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.