A Christmas Miracle

So the past few weeks have been a huge challenge and a big lesson in patience, for many different reasons. Hannah has told me that a previous volunteer passed on that Kambia meant “Come and be patient”.  Her boyfriend then later corrected her:

“No Hannah – it means come and endure.”

Sam also pointed out the other day that we are in the country with the third worst health indicators in the world, in its worst district used as a dumping ground for the staff that no one else in the country wants, where even volunteers avoid  and no money is invested. This perhaps shed a little light on why we were so frustrated.

The best words of wisdom came from Lucy, Hannah’s lovely friend who came to stay:

“However bad your day has been it is not as bad as Jack Bauer’s.”

We have been obsessively watching 24, an old series where Jack has to deal with his wife and daughter being kidnapped and save America along the way.  For a moment I did wonder whether the death toll of our day is higher, although after counting both up we thankfully came to the conclusion that no, Jack wins by a large margin.

There has been big excitement over the past few weeks ...

The road is being surfaced in tarmac AND our first shop has officially opened... a garage!!!! There is no stock yet but that is a minor detail. It may mean that 2014 will bring a daily opportunity to buy chocolate. Very important for morale and bribery.  

 

 

 

 

 

The grand opening of our new shop and garage

 There are also now solar street lights, which gives children light to do their homework at night, provides more of a social life and makes walking around at night feel very safe.

 

 

 

Tarmac in progress with solar street lights above

Not only does the tarmac mean that the dust is massively reduced, decreasing the need for showers and antibiotics for respiratory infections, but it might just mean Kambia will start to develop, bringing with it job opportunities.  Unfortunately it will also bring traffic and the motorbikes that give us lifts have already sped up, increasing everyone’s daily chance of death/ mutilation.

So I could write about the amount of babies who die daily unnecessarily here, or the women who have died through the incompetence of the staff or lack of resources, and my frustration that despite my best efforts this still, and will continue to, happen regularly. But instead I am going to write about my favourite ever (work) baby. Baby Sheko.

He was born a couple of weeks ago now, on a day that followed a particularly bad few days. His mother came in with yet another ruptured uterus, with palpable fetal parts. There was no doctor, but luckily Alhasson, a brilliant CHO, was willing to do the caesarean. I heard a fetal heartrate, but just put it down to my lack of experience using a pinard, rather than the battery operated dopplers.   Just in case I might be right, I insisted on going to theatre on my own, knowing that resuscitating with someone else would mean a diplomatic battle and wasted time (“just a bit more suction... lets swing the baby from it’s ankles... why are you bothering to dry it... lets go straight to chest compressions?”). 

I was determined that that day I would forget about long term benefits and just try to do the right thing for one family. After pushing for sterilisation (which has to be agreed to by the husband, many of whom think that their wife is less important than another son), we were in theatre, ready to go.   At least some of us were.  Another hours wait went by for the various members of staff to turn up at work and the operation started, after the compulsory prayer. Considering you have a maximum of 30 minutes for the baby to be out in the UK when it is an emergency caesarean, these couple of hours drove me insane, and I gave up all hope of a live baby.

BUT... you guessed it, baby Sheka came out of the abdomen, as the uterus had opened so much he was no longer inside it, and gave a gasp!! Alhassan and I were so excited that we almost forgot to clamp the cord, but sure enough after a few minutes of resus (to a chorus of “what are you doing, give it suction, swing it, smack it”) he cried!! As anyone with any experience of obstetrics or midwifery will know, this was perhaps the closest thing to a miracle I have ever seen.

Beautiful Baby Sheko survived and thrived, with a mum well enough to feed him a few hours later. Happy day!

Baby Sheko, with permission from his lovely mother

We have also had Christmas to keep us going. The staff are definitely in party mode, and with cooler nights we have been to two hospital parties the last couple of weeks. This involves every member of the hospital, so patients are left with the night staff popping over to check on patients occasionally, perhaps bringing a few of them back along. It also means no one goes to work the next day. It has done wonders for our street cred however. Not only are they amazed that white people dance, but I have now been asked to give Konnie, a VNA, dance lessons. With my history of dancing like an enthusiastic crab I think this will be by far my proudest moment and biggest achievement in Salone. I cannot believe that I, a distinctly unsmooth white girl has been asked for moves from a beautiful African women. Score!

Hannah and I glammed up, Africana style

We watched our first Christmas film yesterday, while sweating, underneath our makeshift decorations. It was The Holiday, and as Sam pointed out, the first film the boys haven’t been interested in.  As soon as they realised it was more romance than violence they soon drifted away. Not surprising considering we found out recently that the retribution of choice for the increasing number of thieves around Christmas is an injection of acid into the stomach. Not for anyone they know of course...  I certainly felt warm and fuzzy following our dose of Christmas spirit, although that might have been the sun and dehydration.   My wonderful family have also made me a beautiful advent calendar, with a gorgeous treat each day.  It has meant whatever my day in hospital has been like, I have always come home to a smile. Thank you!

I have to say though I hope our Christmas dinner will not consist of another of Abraham’s star catches.  Groundpig (rat) is a grand cause for a roasted celebration here!

Abraham and Rat

I am keeping my fingers crossed for a few more Christmas Miracles and wishing everyone a very Merry Christmas and a Happy New Year. 

From One Born Every Minute to One Dies Every Minute

So I thought I would be able to sit down and keep a daily record of my time here - how wrong I was! Mainly because I have already had more fun in my first three weeks than I expected to have in my whole 6 months here. 

Who would have thought that I wound find myself in a tropical paradise last weekend, watching a safely distanced sea tornado with good company. Wasn't I supposed to be trying to save lives rather than sunning myself?!

Bureu Beach

It already seems another world ago that I arrived in Kambia. After setting off piled high with gloves and treats in a Redcar train on Halloween, I ended up in a crammed and temperamental car bouncing my way through a dramatic storm. Torrents of rain created lakes in the bumpy pot hole filled road, with lightning illuminating the dramatically flat landscape fringed with palm trees. This appealed to my romantic side, as though some one actually cared that yet another "Oporto" had arrived in Sierra Leone!

Soaked and smelly after 29 hours of nervous travel I finally got to meet my wonderful new Kambian family. Hannah, Sam and Martin who I would be working with in the hospital, then Charles, Abbas, Santigie, Almamy and Abraham who are in charge of the base, security and extremely important things like food. Despite images of dire shacks my hut and the base seemed very hospitable, helped by a kind donated candle and welcome poster. No serial killers living here with me then (or very friendly ones). 

Luckily it was the weekend, so my first couple of days were spent wandering around the red dust roads, meeting many very friendly neighbours and being dramatically introduced at one of the colourful local churches (the attraction being the networking,singing and dancing - making me feel decidedly white and unsoulful).

Outside our base

I also purchased a very colourful bucket at the even more colourful market, which I was told would be invaluable. So far I have seen many being carried on heads and find it slightly surreal washing in the same looking bucket that the bloody delivery instruments are sterilised in! 

All this to put off my first day at the hospital. Still it finally came so when I realised I had no way of escape save a 4 hour motorbike ride, meaning probable death or mutilation, I made my way in.

Perhaps the easiest way to describe it is by telling you what surprised me the most:


Number 1: The rats (and chickens, dogs, goats...) freely running throughout the ward, no doubt enjoying the blood and urine stains covering most surfaces.

Number 2: The warm welcome of an over worked, non paid and under valued work force.

Number 3: However hot it is, you should dress smartly. My scrubs didn't really cut it next to the sister's flamboyant tailor made outfit and matching hairpiece.

Number 4: The lack of job doing. Why would you bother to give drugs or care for someone when you could be lying on a bed giving yourself metronidazole for period pain? Or watching a film?! (especially when you come in for free).

Number 5: The normality of death. In my first week I saw more dead babies than live ones, a breech delivery, 3 eclamptic (fitting) women and 2 ruptured uteruses. Considering some midwifes won't see this in their career, it's safe to say I was a little overwhelmed.

Tragically one mother also passed away, although I feel her story is not something to share on here. It made all those books I had been reading in preparation so much closer to home. Matching faces to the glum mortality figures of this beautiful country is something I never wanted to do. I couldn't help but make the comparison between the fact one mother dies in childbirth around the world every minute, yet In the UK with our glorious NHS one beautiful baby is born every minute. 

What I wouldn't give for an emergency buzzer... 

I have quickly understood the importance of educating women and girls especially about the importance of family planning. It is very hard when faced with huge challenges in the hospital to try and find a way to sloooooowly change some of the problems, while being aware that this may not be possible, and understanding that more time means more deaths. Therefore it seems much simpler to stop a lot of the problems from ever appearing! This is something we are trying to get more involved in.

I never guessed that one day I would be helping to teach sex education to an all girls school, cringing my way through questions about wet dreams and "mummy and daddy business", then the next pushing the broken down "ambulance" containing two women in desperate need of a cesarean, to try and find a hospital with a Doctor. They now however both seem of equal urgency.

With Lamin trying to explain "wet dreams"

Luckily we managed to get to a hospital which was just an excruciatingly bumpy hour and a half away (we did not have to push it all the way or I would have been in the ambulance too), banishing my panicked thoughts of a 4 hour journey to Freetown turning up with two dead babies and two dead mums.  

I have to admit I did wonder for a few seconds whether a road side attempt at a section with my paper scissors and travel sewing kit was an option.

Overall life here is good.  We have just come back from a very long and entertaining matriculation ceremony for Charles Abbas and Santigie (we of course, sweat dripping from us, late, were ushered up onto the stage leaving no chance of an early escape), complete with two squawking chickens given to the college as a gift.  We have access to plenty of cheap plastic sachets of gin and coffee rum and we even managed to do a kind of bonfire night, although no one stood around the bonfire for long in 90% humidity. 

For now, I am taking a leaf out of Salones's book and "telling God tenki",

keeping all my fingers and toes crossed for a few more births than deaths this next week. 

 My African lappa dress for the matriculation