Familiarity & Faith

 

As September comes, so does the first day of school in Sierra Leone. The Catholic Diocese does everything it can to promote education here in Makeni. They built most of the schools in the city and in the bush and continue to manage them to this day. They are also responsible for the University of Makeni. Every morning, I see students dressed in their uniforms with their skirts or slacks and ties, making their way up and down the streets. It reminds me of scenes from anime shows, except there are no cherry blossom petals floating around and no one is Japanese. Most children here go to the Catholic schools, whether they come from Chistian homes or Muslim homes, and are taught by priests or sisters. My dad and his siblings went to Catholic schools. I never had that experience. I was happy with public school, but it makes me wonder what that would have been like. As I see all these children rushing to school, it makes me think of home. Education was very important to my dad’s parents. They both immigrated from Nicaragua to the US and wanted all their children and grandchildren to receive good educations.

A lot of the local food here reminds me of the Nicaraguan food I grew up with, which was a lot of rice and beans and chicken and fried plantains. It’s comforting. My paternal grandmother passed away this Sunday. We called her Coco. She came to the States where she met my grandfather. They both had grown up in a country that didn’t let everyone get an education and wouldn’t let people speak freely. While they lived in the States, they brought their children up in the Catholic church. My Coco gave me my first rosary. She prayed for me and all my cousins every day. When she found out I was going to be a missionary in Africa, she was very worried about me and my safety. But she told me that she was very proud of me. She told me no one in our family had ever done anything like this. She gave me another rosary blessed by Pope Francis and told me, “God bless you, mi amor. I love you.” My mom taught me to follow God. My Gram taught me to love God. But my Coco taught me to love the Catholic faith and I’m so grateful she was my Coco. All three of those lessons will never leave me. Especially here on my mission when I need them the most. I pray I remember them the rest of the time I’m on my mission.

Expedition

 

Since it has begun to rain a little less often these days (and it is way less hot than it is in the dry season), I’ve started venturing out and taking longer walks, exploring the surrounding areas of Makeni on foot. Some days are absolutely overcast and gloomy, but some days I get nice sunny days with fluffy clouds dotted throughout the sky. It’s so good to feel the sun on my face! I even managed to get pictures of Stocco Road in the sunshine!

 

Usually before I set out, I’m greeted by Bobby. Bobby is one of the local dogs here at Stocco Compound. He is always so friendly. I’ve trained him not to jump on me anymore, but he sometimes forgets himself. He’s always so happy to see me out and about. I usually wander around the University of Makeni (Uni Mak). The grounds are well maintained and clean and I like seeing the different lecture halls. I took a picture of me there with Wusum Mountain in the background.

  

During one of my expeditions, I went to a dress shop that we always pass on the way to the hospital. I had always admired one of the custom-made dresses they had on display in the front, but it always looked too small for me to wear. However, when I got there, the owner insisted I try it on and oddly enough, it fit me perfectly! I wore to mass the next day! All the Sisters complimented me and told me I looked very “Africana”. It makes me feel like I’m from the 80s. I love it!

 

 

I’ve been trying to stay more active. The Wusum Hotel has a gym, and I sometimes go with my Italians neighbors. It’s very tempting to just stay in my house all the time and avoid the gym all together. When it was raining all the time I had a better excuse. But now, I’ve found it’s better to get out and about more. Yesterday we were invited by several of our expat friends to go on a hike up the Menna Hills. I thought for sure it was going to pour on us but it only sprinkled a little and it was refreshing. The view was nice from up there. We didn’t go the whole way up because the paths were too overgrown. 

 

But it was nice being able to see the town I’ve been living in from a new perspective. Makeni is much larger than I had thought. And it was nice sharing it with friends. Some locals even came and joined us with their two dogs. It was a fun day. I hope I can climb the other hills around here and get some practice before I try to climb Wusum Mountain. That’s going to be way more challenging.

New Intensive Care Unit

 

Holy Spirit Hospital has just opened a brand-new Intensive Care Unit (ICU). Sister Julianna had been trying to open one for so long and right when she leaves, it becomes ready to use! It’s not like our ICUs in the States. It’s closer to what we have in general admission wards. They have monitors and IV pumps and oxygen that can be plugged into the wall where it is attached to oxygen tanks in a separate building. Usually, patients don’t have monitors or IV pumps to deliver medication and if they need oxygen, it comes from a machine that relies on electricity. Many of the nurses here have never worked with machines like that and don’t have the proper training. So, I have been spending a lot of time on the new ICU helping set up monitors. I really need to teach more people about how the settings on a monitor for a child are very different than the settings for an adult. I also need to reinforce the need to not allow bubbles in the IV line. Even one tiny bubble can set off the IV machine. They also have a baby incubator in the ICU. They have no plans at the hospital to use it any time soon, but I want to ask if I can check it out to see if it works like the ones we have in the States and teach some nurses how to use it in case the need ever comes up. I can see myself spending most of my time in the ICU, but I am primarily a pediatric nurse and while I don’t just work with children while I’m in Sierra Leone, I feel I should spend some time on the general pediatric ward as well as the ICU.

 

The other day I had a chance to use my knowledge of medical machines and pediatric nursing care. In the morning while doing rounds, I saw a child with increased respirations and labored breathing. I knew the signs that the baby would soon exhaust itself and wouldn’t be able to keep up breathing like that. I began doing what we do in the States and had the baby sit up and I made what we call a nest so she could sleep while sitting up. I also placed a shoulder roll under her shoulders to help open her airway. Dr. Turay saw what I was doing and examined her for himself. He recommended the child be sent to ICU. Now I should explain, ICU is much more expensive than the general ward and the family has to be consulted first, so they are aware of the cost and to be sure if they have the money available. It took a while to figure that out, but eventually we moved her to the ICU. I taught the younger nurses who were there about the difference between pediatric and adult monitor settings, but I don’t think the understood my broken Krio. I also taught them about positioning that helps with the baby’s breathing. Besides teaching, I was also trying to advocate for the baby to get the proper medications to help open her airway. What she really needed was a dose of albuterol from a nebulizer. But it took so long to find all the parts for a nebulizer and then when I finally assembled one, it turns out the hospital didn’t even carry albuterol, so we had to wait until we could send someone to buy some at another pharmacy.

 

If there are two things the hospital here truly needs, it’s more resources and better communication. Maybe one day when I’m back home I’ll set up a fundraiser to help with acquiring more resources for Holy Spirit Hospital. And maybe one day I’ll figure out some kind of class where I can teach methods of communication. Until then, I’ll just keep doing my best helping where I can and teaching where I can.

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.