A team traveled to Sierra Leone for six weeks from March 28th through May 10th. The medical team was small to allow for more one on one time at the clinic with clinic staff. Here are a few of the highlights from our clinic at the National Rehabilitative Center in Murray Town located in the capital city of Freetown.
Once again we thank all our donors for your support.!!!
Each day the staff at the Greatest Goal Ministries clinic work hard and save lives. Each day they are exposed to a multitude of germs and bacteria. Each day they go beyond the basics to provide exceptional health care services to the community they serve. These are local Sierra Leone health care workers who have been further empowered by teaching and mentoring from the US medical teams that travel to Sierra Leone. They are payed a stipend above their government wages.
The government wages in Sierra Leone for health care workers is very small and often months will pass with no salary by the government. In fact today, March 9, the Community Health Officers or CHo's (a CHO is similar to a Nurse Practitioner with prescribing authority) in Sierra Leone have gone on strike due to lack of pay. This means the few medical clinics and hospitals staffed with trained medical personnel able to diagnose are virtually shut down. This is devastating in a country where health care is marginal at best.
But thanks to donations from the public, GGMUSA is able to pay our staff at the clinic a stipend above the government wages. Our staff is working through the strike to continue providing free medical care, laboratory tests, and medications to the people of Sierra Leone.
I am so proud of our staff and their dedication to their profession. Below is a narrative by our clinic director about a recent patient treated at the GGM clinic. I believe it fully illustrates the quality of care we provide and how desperately we need your continued support. Thank you
"If it were not for this clinic, I would have certainly lost my life. But thank God for the free care GGM clinic is giving to this community especially for us that cannot afford to pay. God bless the providers!" GGM Clinic patient Mohamed
This is Mohamed's story as told by our clinic director, PhilipSesay.
NAME: Mohamed Fornah
DIAGNOSIS:Diarrhea and vomiting with marked dehydration.
Mohamed was brought to the clinic by a friend called Michael and accompanied by his wife and friends. He was almost dying when he was rushed to the examination room for resuscitation. I/V line established and an infusion was started. At that time, he was still passing frequent stool, weak and cold and clammy skin observed.
With the aid of the clinic staff, Mohamed was rapidly rehydrated and vital signs returned to normal. After he was stabilized, his medical history was obtained from his wife and Michael, his friend. According to them, they said, he was taken to the National referral Center called Connaught Hospital, where care was poor for this gentle man. They also said, if this patient would have stayed for the next few minutes, they would have lost him.
He was observed for hours at the clinic before closing for the day. But the idea of taking him home was not welcomed by the clinic director. As a result, accommodation was secured at the National Rehabilitation CentreDormitory, where he stayed for two nights with proper monitoring and rehydration during the day. The overnight stay of patients is not a normal occurrence at the GGM clinic as we are not set up for such care although we are capable of providing such care.
Mohamed so appreciated the life saving clinic at this Center and more so, because it is done on a cost free basis, Michael commented. Michael is from Germany supporting a program with the polios in Freetown.
Michael later took Mohamed back to Connaught Hospital for re-admission as the GGM clinic facility is not prepared for long term overnight patient care. The Clinic Director made several visits to evaluate his progress. One month later, he was discharged home in an improved condition. The thing that impressed the clinic was that, the gentle man returned to say thanks in bringing back his life to normalcy.
Thank you for your support.
Greatest Goal Ministries currently has two volunteers working in Sierra Leone. Jerry, is a 60ish man who took early retirement from his position as a Laboratory Director at a large hospital in Bellevue, WA. Bethany, is a laboratory tech and pre med major waiting to be accepted to medical school. Jerry is now living in Sierra Leone overseeing our programs and projects and attempting to improve laboratory services in the country. Bethany arrived in early October with our medical team and returns in mid January.
Below is an excerpt from Bethany's blog:
Tuesday evening we got word that one of the amputee football players, Mohamed, was in horrible condition after spending several days in Connaught Hospital (SL's only tertiary care hospital). He had been removed from the hospital by a man from Germany, Michael, who happened to be in town working with some of the polio. Michael was getting some medications for some of the polio at the hospital when he came across Mohamed who would have likely died had he stayed there another night. Michael somehow heard about out clinic and thinking it was an inpatient facility he took him out of Connaught and brought him to Phillip (nurse and clinic director of our GGM clinic), who happened to still be at work. After some IV fluids were administered properly Mohamed was in much better shape, but would need 24 hr care for several days. Wednesday Umaru, Victor and I went to Mohamed’s home to get him and take him back to Connaught Hospital where inpatient care is available, if you have funds to pay. I called Michael, the man who had found him and fought to keep him alive and arranged to meet him at the hospital. Michael is working from Germany with a German NGO, Robin-Food, and hopes to bring more aid to Sierra Leone. We got Mohamed readmitted into the hospital, this time making sure that he would be cared for properly. Just being in Connaught hospital is always an eye opening experience. Patient confidentiality is pretty much unheard of, you can just walk in there without anyone even questioning your purpose for being there. The triage room has about 10 beds in it, none of them have sheets, they haven’t been cleaned in ages, and until you pay the registration fee and purchase your chart no one will even give you a second glance.
I include this portion of Bethany's blog as an example of the quality and cost of healthcare in Sierra Leone. Your donated funds are saving lives everyday.
Jerry recently wrote:
"This maybe a good time to tell each of you it has been a very good 5 months of being in Sierra Leone this year counting the time I was here last April. I have met some wonderful people. The employees we have are special and it has been a pleasure getting to know them and their families. Seeing our medical facility be one of the best in the country makes you proud but at the same time my travels in the country going to the hospitals, hospital labs, clinics, "medical centers" as they call some of the medical facilities in the up country villeges breaks my heart at how bad the medical care is in this country. The medical supplies, medications, and healthcare workers are all so under supplied and available. The people in the country are so very poor compared to those in the city but wow challenges for this developing country."
Your donations and your prayers for this struggling nation are desperately needed. Thank you for caring and supporting Greatest Goal Ministries as we continue to serve the disabled and the underserved people of this beautiful country.
On September 30th Greatest Goal Ministries will be sending a mission team to our clinic for two weeks. Our team includes two physicians, a nurse practitioner, three registered nurses, one ultrasound technician, one microbiology technician, an architect, an electrical engineer and a computer programmer.
In addition to the medical personnel bringing their expertise to the clinic, we are bringing a few specialists too.
Our ultrasound tech is equipped with three hand-portable ultrasound machines; two on loan from Sonosite and one donated by the Australian Rotary Club of Croydon and “Captain’s Choice Tour” company. This ultrasound will allow the clinic staff to accurately diagnose numerous medical issues which can only be done with the ultrasound. Issues include, but are not limited to: pregnancy (gestational age, breach position and placental positioning), abdominal pain, limb fractures, soft tissue pain, hernias, distinguishing between benign cysts and solid masses needing biopsy, parasitic infections, appendicitis, and gallstones/gallbladder disease.
The architect will conduct a survey of the clinic compound and create plans for a new outpatient clinic. This upgraded clinic will allow for a larger resource lab, x-ray, ultrasound, small outpatient surgical suite and five exam rooms.
The electrical engineer will conduct a feasibility assessment to determine what is needed to equip our facilities with solar power. This will allow us to go “green” by no longer being dependent on a gas generator and the intermittent electricity of the current grid system.
Our USA medical staff will also be conducting continuing medical education for our Sierra Leonese medical staff. The USA medical staff will continue with our community health education classes in the community surrounding the clinic.
As part of our evaluation of the pediatric population, we will conduct assessments of all children coming to the clinic who are under the age of five. These assessments include height, weight, mid-upper arm circumference (MUAC). This information will be compared to World Health Organization (WHO) standardized malnutrition chart, and allow clinic staff to compile data and refer those needing assistance to the local malnutrition center.
Stay tuned for lots of amazing photos and stories in our next report, after our team returns on October 16th!
What does health care mean when you live in the poorest country on the planet? First, one can pretty much forget about being treated for any chronic health care problems such as high blood pressure, diabetes, asthma, seizure disorders, sickle cell anemia or any anemic condition, rheumatoid arthritis etc. The expertise to diagnose and treat and the availability and cost of medications is prohibitive for most people. If you have a more serious condition such as heart disease, kidney disease or cancer then there is no treatment available other then the possibility of surgical excision by a general surgeon, of which there are only a handful in a country of 6.2 million.
In the area of diagnostics, Sierra Leone has no operating CAT scan machine, a few ultra sound machines and a few x-ray machines. And, this is in the capital city of Freetown. This is as good as it gets. The laboratory situation is even more dire with only a handful of laboratories able to process the most basic of laboratory tests. There is only one pathologist in Sierra Leone and no lab capable of preparing or reading any type of culture.
This means virtually the only health care available is for acute cases of malaria, parasitic infections, upper respiratory infections, skin rashes and basic trauma. The hospitals will do their best for trauma cases and hernia operations, appendix surgeries etc. but supplies are limited and the cost to the average person is very expensive.
The Greatest Goal Ministry clinic is operated in collaboration with the Sierra Leone Ministry of Health and it is FREE to the people of Sierra Leone. Our staff consists of a Community Health Officer (CHO) who sees patients and diagnoses, a nurse who administers treatment such as the cleaning of a wound, giving an injection or distributing medications, and a lab technician who is trained to test for malaria, parasites, and basic red and white blood cell counts as well as pregnancy and urine tests.
Every clinic or hospital in the rest of the country will expect a person to pay for all aspects of their care. There is no health insurance. There will be a registration fee, a medication fee, and test fees. No one will care for you even in the case of an emergency unless those fees are paid. Currently, in collaboration with UNICEF and the SL government those children under five and pregnant and lactating women are to receive free health care.
Let me share two stories with you that will illustrate the desperate need of the GGM clinic and our continued operation in Sierra Leone.
A 4 year old boy arrived at our clinic with a high fever. His lab tests confirmed malaria. We started him on oral antibiotics and acetaminophen but his condition continued to deteriorate. At the time we carried no IV malaria medications. We felt he would be better served at a hospital. With UNICEF’s new health care policy of free health care and medications to all children fewer than 5, all pregnant and lactating mothers we knew they could take care of him better then we could. We located a vehicle and were soon caught in traffic and at a standstill. By this time his breaths were labored, his heart beating fast and his body temperature very high. The projectile vomiting began as we tried to weave through traffic, coating the inside of the vehicle and my clothing. Then he had seizure. The boy was spiraling down hill fast.
Weaving in and out of traffic we arrive at a hospital full of crying children and exhausted mothers. With his limp body in my arms I am unable to find anyone to help us. Finely a “doctor” looks at him, scribbles something down and is gone. My guide takes it to the pharmacy. She comes back in tears, “no medicine” she says, and “what do we do”? We find the doctor again. Something is spoken in Krio that I did not understand. I am told we are to go back to the pharmacy, tell them we have money and there will be medicines. We do as we are told and medications, IV fluids, tubing etc. are given to us. The IV is started and life saving antibiotics begins to flow into his limp body. The next day the young boy is brought to the clinic to tell us thank you. Where was the free UNICEF healthcare? Had we sent mom alone he would have died, one more statistic. His condition to far along without the funding to save him, and yet it should have been free to him. Corruption permeates all avenues of the lives of the people. GGM clinic offers a place where people know they will find the quality health care they so disparately seek.
My second story occurred during my last visit this spring. A young, healthy appearing amputee was helping us paint at the clinic on Saturday. On Monday morning we found him, writhing on a mat on the concrete outside the clinic doors. He could not explain his pain other than it came on suddenly on Sunday after being at the beach. I did not know at that time that he has slept at the clinic on his mat for several years. This was his home. He complained of back pain and little else but the pain seemed to move. The CHO, Nurse and two of us nurses from the USA assessed him. Massage therapy was tried as well as anti inflammatory medications. He finally slept and we moved him to his mat.
Early the next morning I was called that he was in a coma. They had started an IV and were giving him fluids. We instructed them to take him to the only tertiary care hospital in Freetown and we would meet them there.
We found him on a gurney in the hallway with no mattress. When we paid the registration fee they moved him to the “ER”. The door was locked as we tried to enter. He was seen very briefly and moved to an observation ward still in a coma, nothing happening. No doctor ordering anything. I remembered a doctor on staff and called him out of desperation. He asked me to give the phone to another doctor. Prescriptions were written for the medications and treatment items that would be needed and we went to pay for all of them. We left the nurses at the hospital to administer care. He was dead by the next morning. No explanation, no cause of death known.
The people know this may be the outcome of any illness that strikes them. The thought hovers around them and their families each and every day. Compound this with the lack of water and food and it is almost amazing more are not dead.
We know we are but a small clinic, and to the locals we are referred to as a hospital. With a full medical team here in the states working hard on protocols to teach our staff there we are making a difference in the education of the local medical staff. Our WHO community health education program is making a difference in the local community and we hope to take it to the polio villages and amputee resettlement centers around the country beginning this fall.
Construction of our new well at the clinic has just begun and with continued funding clean serviceable toilets will be constructed to serve our patients.
Our three year plan is to construct an outpatient facility that can serve the general population with a mission house where visiting health care professionals can stay and work teaching and serving the people of the beautiful nation.
It is a grand vision but one I believe can become a reality with continued support.
Thank you our valued contributors.
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