Lady Deborah Berewa outpatient Hospital Lakka, SL

by Greatest Goal Ministries USA

Sierra Leone’s cholera epidemic is all over the news and a few of the headlines are listed below. Cholera is a preventable disease but it spreads like wildfire in a country such as Sierra Leone ranked as one of the poorest countries in the world.  Lack of housing, crowded living conditions, poor to no sanitation, a lack of understanding of basic hygiene, lack of clean water all of these descriptions help create the picture of why the epidemic is traveling so fast and why more will die before the epidemic is over.

As of September 11th, Sierra Leone has reported over 17,500 cases of cholera and over 260 deaths. Twelve of the 13 districts in the country have been affected.  Cholera is an acute intestinal infection caused by the bacterium Vibrio cholerae. People usually become infected from drinking or eating contaminated water or food.  It is associated with watery diarrhea and rapid dehydration, which can be life-threatening.

The GGM clinic in Freetown is not treating cholera patients due to the size and staffing of our clinic but we are seeing patients with the disease and referring them to cholera treatment centers.  We have received funding from some of our donors for test kits that we are hand carrying to Sierra Leone in mid-September.  These kits will be used at our clinic as well as donated to several of our referring hospitals. 

We are also educating patients about the disease and what preventive measures they can take to keep from contracting the disease and what they should do if they or a loved one has symptoms of the disease.  These are classes are being held in our new education center.

Government  officials and the WHO are all stating that this epidemic is going to get worse before it gets better and education is the best medicine.  GGM is joining the fight to educate the patients and the community against this preventable but deadly disease. 

News Headlines:

BBC News - Sierra Leone cholera death toll rises

Aug 20, 2012 – A cholera outbreak in Sierra Leone has infected more than 100000 people and kills at least 176 since January, officials say.    

From Freetown the Sierra Express Media writes-Prevention is best for Cholera… By: SEM on September 7, 2012. Sierra Express Media would like to add voice to the latest threat of existence that has scourged our land and is still threatening the lives of our treasured country folks. As of the first week in September, the cumulative cases and death from cholera as reported by the Health and Sanitation Ministry were 15,564 and 249 deaths respectively. Twelve of the thirteen districts of the country are now affected. The Western area has continued to report the highest cases with Bombali, Tonkolili, and Kenema toeing the line.

World Vision Issued this Declaration

WV SIERRA LEONE Category II National Office Response Level Emergency Declaration for the Flood and Waterborne Disease Out Break: Owing to the current heavy rains that started in May 2012, Sierra Leone has experienced seasonal floods in different parts of the country especially in the low lands that includes the capital city Freetown. These floods in turn have caused an outbreak of water borne diseases of which Cholera is the most notable and has been declared a National Health disaster.

The Minister of Health, Madam Zainab Hawah Bangura, confirms that this is the worst Cholera Outbreak, since 1998, and as at 28th August 2012, it has claimed 231 lives, 14,465 reported cases and 11 districts affected
out of 12 districts, the Minister further predicts that the death toll will surpass the 2,500 deaths in the 2011 Cholera outbreak.  Further, other agencies including UN have predicted that number of cases will increase to 32,000 in the next three months.


SL staff after completion of teaching area
SL staff after completion of teaching area

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.

  1. One on one staff evaluations and goal setting  was completed with each staff member.
  2. Statistical data collection was completed and will now be analyzed. 
  3. Initial data indicates that 1323 under five new child visits occurred from April 2011-2012.  These do not include repeat visits or circumcision patients.
  4.  8,580 over five years of age patients were seen in that same time period.  Again these are new registered patients and does not include returning patients
  5. With the arrival of our 3rd, 40ft. supply container came our file shelving unit and empty charts.  Thanks to the hard work of our staff all the past paperwork has been filed and patients charts are now easily accessible.
  6. An education area was constructed to provide health education and staff development classes.
  7. A new health educator/pharmacy assistant has joined our clinic staff to provide additional support to our SL clinic staff.
  8.  The clinic staff now includes a community health officer (CHO), clinic director and nurse, a registrar, two laboratory technicians (one is deaf), a pharmacy assistant/health educator, a clinic assistant for cleaning and a an amputee grounds keeper and general electrical maintenance.
  9. Malaria continues to be the greatest illness seen along with parasite infections.  A high number of patients are seen with diabetes and high blood pressure.  Our protocols for both allow the medical staff to provide quality care and education.  Because we provide free medications and follow up patient compliance is high.
  10. A visiting podiatrist from the USA who was directed to our clinic by individuals in the disabled community gave an impromptu wound care in-service to the clinic staff. 
  11. Outreach into the community and health education remain a high priority.
  12.  Funding for medications and laboratory testing supplies remains a challenge  We would appreciate hearing from anyone who knows how we can have access to both or either one on a reduced or free basis. 

Once again we thank all our donors for your support.!!!

Staff Development class in session
Staff Development class in session
New filing system at the GGM clinic
New filing system at the GGM clinic
Impromptu wound care inservice
Impromptu wound care inservice
Mohamed with Philip Sesay, GGM Clinic Director
Mohamed with Philip Sesay, GGM Clinic Director

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    

SEX:   Male

AGE:  38yrs

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 Centre
Dormitory, 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.

Lab techs Mr. Kelly and Martha Davice
Lab techs Mr. Kelly and Martha Davice
GGM Clinic Staff
GGM Clinic Staff
Checking in a patient at the clinic
Checking in a patient at the clinic
Patient data entry at the clinic
Patient data entry at the clinic
Weekly circumcision clinic
Weekly circumcision clinic
Bethany working in the GGM laboratory
Bethany working in the GGM laboratory

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.

Rear view of the GGM clinic
Rear view of the GGM clinic
A medical team member in October starting an IV
A medical team member in October starting an IV
Newly constructed well at clinic
Newly constructed well at clinic
Donated ultasound unit from an Australian Rotary
Donated ultasound unit from an Australian Rotary
Nurse Practioner examining a patient
Nurse Practioner examining a patient


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! 


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Organization Information

Greatest Goal Ministries USA

Location: Bellevue, WA - USA
Website: http:/​/​
Greatest Goal Ministries USA
Project Leader:
Carolynn (Lynn) Pelton
Executive Director
Bellevue, WA Sierra Leone

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Combined with other sources of funding, this project raised enough money to fund the outlined activities and is no longer accepting donations.

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