Lessons In African Healthcare

 

My education in the world of African health care continues. My teachers are very patient with me, answering all my questions and allowing me time to understand even the simplest procedure. It will be some time before I’m able to admit a patient to the unit on my own, but I’m okay with that. My teachers are enthusiastic for the day when I can be on my own. I don’t feel pressured by them to start working on my own. But I can tell they want me to learn and experience everything.

 

Something I didn’t expect to follow me to Sierra Leone from the States is the thing that gets on the nerves of all Pediatric Nurses: Coco Melon. For those of you who are not raising young children in this modern day and age, I envy you. You’ve never had to hear beloved songs mangled by whatever autotune voice modulator the site uses, and you’ve never had to watch creepy CGI babies and children sing and dance to those tunes. In the States, I would go home at night after work and hear those songs in my sleep. But the kids at the hospital always loved it. They could watch it for hours. I shouldn’t have been surprised the kids in Sierra Leone like it too. But I could hardly believe it when I heard that dinky little jingle coming from the Pediatric Ward. And lo and behold, a mother was using it the same way we used it back in the States; to distract her child from an IV placement. Again, it’s funny how many things are similar to things back home instead of being different.

 

My lessons at the hospital tend to get interrupted because I have other things I need to attend to, like getting a work visa and buying things that I need. The only way I’m able to get to the market or to church or anywhere is with my hospital driver. So sometimes in the middle of being taught something, someone will drag me away from my instructors and take me to perform another task. I don’t mind really. I’m happy to do whatever needs to be done so that I can live in this new country. But I can tell it frustrates my fellow nurses to have me taken away in the middle of their instruction. For their sakes I feel bad, but a break from their teachings is always appreciated because it helps me process what I’ve been taught so far.

 

I was able to go shopping for the first time today! My driver took me to a mini mart where I was finally able to buy dish soap, laundry soap, a lighter for my stove, and toilet paper! The driver came into the store with me, and he made sure I got everything I needed. It made me feel more comfortable having someone go with me. I like the driver a lot. He always picks me and Sister Peace up from Stocco Compound with a wink and a smile. His name is Sandee. I’m sure that’s not how you spell his name, but that’s how everyone pronounces it.

 

According to the hospital manager, I should be getting a Sierria Leonean ID soon!

 

I can’t wait!

Learning The Ropes

 

Being at the hospital has helped me feel less lonely. Every morning me and Sister Peace are picked up by our driver, Sandee, who always greets me with a smile and a wink. I’m greeted by nurses and other hospital staff every time I enter the hospital. Eating breakfast at the canteen has helped too. The cook gives me a hot meal and a smile. I no longer feel as isolated as I used to.

 

I’m already starting to shadow the nurses and learn how they do things at Holy Spirit Church. I knew things would be different in African hospitals even before I applied to LMH as a volunteer. So, it was no surprise to see nurses charting with paper and getting written orders from doctors. And of course, I knew resources would be limited and equipment would be used differently. But being trained in the States can make you a bit squeamish when it comes to certain things. My fellow nurses back in the States better strap in, I’m about to tell some stories that will make you squirm in your seats.

 

I’ve mostly been observing the nurses’ day-to-day routine and giving medications is a part of that. I watched one nurse take out a syringe and use it over and over to administer a medication to a patient. Then she accidentally dropped it on the ground. She picked it up and was about to use it to draw up more medication when I asked, “Do you not throw it away?” She replied, “No, our resources are limited. We use the same syringe for the patient until the end of the day.” I nodded, hoping my eyes weren’t betraying the internal screaming in my mind. I get it. I really do.

 

Other things shock me in completely different ways. I watched a nurse tell a 3-year-old boy to open his mouth. He then obeyed without complaint, she put medication in his mouth, and wonders of wonders, he swallowed. I can count the number of times I’ve seen a child that age take medicine willingly on one hand. I’m sure not every child who comes to Holy Spirit Hospital will be so accommodating, but still it was a beautiful sight to behold. I have never been this excited to start working at a hospital.

 

I love talking with the staff and learning from everyone. No matter where you go, it seems that what nurses talk about is the same. I was sitting with the nurses at the station and overheard a conversation in Krio that I could actually interpret. The basic discussion was about a pen. My fellow nurses out there will understand how necessary a pen is to a nurse working on the floor, and how often said pen gets lost either by leaving it lying around or by people “borrowing” it. One nurse I was sitting next to kept begging Sister Peace to let her borrow her pen and Sister Peace kept denying she had a pen. Both were laughing and nudging each other until the first nurse managed to cajole Sister Peace into letting her use her non-existent pen. It was a good pen too. I could see why the first nurse wanted to use it. It made me laugh because I’ve had the exact same discussion with colleges at my old job. Letting your fellow nurse borrow your pen is the epitome of trust in a nursing environment. It’s nice to see something familiar in a place that is different from what I’m used to.

 

The nurses have already taught me how to write morning reports in a paper chart and change of shift reports. Some protocols and medical abbreviations are different than what we use in the States, but it’s almost like learning words in Krio; some are similar while others are very different. I’m glad I’m starting slowly. I don’t feel overwhelmed yet. So far I’ve kept my promise to Dr. Turay and I’ve been patient with myself in the hospital. I realize I don’t know everything I need to know yet. One event today reminded me of that. While the doctors and nurses were rounding on the patients, one doctor asked me if I knew how to tell if a patient with a fever was more likely to have malaria or typhoid. I told him honestly, I wouldn’t be able to tell. He then explained that malaria patients tend to have intermediate fevers while patients with typhoid will have fevers that keep increasing gradually. I’m glad that I know that now. Any piece of information I get, I’m going to do my best to remember. I don’t feel bad that I didn’t know the answer. I’ve never worked with malaria or typhoid patients. They’re not very common in the states. I read up on common diseases in tropical climates, but it takes working in the field to truly learn and I’m grateful for the chance to learn. The staff in Holy Spirit are so nice. The nurses here are patient and do not let a new nurse drown in information. But they make sure new nurses learn lessons at every opportunity. From what I’ve seen so far, I think I will be happy at Holy Spirit.

The Hospital

 

I finally got to go back to the hospital today. Me and Father Gabirel had a quick Krio lesson before Vicar General Dominic drove me to Holy Spirit Hospital. I met Dr. Turay and Sister Juliana again. I also met the administration manager of the hospital. We had a meeting about the best course of action going forward. Today, we started slowly by showing me around the hospital and introducing me to the staff.

 

Sister Juliana, the head nurse or matron, showed me where the different wards are, where the surgical theatres are, where physical therapy is, etc. The hospital is much smaller than other hospitals I’ve been to. All the wards and clinics are split between many different buildings. It will take me a while to know where everything is. I met other clinicians, nurses, the pharmacist, Human Resources, Finances, and lab techs. It’s going to take me a while to remember everyone’s names too. But no one seems to have any problem with my name. Everyone is so surprised to hear the name Sally is an American name and a Sierra Leonean name.

 

Sister Juliana told me that she is from Kenya, and it took her a while to get used to speaking Krio and how the hospital is run too. She says I will get it, I just need to be patient with myself. For lunch, Sister Juliana took me to the canteen. It’s called the Hastine Restaurant, where we were greeted by a woman wearing a green apron with a logo belonging to a coffee organization that shall remain nameless. Sadly, the restaurant does not have a coffee shop, though they do serve instant coffee.

 

The canteen has a pretty good menu. I ordered chicken, cuscus, and a veggie salad. They even had cold sodas! For some reason they also served me pasta with ketchup on it. I don’t know why. Maybe it just comes with the cuscus. Next time I think I’ll order something that’s more local. I was thinking the cassava leaf stew. Most of the staff eat there for lunch. I think I’ll like eating there. It’s clean and pretty with purple and gold decorations on the walls and tables. And there are no doors, only light flowing curtains with roses on them. It keeps the canteen nice and cool. I plan to have breakfast there tomorrow morning.

 

My work schedule for now will be Monday through Thursday from 8:00-2:00. I think that’s a good place to start. I know I’m going to be learning so much from everyone while I’m there. And the best part about working there is the air conditioning!  I’m looking forward to spending more and more time at the hospital!

Sunday At A Different Parish

 

I didn’t get to go to the Holy Spirit Church for mass today because there was no driver available.  It was okay though because Sister Veronica made me breakfast and for the first time in a long time, I had something besides cornflakes and powdered milk for breakfast. She made me an omelet with bread and, praise the Lord, hot coffee! I haven’t been able to boil water in the electric kettle to make hot coffee because the power has been out every morning, and I need a lighter for the stove to boil water. Hopefully I can buy one soon. Any way the food was so good!

 

After I got dressed, two Sisters walked with me across the street to a different church called St. Guido Conforti. It’s a much larger congregation led by an Italian priest called Father Jerry. Everyone greeted me and all the children would come up to me to grab my hand. During the mass I sat in between the two Sisters. One little girl chose to sit next to me. She loved holding my hand and playing with my hair. Most of the children here seem fascinated with my hair.

 

The church choir sang beautifully. They were led by a young man whose voice range is a tenor. I told him later how beautiful his voice was. The music was a lot of drums and other percussion instruments. That day was also Father Jerry’s birthday, so the congregation sang to him and gave him gifts. After the service was over, one of the Sisters took me to a community hall next to the church where they were celebrating children who were becoming altar servers. They served everyone lunch (chicken and rice) and passed out fruity sodas I had never seen before. I had one called a “Tik Tock”. After only having water to drink for the past week, a cold soda was heavenly. At one point, the little girl who had been sitting next to me began dancing in the middle of the hall, making everyone laugh. I believe her name was Vanya, but I think that’s wrong.

 

Later, some more priests joined the group. One was another priest from Italy. He introduced himself as Father Brioni. At first his name didn’t sound familiar, but then he told me his first name, which is Luigi. It turns out, he knew Janice England who was in Sierra Leone when she did her mission. Janice had told me about Father Luigi when I was still in training. Father Luigi and I exchanged contact information before the Sister and I went back to Stocco compound. I hope we can meet up sometime and talk about mission work.

 

When we got back, Sister Vivian had made me lunch as well. I felt bad because I had already eaten at the church, but the food she made was so good I had a second lunch. I told her I would take the rest to my house for dinner.

Sports Day

 

Today I had another lesson with Father Gabriel. This time it was about grammar and the culture of Sierra Leone. Afterwards, I went back to the parsonage headquarters, where I met up with Monsignor John and an IT worker who helped me set up my phone and my Wi-Fi. Later, Monsignor John took me to his home next to his church and gave me lunch. It was another fish stew with rice, but this one had chicken legs and meatballs in it too. I got a chance to practice my Krio with his housekeeper. I’m still shaky on some words but I’m getting better.

 

I could hear an announcer on a loudspeaker outside and I asked Monsignor John if there was an event going on. He said that next door there is a school sports field, and two schools were competing in running and jumping, like track in America. He asked if I wanted to go over and I said I would absolutely love to! The children were divided into four teams (though they call them houses): blue, pink, white, and yellow. The children (or pikkin) would choose one person from each house to run the race. For the first event, the competitors had to run around the field 3 times. While I was watching them, I wondered how none of them were passing out from the heat. Then one girl on the pink team passed out in the middle of the race! Luckily, Sister Peace, the sister who will be going to the hospital with me every morning, was there to check on her. I got hot too and very tired, so Father took me back home.

First Week in Makeni

Today and yesterday I was left to myself. On Monday, Vicar General Dominic asked me if I would need some time to settle in before I began work. I told him I think it would be best to take some time to get used to living in Sierra Leone and yes I definitely needed to rest. So he said I could start working at the hospital next week.

I’ve been trying to stay active while I’m here. First, I usually do some light yoga. But then I go for a walk down the road where I live. It’s called Stocco Road at Stocco Junction. I live in the Stocco Compound. Stocco Compound is very clean and there are a lot of beautiful plants here. In front of my house are two bushes with white flowers that I found out are called “crepe jasmine”. They smell heavenly. Outside the compound, Stocco Road is a dirt road with many pot holes and bumps. The road is lined with the homes of people who live here. Chickens run around free and goats are usually tied to trees but sometimes they get loose too. Cars and motor bikes make their way up and down the road, honking their horns the whole time. Children play close to the road. All the locals are very friendly. When I’m walking down the road they smile and wave. Many people, especially children, invite me to talk with them. One family even had me come and sit on their front porch with them. They all are pleasantly surprised that my name is so similar to a Siera Leonean name. I try so hard to remember their names but it’s so difficult because I’ve met so many people and the names I am given are so different from American names. After seeing what I can see of Stocco Road, I go back to my house.

There is something a bit odd about my meals though. The Vicar General had told me on Monday someone would come to take me to dinner that night and no one did. And then no one came at lunchtime the next day. It’s not like I was starving. I had been given some canned tuna and ground nuts by the bishop so that was good. Lunch finally did come at 2:30 pm with a delivery man. Apparently, my meals are going to be brought to me instead of me brought to them. It was a chicken leg, with some very spicy rice, and some vegetables. Dinner was the same. And then the next day (thankfully at an earlier time), lunch was the same. I wonder if I’m going to get tired of chicken and rice. Actually, as I’m writing this, the delivery man just came with dinner and low and behold, something different! It’s fish, pasta, and vegetables! Hurray!

I do worry I’m going to get bored while I try and rest up. Granted I do have chores I do around the house but even just the little things wear me out so much because I’m so hot and sweaty all the time. I have a kindle and other things to keep me occupied though. And a cold shower always makes me feel better. The power still goes out a lot. I hope the water doesn’t give out too.

I also hope I can learn where I can go and buy things. I especially want to learn how to barter. I asked one sister living here named sister Vivian if she knew of any stores close by. She said she would show me. I also want learn what a fair price is. There is so much I need to figure out while I’m here! God bless!

 

The Next Day:

 

Today was a great day! This morning, I had my first class with Father Gabriel learning about the language here called Krio. I learned different ways to greet people, different words that they say here that are similar to English, and different phrases that will be useful when I am working at the hospital, like “Do ya si don” which means “Please sit down” and “Ow yo dai fill?” which means “How do you feel?”. He even taught me the Krio words for different parts of the body. For example, when people say “han”, it means more than just hand. It means the wrist, arm, and shoulder. Father Gabirel is a good teacher. He is patient but also makes me do work. Instead of just talking at me, which I feel a lot of teachers do, he has me repeat phrases and try to figure out what phrases mean on my own.

When he asked me how I was doing, I told him I was doing fine, just a little tired being at the house all day. It’s good I’m resting before I start work, but it’s hard being here with no internet or phone yet. When he heard that, he told me he was going out to the bush today to meet with some people in a village. The bush basically means the countryside outside of Makeni. He asked me if I would like to go with him. I said I would love to! So after lunch (and applying a lot of sunscreen and bug spray), I got into his car and we drove out of Makeni.

The roads in Makeni are paved. But when you leave the city, it’s all dirt with a lot of bumps and pot holes. It’s kind of like Stocco Road, the road I live on, but that road is short. This road goes on and on into the jungle. I’m sure we went for miles and miles but I didn’t feel any of the bumps or dips. I was too fascinated with my surroundings. We passed by many villages with colorful buildings. There were palm trees, mango trees, people walking up and down the road, farmland where people grew their crops. Father pointed out many churches where he used to preach and baptize people. Everything was so new and different for me I was over the moon seeing everything. At one point we passed by a plot of land where people were growing peppers. Father Gabriel asked if I had ever seen these peppers. I said no and he immediately stopped the car and let me get out to go meet the people in the field. They showed me all the hard work they had done picking the peppers. I even got to practice the greetings I learned. They were very friendly.

Later down the road, we passed some mounds that looked like giant fancy mushrooms. I asked Father Gabirel what they were, and he said they were ant hills. He told me that people will saw them off at the base and break them open so their chickens can eat the grubs inside. Then people will mix the broken pieces of the ant hill with sand to help them build their houses. Father let me go out to take pictures of the hills. I was careful to watch my step so I wouldn’t run into those ants. The last thing I ever want is fancy ants in my pants!

 

Every time we passed by a village, the children would see me and call out “Porto! Porto!” Father Gabriel explained that it’s short for “Portuguese”. The Portuguese were the first Europeans in Sierra Leone. So now whenever they see someone with pale skin, they call them “Porto”. When we stopped so Father could speak with someone, all the children came up to the car to see me. I greeted them by saying “Kushe O,” and they all smiled and greeted me back. I gave them all high fives before Father drove on.

When we came to the village that was our destination, Father explained that he was building a church there across from the village school. We met one of the teachers and a builder there and while they spoke with Father, I took some pictures and looked around at the surrounding area. I was careful not to go off the road though because of snakes or whatever else was crawling around in the brush. The flowers are so beautiful here. I asked Father what kind a pretty pink flower I found was. He told me it was just a regular flower. But not to me! It was brand new and beautiful. One of the men Father was talking to saw how much I wanted to get closer to the flower, so he picked one for me so I could see it better. It was so nice of him. Everyone I meet is very polite and say their happy to see me. And I tell them I’m happy to see them too!

After his business was done, Father drove me and some of the villagers back to Makeni. We made one stop at a hardware store so one of the builders could get some materials, then came back to Stocco Compound. Father says if I want, I can come again with him sometime. I can’t wait! I thank God for this day. Or as they say in Krio, “Ah tankee God!” It was truly a blessing to get out and see more of Sierra Leone.

  

Meeting New People

Miscommunication happens every day. So it was no surprise when it happened to me. This morning, while I was still in my pajamas, I heard a knock on my door and found a sister, who introduced herself as Sister Peace. Sister Peace is also a nurse and works at the hospital I will be working at. She also lives at the convent close to my house. She told me that she had come to take me to the hospital. I told her that the Vicar General had told me yesterday that he was going to pick me up himself at 11:30. She told me that the Vicor General had told her that she was the one to pick me up. As quickly as I could, I rushed to dress and clean myself. The driver, Stevie, Sister Peace and I crammed into the front seat and we drove to Holy Spirit Hospital. Sister Peace introduced me to the head nurse, Sister Juliana. She brought me to the resident doctor, Dr. Patrick Turay, and a nurse manager, Sister Nora. Dr. Turay told me that I should not hesitate to ask questions while working at the hospital and to be patient with myself because I was now going to be working in a new culture. I appreciated his words.

Sister Nora then took me on a small tour of the hospital. I asked her when I would see the bishop. She said she didn’t know and asked me what the Vicar General had said. I told her that I thought he was going to take me there himself, but I guess I had misunderstood. Sister Nora called the Vicor General himself to ask. He told her that I was supposed to still be at my house and he was going to send a car for me at 11:30! Classic miscommunication.

Everything worked out all right though. I visited with Sister Nora while we waited for the driver. Turns out she’s from Kenya! And the sisters who live near me are a Nigerian order. I didn’t expect there to be so many different people from all different parts of Africa here!

Later, I was brought to the parsonage headquarters where I got to see Father John again, this time at his work. I also met the current chief of the local tribe who was visiting Father John that day. The Vicor General brought Bishop Bob John (named after Bob Marely) to meet me. If I thought Father John’s greeting at the airport had been warm, it was nothing compared to the Bishop’s. He took my hand in both of his, looked me in the eyes with a wide smile and said, “Welcome, welcome, Sally. I am so happy that you have come at last.” It was the sincerest and kindest greeting I have ever received. He led me to his office and asked after my sister Mary. He had been told that she had been sick in the hospital with pneumonia, and he had been praying for her and our family. I thanked him for his thoughtfulness. Our meeting made me feel so glad that I had come to Makeni. The bishop told me that my presence here showed people that we are connected. That we are not just African Christians or American Christians. But we are all Christians. We are all part of one family. He told me how much he appreciated that I had sacrificed so much to come here: my family, my friends. He wanted to make sure I was well cared for while I stay in Sierra Leone. That meeting gave me a new feeling of belonging.  I also got to meet Father Joe Turay, Dr. Turay’s brother, who Janice had known during her mission stay in Sierra Leone. Bishop Bob made sure that I had some more food at my house and Father John got me a new tea kettle. I am so happy that I will be working under Bishop Bob. He seems to be a very kind man. I can see why he became a bishop because he is so friendly, and people oriented. I enjoyed meeting him so much. I know that he is a very busy man, so I probably won’t see him a lot, but I hope I get to see more of him occasionally.

After meeting the bishop was finished, Vicar General Dominic drove me to a canteen at the University of Makeni for lunch. I was served a chicken leg and some very spicy rice. I felt bad I didn’t eat more but the heat has started to affect me. I don’t really want to eat large meals when I’m feeling so hot. I’m sweating so much and it gets worse if I move too much. Shout out to Kendra Harrison for suggesting Carpe Anti-Face Sweat cream and another shout out to Tia Virgina and Uncle Joe for Anti-Chaffing body sticks! Both help SO much.

The rest of the day I just rested at my house. It feels nice getting to know where I’m going to live and finding places for all my stuff. It’s also kind of fun when the power goes out. I get to use my solar powered lamp and fan (shout to Katie and John Miller).

Every day is an adventure. I wonder what tomorrow will bring. God bless!