Gumption.

I have been safely back in Shropshire for the last six weeks now after a brilliant and tearful Africana send off. This means snuggling down each night with a duvet, enjoying my wonderful family, staying too long in the bath and watching Made in Chelsea (shudder- I mean from Kambia to MIC, I guess you could call that escapism). Luckily I start a new job next week in a friendly birth centre in South London. Hopefully I will then be spending more time marvelling at the NHS and less time wondering whether Binky is finally going to man up or if Jamie is going to ever give up on Lucy.

However Salone has never been more than a thought away, especially in the last couple of weeks. Ebola finally, tragically, made it's way to Kambia District.

This has meant that the Kambia Appeal volunteers have had to be evacuated. It must be heartbreaking to leave behind close friends and hospital staff in such difficult circumstances, with such mixed emotions. They have handled it brilliantly, and I have no doubt that their hard work, despite all the set backs due to this lethal and persistent virus, will pave the way for future volunteers and has supported the local staff.

Having said this, I know the hospital will be fine.

I know this because despite the immense challenges and difficulties there are some staff members who just refuse to be ground down. Instead they continue to work hard and change things for the better, small small. They have Gumption. 

This is a great word.  It always feels as though it has to be spoken with feeling, as though just by saying it you are making a statement. In The Holiday (hardly the Holy Grail of films, but one I love none the less) Alfred uses it to try and explain the extra something that some women just seem to have. 

My Kambian heroes, however, put a weeping Kate Winslet to shame. They don't have gumption just because they decided to stop crying over a man, it comes from somewhere much deeper than that. It has to, otherwise they would have given up long ago. 

I will talk about three such people who are just a few of some of the incredible characters I met during my time in Kambia. 

I have chosen them firstly because they are women. In a country where to be born a girl means you have often disappointed someone before even taking your first breath, they prove that being female is something to be proud of. A barrier to be beaten down not to change your path. Secondly all three of them regularly do their best to save lives and do so under ridiculous circumstances: low or no pay, continuous long days at work, separated from their families in other villages and often without even the most basic of equipment, such as gloves. Lastly they are leaders, shouting (literally) about problems that others ignore and giving colleagues the boost they need to keep plodding on. 

First up we have Memuna:

     

I am proud to say she became my friend. Working long hours on the female ward, even right up until the day she gave birth, Nurse Memuna has stamina and strength. She got fed up of waiting for facilities to be provided for hand washing, so to keep staff safer she raised the money herself. Nobody has a bad word to say about this kind and funny women. To top it off she volunteered to be one of the nurses who will care for patients with ebola if they need to be isolated in the hospital: Gumption.

Sallamatu also stepped up to the mark and volunteered to be an ebola nurse:   

She is very feisty and now in charge of male ward. Sallamatu would be able to stand up to any old school senior midwife or consultant who tried to reduce her to jelly. In fact it would probably be the other way around. She is teaching in the picture above, something she is very good at. If there is a problem she will not accept it quietly, and would rather lead a riot than settle for second best: Gumption.

Sister Sally:

   

On call 24 hours a day, midwife Sally stubbornly protects what she believes in, and passionately cares about all the women and babies that are in her care. Pop round for a visit to her home in the hospital, and in between looking after her children, the youngest of which she has adopted, she has a steady stream of community members and previous patients asking for her trusted advice. This women is extremely loyal and seems to have unlimited time for the things she is passionate about: Gumption.

The trouble is these incredible women need people coming up the ranks to join and eventually replace them. It is these local heroes that will bring about real change in the long term. When tuition fees to train to be a nurse are so expensive and unpredictable it can be very difficult for enthusiastic, talented,  hospital volunteers (effectively unpaid nurses) to take the next step and get the teaching they deserve and need to work effectively. There are no student loans for them.

This is why we have decided to support these five volunteers in their quest to become qualified nurses. All of them worked incredibly hard, for free, in the hospital, attending Kambia Appeal classes in their own time, competently running wards. They all made the effort to apply to the course. Surprisingly no easy feat due to the politics that surround the process like so many other things in Sierra Leone. They all have young children, often making the sacrifice to leave them with family so they can try and build a better and more secure future for them. Gumption.

It is going to cost up to £20,000 over three years to train them all, but I think that this is possible. It has to be - this training would ensure that Kambia gets new, appropriately trained staff to join the ranks, and would mean stability for the families of Isha, Yaka, Hawa, Francess and Isha.

One day I hope that some of them will rub off on me, but for now I, and other volunteers they inspired, are going to try and raise the money they need to change their world.

If you want to help and can spare some cash, please follow the link below.
www.bmycharity.com/SupportKambiaNurses 

It's Only Lassa

A few weird and wonderful things have happened in the past month or so.

Weird was the excitement of developing Tumbu Fly larvae in my ankle. This happens when the fly lays eggs in your clothes while they dry, which then burrow into your skin when you put them on. A maggot then grows under your skin getting bigger and fatter thanks to your juicy flesh.

I have to admit we were all grossly excited about this, and I cringed as a little head poked itself of my ankle after I had put on some vaseline (I suppose the equivalent of smoking it out). We were so excited that the only concern was that it hadn’t grown any bigger, therefore ruling out the option of a youtube video. Next time I must do better.

Wonderful was the arrival of the first rains, starting surprisingly early in March. It was comforting to hear the hammering of the rain on the tin roof again. Unfortunately, as Samuel warned, the rain “washes the sun”. I think that the fact that there is now never a moment when my face isn’t dripping with sweat proves this theory.

Also the arrival of the mangoes! They are incredibly delicious, and add some much needed variety to our diet. I do feel though that I would not risk my life for their taste. Several boys disagree with this however, not willing to wait for them to ripen when they can be easily shaken or hooked down by bamboo sticks, instead climbing high into the sky, balancing on precarious branches, many of which crash down later throughout the day (the branches, luckily not the boys... yet).

Another great day was a casual trip to the border to see a community health clinic and visit our friends. This led to a trip over the river border to pop into Guinea and see the border village. Who needs visas when you can just smile and talk badly in French? This woman was the friendliest person I have ever met.

Unfortunately not all new developments are good. Dare I mention the E word?! Ebola is in Guinea, and sadly as we are the direct route between Guinea and our capital Freetown, as well as being the first hospital over the border, this is not an idle threat to us.

We have discussed contingency plans of course, the most sensible being Josie’s suggestion of hiding in a bucket. No chance of a bodily fluid splash then.

Another option is to run away to the beach, perhaps slightly more appealing.

Sadly the reality is actually that we have been taken out of clinical contact. Extremely frustrating (if understandable on the Kambia Appeal’s part). It was hard to look our friends in the eye, and say you cannot help them, and yet they cannot leave and have to continue working, often without being paid, with not enough gloves and in some cases not even anywhere to wash their hands. Amazingly the staff were incredibly understanding, only saying how much they appreciate our efforts.

 I think it is safe to say that I wouldn’t be so gracious in their shoes. My respect for the unique staff of Kambia Hospital is increasing daily.

We had a scare last week, when we were told there was a suspected case 10 minutes from us (this would mean we would have to be evacuated home). Luckily it was only Lassa, another horrific viral haemorrhagic disease, but this time with only a 20% mortality rate rather than 90%! Yay! I hope this is the only time in my life I will be celebrating a Lassa diagnosis.

We have been finding other ways to stay sane/ keep busy. 

Here are a few examples:

1)      Drinking many suspicious plastic sachets of ginger rum.

2)      Taking out frustration on mud and transforming it into bricks.

 

3)      Trying to cook on a charcoal fire (with many furry and feathered friends to keep us company).

 

4)      Taking a sweepstake on the amount of time it would take for our fence to finally be repaired. Good news – I won a whole 30,000Le (about £5).

5)      Being slightly awestruck at the sporting day talents of the local secondary school. Also laughed the loud speaker booming out a harsh ten minute long scolding for the tiny 5 year old scout who couldn’t lower the flag properly. Poor boy (but pretty funny)!!

Hopefully I will be UK bound in a few weeks time, unless Ebola has it’s wicked way with Kambia, in which case it may be sooner. Let’s hope I have a little longer left of sweating to go.

Angel Delight, KFC and a Malnutrition Ward

I have been meaning to write this for a couple of months now but it is becoming much harder to know where to start. The trouble is life here is tragic and cruel, and to write about it is to trivialise it in some ways. But at the same time life here is also very colourful, rich and incredibly fun. The more friendships I make and the more politics I discover I realise both how fabulous it is to have the privilege to live here, if only for a while, yet also how hard it is to know how some things will ever improve. 

As I am constantly being told by the wise staff, small small is how it will happen.

So a few things that have happened:

Our wonderful Dr Small left but only after making us pancakes and being given many gifts of Africana outfits and a delicious chicken called KFC .

The beautiful new malnutrition ward opened which is the culmination of many people’s hard work. This is both a victory and a sad reminder of the fact that this kind of ward is needed in the first place.

It puts my chocolate and roast dinner cravings into perspective. (Also makes our cupboards stocked with UK goodies seem ever so slightly selfish...)

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We had a party fuelled Christmas and New Year including a riverside rave, a botched but fairly successful attempt at mulled wine (while pretending it was cold), countless Christmas films and cocktails and surfing on the beach. Not quite the sacrificial Christmas I had perhaps been envisaging pre departure, but we did end up welcoming a special Christmas Eve baby into the world. Never just pop in to say hi...

Then it was all change. With the departure of Hannah and Martin we then got to welcome several new faces. With them came copious amounts of angel delight - the closest thing to ice cream here and heaven on a spoon. My standards have slipped but I have no shame in saying that when I return home butterscotch angel delight will always be on my shopping list.

So as for the hospital, what do I say? 

There have been clear steps forward which are incredibly exciting. I really enjoy (and find very frustrating) the never ending hilarity of the work ethic here: I have recently discovered that it is much easier to persuade people to do work with you if you sing when you ask... “Let’s do this blooood presssureeeeeeee, what could beeeeeeee more fuuuuunnnn!!”. Also the community feel of the team, particularly in the evening when all staff members seem to congregate on the ward in their satin pyjamas.

This can’t deflect from the terrible reality of caring for a young women overnight, who has several children already, watching her uterus rupture, knowing there is nothing you can do about it until morning (by which time it may be too late). 

Or take away the frustration of suddenly not being able to hear yet another baby inside its mother due to the lack of effective monitoring allowing us to spot the moment of decline. And is it even right to take someone into life threatening surgery (because that is what it is here) to save a baby? However precious that little person is, how can you weigh up the perhaps small chance of preserving life when the mother may die leaving her family behind to fend for themselves?

Not enough blood, not enough skills, not enough motivation, incentive or morale, never enough money and certainly not enough resources or equipment.

And yet so much can be done with words, kindness and skilled hands. This is why it is never worth giving up. And one day, all this will change. I hope that I will come back in the future to Kambia, perhaps on a family holiday, to go to a thriving beach packed with tourists, drive through a fantastic infrastructure with ethical and growing local business, brilliant sanitation and agriculture, not having to worry because if I get sick I can  go the hospital with full faith in their care and facilities.

This will happen, but how many have to die first?

I will never forget the women and babies who would be alive if only they had been born a couple of decades later, or somewhere else not so far from here.