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I hate ISHI because it is addictive: the more I volunteer on missions, the more I want to volunteer on missions.
I hate ISHI because I get to share intense days with a group of fabulous people I barely know, and by the time I get to know them it is time to depart.
I hate ISHI because it saturates my senses and mind with an array of intense experiences impossible to communicate to folks once I’m back home.
I hate ISHI because of that deep and stabilizing internal peace that I get after every mission, but which erodes away as my daily routine sets back in.
I hate ISHI because I’m part of a group that makes me feel is doing a difference, yet every time I checked, the demand for ISHI’s services is infinite and the surface have yet to be scratched.
I hate ISHI because its teams accomplish a lot with very little, yet they often leave with a silent sense of under-achievement.
I hate ISHI because I understand that I am fortunate for the abundance of my comfort, yet I fail to comprehend what are, those that have absolutely nothing, thankful for.
I hate ISHI because it shows me that resilience in the face of permanent adversity is not a choice....
I sit in the newly renovated airport and notice the many chages which have occurred here. The airport is clean, spacious, and air conditioned. I have witnessed many changes during this mission. Solar street lights line the dusty road and some of the nurses within the hospital seem to have become more open and receptive.
During our time in Kabala Emilia and Marina have taught several classes and the number in attendance grew each day. Was it due to sodas offered or the 3 minimal attendance rule? What ever the reason, they attended, were receptive and offered topics for the following year. Bona and Bockarie, two eager young nurses, showed up daily and exhibited a genuine eagerness to work with Emilia and myself. By the end of our stay they were putting in IV’s, transporting patients to the male and female wards and giving report on patient status and plan of care.
This has been a successful mission and ISHI has developed a partnership with this hospital. Empowering the staff and supplying Kabala with necessary equipment is a challenge, but small changes have been seen and made. I look forward to seeing what has changed and what influence our presence have made next year.
Last patient who we operated on today was a 20 something old young man with an inguinal hernia. His hands callused from a job that he has done for more than 10 years now, since he was a young child. It is the only job he knows how to do. His entire day spent in the field. Despite the pain that he goes through daily, he does it because he has no other choice. As the song playing in the background on Malik's I-pod plays the words... "And I think to myself, what a wonderful world"....and I realize that this patient can't read, he can't write, he can't even spell his name. He doesn't even know his date of birth, or his age. What is so "wonderful" about it? And I think about the walk to the hospital every morning, and I see the children that greet us as they walk to school, and I see countless others about the same age who will never be given that opportunity, and it makes me sick to know that they too will never discover the beauty that lies in books. It breaks my heart to see so many potentially "brilliant" minds who will not be given that chance. The disparity that exists between the "have's" and the "have not's" in this world is extremely upsetting. It really changes you, and the belief that you have about this world is suddenly completely different. Even though my life's work, my entire nursing career was spent caring for the underserved, people who live in poverty, it is a completely different feeling when you realize that here in Kabala, Sierra Leone, some of these children don't stand a chance, they are forced to work , stripped from their childhood because they need to put food on the table.
Today we arrived to the hospital to not only set up the OR and recovery room, but also triage. We entered the triage area and were greeted by a large group of women, men and children. Walking towards the triage area; we are flanked. Looking both left and right…faces are hopeful and grateful. Many of the potential patients have traveled miles by foot and are from different villages and tribes. They speak unfamiliar languages. The key today is booking the weeks schedule and knowing ones limitations. Cases easily done in the States, are not so easily accomplished here. Long treatment goals and medications are not easily obtained here. And although we want to help everyone, we certainly don’t want anyone harmed by our poor judgment call…some patients therefore are turned away because their problems are beyond our resources.
Total patients seen:80. Booked surgical cases include 11 females and 69 males. There is a much larger number of women who came to triage today, then on the previous missions. I attribute the increased females due to a radio announcement done the evening before where Dr. Julie Son announced that she is a female surgeon and she invited women patients to come out and be triaged. It worked.
Dr. Zina used her ultrasound skills on 25 patients. She has done ultrasound on scrotums, lungs, hearts, and complex cysts. Her patients sitting on the bench and eagerly awaiting their turn, and her gentle and efficient touch. As her patients wait, and the bench becomes loaded, we joke around about going on Divert. Dev, Julie, Letisha and Audrey, through local translators have moved the patients through the triage process without incident.
Triage ran smoothly and as Gio and Palmira readied the OR, our week is planned. Formal announcements and greetings have been completed between this triage phase. The staff here have been informed by Dr. Sifri that we are a team and our goal is to work as such. Encouraged to join us and combine our efforts and forces for a common goal of successful outcomes; smiles and gentle nodding in agreement is detected.
Our day has ended and I am worried about a patient seen in triage. The image of this 30 year old mother of 6 children is embedded in my mind. After giving birth a year ago, she developed leg swelling, shortness of breath, and what now seems like Congestive heart Failure. Now her symptoms worsen. She sits up in almost a tripod position, struggling to breathe, and every movement for her is a challenge. Her frail body is frightening. Shallow and rapid respirations, increased heart rate, right leg swelling, and chest discomfort ia an everyday occurrence for this woman with little treatment that the local doctor can offer her. In the States she surely would be admitted to the hospital and extensively worked up and treated.
As this patient is moved from one bed to another, aspirin and nitro are offered. Her prognosis is poor. I sit here and wonder what will happen to her next. Admission is needed, but will it happen? Will her children be cared for? What does this hospital have to offer her? Health care challenges in a third world country do not always yield success stories. We hope and pray for the best and move on, but she will not be forgotten.
Wow…What an incredible experience. Today we visited Bunce Island…Truly an opportunity of a lifetime….For many of you who do not know this history, Bunce Island is a small island 20 miles off the coast of Freetown, Sierra Leone. It was established in 1670 as a Slave Trading Station…it was one of more than 60 Slave Trading Forts off the coast of West Africa. For nearly 150 years four times a year a ship carrying 300 slaves would depart Bunce Island for the New World.. It stands now as a symbol of the tens of thousands of Brave African Men, Women, and Children who were stolen from their villages by their fellow countrymen, who were involved in the slave trade for profit, and sold into slavery…mostly into present day South Carolina and Georgia…it is a painful reminder of their struggles, their sweat, blood and tears. The West African men and women were particularly sought after because of their knowledge of rice farming, and through their hardships made South Carolina one of the wealthiest states. To this day, the Gullah people of present day South Carolina and Georgia can trace their roots to Sierra Leone…and have held on to a lot of the language, customs and traditions
What is unique about Bunce island is that it’s building have never been interfered with…they stand as they stood all those years ago…mostly in ruins now….there are no words that can describe the feeling that creeps over you as you walk through the ruins…When our guide speaks the words “GATE OF NO RETURN”. Even if the slaves were not wanted by the slavers, they never returned to their homes…they were never set free…It is incredibly difficult to comprehend the atrocities that took place on Bunce…people chained together making it impossible to escape…families torn apart and sent to different slave owners….without the hope of ever seeing their loved ones again. Their lives, not theirs anymore. It truly is incomprehensible that civilized people did this to each other and were able to justify their cruelty…
We have finally made it to Kabala. Boxes unleaded and “belly don glady”. Settled into our residence for the next week. Half the group is new to Sierra Leone and so far we have banded well together. The work now begins.
Tomorrow breakfast at 7 and to the hospital at 7:30. Triage, OR set up , then the work begins Entering the hospital gates many have gathered to secure the spot and hope and pray that ISHI will perform a miracle. The goal being a successful mission and knowing the group limitations.
This is my third mission to Sierra Leone and I welcome the familiar sites and smells. I am not appalled by the smell of burning trash or the huddled masses of people which crowd the city streets and roads. The rich red soil, rice swamps, and lush green hills are inviting and hypnotic. I am awed by this place.
This is our third mission to Sierra Leone, and this year we were invited to meet the minister of health. This meeting was facilitated by Mr Peter Conte, our host during our Kabala missions.