse Corina had to be drawn to the ICU because she couldn’t sleep. This incredible timing and all of these wonderful people were part of the miracle that allowed Josephine to grin happily as she left the Africa Mercy as a healthy little girl.
Dr. James was captivated by the mission and hopes to return to volunteer his services. “Really, it’s a privilege to come and see what people are doing while others are sleeping and doing nothing,” he said.
And God never sleeps – miracles still happen every day. Sometimes we are blessed to be a part of them.
Story by Elaine B. Winn
Photos Debra Bell
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