In 2009 we went to Guatemala and witnessed an acrid level of poverty. The 2010 Haiti missions showed us what abject misery could do.
The UN world development index has stirred a lot of controversy, but 3 days in Sierra Leone are enough to give it some credits. If I remember correctly SL ranked 180 out of 187 countries. Be it 160 or 180, misery is just another shade of grey at this level.
Our introduction to Freetown, the capital, was through the ferry that carried our crammed bus the across the Sierra Leone river estuary. Freetown is poor. 24h electricity, running water, street lights are evidently unheard of. Hotels are barely 2 stars and because of their scarcity and the high demand generated by the mining companies, charge between $120 to $250 per night.
Anything can get done in SL, except it takes a lot of time, something we do not have a lot on our hands. We were slightly under stress the first 3 days as many items on our original plans kept changing: the bus originally booked was smaller than the one agreed upon, the two land cruisers that were offered dropped to one, cel phones were difficult to acquire, meeting times with some locals and officials were not respected, most cases turned out to be major surgical cases… Ziad is doing his best to keep the team constantly updated and that is helping keeping everyone on the same frequency.
It took us 7 hours of bus ride to get to Kabala. The road was not as bad as we expected. Upon reaching Kabala we went directly to the hospital to download the 18 boxes of medical supplies we brought with us. We had a bumpy night and some issues at the Senghbe hotel after our arrival. The next day the, district chairman, Mr. Peter Konteh graciously offered us his guesthouse that we moved into. That made a huge difference from the squalid state of our first hotel.
Our mission had been announced many days prior to our arrival on Kabala local radio station. And on the night of the 4th, Ziad, Vishnu, Anastasia and Marina were invited with Mr. Peacemaker (one of our local contact for this mission) to come and talk on the air to the Koinadugu population about the mission. The team mentioned the fact that the surgeries are free and that everyone is welcomed, and highlighted that we do not have the capacity to treat everyone and do all type of surgeries. The next day patients coming for screening and triage overwhelmed us. Some had walked 50-60 miles to get to Kabala and many are walking as this blog is getting posted. It is unfortunate that we will not be able to help them all. Many will be told to come back next year. The stoicism of the people is only surpassed by the scarcity of what modern life is offering them.
The team has been having long days from our day 1 in Kabala: From establishing the electrical need of the OR, buying the necessary plug converters, connecting the newly donated Mindray monitors we brought with us, setting up the OR, getting to know who does what at the hospital, understanding the decrepit state of the electrical generators, coordinating the workflow with the local staff, operating with scarce surgical resources, every step came with its difficulties.
ISHI team has an incredible spirit, and is keeping up with its original schedule. The medical team did 25 major surgeries on its first two days, despite the many challenges faced (dubious electrical supply, no ventilators...). Everyone is impressed by our efficiency, pace and dedication. By now we have learned to adapt and circumvent the constant small obstacles our schedule faces.