Visit Smarter Hospital Board
It is almost the end of the year and I have heard almost nothing from me. So it’s about time to write something. Since October 2017 I have been working at City Garden Clinic in Makeni as a medical super intendent (chief physician).
First of all, one of my highlights of the past year in Makeni: visit of my fellow board members of Smarter Hospital. Besides the fact that it was super fun to have them here, we were also able to make very nice plans. Together with Dr. ABD, the owner of the clinic, and others who play a major role, structurally thought about the future of the clinic: in which direction and what is needed for that.
Together with the Smarter Hospital team, good plans for Smarter Being able to make a hospital. Helping to achieve some of the goals of City Garden Clinic, continue with the Teach-The-Teachers project for primary schools in Yele. And we also want to support the orphanage for the Ebola orphans. More information in this link.
Highs & Lows in the hospital
This week a child has been admitted with an upper leg fracture. A photo could not be taken because all the x-rays in the city of Makeni are not functional (the machine is broken in 2 hospitals and the x-ray film of the government hospital is exhausted). But even without a photo it was clear that the bone was broken. In the government hospital, the doctor was good enough to give a temporary splint of cardboard. Here I spoke with the family and explained that the leg is broken and that the best treatment is traction (about 2 months in hospital).
That was a problem, because the mother is still in school and has exams, so she cannot stay with her for 2 months be a daughter in the hospital. Furthermore, the family could not arrange someone else. Then came the money they have to pay for the treatment (so that we can buy medicines, pay salaries, the electricity bill, etc.). But with grandpa and uncle finally agreed that they would arrange it and we had to take her in. But after I applied the traction, the grandmother, who wanted to take the child to the herbal doctor, came. I refused, but I doubt that I will continue.
The herbal doctor is unfortunately not a “traditional bone setter” of which I have seen pretty good results in Malawi. Here it is “herbalists” who put boiling hot leaves on the swelling, causing serious burns in addition to the existing injury. They often get inflamed and sometimes it ends that the hand or foot needs to be amputated …. (so far she is still in the hospital).
An adult lady who we had to amputate on the foot due to necrosis, has mastered through a sponsor from America (Arms Around Sierra Leone) received a prosthesis. She danced for me on the day I sent her home.
We have received financial support from Insuline for Life and the Antonius Development Fund to furnish the conference room / education room with tables, chairs, a cupboard and a projector. Awesome ! Another step towards improving the clinic! There is still a lot of education to be given, so I expect that this space will be used properly.
What strikes me is the poverty of this country: lack of knowledge, education and insight, money for essential things, and absence of provisions that are for us Westerners are so self-evident.
People who need insulin for diabetes, and who then have to administer it themselves at home, but cannot read it, write it there. I then color the correct amount with a marker, so that they can still treat themselves correctly.
An 18-year-old girl who dies of toothache, because she lives in a remote village, so first goes to the herbal doctor and only too late to a actually be hospitalized and actually unable to pay (we were eventually able to pay only 1/5 of the bill).
Furthermore, we still have at least 5 patients who have actually been better for a long time, but still have to wait for their family to raise money to to be able to pay a hospital bill. Patients with cancer, but nowhere else in the country is chemotherapy or radiotherapy available. Patients with large growths, but pathology is not available in Sierra Leone. A private diagnostic institution can give results, but that costs a lot and then it is sent to Ghana.
The wife of one of our staff, who would give birth to her 5th child. We even talked about a planned caesarean section, her husband wanted that, but she would rather just give birth, which I agreed with. Now I regret this decision. Eventually, the child died in the abdomen, the uterus torn, the uterus was removed during surgery at the government hospital, probably one of the ureters being damaged. And now she also appears to have a vesico-vaginal fistula: the woman then loses urine uncontrollably through the vagina, because there is a connection between the bladder and the vagina. This is because the child’s head presses the pubic bone for a very long time (with the bladder and vagina in between), without the child being born. Fortunately for this fistula, and therefore for the loss of urine, treatment is possible in a specially equipped clinic in the capital.
But there are also positive things.
I regularly manage to get good advice for patients here via internet / email. For example, a newborn baby was referred to me with an innate tumor. Through advice and information from the internet I was able to get the tumor small with injections.
Cervical cancer screening
The plans for cervical cancer screening are going slowly, but it seems to be moving in the right direction. Meanwhile, good contacts with Female Cancer Foundation in the Netherlands and also contacts with the government, both at local and national level.
I hope and expect that in 2019 more concrete steps will follow …
Finally, I want to make a request for support, to make a small but essential improvement for the patients in our clinic. Namely a contribution for new mattresses. The current mattresses are up. The springs protrude, the cover is through and there are dents in the middle.
We want to try to buy new mattresses locally, but with specially strong upholstery, so that we can obtain good hygiene, which is now a major problem with the broken mattresses. A mattress costs around € 50 – 75.00 (exact quote was not available for the holidays).
Depending on the amount available, we replace as many mattresses as possible. Donations for City Garden Clinic mattresses to me or via Smarter Hospital Foundation.