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)

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.

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.

……..and the inevitable happened…..

A few of you might have heard …………….. Little J is now officially an African. Last week proved to be a very testing and trying time, as she had what we thought was malaria. We think we have come out stronger and wiser for the experience, but would not want to go there again!!!!!

Little J had symptoms of malaria which lasted for seven days. It lasted this long because she refused to take the medication – even after holding her down and pouring it in with a syringe. She has proved to be a headstrong and determined patient and we have gone through some very, very long nights. We have told her being headstrong and determined are good traits, but not at this age when she cannot be reasoned with. She eventually went through (or was bathed by) a whole bottle (100mls) of Calpol, 2 regimes of anti-malarial (for treatment) and countless number of paracetamol tablets. She is now battling an upper respiratory tract infection, which we are sure will pass without ill effect (she is being ‘bathed’ with antibiotics). It was a very different experience, but one which we have learnt many lessons, of which we will try to share:
- God is in control at all times, especially when it seems so unlikely
- Family ties need to be maintained at all cost – they are the ones you may need to call in the middle of the night for reassurance, advise and prayer!!!!!!!
- Never, ever think the devil is in control. Superstitious people may say or suggest this, but the God we serve is larger and stronger than all the superstitions.
- Hold on to the promises of God esp. when exhausted from the battle and the night seems longer than normal.
- Live a moment at a time – trying to think of the next task/ challenge ( which may never come) will only prove to wear you down more
- Parenthood is the most challenging but rewarding profession that one can undertake. Parents need to be proud of our status and embrace it with an open heart – God is there with us every step of the way. We are special people!!!!!!

We became stronger as a family through this trial, and now I understand what the Bible says about trials leading to perseverance and perseverance to character, and character
hope etc.( Romans 5 v 3,4). Only trials can make us stronger in Christ.

We have tested our degree of integration in the Nixon community. So many people have prayed for us on so many different occasions and on a particular day, the whole school population that attended the chapel service that morning walked to our house to pray for Little J and us. It was touching and moving. We felt a part of a large family, and we will never ever have to wonder what they think of us. We are no longer outsiders.

We have also tested the health provision here. We were blessed and pleased to have the choice and advise of 3 doctors (all Sierra Leoneans but with different specialities – one a GP based in England working with us for a short period). They were accessible even late at night and we realised we are in a relatively better position than if we were in London – no GP would have left his house to visit a sick (feverish) child. We would have had to wait until morning to make an appointment, or bundled her up and rush to the A&E in the cold night. We counted our blessings even more when we were reminded that one can get sick anywhere, but it seems Nixon is the place to be when malaria strikes!

Now we are well (a bit tired and also battling the symptoms of ? flu). We are slowly getting back in the routine of things. We are reminded this can happen again – and we will have to start to use our mosquito repellents more often. The consolation is that if it strikes again, the symptoms should not be so intense, as the body would have the memory to fight. We are hoping this will not be for a very, very long time.

Prayer warriors, please help us to thank God for Little J’s health. Now she needs to start eating better to increase in strength. Pray for the blood of Jesus to cover us all wherever we are. Pray for our doctors and nurses to continue to use discretion and wisdom in their daily consultations. Pray also for us to have discretion, wisdom and strength to continue the mission journey.
We miss you all, but know that God is with us all. We are connected because of His blood and we feel we have ‘… the peace of God which passes all understanding….’ (Phil. 4 vs. 7)

With God’s richest blessings,
Michael, Joanna and Little J

Another Milestone – We are Mobile

No, not that irritant that makes one accessible to everyone irrespective of location or time of day. Instead, I mean our outreach mobile clinic, which is now operational. Praise God!!!

The beginning of February marked another chapter in the ‘life’ of Nixon Hospital. The hospital re-started its outreach programme to surrounding areas after a 17-year break. Nixon Hospital previously used to run a number of outposts before the civil war. It was a vital service to the communities that the hospital served at the time. It was another way of making the hospital’s services available to a greater percentage of the population. In a country where road and communication networks are very rudimentary, access to health care can be very difficult and mobile services are usually one of the best options for reaching the public.

Also, another doctor has joined us albeit for a 6-month period, but this has increased the number of doctors to 3. In a country where the flow of medical personnel is ‘out’ rather than ‘in’ this is a welcome addition. The new doctor, who is a native of this country, has taken to the task like ‘duck to water’ even though he has been based abroad in the UK for the past 27 years where he practised most of his medicine. We are really grateful to God for the additional resource and help that he has brought to the hospital. This is because his presence makes running the mobile clinic less taxing on our present doctors.
The clinics are running presently in only two villages and our plan is to extend that to about 10 more by the end of the year depending upon availability of both financial and human resources. Our prayer is that God would open the windows of heaven and provide us with financial resources to enable us achieve this objective. Prayer warriors, please kindly make this a prayer point.

We have also had a bit of bad news. The handle on the only well that provides the hospital with good drinking water was damaged due to overuse. We are therefore without drinking water within the hospital campus but praise God there are other sources in town. It is however imperative that it gets repaired as soon as possible since the surrounding community depends on the well for good drinking water. Our major problem is finding the financial resources to repair the handle. Again, we are trusting the Lord for His provision because repairing the well would mean diverting badly needed resources that otherwise would have been used for looking after the patients. Our hope and trust is in the Lord. Please pray for us as we have sent off an email to an international organisations asking for financial help to repair the well.

As we go about our daily activities at Nixon, we are challenged every day to live as Christ would and to make decisions which can be both emotionally and professionally taxing. How do you deal with difficult and sometimes life threatening medical conditions when the patients have no ability to pay the medical bill, albeit a very small fee? Nevertheless, in all of this God has shown us His faithfulness when we have trusted Him to provide for us in such difficult times. As a mission hospital, our number one priority would be to show compassion and understanding and this sometimes means undertaking medical interventions even when we know that the patients may never be able to repay their medical bills. Saving lives through affordable and accessible medical care is our main objective and we thank God that despite some difficult cases we have not turned any patient away because of their inability to pay their bill.
For us as a family our lives are beginning to take on a regular pattern. We the adults leave for morning devotion at 7.30 am with the nursing students at the hospital chapel. Of late Little J has been waking up early – about 7 am and insists on going to chapel with us. Maybe this is just her way of spending as much time with us before we leave for our respective places of work – Michael to the office & Joey to the classroom. In respect of our daily routine, we are grateful to our house helpers who help us with Little J and with the house keeping, thereby enabling us to focus on our jobs here at the hospital. We consider this yet another blessing from God to have found very dedicated and trusty people to take care of our daughter and our home.

Little J is really flourishing and have made good friends here with some of the children on the campus. We have still not being able to find a teacher to help her with her development so mummy helps her with her alphabets and colour identification. She has recently taken a great deal of interest in trying to identify various colours. Presently the phrase ‘what colour this?’ is a constant one in our home.

Just to end I recall a recent devotional piece I read about how the efforts of one college student changed the lives of a whole family. This is because he showed compassion to one man which led to him and his family accepting Christ. This started a chain-reaction, which led to a change in the lives of a whole generation who dedicated their lives to Christ. The bible verse that talks about not despising the beginning of small things comes to mind. Our prayer is that God would find our work worthy to be used to touch the lives of others.

A New Year begins

This is the first opportunity to update the blog since the New Year. Already the 'newness' of 2008 has begun to wear a bit thin and we have now settled nicely into a routine here in Segbwema. Joey started teaching nursing to the second year nursing students at the beginning of January. In addition, she has had to assist in marking exam papers for the first year students - 54 in all. The year started on a very positive note for the nursing school. A non-governmental agency (NGO) has awarded full tuition scholarships to 10 students - a very welcome gift considering students struggle to pay their fees.

With regards to the hospital, we have initiated plans to start a mobile clinic to a few of the surrounding villages in order to increase access to health services to a greater percentage of the population. These are really exciting times for the hospital because it marks another important stage in our vision to make health services accessible and affordable to as many as possible. During the initial visit to the first village, we had the privilege of sharing the health concerns with the villagers who were very clear in their minds of what they expected from the hospital. It was pleasing to notice that the village and its surroundings not only had a feel of home (Ghana) about it but also had a number of breadfruit trees - so it could have passed for a setting in Jamaica.

As a family, we have now settled into a routine with the help of our neighbours, friends and house helps. Little J is still struggling to come to terms with both her parents leaving home at 7.30am - first for morning devotion and then to our duties ( whether teaching or overseeing). This is a huge change for her as she was used to spending most of the day with her mum and now she has to contend with a child minder. Despite the changes she is getting on very well, enjoying her friends, the weather and the atmosphere. Our prayer is that this experience would enrich her life for many more years to come.

Joanna has found teaching a challenge - with long teaching sessions and a mixture of Sierra Leoneon and Jamaican. Considering however that the classroom is only a few walking distance from the house, one cannot really complain. There are 40 students per class and they are taught in 2 groups, so the same topic is taught two weeks in a row - which in some way is a blessing. It affords the opportunity to rectify any mistakes or misunderstandings during the second week, and makes for a richer more detailed information to be provided on the hand outs given to all.

For those of us who love football, this month of January is a feast - with the African Nations cup in Ghana. I was very delighted and overjoyed when Ghana won their opening match. I wish I was in Ghana then but managed to savour the atmosphere in Ghana by watching the game live. People in Sierra Leone are very passionate about their football and enthusiasm for the games have not waned a bit even though SL is not represented in the games. Most of them support Ghana, which is great for Michael.

That brings me to the issue of the weather and football. Listening to the BBC world service's commentary on football matches in England gives you the impression that we are not doing badly here at all. Presently the weather is very dry during the day with the harmattan winds from the Sahara but the nights are really cool, even cold sometimes and which makes for a good night's sleep. The understanding is that this is the best part of the year in S/L then it gets really hot during match before the rains set in from March ending to late August so we are enjoying this change very much.
To end we just would like to say we are very grateful to God for all that He has been doing here at Nixon and in our lives. Changes are taking place albeit slowly but we can see progress in our respective work which is really down to the grace of God and for this we are grateful to all who are praying for us. Please continue your efforts and we are very grateful. God bless you all.

Yet More Pictures

On the beach at Lumley- Freetown
Hospital laboratory

Enjoying few moments of quiteness at the hotel in Elmina - Ghana

Pictures of Mum and daughter enjoying bonding time on the beach in Freetown.

Picture of the hospital laboratory. Desperately needs equipment to increase the utilisation rate - which is presently only about 25%.

More pictures at last!!!

Pictures showing different aspects of life in Sierra Leone. Top left is the remains of the old hospital theatre destroyed during the war.
Middle pictures show clouds gathering over Freetown bay. Other pictures show Dad and daughter on the beach in Freetown - just enjoying the sea.

Righton top of the world. This is not unique to SL - ery common in most African countries - including some parts of Ghana

pictures?

Despite numerous attempts to upload pictures I have been beaten by the system. Connectivity is so slow uploading pictures would require a whole day - at this rate. We live to fight another day. By the way the only picture that uploaded was that of the President of the Methodist Church Sierra Leone receiving the books that some of our friends in Britain donated to the Nursing School.

Pictures - as promised

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.

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.

Segbwema - Wish you were here!!!!!!!!!!!!!!!!!!!!!!!

It has been a month now since coming to Segbwema and we think this is a good point to sit and reflect on what we have experienced so far. It’s been a beautiful time, and we thought we would have been bored silly – but we don’t miss TV, nor watching movies. We go to bed on average at 9 p.m. and by then we are well and truly exhausted. The tasks at hand are numerous for all and with the arrival of our shipping (which arrived safely and intact – Thank God!!!) Joey is in the middle of trying to sort the books as quite a few of them are for nursing tutors, higher-level studies, and NHS biased. Some of these will most likely be used in the very near future, as there is a national plan to add to the syllabus nursing research, management and the use of the nursing process. So, with Little J more active than ever, the house hold duties to sort and the ad hoc meetings to attend, Joey is very occupied and often exhausted.

Michael continues to be on demand – as Business manager he needs to oversee the daily running of the hospital, conduct meetings, supervise building work ( current and future), in addition to going to the nearest town to facilitate hospital and personal business. As described in an earlier blog, it takes a good 2 hours one way to meander these roads – so a trip to the town (Kenema ) and back takes the better part of a whole day. It’s a very different stress indeed, but we are learning to deal with it as much as possible. Hopefully we would be able to upload pictures of our house, the hospital, roads and other interesting places soon. To give you an idea of the state of the road and the challenges they pose – Michael and the two doctors once left for a meeting at a town about 47 miles away. They were forced to turn back three-quarters of the way because a vehicle had got stuck in the middle of the road making it impossible for other vehicles to get pass from either direction. Great fun now!!!! But it wasn’t then – think of the man (or is it doctor) hours lost.

Little J continues to be the star of the show. Her best friends (2 ½ yr old F and 3 yr old S) are just so suited for each other. Their temperaments all fall in place, although Little J has become more assertive (or is it aggressive) and F and S have learnt to say ‘please’ and ‘thank you’ – with some reminders- but all in all it’s a good mix. It gets a bit much when the group is joined by 7 yr old P, 10 yr old F and two young teenagers who compete for toys (we shipped a tricycle), but they help with supervising the little ones. It can be a very noisy and overwhelming affair at times, but growing up with brothers and sister and cousins have given Joey enough practise.

We promised to give a picture of the nursing school. There are 117 students presently, and the composition is similar to any other nursing school (1st year/introductory: 2nd yr: 3rd yr). Its good to see a few males (about 24) in the group and the age range would put some of them in the mature student category. The majority of the students live on site in hostels (2 in a room – some of us can just imagine how uncomfortable that can be). Economically it is better for the students because it reduces drastically their cost of living re: no transportation and accommodation cost. Their cooking facilities are coal pots in a huge kitchen – and they have to fetch water on a daily basis -there are no mod cons here, so they are given a generous 2-hour lunch break, as many have to heat up/cook lunch on coal pots.

There are 2 classrooms and 1 practical room. The biggest (and better) classroom has no windows and doors and was used as an eye clinic before being destroyed in the war. It can comfortably seat 50 – 60 students and the ventilation is ideal (as there are no window panes or doors to block the breeze). The second classroom is a ventilation disaster (It is not ideal for teaching and for the fear of keeling over in the middle of the lecture, the management – oh Michael - is exploring ways of making it healthy for lectures) . It seats approx. 30 students, but to do this the blackboard needs to cover the only window in the class – making it dark and hot. The library is a very very small room ( relative to the student population), with only few very old books. This is about to change soon – thanks to all of you who worked hard to secure some books which we presented to the President of the Methodist Church of Sierra Leone on behalf of the School. (Pictures to follow soon).
The practical room has one mannequin/model – a male head on a female body and one attached arm. The only midwifery teaching aid available is a model of a pelvis (though Joey hasn’t seen it yet). Although we have all these limitations, I must say the staff is incredible and passionate. There are only 2 nursing tutors (the principal tutor is blind and has been at the school for over 30 years. He still writes on the board in his lectures and teaches strictly from memory. For diagrams, he gives his very old and tattered notes to the students to reproduce in their spare time. The other tutor does some lectures, all of the practical sessions and supervises students on the wards. They are gems and true saints!! However, this cannot go on indefinitely as the principal wants to retire (for good reasons) and the practical tutor also needs to have some time off. This is where they hope Joey can help…………..in addition to everything else mentioned in earlier posts.

There are many, many limitations, but we are happy to report the willingness of a NGO to help asap, esp. with white boards for the smaller classroom ( thus relocating the black board covering the window), to put windows and doors on the bigger classroom making it a proper classroom and possibly a library from an adjacent room. We have already received estimates for the classroom. They also will possibly donate some models and teaching aids. So, we are hopefully going to make a difference, before next year. Watch this space………. God is faithful and already we are beginning to see the ‘rain’ of blessings on the way.

Prayer warriors, thank you so very much for your constant and faithful prayers. There are signs - ‘a cloud the size of a man’s fist’- before the abundance of rain. We continue to trust God, as He is faithful. So far we are overjoyed to report we are healthy- no sickness of consequence - ;well fed (Little J has joined her father in the love for grass cutter – a bush meat. Joey is yet to be converted); not too hot (some mornings are very cool and foggy) and generally making many friends and professional acquaintances. Pray though, for God to bring peace to the hearts and minds of the people on the hospital team as we try to introduce changes (systemic, professional and personal) which the team have all agreed will be proactive. Some people have been working so long in a vacuum they have forgotten how important and progressive it can be when we pull together as a team. Pray also for the supply of drugs and other medical equipments to come through for us. We are desperately in need of drugs but our location makes it extremely difficult to travel regularly to either the capital or the district headquarters to pursue our supplies. We thank God though as w have recently taken delivery of a small stock of mediation that should see us through to the end of the year.

We miss you all, but we really think you guys need to come to visit. It would be worth it to see how beautiful and peaceful the surroundings and people are. Think about it…..we have an extra room…..
With all our love and with every blessing.
M,J and Little J

Settling In - The Task really starts now

Its been 2 weeks since we have been in Segbwema, and we are loving it more and more each day. We had the opportunity to go to Freetown for a few days for a meeting and were longing to go back ‘up country’. We have become comfortable with the night noises and the peace and quiet that comes with a deep rural setting, and were uneasy with the city noises of Freetown. We are well and truly converted.

So, Michael is on full speed ahead at his post as Hospital manager. There’s lots to do here, with challenges similar to regular hospitals, in addition to many other problems. We seem to have a good team to work with, though, they just need to be organised and motivated to develop and fulfill a specified goal. Knowing Michael, the greater the challenge the more exciting the job, so he’s very happy.

Joelle continues to have such a great time. The kids are numerous and we are expecting a few more in December. Our house is always full of children ready to play at all hours (after school ). We have to limit them – once it gets dark everybody needs to find their yard………..

We are still trying to work out child care – the lady we found will need help with house work ( the fetching of water is a day’s work on its own) as well as running after Little J – so Joey needs to be home until this is sorted. Even then she has started her orientation of the hospital and the nursing school. We were pleasantly surprised to find 117 students enrolled – mostly all of them living on compound in addition to some of the hospital staff and their family. So, we feel we are living in what seems like a mini- village. The land space is huge – more than 50 acres - maybe covering more than a mile or two – or more!!!! We haven’t toured it all yet. The problem is that it’s so remote that selling the land would not fetch much, so we have to think of other means – maybe farming to market or to subsidize our needs. I tell you, we are far from being lonely.

The statistics for the country makes grim reading and the midwifery course Joey is asked to coordinate will have to reflect this in its preparation of the students. Death is nearly a daily occurrence here – and one needs to get used to this fact. Delivering macerated babies or watching a mum die from obstructed labour or ruptured uterus is an experience one dreads– so it’s going to take real guts to face a case.

We understand the need to highlight the current situation ( as much as we are aware) of the country, as this will give a somewhat updated picture of the hospitals’ situation.
A networking proposal by Cordaid has described SL as:

‘….from a period of more than 10 years of civil service ..…SL is now one of the poorest in the world with over 50% of the people living in absolute poverty. Large part of the health service infrastructure was destroyed and more than 60% of the health workers stopped working. The health indicators is the worst in the world with maternal mortality 2000 per 100,000 live birth, infant mortality of 170 per 1000 per live birth and an under five mortality of 286/1000 live birth.’

As indicated in an earlier post, the maternal mortality rate feels similar in this hospital. This is not due – as far as we are told - to health professional mismanagement, but to sheer cultural practice of many women finding it easier and faster(roads to the hospital are atrocious) to go to the village Traditional birth attendant (TBA) who have very limited knowledge and resources to deal with complicated and difficult deliveries. The women are usually ‘rushed’ to the hospital at the point of death ( days in labour leading to ruptured uterus’/ post delivery bleeding). So far we have not personally experienced any of this (and pray we will not have to at all) but Joey personally witnessed a case of eclampsia – the woman was having an eclamptic fit. After helping to settle her with medication ( there is no magnesium sulphate in the hospital - she was prescribed and given diazepam), Joey was informed that this was her first baby, she had no antenatal care ( she didn’t visit the hospital for this ) and her only symptom was very bad frontal headache for a couple of days (her blood pressure was in normal range and there was no sign of odema). She was seen in the community by a MCH who referred her immediately to the hospital. She started fitting before delivery, delivered normally and then fitted again. Happily, she recovered ( however slowly) and when we visited the ward she was reported to be able to care for herself and her baby after a few days of being in an unconscious state.

The health professionals are doing their best – there is only 1 midwifery sister( she works every morning shift – except Sunday – and is on continuous call in any emergency) and student nurses who have done basic obstetrics on the maternity ward. We now have 2 doctors and they are also on call 24/7. We cannot imagine working in this kind of condition and pray the hospital management will look into employing another midwife – fast!!!!!!!!! Sister has already implied Joey takes a few morning shifts on Sat. to allow her to have a weekend off, but that is still to be decided. .

The infrastructure is dire indeed – there are hardly any drugs, one blood pressure machine and stethoscope available for the whole hospital (4 wards – male, female, children’s and maternity- and clinics), mattresses are filthy and flimsy, no running water or electricity (the generator is used on surgery days and alternate nights) and one very small operating theatre for every case.

We have started highlighting the need in emails to friends and have appealed for small groups of people to help. There is so much need here that we believe that it would take more than the public sector/ government to help with alleviating some of the problems .
Even with all this limited resources, the hospital’s catchment area covers 100 or more villages and even see people as far away as Freetown. We believe people visit hospitals mainly because of its reputation/cadre of doctors/level of care, and this somewhat explains them trekking more than 100 miles on very very bad roads to be seen here. It says much about this hospital, but we are not surprised as it was rated the second largest 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, ( linked with an institution in Atlanta, Georgia, USA) and had specialist TB and leprosy wards. The reputation of the hospital was such that it drew patients from all parts of the country and from neighbouring countries such as Guinea, Liberia and Ivory Coast. Therefore, it has the potential to regain its reputed form. This is not necessarily our goal, but it is close to what can happen in the next few years. We feel this is enough ( distressing) information for now, so we’ll leave the story of the nursing school for future posts.

Thank you for your prayers, we have felt and seen their effects as God continues to watch over us and prepares the hearts and minds of the people here for change. We are comfortable and happy and are convinced that this is the right move for everyone. Continue to pray, esp. for continued good health and strength. With all our blessing and love.
M, J, and Little J

And it took a day and a half to open an account………………………………….

There are many acres of unoccupied land just outside of Freetown – green and lush and well watered with many tributaries. With all of this, we wondered why so many people prefer to live in the overcrowded conditions of Freetown. We were told because of the war many of the young moved to the city, leaving the older generation to farm the land and the new generation have become strangers to farming, preferring to haggle wares and services or just to plain beg. We see too many beggars in Freetown. There is a need for a new sense of survival and empowerment of the people.

We found out (the hard way) how much we take little things (like opening a bank account and changing flights) for granted, esp. how very tedious it can be, when done manually. But that’s how things are done here.

We finally came to the time to travel to Segbwema. The plan was to have a one day retreat to meet the staff of the hospital before we finally went. This was done in a Catholic guest house in Kenema (the catholics were the only religious body to have the vision to invest by building guest houses all over the country). The retreat was well attended and was very effective in highlighting the current problems, suggesting solutions and creating a pathway to reaching the solutions. The day went fast for us as we were anxious to see the end of our 4 week journey. At last, at 4:30 we set off from Kenema. We had only 27 miles to go – but we were told these were worse than the 100 plus miles we had already travelled. All the warning couldn’t have prepared us for the roads to Segbwema. It was worse than ‘river bottom’!!!!!! It took nearly 2 and half hours to travel. We were appalled. It seems it rains nearly on a daily basis and the roads reflected this. At one point we went through a muddy section where we could reach out of the window of the 4x4 and touch the ‘ground’. The more we drove the more it looked and felt remote – like driving into a jungle. We saw less and less concrete houses and more and more collection of mud huts with grass roof (villages). It was then it slowly dawned on us, we were really going in deep deep deep rural. It’s not going to be easy if we wanted to leave ( physically).
When we finally reached our destination it was dusk. The hospital grounds is not much to look at ( esp. in the dark – no electricity) and we were further alarmed. Was this really a hospital? We saw dilapidated buildings, overgrown premises, and few people milling around. Then we came to our new home. Of course, it was dark. The neighbour’s children came out to greet him ( he is the head of the nursing school) and they of course greeted us too. Everyone seemed pleased to have us. We found some light (our rechargeable lantern) and headed indoors – holding our breath for the surprise. And…………..we were pleasantly surprised. Our bungalow has 2 large bedrooms, both large enough to hold a king size bed, dresser, wardrobe, desk and chair, and also our many suitcases and bags and still find space to walk around without bucking our toes. We have a large living and dining area, toilet and bath (separated) and an ok kitchen. We have a fridge ( electric) and a gas operated stove. The corridors are huge!!!!!!!!! and Little J fell in love with the space. She also fell in play with the neighbour’s children. We were well looked after as person after person came with items for our comfort – food, water ( we have to get this at the communal source), light ( the generator was turned on for the hospital), somebody to kill the spiders ( they seem to just love the place) and someone to quickly give the tour. It was amazingly overwhelming.
We went to bed tired yet not, and woke at 3 a.m. to talk about our feelings. At 4:30 we heard crying (we’re approx 30 yards from the hospital) as it appeared there was a death. It turned out to be a maternal death ( obstructed labour ). This was the second in 2 days, and it seemed they are regular because of the practise and mentality of the people. They tend to go to TBAs even though the hospital is close by. But that’s another post.
Prayer warriors, please pray for team spirit to quickly grow on the workers and students; for the spirit of peace to descend when damaging old behaviour is confronted; and for people to want to change for the better. Don’t be alarmed or worried, we are all very, very well and learning to love the place more everyday. God has gone ahead and prepared the way. We are confident he will continue to be there for us. We are happy. With every blessing.
M,J and Little J.

First Few Days in Sierra Leone

Freetown is a beautiful city from where we are staying – up in the hills. We have uninterrupted view of the bay from the over hanging hills.

On the first day, we went into Freetown (down town) to register at the British High Commission and to start the search for a vehicle of our own use. That was a task and a half. Because of the terrain and the state of the roads ‘up country’, we were advised to purchase a 4x4, manual( instead of automatic). So the hunt was for a durable and affordable 4x4. Easier said than done. We looked at a number of vehicles but they were either not in very good condition or not affordable. Those in good condition were either automatic, very expensive or both. To buy anything here one has to haggle, as in all other African countries. Items are way above the selling price and the trick is to haggle to a price acceptable to both parties. We think we will leave the haggling to the locals.

Freetown itself, is like any overcrowded city. The roads are filled with people, the buildings are old and not maintained. They would have been beautiful – old colonial style, with wooden louver windows – if they were well maintained, but they looked over used (infrastructure and facilities). Of course, there is a massive shanty town on the outskirts ( just on the beach) which floods when there is too much rain. Some secondary roads ( just off the main), resemble trails of red dirt leading up hill into ‘homes’. Many people live in corrugated zinc houses, with no light and water facilities. In all of this many of the people are beautifully dressed in African styles and the women’s hair are immaculately plaited. These people do not have much, but they hold their heads high. Even going to church, they were immaculately dressed and accessorised. Poverty does not show on them at all. However, because of the lack of infrastructure, there is a lot of unfinished work to do in Freetown. The new government have a great task on hand. In some ways, we are glad to be going out of the city to work.

On our first Sunday, we attended the Buxton Methodist Church in Freetown. We were informed that services usually last for an hour and half, unless when ‘they have a special programme’. And, of course, this Sunday was a special programme – the Zion Circuit Youth Fellowship was celebrating their yearly African Service together with the 99th Yearly Celebration of the Methodist Local Preachers’ Mutual Aid Association. Needless to say, the service lasted for more than the 90mins. Actually, the service lasted for over 3 hours; however, I can honestly say I enjoyed every bit, even though I struggled with the Creole language in some instances. There was the usual and typical praise and worship, which lasted for about an hour, whilst I counted about 6 different offerings – for the building fund; the MLP,MAA, and others. This should not have been a surprise since we had to pay for a copy of the ‘Order of Service’.
One feature which I found really ingenious was the ‘decorate a friend’ section, during which members of the congregation were encouraged to purchase hand made florets for other members of the congregation who have done ‘special acts’ and who deserved praise and acknowledgment. This I thought was an ingenious way of raising funds whilst encouraging other congregants by showing appreciation.
Little J had to be escorted out of the service after an hour ( after the praise and worship and just before the sermon). We found the Sunday School children who were practising songs for the annual Harvest Sunday in the basement of the church. Of course, she enjoyed the singing and managed to disrupt the programme by going up to nearly every little child and touching them. They didn’t find this amusing and she had to be parted from a few fights. At (the sudden) end of practise, she found a few ‘friends’ to run around with. Then we were told the children should go up to the main service, which they did, but ended sitting up in the top floor listening to the service (for the next hour and half). Of course, Little J wasn’t amused and Mummy had to take her outside ( again) to do some running in a safer environment. As usual, Mummy heard none of the sermon ( she hasn’t sat through a sermon for nearly 2 years) and had to get it second hand ( and not very thorough) from Daddy. I guess that’s life!

Monday, 16 October was a public holiday. We had hoped to visit other parts of the country and probably to have ended up on the beach with most of the ‘Freetownians’. We were taken to a relatively far beach in Kent (we didn’t see a beach – as we refused to pay the entrance fee) and York ( which turned out to be a fishing beach). The coast is really beautiful, and we enjoyed the outing, although we did not get to swim. The driver took us back to Freetown through the back roads and we got a taste of the ‘bone crusher’ roads everybody talks about. I thought I got whiplash going over a few of those pot- holes, and we were relieved to have left the vehicle at the end of the journey. We wondered what it would be like going to Segbwema – a good 50 miles of very, very bad roads. But that’s another post.
Prayer warriors, keep praying for journeying mercies and survival of the terrain – ‘ bone crusher’ roads, heat and mosquitoes. God bless you all.

M, J and Little J.

PS: System too slow to allow uploading of pictures. Still working on it.

God answers Little J’s prayers……… for French fries!

Finally we’re in Sierra Leone (SL) !!!!!!!

We eventually checked in 4 suitcases averaging 35 kg each onto the flight. The charge for being overweight was US$250.00 for the 50kg excess. Again, local currency was not acceptable – remember the ‘visa saga’. There was however, a ‘small’ problem since Kenya Airways would not accept a credit card for payment. At least that was what we were told at the check-in desk even though their partners KLM previously accepted the same credit card for excess weight – a fact we pointed out to the check-in clerk. We only had travellers’ cheques on us at the time….so we had a small problem. There was a stalemate since we were not in a position to do anything else, and were asked to stand to one side whilst other passengers checked in. We had no choice but to pray whilst trying to reason with the check-in staff. Finally, after nearly 15 minutes waiting, our excess luggage were checked on to the flight and we thanked the check-in clerks with a ‘modest gift’. Whether the check in clerks were expecting us to ‘dash’ them (grease – palmed the Ghanaian way), we will never know because we did not ask and were determined not to pay. We consider this another miracle of God – because it was a risk to take all the luggage with us. We were the last people to be checked in and we had to race to catch the plane. The flight made up for the rush, as it was short, earlier than scheduled, and the crew were very accommodating. We sat together and Little J even had a seat for herself.

Flying in to Sierra Leone was interesting. The landscape seen from the aircraft is nothing like the city. We flew over a wide expanse of green forest – mostly palm trees, criss-crossed by rivers flowing into the sea. This is because the airport is on a strip of land - island really - away from Freetown. The view coming into land was mostly green expanse of land with ‘houses’ sprinkled – few and far between. Our flight was the only one at the time, so going through immigration and getting our luggage was a relative breeze. We had a representative from the church waiting for us – identified by our name on cardboard.
Getting from the airport to the city is an adventure by anyone’s standard. We had a choice of the ferry (2 hours), the hover craft (1 hour), by car (a 60 + mile merry –go – round taking a few hours) or by helicopter (7 minutes). Of course, we took the helicopter – not that we had a choice since both the ferry and hovercraft were out of service. This turned out to be a larger than normal army looking, privately run helicopter (picture M.A.S.H.), which transports approximately 12 people and their luggage with each trip. Therefore, for any one flight they may have about 4 – 5 trips (or more). It was a noisy and bumpy affair. In all that palaver, Little J fell asleep. She amazes us!!!

The route to Freetown from the helipad took us beside the beach. Now, this was nothing like Accra or Cape Coast – this was a nice sandy beach. There were people jogging and walking on the beach and the waves reminded me of Negril. Surprisingly, really nice. Freetown was bustling with people selling wares and (at the time we landed) trying to get home. It was hot, but nothing like Accra.
Our ‘hotel’ is in the hills overlooking Freetown. The road reminded me of Mobay, going up to the hills to Cambridge. Very narrow, winding through the hills, with gullies to the side, and in those gullies are peoples’ houses. It feels like Mandeville – cool.
The ‘hotel’ turned out to be a guest house owned (but not operated) by the Catholic church. So, our vision of a hotel by the sea, with A/c, some modcon, (like tv and phones) and maybe internet access was not really that. We have the natural a/c, a transistor radio and mobile phones (which we bought), definitely no internet facility available. We are provided with 3 meals, hot water (for bathing) and breakfast as early as 7 a.m. Electricity is via a generator which has a operating regime – lights/electricity out at 11 a.m, 5p.m and 11p.m. So, we have to work around those times if we want to do anything related to the use of electricity. Good practise for our own generator in Segbwema.
The first night was hard. We had to get our heads around the electricity, lack of tv and the remoteness of the place. We can’t just go down the road to buy neccesities. Our nearest neighbours are those working at the new American embassy, sprawled over more than 100 acres. They’re not that friendly anyway.
Little J’s craving was for ‘fries’. After one day in the city we saw no Mcd, Burger king, Nandos etc etc which might sell this highly demanded fries. But lo and behold, without saying anything to the cook at our hotel, our dinner that evening was chicken and fries!!!!!!!!!! Now, this was confirmation that God does answer prayers – even of a nearly 2 year old toddler!!! He will provide for even our wants and of course our needs.
We are still trying to understand the system. We are being ably and patiently helped by the church and hospital staff and transported in comfortable vehicles.
We will be in Freetown for maybe an additional week as we try to do all the paper work (work permits, registering with the nursing council and trying to get a vehicle for our own use). This makes sense as it is an 8-hour journey to Segbwema, and once we’re there we need to use most of the first few months to try to settle – esp. to sort all the books we had shipped.

For the prayer warriors – continue to pray for a swift settling as we try to understand the system, attempt to communicate and become apart of the community. So far, so good.

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Crocodiles, Lizards and all things creepy…..

Crocodiles, Lizards and all things creepy…..

It’s been great visiting family and friends in Ghana. It has turned out to be an ideal R&R stop as it has forced us to rest and re-group after leaving London in such a whirlwind. We are blessed to have such friends and family who are willing to accommodate us for this time and also to help to clean and rearrange the mess we left. We will be eternally grateful to you all.

A part of our stay saw us in Elmina, near Cape Coast for a few days. It was a beautiful and quiet break from the hustle and bustle of Accra. The bus ride to Cape Coast was surprisingly fast and smooth. Granted the bus left approx. 20 minutes late, but the roads were quiet, hardly any traffic and pot- hole free.



Map of Ghana – Cape Coast to the west of the capital Accra – along the coast obviously.


The infrastructure has been improved since we last experienced it 4 years ago. We decided not to take pictures of the journey, as the scenery is so much like Jamaica. For you all from Ja. just imagine the scene through Santa Cruz, or Westmoreland or St James. The only difference is we (in Ja.) have more mountains on the horizon and there are gullies beside all the winding heart-stopping ‘tracks’ called roads ( for example the Ginger hill road). The road to Cape Coast was like a highway through Jamaica, flat and mountain-free and somewhat safer.

Our friends’ hotel was situated in a green, ‘cool’, quiet area. The food was sumptuous and we had the whole hotel to ourselves. He had a great collection (they seem to like his rock garden) of lizards – all varying sizes and colours and behaviour! We got some good ‘up close’ (but not too personal) pictures. Everyone seemed ok with these lizards running around and they seem to come out approx. 8-10 a.m. Any other time and its too hot/cold. I think I can tolerate them for that time.



Lizards – female and the differently coloured male….and dem very big!!!!!!

We visited the Crocodile park, which turned out to be a house/ restaurant on stilts with water all around and the crocs (babies and adults) all free to roam (too near for comfort) around. This was the closest I had ever come to one so huge and I never want to experience that again!!! We had our meal - hastily- and made a literal run for the hills!!!!!!!! Only to find the cursed things were allowed to wander freely near fields by the roadside.

The restaurant sitting in a ‘croc’ infested ‘pond’.

So, if we really decided to run for the hills via the field we would have a very very rude meeting indeed. These crocs are not little. They look large enough to swallow a small adult (like J!!!!!!!) whole. We couldn’t put Little J down for a moment without watching her every move, because ‘…management is not responsible for any accidents or incidents and parents should supervise their children…’. I tell you, no way Jose. That’s the first and the last time for us.





We then decided to go to Elmina slave castle to take pictures ( since the last time we were here we did the tour - plus we thought a fidgety 2 year old wouldn’t want to hear about the misdeed of her father’s and mother’s great great great great grandparents). We were sad to leave but it reminded us that Ghana has many interesting places to see.

Elmina Castle – the beginning of the Middle passage

Little J has really acclimatized. She doesn’t sweat as much anymore even though she’s busy playing, running and jumping etc. She’s barefooted most of the time and really enjoying her
cousins (and vice versa), even though she does most of the bossing around! She’s eating most of what is put in front of her and even asks for ‘fufu’ when she’s hungry! We think if she had her way she would ask to stay in Ghana. We’re actually thinking this may be a great idea – eventually. We just need to look around for good international schools and maybe we will decide to stay for her prep school days. We’ll see. How things change. We never thought we would ever be saying this because our thoughts were to send her back to England for her education when she’s older. That plan is already beginning to unravel. God works in mysterious ways.

We have made contact with Michael’s former colleague and friend who is a pharmacist here in Ghana. He was so impressed with our decision to work in Sierra Leone and has promised to help with a software to capture management information. This is very promising and God’s doing because one of our major tasks would be to set up a management information system for the hospital. God is great!! – who thought we would find a solution to one of our key needs in Ghana?

We are a few days to starting the real leg of our journey and it really feels a little like an adventure now. We have no clue of how the place looks, who will meet us (hopefully he’ll have a card with our name) and where we will stay for the first few weeks. We just know the flight time and date, and the name of the hotel. We have limited ourselves to 3 suitcases, 20 kg each and again we are praying hard for a miracle to fit all we think we need in 60 kg. It’s mind-boggling.

We would be leaving Ghana with very pleasant and fantastic memories but then we’ve always known that. We intend making the country our ‘base’ for the next 24 months so we may pay periodic visits just ‘to get away from it all’, think, plan, re-group and strategise. We will keep you all updated as much as possible. Prayer warriors – continue doing what you do best. With every blessing.
M, J and (a very Ghanian) Little J.






Bird nests overhanging the croc infested pond