Saturday 29 December 2007

The First Three months

The first three months have whisked by like a whirlwind - and what an exciting time it has been for us as a family. As most of you probably would have read from our blog site, we have by God's grace, settled down quite well in our new environment and home. This was due to the generosity of the Church in Sierra Leone and to the efforts of our new neighbours who have gone out of their way to make us feel really welcome. The transition was made as smooth as possible despite the obvious challenges people faced and I wish to take this opportunity (on behalf of our family) to thank everybody involved for their efforts, help and practical advice in making this possible.

Now a bit about Nixon Memorial Methodist Hospital. For those who do not know, Nixon Memorial Methodist Hospital was founded in the 1930’s. It quickly developed into the second largest hospital in Sierra Leone before the war. At its peak the hospital had 4 Medical doctors and provided both general medicine and specialized services such as eye clinic, Lassa fever research, (NMMH was linked with an institution in Atlanta, Georgia, USA); and had specialist TB and leprosy wards. The reputation of the hospital was such that at its peak it attracted patients from all parts of the country including Freetown, and neighbouring countries such as Guinea, Liberia and Ivory Coast.
There is a Nursing School attached to the hospital. The NMH Nursing School started in 1953 and initially trained State Registered Nurses (SRNs), State Enrolled Nurses (SENs) and Midwives. As a result of a change in national policy the school presently trains only State Enrolled Community Health Nurses. There are currently 117 students at different levels; pursuing the SECHN course and they are at different stages of their training. The three levels are as follows:
Introductory level - 54 students (including 8 male students);
Second Year - 39 Students (including 10 male students);
Final Year - 24 Students (including 6 male students).

There are presently 5 full time and 2 part-time lecturers at the Nursing School. Composition is follows:
1 x Principal Tutor who is the general nursing tutor
1 x Midwifery and general nursing tutor (recently joined from UK)
2 x Clinical Tutors
1 x Public Health Tutor
1 x Part-time English tutor
1 x Part-time Mathematics tutor.


Workwise, we have faced new challenges and opportunities. The hospital is an exciting place to work. When we arrived, we were faced with a hospital, which was (and still is) in crisis due to a number of reasons, but mostly because of the war. The war has wreaked a lot of destruction on not only the hospital, but also the country as a whole. The hospital faces an acute drug shortage problem, it lacks adequate qualified staff - both medical and auxiliary - to help with the efficient running of the hospital. Most of the infrastructure was destroyed - the evidence is littered all over the hospital campus. For example, we have the shell of what was originally a very large and modern theatre, the laboratory, which was a first class research laboratory, has now been reduced to only blood and stool testing for parasites etc.

Despite the above obvious disadvantages, the staff is wonderful, with a desire to bring genuine relieve to the patients.

My workday starts at about 7.30 am when I join the students for morning devotion in the chapel. The days activities could then involved anything from supervising the contractors repairing the OPD building to holding meetings (both formal and informal) with the staff and senior Managers of the hospital, or generally supervising of the groundsmen.

The key areas that we are working in include:

a. Improving the drug/medicine availability. The chronic shortage of drugs - due to both lack of funds (due to low patients numbers and poverty, coupled with general shortage and improper management, has hampered and continue to hamper the work of the hospital. With the help of the Christian Health Associations of Sierra Leone (an umbrella organisation for Christian Health Service providers), the hospital managed to procure some medicines to help alleviate the problem in the hospital. This would be one of the key focal points for the hospital during the coming year. Our strategy would be to generate extra income from other sources to enable the hospital purchase more drugs and equipment.

b. Income generating activities
As mentioned above, the hospital is exploring new avenues to generate extra income and this would focus primarily on using the large tract of unused hospital land to grow cash crops such as maize, cassava and groundnuts for sale. The plans are in the infantile stage and I hope to update you all when these plans get off the ground.

c. Outreach to the villages
The hospital has plans in place to start mobile clinics to two villages at the start of the new year. We recognise this to be very crucial in our plans to increase the accessibility of health services to the community within the hospital's catchment area. Most people in developing countries are unable to access medical services due to poverty and transport difficulties. We therefore see these outreach clinics as pivotal to the hospital's plans to improve access to all within our catchment area.

Nursing School. The nursing school is going on in leaps and bounds and we are hoping to work with another organisation to improve the facilities for the school. Joanna is scheduled to start teaching at the school at the beginning of the New Year. She was busy towards the end of the year with preparation of the examinations for the introductory level students.


Altogether, the last three months have been both exciting and challenging, not necessarily in equal measure. We are grateful to God for the opportunity to be involved in the lives of the people of Sierra Leone and hopefully to be able to make a meaningful contribution to their lives.
The first few weeks have seen the seeds of good management planted in Nixon to try to bring the hospital back to its former days when it was a key health service provider. It is our prayer that the coming year would see the hand of God tend these seeds as they begin to 'germinate' and sprout into good practices that would help us all move the hospital to the level where God's wants it to be and to make a huge difference to the lives of those who access its services.

Week-ends
Our Saturday's generally are not very eventful, except when we organise a general clean-up of the hospital wards. Sundays are devoted to church activities - either attending the chapel on campus or the local Methodist Church in Segbwema. Most of the services are conducted in the local Mende language with a sprinkling of Creole (pidgin/broken English). I know Joey struggles with the church services because she cannot understand much of what is said and also because Joelle does not stay still in church for long periods. She therefore ends up spending most of her time sitting outside and trying to get Joelle amused. There is no Sunday school so this may be an opportunity for us to start one for the other children - who generally look very bored during the services.

Segbwema is a very small town but very peaceful. The scars of the 10 year civil war are everywhere for every one to see. The town has one only one bank - a community bank, a police station and a number of secondary schools - I think three in all. The hospital is the largest employer in the town with less than 50 employees. The town is noted as one of the most 'covered' towns in S/L in terms of network coverage. All the four mobile networks have erected masts in the town so mobile connectivity is generally pretty good.

Tuesday 11 December 2007

Reflections- the Peace of the Times

The past few days have given us the opportunity to reflect on the job ahead, the people we work with, and what we’ve done so far but above all what God is doing in our lives during the short time we have been here in Sierra Leone.
The short time here in Sierra Leone has brought home to me how peaceful this country really is considering the recent history of the country. It is a general occurrence to see children walking home from school along the bush path without any concern. I have on a number of occasions, seen young women walking from the farm along dirt, isolated roads, carrying firewood or farm produce with children strapped to their backs without a care or concern on their faces. These pictures brought home to me how far the county has moved on from its recent past and I am very proud of the people and the country. This really gives me hope and confidence as we try to contribute our little bit towards the rebuilding of this beautiful country.
Yes, SL is a very beautiful country if one can take their eyes away from the immediate poverty that is around for all to see. The rolling mountains and the green, forest teeming with all sorts of food items and animals depict how blessed this country really is. Every village we drive through in this Eastern Province of SL have loads of food sacks stacked by the roadside waiting to be carted to Freetown. There is abundance of food everywhere, and the rolling mountains ensure that there are so many streams and rivers in SL it is unbelievable. The number of streams in the province amazes me. I wish these would be harnessed to provide clean drinking water for everybody in the country.

The people are beautiful and one will never see more elaborate hairstyles and hairdos anywhere else like in this country. Yes, the people may not have a lot to show for in terms of material things but they do know how to carry themselves with dignity and poise. My first Sunday in church made me realise how fickle some of us, especially those of us used to having things ‘on tap’ can be. I have seen children wear the same clothes to church three weeks in a row, but each time the clothes are clean, well kept and in very decent shape. I wonder what a 7 or 8 year old in the west would say if asked to wear the same clothes to church two weeks in a row, let alone for three weeks. Don’t get me wrong, I am not suggesting the people do this by choice but at least they do so with pride and dignity and have learnt obviously, to live with the little that they have. As Apostle Paul said, they have learned to live both with plenty and with little. (See Phil. 4:12) I wish those of us living (or who have lived) in the West would learn to live with little. It made me realise how we try to create ‘little Londons’ or ‘New Yorks’ in the village as we (the expats) flock to the only supermarket in town to try to replicate our western lifestyles in these villages. How ridiculous when there is so much fresh food and fish about. I agree, some food items may not be very familiar but then most of us were unfamiliar with cheddar cheese and brie until we went to Europe. Now they are our favourite foods. Oh dear!!!!. Please forgive me – I digress.
I want to talk about the real heroes I work with. Some of these people have worked for over two to three years without a break or the obligatory annual holiday. Of course I am by no means suggesting that it is a good state of affairs, but these people have recognised the shortage of personnel and are doing their very best to keep the hospital going under very trying circumstances. I cannot imagine anyone working anywhere in the West without annual leave; to be on call 7 nights a week, including bank holidays, and to cap it all sometimes not getting paid at the end of the month – oh yes- it does happen here. These guys have taken dedication to another level that personally challenges me a great deal. I am grateful to God that I have been given the opportunity to work with such dedicated people. Some of them single-handedly kept various parts of the hospital going during the civil war. The current Principal of the nursing school at the hospital had to flee about 10-15 miles through the bush to escape from the rebels during the war. He managed to re-start the Nursing school in the nearest town and ‘bussed’ all the students there so that they could continue with their studies in the midst of all the conflict. He then returned after 3mths – when there was a lull in the fighting to re-start the school in Segbwema and thanks to his efforts, the Nursing School survived. This may not be a remarkable story except that this gentleman is blind. Yes BLIND!!!. I feel challenged – and oh by the way he is still teaching. His is not the only unique story. Time will not permit me to narrate the story of the doctor who operated a ‘field’ hospital during the war by sleeping on the theatre floor just to keep the hospital going. Through his efforts, a remnant of the hospital survived and this is what has now flourished into what is now Nixon. Incredible – but there are more similar stories.

We spent the last few days in Freetown trying to clear the last of our shipment from the port. That was a challenging experience – a story to be told another day. I was struck by the number of hurdles and hoops the ordinary person has to jump through just to clear ones personal effects from the port. The requirements just made it so conducive for corruption to flourish, but even here God again came through for us by putting us in touch with someone who was more interested in us as people rather than in our money and was able to clear the consignment for us without demanding a fee. There are still honest people even in the face of such obvious underhand activities.
During the time we spent in Freetown, we were able to enjoy some of the beautiful spots in the capital but our favourite place no doubt is the beach in Lumley. The beach was very clean, not teeming with people and above all no traders hassled us to buy their wares. The beach stretches for the best part of 3 miles with beautiful white sand and the sea was so calm. The rolling hills in the distance contributed to a very calming effect in a very unique way. It reminded me of the saying – He (God) made all things beautiful.
This last week saw both Little J and Michael celebrate their birthdays. It was an eye-opener. A party here is not limited to only the invited guests but to the hospital 'family'. Almost everybody joined us in celebrating their joint birthdays and that was fantastic even though we were surprised by the number of people who turned up. Thank God there was enough food to go round and to be fair - the food was cooked by the student nurses. We had a real African party - together with the music and all the accoutrements that go with African parties. We are blessed to have such a family.

This was demonstrated to me when we organised the students to help give the wards a thorough cleaning during the past week. Almost 59 students turned up - albeit most of them had no choice - they were ordered to do so - but even then the work was done with such enthusiasm it was a joy to be part of the team.

I have noticed how stress free our lives have been for the past few weeks. We do have stress of a different kind - but not stress from travelling to work or that associated with catching the underground or the bus. I don't particularly miss the hustle and bustle of London - well not yet but I am sure that would come one day - but at the moment we are doing fine - by God's grace. Having said that we had a visit from a friend from London recently and I must admit I asked him to get me a couple of stuff from the UK but glad to say not cheddar cheese nor brie!!

Yes, it is the Christmas month but it feels very different here. No adverts on the TV trying to convince me to buy what I really do not need ….. oh yes, no TV!!!!!!!. It is really surreal and I sometimes have to bring myself to realise that Christmas is only 15 days away. I remember that just before we left England in late September, the TV stations were beginning to run the Christmas adverts. It is a welcome break from the commercialisation of Christmas but I must admit - over here there is no hint of Christmas at all, except for the week end dances which have now become a regular feature of the week end here in Segbwema. I am reliably informed that the week end dances will continue till after Easter when they all stop because of the start of the farming season.

Reflecting on the last few weeks since we arrived has made me realise how baseless some of our fears were. This place is like most normal African villages where the inhabitants are friendly, warm and ready to share despite the obvious lack. There is poverty, marginalisation, lack of amenities but despite all that one can sense the friendliness of the people, the warmth and desire to do their best for each other. We thank God that through His grace He has made it possible for us to share in the goodness and life of the people of Segbwema, and Sierra Leoneans in general.

Let us share Little J's favourite song;

Tell 'Im thank ye, tell 'Im
Tell Papa God thank ye.
For what 'im done for me,
I go tell 'am thank ye
I want to tell 'im (tell 'im ) tell 'im, tell Papa God thank ye,
What 'im done for me, I go tell 'am thank ye
Tell Papa God thank ye.

Only a child can highlight the simple fact of life. Out of the mouth of babes praises ….
God bless.