Sierra Leone (Day 6)

Trip Start Sep 28, 2007
Trip End Oct 12, 2007

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Friday, October 5, 2007

Day 6

Friday Oct. 5, 2007

Up at 7:30 am and met with an NGO known as The Center Of Victims of Torture centered in Freetown. Our intention was to determine if there were any partnering possibilities. They work exclusively with the psychological and emotional aspects of the individual. The psychological recovery programs here are almost non-existent, but we are hopeful that we can refer some of the amputee victims to them for counseling. Once again, determining the purpose of each NGO has proven to be of great benefit to our overall mission.

Next stop was a visit to Mercy Ships (in this case a land-based surgical hospital to treat women with a common problem here of birth or rape-related trauma of the bladder/vaginal or rectal/vaginal structures known as a fistula resulting in chronic incontinence of urine or stool). But we are traveling by a rented Toyota Landcruiser. This requires some embellishment. Our expectations of a reliable vehicle was totally unrealistic. What we were given was a Landcruiser with no working AC, broken door and window handles, no working gas gage, leaking exhaust back into the car, and burning more oil than gasoline. This same vehicle caught fire when Mambud was getting refreshments for the soccer team and literally had to jump from the car to escape the fire coming from the engine compartment. Traveling from point A to point B means we arrive hot and sweaty and only get there on a wing and a prayer. We have pleaded with the rental company for a reliable vehicle when we travel for the next 3 days up-country into various remote villages to visit other amputee resettlements. We shall see...........

Back to Mercy Ships. The director was out of town but one of the resident surgeons who has trained other physicians in this highly specialized fistula surgery agreed to meet with us and give us a tour of their facility. The women they treat have become outcasts of their villages because of the shame they face with the problem of leaking urine or feces and inability to bear further children. Many are forced to live alone in the bush and fend for themselves barely able to stay alive from day to day. Mercy Ships will go from village to village, locating these women bringing them back for surgical treatment. This amounts to approximately 400 patients yearly at no cost to them. Their facility far exceeds any of the government-run hospitals in the country. The most common cause is due to improper birthing. Local midwives teach the women to squat at the beginning of labor rather than waiting for the proper timing and this results in tearing of the organs/structures and sometimes associated nerve damage of the pelvis and legs. We visited the post-surgical ward and posed with them for photographs. The joy on their faces was overwhelming. This was the first time they were dry!! When they leave the hospital, they are given a new dress to wear symbolizing their new life as they return to their village without shame. The impact of this program is too great to express adequately.

Our next stop, ConNaught Hospital - the only tertiary care hospital in SL and government run. This was offered as the best care available in the country. We met with the Chief Medical Director, Dr. Bayouh who told us that during the war, the rebels destroyed most of the operating equipment and supplies. Even sterile gloves are a luxury. When Jim asked him what he needed most he did not hesitate - a CT scanner. Their radiology department has rudimentary x-ray and ultrasound equipment but no advanced imaging systems. Dr. Bayouh is an orthopedic surgeon who was trained in Germany but is hampered by a lack of adequate diagnostic procedures. Jim will pursue this problem when he returns to the US. Meanwhile, we will take inventory of their radiology department and current capabilities. There is no CT scanner in the country of Sierra Leone!!!

We also hope to formulate a medical advisory committee upon our return to enable us to assist with their multiple health needs.

We ended our visit to the hospital by presenting two cases to Dr. Bayouh that we had encountered so far. One was a young man whom we met while watching the single-leg soccer team. He was there as a friend of many of the players who have become his only family. He lost both parents in the war. He was using crutches because of a diseased left foot and leg. He has been told that he has a tumor of his left lower limb that requires an above the knee amputation. He cannot afford the $200.00 for the operation! Dr. Bayouh agreed to take him on as a patient and promised to see him the next day if we could arrange transportation (we did). Ironically, surgical amputation of his leg will allow him to potentially join the amputee soccer team and play with his friends!!

We also discussed Constance, the 11 year old daughter of GGM board member Janet. Constance sustained a playground injury at the age of 5 which actually fractured her left upper arm. No x-rays were taken until 3 year after the injury when chronic infection set in which persists to this day living with constant pain. He agreed to do the surgery if we could arrange for overnight shipping of Gentamycin antiobiotic beads (strips) from the US to implant into the bone. When we discussed this with Janet, she was appreciative but fearful of any surgery done in SL for her daughter - fearful of this resulting in possible amputation of her arm due to a lack of expertise. She begged us to consider taking her to the US for more expert care. It would seem that the severity of her case may be beyond the capability of the medial system here. We will be bringing her x-rays back with us for consultation with orthopedic physicians in the US.

Back in the car through the incredibly congested streets of Freetown. A 20 minute distance by car takes an average of 2 hours. There are no street lights in the city, people and venders line the streets, sidewalks are in disrepair, organized chaos is the order of the day. Literally thousands of people are struggling for their individual commerce risking their lives in the chaotic traffic. We arrived back at the GGM office around 5 pm. Waiting for us since 10 AM were a dozen female amputee victims who meet monthly for counseling. There were there to share their stories with us and apply for micro loans to re-jumpstart their lives again. Each had a business plan to present. Pastor Samai insists upon a complete program of application included individual photo, personal profile, business plan and counseling for basic accounting skills and reporting practices. Each is expected to repay 100% of the loan so as to recycled the funds for others to benefit.
There is never a direct handout because the goal is empowerment not dependency.

Asana is such an example. She is a beautiful young mother of 5 children. The rebels amputated her left leg above the knee, the toes of her right foot, and the fingers of her right hand!! A remarkable survival story in its own right. Despite this, she has a remarkable spirit and will to succeed and not be reduced to a life of street begging. Her youngest infant was along and Lynn noticed its raspy cough and congestion. The child was recently discharged from a local hospital and given prescriptions which Asana was unable to afford. Asana was encouraged to return for new prescriptions and bring them to GGM to purchase for her.

Alas, another day in which we learned so many heart-filled stories of personal courage and perseverance. We crawled into bed by midnight exhausted but determined and challenged to make a difference here in Sierra Leone.....................
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