Counting my blessings

You know those weeks when getting 'over the hump' of Wednesday seems like a big achievement?  Being able to breathe a sigh of relief as the weekend nears?  This month has felt like the biggest, longest hump I have ever experienced.  We are reaching the point in the field service where many of us have been working non stop for 6 months dealing with the constant challenges of living and working in community and, for me, working out in Freetown.  Emotional exhaustion and fatigue are starting to set in, coupled with being battered by the huge needs of my patients, the never ending problems that cannot be fixed and working with a very frustrating hospital system to try and keep the Burkitts programme running.  All these things came to a head a couple of weeks ago and I began to think that I really couldn't continue on, had no more to give.  I turned to the Lord and poured out my heart.  I asked for his strength as mine had all gone.  I knew that he would not push me beyond what I could handle but I was very much at that limit.

Then he totally stepped in and out of nowhere refreshed me, gave me renewed strength.  I think that this is the first time that I have been put in the position where I have been forced to give in and completely rely on God's strength.  And that is what I know this year is all about.  Yes, I am here to be immersed in a people and a culture that I would never have thought I could be and it is an experience that I will never forget.  But it has also been a time of huge changes in me.  I have learnt that, no matter what I have to trust in God's plan for me.  To keep pushing on despite all the barriers.

Taking advantage of a 3 day weekend, another friend and I headed away for two nights to a peaceful, relaxing hotel on one of the beaches.  Despite the fact that it rained most of the time we were there, I was able to rest and get some focus for the next 3 months.  It is so easy to look to the end of the year and what I will do when I get home but I know that I need to continue on blessing those God has given me to care for.  I am blessed to be here living my life in a way which so many people do not get to experience.  And for that I am so thankful.

Two views from the windows of the hotel that I stayed in at the weekend

Clarence and Me

Many times in the past I have come away from the house of a patient with a coconut, some corn or maybe a pineapple as a thank you gift.  Each time I am touched by the generosity of those who give out of an already meagre existence.  The gift I got on Monday, however, was definitely a first...a live chicken.

We had gone to do a bereavement visit for the family of a patient who died last week.  We had only seen this patient 3 times so had not really got to know the family.  However the patients son was hugely grateful for all that we had done for his mother in the last few weeks of her life.  As we were sitting chatting a very plump, healthy, large chicken walked past at which point I remarked on what a good chicken it was.  (Now you have to understand that chickens here come in all shapes and sizes and levels of scrawniness.  Many have lost much of their plumage and are left to forage for themselves so are often very tough and skinny.  When you see a nice healthy chicken it is a surprise and always worthy of comment!)

As we continued to talk a family member caught the chicken and it was given to the son to have its legs tied together.  I began to realise what was coming as soon as a plastic bag was produced.  (Many chickens once bought are put in plastic bags for ease of carriage and to stop them from flapping around.  It is a pretty common sight on the streets.)  The chicken was then duly handed to me, plastic bag and all, with profuse thanks.  This was a hugely generous gesture as this chicken could have fed several of the family.  I tried to point this out in as polite a way as possible but the family were having none of it.  The chicken was coming with us.  As I looked into its beady eyes a name popped into my head - Clarence.  So Clarence the chicken was named.  (Despite the fact that I'm still not sure whether it was a boy or a girl).

As I slid down the muddy hillside with Clarence under my arm I knew that we could not take him back to the ship.  There was only one solution - give him to Esther (my translator) to take home and meet his (very delicious) fate.  As we bumped our way back to the main road Clarence sat patiently on the floor scowling at me.  Esther seemed very excited at the prospect of a good chicken meal (she even bought a special bowl in which to eat him) however part of me thinks, just maybe, that Clarence could have lived a quiet life with me on the ship.  Who knows, he may have even enjoyed it.

Clarence entombed in his bag on the floor of the Land Rover

Clarence and I bonding - don't worry, I wasn't driving at this point!

Clarence going off with Esther to meet his fate.  The girl selling popcorn next to her was very perplexed that we were taking pictures of a chicken.

Time with Mum

So sorry for my silence over the past couple of weeks.  The main reason for this is that Mum came out to spend 10 days with me to follow me around at work and generally get a feel for my life here. You can describe your life all you like to people back home but until someone has actually been here and experienced it they can't really get an accurate picture.  It was great to have Mum here, if a little surreal to have her in my life which is so separate from home.


We certainly had a crazy few days in which Mum experienced the highs and lows of my work, the driving up and down hills and through rivers and all the things in between.  We spent Saturday of the weekend walking to some waterfalls (in torrential rain) which I visited earlier in the year.  At that point they were a gentle cascade which feet could be dipped into.  But now due to rainy season they are a swollen torrent which we could not get near.  Not surprisingly Mum spent a lot of time looking at and taking pictures of the huge variety of plant life!  On the Sunday we went to the beach and enjoyed a rare few hours of sun (see below).  We seemed to spend much of our time together chatting and drinking coffee.
I think that Mum was overwhelmed by the vibrancy and craziness of Freetown but I know that she was impacted by all she saw and experienced and it was great to be able to share that with her.  


Thank you Mum and Granny for the coffee and all the bits and pieces from home!

At the beach

Out and about on patient visits

Questioning witchcraft

Where we in the West scoff at religion and spirituality, here in Sierra Leone (and most of Africa) the belief in the spiritual pervades almost every life.  I'm not talking about mainstream religions of Christianity and Islam which are very present but the belief in traditional medicine and, most worryingly, witchcraft.  In a country where there are only 2 paediatricians and 4 gynaecologists for over 5 million people and health care that is beyond what most people can afford to pay many turn to traditional medicine to attempt to cure all manner of ailments.  And the problem is these 'healers' never say no.  I have come across so many people who have spent money on 'treatments' for cancer which often end up causing infection or exacerbating the wound.  Sometimes, in the case of acute illness, treatment can hasten death.  There is a very fine line between re educating people that these treatments will not work (especially on cancer) but not belittling the beliefs that have pervaded society for so long.  These healers are widespread, easily accessible and provide a service which most people can afford.  As a result, many people put their faith in them.  Many, many people believe in their healing powers from the poorest villager right up to people in government.


Traditional healers aside, the lack of health education, awareness and effective treatment mean that so many of the population do not have any understanding of medical conditions.  This leads to fear and from this fear comes accusations of witchcraft.  Stories of witchcraft and curses abound in everyday conversation.  If you stop and ask any person on the street they will more than likely have a story about how a witch made a relative sick by putting a curse on them.  If a person has a sickness which cannot be cured with (the limited) medicine available, if someone has had misfortune with their crops, a bad marriage or a sudden death in the family it is blamed on witchcraft.  I have recently taken on the care of a young girl who has been accused of being a witch because she has a very aggressive, fast growing tumour on her face.  She was accused of causing the death of a boy in her area who died after being bitten by a snake.  She has been threatened with death, abused and mistreated.    


It is so difficult for us to understand this.  But sadly it is part of normal life.  Even though I struggle with believing things that I hear I don't actually disagree with them.  My translator, Esther, has helped me so much to understand traditional practices.  She is so wise but is not caught up in so much of the sensationalism that surrounds accusations of witchcraft.  This has been such a blessing.  


I believe that there are spiritual powers out there which we do not understand and with this power comes an unnecessary fear.  Many times whilst getting involved with this girl I was afraid.  Afraid of what forces were behind this, of what I would be exposed to.  But many times I have been bought back to the spiritual armour in Ephesians 6:10-18.  Who am I to fear these things when God is my protector, my shield?  His power is so much greater than anything else that is thrown at me.  I have recently been doing a bible study series by Beth Moore on the fruit of the spirit called Living Beyond Yourself.  As I was struggling last week, I was reading a section on faith.  In it she is talking about using our 'shield of faith':   
   
'God designed our faith to be exactly the same kind of protector (as a shield).  When we are convinced that God is believable and we respond to Him in faith, practically nothing can get through us.  But when out faith diminishes, our shield begins to drop, and we are immediately vulnerable to the enemy.'


We can be attacked on so many sides, especially by things we do not understand.  I am determined to respect this culture, as bizarre as it seems to me.  But with that respect also comes a knowledge that I am protected by the greatest power of them all and that I need not be afraid.

An epic adventure

Take one large van, 11 friends, several hundred kilometres of driving and a lot of potholes and what do you get?  One epic long weekend away from the ship!
Last weekend was a ships holiday giving us a three day weekend.  A group of us decided to be a little adventurous and travel up country.  Here it is very easy to stay in the area around Freetown with the hills and beaches but the idea of coming to Sierra Leone and not experiencing other parts of the country was disappointing.
We decided to head to Kabala, a town at almost the furthest point away from the ship (in the north east corner of the country on the map). 



View Larger Map


On Friday morning we set off early, full of anticipation for the weekend ahead (note the excited grins!)

The road to Makeni (in the centre of the country) was great - smooth with no potholes.  We were about 3/4 of the way there when we heard a loud noise.  Once we pulled over, we saw that the tread on one of the tyres had completely sheared off!  No problem, we thought, we'll just put on the spare and be on our way.  The jack and wrench were duly fetched from the car only to find that because the tyre had alloys, the wrench would not fit onto the nuts.  So with 12 white people standing by the road, we flagged down several vehicles none of whom could help us.  Eventually the decision was made to drive, very slowly, to the next place that we could get help.

We soon arrived in a small village by the road which had a mechanic shop (more like a palm hut).  Of course in these situations as soon as white people appear out of a car a crowd gathers.  Most things done here also involve the whole community which meant around 10 men gathered around the car with various sized wrenches.  A lot of debate ensued but after a while the wheel was successfully removed and the spare tyre put on.  In that time we had also collected most of the local children who were entertained by several of my friends!

The crowd of children (note another crowd also gathered on the other side of the road!)

Soon we were on our way and made it to Makeni.  We were advised that the road to Kabala was not great so we should carry another spare tyre.  This was duly purchased for Le120,000 (around £17.00!).  The advice was not wrong, the road to Kabala was pretty bad however we made it in one piece arriving in the afternoon.  Our guesthouse sat at the foot of the cliff/hill that dominates the skyline of Kabala.

In attempting to find somewhere to eat in the evening we suddenly realised just how spoilt we are in Freetown.  Being used to some variety it was a bit of a shock to realise that yes, we are in one of the poorest countries in the world in the middle of nowhere.  The only place to eat in town was ironically called 'Choices'.  But it certainly didn't have any choices.  You were given what they happened to have which that day was beans and rice and some chicken which looked like it had been cooked for a week.  After debate, Jeff the adventurer of the group suggested that we should buy eggs and bread and a frying pan and cook a meal over a fire.  He also just so happened to bring 40 hot dogs with him (don't ask).  The eggs were purchased and Jeff decided to play the game with a kid where you throw an egg and try to catch it without it breaking.  Each time you stand further apart until the egg breaks.  This gathered quite a crowd and a lot of cheering until the kid dropped the egg.   Much to our surprise (but not the locals) the egg did not splatter on the road but bounced.  It was hard boiled.  Thankfully these were swapped for new (non hard boiled) eggs. 12 white people buying goods and water did cause quite a stir in the (very small) market area.

Carrying water back, African style.  Not as easy as it looks!

We dispatched 2 guys from the guesthouse to get coal, wood and a burner and in no time quite a feast was cooked up in the field next to the guesthouse.  It was a beautiful evening as not only did we have an amazing electrical storm but I also saw my first firefly's twinkling in the grass around us.

The following day we set off to hike up the hill behind the guesthouse.  It was a pretty steep vertical climb which required a lot of scrambling up a muddy, slippery path.  We are informed that at New Year the locals have a party on top of the hill.  This requires carrying a large sound system and generator up the hill, of course in African style, on the head!  It was challenge enough with just a backpack.

Once we reached the top though there was a beautiful view over Kabala and the mountains in the distance.

On returning back from the hike, we decided to head back to Makeni for the second night.  On arriving we went to check out a guesthouse.  Our guesthouse in Kabala was cheap, but this took it to a whole new level!  We left our stuff and headed out to the most expensive hotel in Makeni

My friend Miriam in our luxurious accommodation (the picture does not do the grottiness justice)

The following day after very little sleep and a lot of coffee, we headed about 30 miles north east of Makeni along a very potholed road to waterfalls at Bumbuna.  As we arrived some friends (who had overlapped with us for most of the trip) were just finding out that their van had been broken into whilst at the waterfalls.  Sadly they had several things stolen.  This meant that after they left we decided to split and stay in a small group at the van whilst the others went to the waterfall and then we swapped.  It would have been great to see it all together however the risk to our stuff was too great.  There were several kids hanging around to see if we left the van so it was probably just as well we stayed!  The waterfall was huge and so stunning.  Certainly worth the 2 hour trip!

Van guarding

On the way back to Makeni the trip was much shorter.  It was fascinating to drive past rural life, through villages with thatched huts and people living their lives.  It makes me wonder how people in such rural areas survive.  But somehow I think that their quality of life is better in these communities than squashed in Freetown with no job.  There were also several near misses with the van and animals (goats, chickens and dogs mostly) and one duck fatality!  
Here are some of the interesting sights along the way:

(This, believe it or not, is quite a common sight)

After filling up the tyres with air in Makeni (surprisingly the spare had a slow puncture!) we headed back to Freetown, arriving at the ship at 8pm.  Exhausted and smelling pretty gross (from having cold bucket showers all weekend) but having had an amazing time.  Most definitely an epic adventure.

An inspirational woman

I am so sorry that I have not written for so long (I seem to be doing a lot of that lately!).  July is flying by and many things have happened in the last few weeks.  But this week I have been able to take a deep breath and gather myself for the next onslaught of craziness!


I have been wanting to write about a lady for a long time but it has just never seemed appropriate.  She has been through so much in her life and her sunny nature and drive to make the best out of a situation is so inspiring to me.
I first met Mary when she came with her 4 year old daughter to the ship to seek help.  Her daughter had retinoblastoma (which I spoke about in a earlier blog).  She had one eye removed last year in an attempt to stop the growth however it had come back on the other side of her face, causing her eye to protrude.  As I sat and explained to her that there was nothing that we could do, she told me that her husband had left her when she was pregnant with her twins, now 9 months and that she had other children.  She had been living off the kindness of her neighbours, begging food and money to be able to feed her children.  She was living rent free in an unfinished house.  


As we began to visit Mary and her family her laughter and joy was infectious.  I found myself warming to this woman who had been through so much yet was so thankful for what she had.  Part of our work is to help families in need with income generation.  This generally applies if the breadwinner is the patient and will leave behind a family without income.  But in this case we were able to help Mary.  She mentioned that she used to have a market stall in Freetown so she wanted to set up a food stall selling basic food such as rice, onions, flour and oil.  It was not possible for her to go far from her house so we arranged for a local builder to construct a stall under the porch at her house.  


The day we drove her into Freetown to buy the basics to start her off, she was beaming with delight.  We were able to provide very little (some rice, onions, oil) but the next week we returned she had already bought more produce and added to her stall.  Every time we have gone back to visit, she has new things and has sold more.  She is such a great business woman!  With the money from her stall, she was able to buy some seed and plant crops such as corn to feed the family.  With rainy season getting going, the humidity and dampness is perfect for growing crops.  We have watched the crops shoot up, growing from seeds to almost ready to harvest in around 5 weeks!  Her determination to succeed with what she has been given has been amazing.

The inside of the stall

The outside with Mary standing next to it

Sadly since we have been seeing Mary's daughter, it has still been a struggle.  When retinoblastoma starts growing, it becomes a very aggressive tumour.  We watched as the tumour began to take over one side of her little girls face.  Her pain was always a challenge to control and her distress at the growth was so difficult to see.  As the tumour began to grow through the roof of her mouth, the little girl took up more and more of Mary's time so that she could never be more than a few feet away.  Mary has an older son, Ishmael, who has been incredible.  During the little girls sickness, he manned the stall, did the washing, cooking and cleaning and cared for the twins.  I don't know how she would have coped without him. 

Ishmael with the twins

It was so difficult going through this time with Mary.  Her love for her daughter was evident in the range of emotions and heartache that she experienced seeing her daughter get worse and worse.  Two weeks ago her little girl died peacefully.  The tumour was growing in such a way that made swallowing and breathing difficult for her.  We had given her a sedative to ease her distress which mercifully had a good effect.  When we went to the house the following day, the little girl had been laid out and wrapped in a shroud we had bought for the family.  I was so touched that the family had waited for us before burying her.  As women we were not able to bury her as she had a Muslim burial however we were there to be able to support Mary.  It broke my heart when she said in Krio, 'Yu try fo me' meaning, 'You did all you could' but I know she meant it.


Since that day, we have continued to visit Mary and her family.  I have a particular soft spot for the twins.  Hassan, the little boy eats...a lot.  He is only happy once he has a full belly and always is munching on something.  He is also the king of suspicious looks, especially if you are trying to take away food!  The girl, Hassanatu is affectionate and smiley.  She also loves checking out your face with her hands which is not great if she has just been sitting on the dirt floor!  They both know us now and it is a privilege to watch them growing up and bond with them.

The twins

Hassanatu checking out my face!

I hope to be able to continue to visit Mary up until the time that I leave.  Not because she needs much support but because she now holds a special place in my heart.  It is amazing to go and just spend time with her and the family, to help her to heal her grief and to feel accepted as part of their lives.  This acceptance, despite the language barriers and enormous cultural barriers is an amazing thing to experience.  I just love it.

Esther (in the middle) with Mary, family and friends

Two Celebrations

I have found myself in the midst of two causes for celebration this week.  
For the last 3 Tuesday nights, myself and my team - The Procrastinators (don't ask how we came up with the name) - have taken part in the Africa Mercy Quiz.  Each week our points were added up and the winner of the week announced.  Last night, after some stiff competition, all the scores were totted up and the overall winner crowned.  Our team came a hugely respectable second out of about 15 teams.  We are still not sure how we did it but suffice it to say, following on the Molyneux family quiz legacy, I hope Dad will be proud!  


Below are the top 3 teams, 1st place at the top, us in the middle and third place at the bottom (with the two amazing quizmasters, Jay and Cyle to the right).  And yes, we were the only team not in fancy dress!

Our second celebration was the birthday of one of my patients, Madeline.  She is 83, speaks perfect English and is quite the character.  We decided we needed to celebrate so we made her a cake and sang Happy Birthday as we arrived at her house.  I'm not sure what she thought of the crazy English people turning up with a cake, especially as we found out afterwards that it is not traditional here to have cake on your birthday.  The cake was duly cut and handed round and very politely eaten.  However I did catch her friend slipping back her slice.  It's definitely a lesson learned that maybe we should check the cultural nicities before jumping in head first.  I think it's apt to say that this time round, the thought certainly counts!
Below with Madeline (to my left) Dee, Esther and Madeleine's family.