A Great Day

Today was a great day! It not only kept me busy, but I got to do things I’ve never done before. First thing after rounds, the doctor asked me to do a one-on-one talk with a patient because she seemed very anxious with so many people in the room with her. Me and another nurse who could help me understand the patient’s Krio better sat with her and I asked her some questions. She had been having nightmares for several years and every time afterwards she would have chest and stomach pains, dizziness, and start vomiting. All of this is a sign of anxiety or a panic attack Back in the States, I had many young people who would be experiencing anxiety in the hospital setting, so I would teach them some methods on how to manage that anxiety. It doesn’t make it go away completely, but it at least helps. She seemed grateful when I taught her.

 

We also had an emergency code on the inpatient unit. That wasn’t a good thing that happened, but the good part was I felt like I knew what to do and how to help in a code situation. The patient was fine; they just fell on the way to the bathroom. But I knew what interventions we had to perform.

 

The best part of today was I successfully placed an IV today without the help of an ultrasound! I used the patient’s anatomy to find a vein! It was awesome! I gave patients their medications and monitored them afterwards, I charted everything. I finally felt like today was a productive day and that I’m finally able to start helping more at the hospital!

 

I’ve also been having a lot of fun hanging out with the ex-pats that live around here. We had a nice dinner together and the person who hosted it was able to make brownies and managed to find some chocolate ice cream. We couldn’t believe it! Everyone started cheering when our host brought out the treats. It had been so long since we had been able to have ice cream! The day after that, we all got together again with some of the locals we know around the area and had a game night! We played Uno and Codenames and had a great time! I keep forgetting to take pictures of these events, but I keep having too much fun to stop and think about getting out my phone. I feel like I’m making so many wonderful memories here and meeting so many interesting and nice and kind people from all over the world! I’m so happy to be back in Sierra Leone! 

The Diabetes Problem

So, a lot of this post is going to be about health care. Forgive me if this sounds like a medical journal.

The hospital is still the same as ever. We’re low on supplies and medicine, malaria is still rampant (more than ever actually since it’s rainy season), and all the hospital staff keeps pushing on and doing their best. But something I kind of touched on here, but didn’t get very in depth in, is the diabetes problem here. Type 1 and type 2 are both problems here in Sierra Leone, for similar yet different reasons.

Diabetes type 2 is prevalent in the elderly population and like the US, it’s primarily due to poor diet. Most of the foods eaten here are fried foods: fried rice, fried chicken, fried fish, fried casava leaves, fried everything. So, doctors recommend eating grilled chicken and fish instead of fried. But let’s face it, fried food is delicious! I’d rather have fried food over grilled any day of the week. But it just bites everybody later in life if that’s your primary meal. Now when you get diabetes type 2, or when find out you have diabetes type 1, you must manage your diet and watch your glucose levels. But that is hard, especially is Sierra Leone. You need insulin that needs to be refrigerated, and power outages are common. You must prick your finger before and after every meal and throughout the day and learn what you need to do for different levels of blood glucose counts. So patient education is very important. Clear communication is important. Making sure your patient truly understands is important.

The problem? Most people will say, “Oh yes, I understand” and even demonstrate that they understand. Then they go home and don’t do anything that was taught to them. Granted, that happens in the United States too. But in the United States, not managing your diabetes can get you a short stay in the hospital because we have so many resources to get a patient back to a healthier state. Here, it can lead to a lengthy stay in the hospital and, more than likely, death. We’ve had so many elderly patients admitted because of their unmanaged diabetes.

Every time these patients see me, they want me to be their nurse because I’m a foreigner and I’m white. They think that because I’m a foreigner and I’m white, I know more than any nurse from Sierra Leone. Which is simply not true. My education was different but that does not mean I know more. And I keep trying to tell people that. Plus, I’m not an appropriate choice for teaching these patients because I’m still learning Krio. I’m not proficient at all and to care effectively for my patients, I need to be able to teach them. So, I’m not a good choice for many patients and their families until I live here longer. It can be very frustrating for both our patients and for me. I want to help, but I’m just not capable of doing that yet.

But I’ll tell you what I can do. I can monitor vital and oxygen levels effectively so I can tell if a patient needs a higher level of care. I know when a patient is critical and needs immediate intervention. I can write handoff reports for the nurses on the next shift (and I try to write as clearly as I can because goodness knows the doctors don’t, seriously it’s like deciphering hieroglyphics). I can put a nasogastric tube down a patient’s nose and into their stomach. I got to do that the other day. It made me feel good that I could do a procedure for my fellow nurses.

I guess the point I’m trying to make here is that there is a huge need for nurses here because diseases and other health conditions are so prevalent here, but I’m not capable of delivering all the care that is needed yet and that can make me feel useless. I have a lot to learn, but I still help where I can and intend to learn what I can. I just need to be patient with myself.

Return to Salone

Welp, here I am! Back in Sierra Leone baby! Or as they call it here, Salone!

The trip back here was not as easy as the last time. At first, it was a straight shot from Fresno to Chicago, then onwards to Brussels. But my flight from Brussels to Sierra Leone was cancelled! Me and SO many people had to stay overnight in Belgium. Thank the good Lord above that the airport set us all up in hotels with dinner and breakfast. It was actually nice to be able to rest before heading back to Africa. I was so tired I slept 12 hours straight and got to have a hot shower in the morning! Plus, I met some new friends who were in the same situation as me (shout out to Simon and Robin)! I like travelling on my own, but it’s so much nicer travelling in a place you’ve never been before with other people. It makes you feel less lonely and like the world isn’t as big and unfriendly as it can seem.

The first thing I noticed when I got off the plane at Freetown Airport was that it’s not as hot as it was the first time I was here. The once skinny, trickling rivers were now swollen and rushing towards the ocean. The sky was overcast, and I could feel rain was about to fall. It’s the rainy season here now and I LOVE it! It is not at all like the dry season. The heat is still here but it’s not as oppressively hot. And, of course, it rains a lot more. The road from the airport to Makeni is paved, so the rain wasn’t much of an issue getting home. When I arrived, I found that Auntie P had cleaned my house and set out clean bed sheets for me. I was so happy! I collapsed on my bed that night and passed out for another 12 hours. Plus, this time it didn’t feel so new and different. I came home and knew exactly what I needed to do to get clean water, electricity, and WiFi. Plus, this time I knew exactly which stores to get food from. Easy peasy lemon squeezy!

Now that I’m back, I get to meet up with old and new friends. Obviously, Auntie P and the Sisters all came over to say hi to me. Everyone told me I had gained so much weight in the States and I had become so much fatter (It’s a compliment. It’s a compliment! I have to keep reminding myself that here, it’s a COMPLIMENT!) Some of my ex-pat friends came to say hi to me too. Also, I have new neighbors! There are two new Italian ex-pats living near me at Stocco! They are so nice! My birthday was this week, and they made pancakes for me to celebrate! It was so sweet of them! I think we’re going to get along great! Sheku came to see me too and wished me a happy birthday!

Monday, I went back to the hospital and got to see all my coworkers! They were so happy to see me, and I was so happy to see them! I had missed them so much and they said they all missed me too! I went around the entire hospital saying hi to everyone! Tuesday was my birthday, and I had brought back some candy from my mom’s restaurant (Down to Earth Bakery and Deli, ya’ll should check it out). I made sure to pass the bag around to as many people as I could to celebrate the day.

I did learn something sad though. Sister Julianna, the matron at Holy Spirit Hospital, is leaving! Her order is sending her to serve somewhere else. Everyone is so sad. She’s originally from Kenya, but she has lived and worked in Sierra Leone for 10 years! I’m especially sad. She was one of the people who helped me the most when I moved here. She was my guide, my advocate, and my teacher. I’m sure she means so much more than that to the people here because they’ve known her for a longer time. This Friday we had a going away party for her. I got to wear a red dress I bought recently and was excited. But as I was looking in the mirror, I wondered if I was overdressed. But I forgot where I was. I got to the party, and everyone was wearing brightly colored mermaid gowns and technicolored suits. If anything, I was underdressed. I love the style of clothes here. There were many tears and hugs at the party. We’re all going to miss Sister Julianna so much. Afterwards, we all danced together. I have a picture of me, Sister Julianna, Sister Nora, and Sister Peace at my mom’s requiem mass so I’m going to include it in this blog post. I also took pictures of the party so you guys can see that too. I can’t wait for more adventures here in Sierra Leone!

Loss And A Supportive Community

I’ve been meaning to post another entry into this blog for a while. I was going to write about the 10-day blackout that occurs in Makeni every year and the Mpox outbreak and how much education about prevention and isolation is needed for the general population. But as many of you know, something very personal happened to me. My mom passed away three weeks ago. When it happened, all I could think about was my dad and my sister and my family and how much this was hurting them. I was so far away, and I couldn’t be there for them. I had to wait a week to go to them. And every day that week was so hard to face.

But here’s the thing; I wasn’t alone. The minute the people of Makeni learned my mom’s condition had become critical, they came to comfort me. The very hour my mom passed away, the whole community came to support me and mourn with me. I was given food, care, and sympathy. More than that, the Catholic community organized a requiem mass to honor my mother and pray for her and my family. I grew up in a small community that supports each other. But I never imagined experiencing that amount of love and support from a community I had become a part of so recently. I felt so blessed. I still feel so blessed that I was able to volunteer in such a loving community. I had come to Sierra Leone to help. But in the end, they helped me. We helped and supported each other. May God bless them.

Extended Community

 

I really feel that I’m becoming a part of the community. Every morning from my window seat in the hospital car, people will smile and wave either shouting, “Porto!” or “Sally!” When I’m at the hospital, everyone knows who I am and greets me with a smile or a nice, crisp high-five or a solid fist-bump. I even feel like I’m coming into my own as a nurse here. On Monday, a coworker brought her baby to work. The baby wasn’t sick or anything, but she had me hold him while she went to take care of a few things. I held him, and talked to him, and sang him to sleep. It reminded me that I will always be a Pediatric nurse at heart. Working with children has always been what I’m good at. I’m starting to give more medications and help with more procedures as well. The weather is much cooler, so I have the energy to do way more things as well! Everyone tells me that the rainy season is coming and soon I will be sick of the rain. I’m excited! I am ready to be sick of the rain!

I’m also starting to learn about a new kind of community in Sierra Leone; my fellow foreigners residing here long-term. Most are here working at paying jobs or internships at NGOs. They come from all over the world: England, Brazil, Nigeria, Kenya, Japan, most are from Italy. Two Italian girls live close to me in Stocco Compound. They’ve lived here for about a year, but they’ll be leaving soon to go back home. They know Father Luigi and he asked them if they could invite me to one of their get togethers. They took me to a restaurant I had never been to before called “Fishermans” to meet up with some other people from around the world. We all swapped stories of living in Sierra Leone and how we’ve adapted over time. One lady from England used to live in the house I live in now. She says she doesn’t miss it. It would get too hot because it was always directly in the sun. When I told her that air conditioning had been put in, she said that would definitely help.

The next day, the two Italian girls invited me to go with some of their friends from Bo and Freetown to hang out by a river close by. I was absolutely down! The girls from Bo were also from Italy and the girl from Freetown was from Japan. We drove out of town and arrived at some large, metal gates guarded by men demanding twenty Leones from each of us. When we were allowed to drive through, we saw a lovely, winding river surrounded by palm trees and locals chilling in the sand. I suspect the river gets very high in the rainy season so we must have come during the busy season when it’s still safe. There were families and college kids and couples all either swimming or lounging by the river. Some kids even had a wooden canoe and were standing in it while paddling it around. There was a volleyball net set up on the beach. There was also a swing that little kids would play on and jump into the water with. We didn’t get in the water. We just found some picnic tables, bought some drinks, and hung out next to the water.

That night we went to Relim leisure center. It was the same place I had gone to have a pool day. It was much busier during the night. Someone was having one heck a birthday party that night with flashing lights and loud music. There were also a bunch of Arab men smoking hookahs in their bathing suits at the table next to ours while we ate. Right as we were about to leave, rain started pouring down on us. We drove back to the two Italian girls house at Stocco Compound where they had baked some banana bread for us to share. It was so nice to talk with other people having experiences like mine. They were all getting used to how different everything is here just like I am. Of course, most of them had been there longer. They were able to give some tips on living here too! I hope I can keep in touch with them and learn more from them.

Independence Day

Happy Independence from the British Empire everyone! I realize it is not July 4^th. But in Sierra Leone, on April 27^th, it’s Independence Day! This morning, I woke up to the sound of a marching band playing down the streets. Drums were booming, trumpets were sounding out their victory cries, cheering was everywhere. I had a quick breakfast and joined the Sisters in the car to take me to Holy Spirit Church, where everyone was sporting the blue, white, and green colors of the Sierra Leonean flag. I joined the choir like I usually do, feeling very out of place in my purple and yellow dress, and sat among my peers who were wearing traditional tunics and hats. Everyone was waving tiny Sierra Leonean flags and sweating like crazy in their woolen outfits. I kept letting people use my fan to help them cool down too.

During the mass, we said prayers for the country and the only songs we sang were in Krio or other local languages. After communion, the Young Adults group gathered in front of the church and began a fundraising campaign. I had no idea what was going on until one of the choir members told me it was Africana! If you read my first blog, you will remember that I had talked about Africana but had no idea what it was. Independence Day is Africana! I had no idea! Whenever I asked, people would say it was to celebrate African culture. They never said it was also their Independence Day! I felt so bad that I was so clueless. Luckily, Father Agustus was also there to explain to me what was going on.

The first thing the group did was sell ribbons and feathers that you could buy and pin on somebody. The next thing was to collect envelopes from everybody who had volunteered to give money beforehand. Everyone was cheering and laughing and singing through the whole process. It was so much fun! Praise God!

 

First African Wedding

Guess who has a new African dress and attended her first African wedding!

Me!

The Porto!

I had been seeing an invitation for a wedding for one of my coworkers at Holy Spirit Hospital being passed around and I was thinking to myself, “How cool would it be to attend?”, and the Deputy Matron Lamrana comes up to me and says, “You will come to the wedding.”

And I shouted “Really?!”

And she says, “Yeah, do you want to?”

And I was like, “Absolutely!”

So, then she says, “All right, I will take you to go buy a dress.” I have been wanting to buy a dress since I attended my first mass here and saw all the colorful dresses, so I was bouncing up and down in excitement!

We drove over to a dress shop where they had ready-made dresses. Usually, you have to order dresses beforehand and have them made to fit you. Most of the dresses they had at the “Ready to Wear” shop didn’t fit me (I was either too wide or too tall), but finally we found one that fit and it was actually a really good look on me. The red and green patterns on a white background looked good against my skin coloring. It also had laces in the back which was so pretty. The only thing they had to adjust was the length. The woman took it over to her pedal powered sewing machine and she hemmed it perfectly in under 3 minutes. Lamrana told me she had a purse that would go perfectly with the dress, and I could use it for the wedding! She helped me so much getting ready for the wedding. I was so grateful to her.

The next morning, Sandy drove me to the hospital where a group of the Holy Spirit Hospital staff were all going together in one car. I was the only one who dressed up before we left. Everyone else was wearing casual clothes and carrying their wedding clothes in bags. Most of the group piled into the back of the car while me and Lamrana got in the front with the driver, Atanzo. The wedding was in a town called Lunsar. It was about a 2 hour drive there. When we arrived in Lunsar, we got out at a house that I assumed belonged to the bride’s relatives. We all sat under a tree to get out of the sun and a gentleman brought out a large container of rice and fish. He started passing out water bottles and spoons and all of us dug in. Some chose not to use spoons at all; they just used their hands and mushed up the rice and fish in their palms and ate that. I went with the spoon. He also brought out bananas and sodas for dessert. It was such a pleasant lunch!

The ladies went inside the house to rest while I decided to stay outside. Big mistake. The wind started picking up and clouds of dust blew over me and Atanzo. We rushed into the car and sat in there to wait it out. Before we knew it, the sky, which had been clear and sunny before, was now completely overcast. The women decided it was time to get ready, so they prepared themselves. When they came out, all decked out in their beautiful gowns, we drove over to the church.

The ceremony was just like the weddings we have in the States: the bride wore a white gown, there were bridesmaids and groomsmen, and flower girls and ring bearers (they call them “page boys”). There were a few key differences. The flower girls threw gold confetti instead of flower petals and there was also a “Little Bride” and a “Little Groom”. Why? I dunno, but it was very cute. Also, at the end of the ceremony, everyone went to the front of the church and started dancing around the new couple. It was fun!

After everyone exited the church, there was another container of fish and rice in the back of the car and more water bottles. We ate our fill, then piled back into the car and drove to the reception. We got lost at first; we almost ended up in the middle of the bush! But we got directions from everyone we passed on the trail and managed to get back on track. The reception was at a resort with a lounge and a pool. Right as we got there, it started to rain. Luckily, I had brought an umbrella (for the sun, not for rain). But there was a covered area, so we were good. There was a DJ playing a bunch of African music that I had never heard before. We stayed to dance and eat a little bit, but we had to leave early because we had such a long drive ahead of us. Luckily, we got to stay long enough for the traditional “throwing money at the couple as they dance” dance. It reminded me of the “pin money on the couple’s clothes” dance we have in the States.

When we got back to Makeni, I was so tired and dirty but so happy. I had so much fun with my coworkers, and I was so glad to experience something else that is uniquely a Sierra Leone experience.