Saturday 22 March 2008

News Letter - A Reflection on the first Six Months

Its being six months since we arrived at Nixon, and they have been lifechanging.
The last three months have given us a deeper understanding of some of the issues facing the hospital. For instance, access to health facilities is more complicated than just the lack of money to pay medical bills, or lack of good roads to the health facility. It embodies also cultural orientation and beliefs and the role of key influencers within the community. Making health services available to the population therefore involves getting the cooperation of all the stakeholders involved.

The beginning of the year saw the launch of an outreach programme via a mobile clinic to two of the surrounding villages, by the hospital. Considering some of the issues highlighted above, this was not a small achievement. We had to work with the paramount chiefs of the two villages involved – and to involve various specialist people in the hospital to stretch their time and commitments further to cover the outreach programme. This programme is very important to the hospital as it increases accessibility of health services to the surrounding areas. The mobile clinic is on Wednesdays with visits to the villages on alternate weeks. Not only does it enable the hospital to reach and treat some people who may not otherwise have access to health services but also it gives the nursing students field experience and an opportunity to put into practice some of the knowledge taught in the classroom.

There has also been a considerable improvement in our drug stock levels and this is due to a combination of reasons. As reported in the last newsletter we continue to receive considerable stock of drugs from the Christian Health Association of Sierra Leone (CHASL) at reasonable cost. This has helped us stretch our budget considerably as compared to purchasing on the open market. In addition, we have managed to secure considerable stock of drugs from the District Medical Stores- again at considerable low prices. This has reduced the pressure on us as it contributes significantly to our key objective of delivering quality health service to the community.

In January, another doctor from the UK joined us for a six-month assignment period. This has been a real blessing to us at the hospital because it has eased the work pressure on the two resident doctors considerably. This means a doctor is able to join the mobile clinic every week without reducing service provision on outreach days.

In February, Mike King, Team Leader of the Africa desk at World Church Office in the UK visited us at Nixon. This gave us an opportunity to discuss some of the issues – both personal and work-related - with him. Mike was able to access and ascertain the key role that Nixon plays as a health provider to the community.
Dr John Cochrane also visited in February though with different objectives. Dr Cochrane and his church in Redbridge (and together with some Friends of Nixon in the UK) have supported a Community Health Based programme run by the hospital for the past couple of years. This started as a pilot project to improve community health through public health education. He was in Segbwema for a review of the programme. Another key objective was to help map a way forward for the programme and explore avenues for funding the Community Health programme when the funding for the pilot project ceases.

In February, the pump on the only source of drinking water on the campus broke down. This has placed considerable stress on the provision of water not only to the Nixon but also to the surrounding community as a whole. The good news is that we have managed to locate a technician who can fix the problem – but the cost of repairs is proving a financial challenge.

The Nursing school received a boost from a local NGO when it received funding for the award of scholarships to10 students of the school. The school however is in need of a number of teaching materials – both for the classroom and practical teaching on the wards. An appeal has been sent out to WCO for help in securing some of these teaching materials.

The staff and workers of both the hospital and the nursing school have made considerable progress, but there is still a lot more to be done. The biggest problem facing the hospital is how to increase income streams. The low patient numbers coupled with the inability of some patients to foot their medical bills continue to pose financial challenges to the hospital.
In addition, the lack of running water and electricity pose their own unique challenges.

The rains are about to set in and we are told to expect the worst. Impassable roads, coupled with an influx of all kinds of creatures – termites, caterpillars, frogs which in turn attract the snakes etc. etc. and of course the good old mosquitoes. The mossies have not been a major hazard to us though we live close to a swamp - maybe because we sleep under nets all the time. However, Little Joelle suffered a serious bout of malaria in February. We are very grateful to God that we had 24-hr access to doctors specialising in treating malaria. It made a great deal of difference to us and we will always be grateful.

Despite all that has been said, we are actually all looking forward to the advent of the rainy season since it marks the beginning of planting and all that goes along with farming. Even for us at the hospital, this could mark the beginning of an exciting time because for the first time the hospital is considering branching into farming as part of our strategy to reduce our dependence on one source of income stream. We have earmarked a number of plots of land on hospital site for farming purposes and we are all looking forward to the rains.

Despite the challenges at the hospital, we still take time to enjoy the country and its beautiful scenery and beaches. We had the opportunity during Easter to visit the No 2 River Beach on the Freetown peninsular. This was a treasure trove. The beach has miles of incredible white sand and calm clear waters. It was just amazing. We were invited by a local man to take a canoe trip up the river, which empties into the beach – hence the name – to see a waterfall and wild monkeys and birds but we turned down the invitation for another day.
The country is so beautiful and we continue to discover ‘gems’ just round the corner. It is easy for one to miss such beauty amidst the tremendous challenges and difficulties that are glaring us in the face but we are grateful to God that He continually gives us the wisdom to sit back, reflect and relax whilst enjoying the beautiful world He has created all around us. One cannot fail to notice the rolling hills, gorges and rivers of Sierra Leone as one drives along. The beauty is outstanding.



Apparently, this creeper flowers once every two years. Unfortunately, we don’t know its name – so any suggestions?

Picture courtesy of Mike King (Africa Desk, WCO)

Friday 21 March 2008

Pictures from Freetown


Pictures of Freetown Bay taken from Leicester Peak. Leicester Peak is the highest point in Freetown where all radio & TV masts are located


Clouds over the Bay

OF SERVICE, SACRIFICE AND CELEBRATION - HAPPY EASTER!!!!! Part 2

Prayer warriors, please help us to thank God for the rains, the relative coolness of the weather and the hope of a good crop of fruits.
Pray the preparation of the farm project goes well and that we will get our crops planted on time.
Pray for continued good health for our families, friends and ourselves. For those needing encouragement and reassurance, for whatever reason, pray that God in His infinite wisdom will give the peace that passes all understanding.
Pray for Little J to continue to enjoy the socialising of her daily routine, and it would bring about positive growth, in the absence of a formal structure.
Pray for direction, discretion, patience and wisdom to be our portion, especially with J about to coordinate the obstetric module at the end of March and M continuing to manage the hospital with all its many challenges.
Pray for peace to continue to reign in the Nixon camp – here and abroad – and that all who set foot on the compound will feel its immediate effect.
We love and really, really miss you all. Keep the faith – we are already six months (and counting) in the assignment. Nothing goes on forever.
HAPPY EASTER!!!!!
With all God’s richest blessings
M,J and Little J.

OF SERVICE, SACRIFICE AND CELEBRATION - HAPPY EASTER!!!!!

For us, this is the best time in the Christian calendar. Jesus is alive!!!!!!!!! and we live in hope – esp. when we have to deal with the finicky ness of humans. We know that one day it will be all over – Alleluia!!!!!!!

So, Happy Easter!!!

With Easter comes the hope of a break and the visit to the beach in Freetown. Little J is really looking forward to this break, and to tell the truth, we the adults are also looking forward to the break. It means a 7-hour journey on some difficult roads for us, especially with the onset of the rains, but we have heard that they are working on them, so it shouldn’t be as bad as our first journey.

It is hot and sticky during the day, but we are happy to report the nights are not as humid as we were warned. We have been having a few scanty days of rain and this seems to be the reason for the relative coolness of the season. Also, it seems the rains may have started early, and the farmers are scrambling to get their planting in on time. It’s wonderful to see the land being transformed from bush to cleared area to, hopefully, something edible. As M had reported, the hospital is hoping to embark on a farm project, and the land is being prepared for groundnuts, cassava and maize. We look forward to a feast.

In the meantime, the mangoes are coming!!!!!!!! The trees are full – although we thought, there would have been more fruits. The ones I’ve ‘eyed’ are good enough and I’m sure there will be more than enough for all. The children have started to pick the green mangoes, which they mix with salt (yuck!....could never get my tongue around that combination!), and knowing them they might even add a little pepper to give some oomph!. I’ll be patient for the real thing.

The breadfruit trees are also yielding a few fruits. We have already sent the scouts out to keep an eye for the ‘fit enough for roasting’ kind. Patience….patience, that is the key. Now only if we had some ackee and salt fish, mmm…………..it would be perfect!!!
We have found a way to make bammies, from gari (for the Jamaicans – just picture the bammy stage. Gari is the product of the cassava just before the baking stage for bammy. It’s the ‘powder stage’ which is then baked to produce the cake) which is a delicacy here. Gari is eaten here (and in Ghana) just as it is, by adding water to make a doughy kind of stuff. However, we have realised, if we put it in a hot frying pan with some oil and press it into a cake – presto!!! we get……BAMMY!!!! Or as close to it as possible. Thanks to my mum – who suggested we try, our diet has been enhanced with this introduction. We are even more blessed as the lady who helps us explains that they call it cassava cake and she is happy to make it when we buy our gari. So, a little piece of Jamaica has arrived (or as M would insists – West Africa is the mum to the West Indies. He’s right -we just do it better!!)

Since my last sighting of our friend the snake, I have not seen another. Yet we know they are there…we just pray they stay in their corner and we will stay in ours. With the rains approaching, we have been told to expect more sightings. Lord, please keep them far in the bush – and nowhere near the house!!!! We have precautionary measures in place anyway with a gate to the veranda and main house in place. We have a rule and practice to keep them closed at all times. We think that’s enough.

Friday 7 March 2008

SNAKE!!!!!

It’s been nearly six months and the fact nearly forgotten until last Sunday morning. It was an amazing sight – a little longer than an earthworm and 3 times the width. But the creature was the exact colour of the soil and when it curled itself under the shrub, blended in so much that the little boy who ran after the shouts only recognised it when it decided to move. Amazing!!!!!!!!!!!!!
And scary………… but, as usual God knows us intimately (esp. when J was mentally packing her bags to catch the next flight). The first lesson at church was from Numbers v which talked about the bronze snake and anyone who was bitten by the poisonous snakes had just to look at the bronze snake and be healed. Of course, those who know the Bible know that the bronze snake represents Jesus on the cross. J felt encouraged, but is now busily walking with her eyes fixed to the ground!!!!!!!!!!

Six months……..and its still interesting. J is now about to start coordinating her 6 months obstetrics module. She is yet to visit the surrounding villages where the students are to get their practical experience. This is all due to red tape and protocols etc. which soon will be resolved – we hope.
M is busy trying to get hospital and the administrative aspect of the school in a running routine, in addition to chasing funds, coordinating reconstruction ( and construction) and basically helping to get Nixon back on track. It’s not easy, but it’s not impossible. Just little things can frustrate – like the slowness of everything here. A phone call is not enough
(although it can be expensive). It needs to be followed up by a series of phone calls and emails and more phone calls and lots of prayer and waiting – not easy at all.
Little J has recovered well and her appetite has improved. She also seemed to have fallen into a routine and we are pleased to report she is officially fully potty trained!! She is now into colours (although not quite there yet) and have been going through her alphabet cards on a regular basis. So, we think she is right on track.
So, prayer warriors, please continue to thank God for Little J’s recovery. Continue to pray for health, strength, discretion and wisdom. We are well and busy with the work. As usual, God ‘does not do boring’ !!!!!!!!! Pray for our friends and families to stay healthy and safe. Pray for the time to go quickly but at a pace that is manageable.
We love and miss you all.
With every blessing.
M, J and LittleJ.