Lady Deborah Berewa outpatient Hospital Lakka, SL

by Greatest Goal Ministries USA
Dr. Jim administering IV fluids
Dr. Jim administering IV fluids

 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.

Don, PT with an amputee with schrapnel in his foot
Don, PT with an amputee with schrapnel in his foot
Sydney RN with a sick child
Sydney RN with a sick child
Alicia RN holds a sick child
Alicia RN holds a sick child
Sandi Speech Pathologist giving meds
Sandi Speech Pathologist giving meds
Before 8:00 am more then 50 people in line
Before 8:00 am more then 50 people in line
US and SL lab tech
US and SL lab tech's sharing ideas
GGM clinic exam room
GGM clinic exam room
GGM Clinic building
GGM Clinic building
GGM  clinic well
GGM clinic well

Dear Global Giving Supporter,

On March 25th I will leave for my 8th trip to Sierra Leone and one week later the rest of the team will join me.  We will return April 15th.

The focus of the trip is multi faceted as there are numerous administrative duties which involve not only the organization of Greatest Goal Ministries within the country but also affect the clinic directly and indirectly.  During our October trip we gathered information in regard to setting up an interventional feeding center for malnutrition at the GGM Clinic.  On this trip we will travel with a pediatric scale, height measuring rod and arm circumference measuring tape.  These will be used at the clinic for the next 6-8 months to gather data in order to qualify us as an interventional feeding site for malnourished children under age five and for pregnant and lactating mothers.  A Handbook written specifically for Sierra Leone in collaboration with the WHO will assist our medical team in the USA as we establish the protocols that will guide our nationals working at the clinic as well as any foreign medical teams.

The team traveling this spring includes me, a neurotology nurse, an ER nurse, a teacher and the director of a large Seattle area hospital laboratory.

Rotaries within the panhandle of Texas are currently fundraising for the dollars we need to install the well at the clinic. During this trip we will seek to locate the company that will dig the well and costs that will be involved.  A portion of the funds need to refurbish the latrines at the clinic site have been raised and that work will begin on this trip also.  Upon our return we will update our Global Giving clinic site and let you know how you can help us bring sanitation and water to Ward 390, the district surrounding the GGM clinic.

In addition to the data we will be collecting from weights and heights at the clinic we will also be evaluating the health of our approximately 50 sponsored school children and young adults.  We will be giving basic physicals and begin all the children and their families on worming medication.  This physical will occur with each of our visits in the future as we not only ensure that the children are progressing at school but we also intend to address their physical well being.

The lab director accompanying us will begin to assess the feasibility of setting up a resource lab at the NRC compound where our clinic is located.  We believe that there is no lab in Sierra Leone with a functioning Microbiology department capable of incubating cultures.  We know that currently there exists only one pathologist in all of Sierra Leone.  We will spend several days visiting and evaluating labs across Freetown and meeting with the Ministry of Health of Health and Sanitation.  Not only will funds need to be raised for equipment but discussions need to take place in regard to staffing the labs and training of personnel.  Our GGM USA medical team is continuing to write and prepare protocols for the medical team which will leave for Sierra Leone the 31st of October, 2011.

I look forward to providing everyone an update after we return in April.  Until then, thank you for your continued support.  You are helping us to help the citizens of beautiful Sierra Leone.

10/2010 US Medical Team in Sierra Leone
10/2010 US Medical Team in Sierra Leone

Dear Global Giving Contributor,

As the 2010 year comes to a close we would like to extend our heartfelt thanks to each of you for supporting the free primary health clinic in Sierra Leone, West Africa.  It is through donations such as yours that our clinic has been able to provide quality health care and medications that are saving lives in Freetown.

Our second, 14 member medical team, arrived home safely in mid October after having seen over 500 patients in 6 days.  One thing is for certain, the children under five are suffering terribly.  Between malnutrition, dehydration and malaria the number of very ill children is staggering.

Word of our clinic is spreading fast through the communities surrounding our clinic and afar.  We were told some people left home at 5:00 am and arrived at the clinic 3-5 hours later.  And these were very ill people.

The priority list for this trip was quite extensive but the volunteers were well prepped and everyone contributed. 

  • At the clinic, our US physicians had put together a teaching plan for our SL community health officer (CHO, similar to a PA or nurse practioner in the USA), nurse, pharmacy tech and lab tech. The CHO and nurse were instructed on how to perform a basic physical exam and a listing of our clinic formulary with proper dosage amounts for infants through adults was made available to all.  Our SL staff worked side by side our US physicians.  In the lab, a tech from one of our local hospitals shared some of her clinical knowledge with our SL lab tech and vice versa.  Thanks to lending by a local Seattle Hospital we were able to use new sophisticated lab equipment which allowed us to have immediate results of chemistry profiles and blood counts.  
  • Community Health Education was started with the local councilwoman of the community surrounding our clinic.  We discovered that 26,000 voting adults reside in this community with an unknown number of young adults and children.  A couple of our USA volunteers came up with an interesting piece of data.  In 1 square mile of Seattle proper, there are an estimated 941 people.  In 1 square mile in Freetown the capital, at our clinic, that number increases to 18,000 people per square mile.  The urban density allows for the passage of so many illnesses.  Add to that the lack of clean water and sanitation and it is no wonder that Sierra Leone ranks one of the highest in the world in infant and maternal mortality. 

The council woman organized 15 members from all the different communities to come together and begin Community Health Training.  They were each given a book and a “teaching bag” to begin introductory teaching of basic health education.  We will meet with them again in April 2011 and October 2011 when we are back in the country.

  • It became crystal clear that our clinic will never reduce the number of treatable diseases if we do not start treating the underlying conditions causing those illnesses.  A walk through of each of the communities was organized by the local council woman.  Much to our dismay we discovered that not only is our clinic without water currently, but essentially so is the community surrounding our clinic.  For those 26,000 voting adults and unknown number of young adults and children there is only one well that can be counted upon.  It is an open well with a pail that is dropped down on a rope.  There is a monitor and the water is periodically tested.  However, people drink from the pail and the door hatch remains open to the air all day.  There are two additional spicket faucets that are attached to the city pipes but they provide only intermittent water.  There is also a weeping wall where a natural spring provides water.  However, people take this water directly from a small flowing stream intermittently as it flows on the ground.  Body washing, clothes washing and drinking all takes place in this water.  Intermittently one will find garden hoses that have been illegally attached to the city water pipe that we had laid to provide the clinic with water.  Unfortunately the pipe was not buried and all of the illegal tapings has literally “sucked our pipe dry”.  And that is it.  That is the only “clean” water available to our 26,000 plus residents surrounding our clinic. 
  • Sanitation is even worse then the water problem as we found that the only public latrines of which there are 8 and the 16 near the clinic are full and have not been emptied in 3 years.  They are broken down and most completely unable to be used.
  • By April, 2011 we hope to implement a Malnourishment Program for our pregnant mothers, lactating mothers and under 5’s.  More on that in my next update.

When we returned to the USA with the realization that we needed to address the water and sanitation problems or we would never be able to begin keeping our clinic community healthy.  Within our first week back we were blessed to have been put in touch with a rotary located  in the pan handle of Texas.  After several conversations they are ready to start raising funds for the installation of wells in and around our clinic.  Depending on the funds raised we are hoping to install 25 wells.  Of course, my dreams are always BIG so I have challenged them for 100 wells.  These would be placed in amputee and polio communities in the provinces and several clinics and a hospital right in Freetown.  In my next update I will let you know where we are in that challenge.

Once again to you, our supporters I say thank you.  Thank you for your support and your prayers for the people of Sierra Leone and for our clinic community. 

In addition to the above work, below is a summary of what has been accomplished this year.

GGM free Primary Health Care Clinic Open 2 days per weekwith  over 2500 patients treated.

Two USA medical teams in October 2009 and 2010 treated over 900 patients total between the two visits and a total of 18 health care professionals worked with the SL staff.

GGM introduced Teethsavers who now support 2 women who teach dental hygiene to government schools and hand out tooth brushes and tooth paste to all they teach

Medical supplies and equipment was donated to Connaught Hospital.  This included hospital beds, gurneys, surgical instruments, radiology supplies and over 50 boxes of books and disposable equipment.  All of this was transported in 2 -40ft. containers through USAID.  In addition to the items listed above books, shoes and educational and office supplies, furniture and equipment were shipped.  Another 40 ft. container of medical supplies and equipment has been gathered and is awaiting shipping in late January.

The entire National Rehabilitative Compound has been painted and electricity upgraded.

GGM USA introduced EMPACT, a northwest NGO, who will begin developing an emergency medical program at Connaught Hospital

Team in front of GGM Clinic sign
Team in front of GGM Clinic sign
By 8:00 am 40-50 people will have already arrived
By 8:00 am 40-50 people will have already arrived
Latrines so full the locals have quit using them
Latrines so full the locals have quit using them
The one dependable well serving all 26,000 plus
The one dependable well serving all 26,000 plus
Dr. Keech examining a patient
Dr. Keech examining a patient
Land Mine took one leg, other with schrapnel
Land Mine took one leg, other with schrapnel


Governing Board of GGM SL
Governing Board of GGM SL

Dear Global Giving supporters of the GGM USA clinic in Sierra Leone. We are in our last weeks of preparation before our 14 member team leaves the USA for Sierra Leone on October 1 and as you can imagine there are many last minute tasks to still accomplish. The team will be traveling with 100 of the WHO Community Education manuals, approximately 200 pounds of material. The majority of the manuals will be secured at the GGM SL office until October of 2011. This 2010 trip will focus on meeting with SL delegates from the Ministry of Health Education. Together we will review the manual and determine the best avenue to present and teach the material to Community Health Officers and Nurses from across the country. The clinic saw 218 patients during the month of July. Thanks to your contributions through Global Giving we will be able to increase our days of operation to 3 days a week rather than the current 2 days as well as increase the amount of funding sent each month to be used for lab supplies and medications beginning in October. Here in the USA the medical team meets twice a month working on protocols for the clinic. Disease Pathways and a pharmacy formulary are almost complete and will be introduced to the SL staff upon our arrival to the clinic. The goal is to better equip the SL staff in treating patients and also to assist USA staff as they evaluate and treat patients. One new member to our team is a nutritionist. We hope to have in place a WHO feeding program for our malnourished, under 5 children and the maternity population before we leave Freetown. In addition to the physicians, nurses and lab tech traveling with us in October we will have a physical therapist who will be working with the only trained physical therapist in the entire country. Together we feel they will have much to share with each other. We are also delighted that a rehabilitation physician whose primary focus is amputees will be traveling with us in 2011 and is already searching for prosthetic supplies that we will take with us to the Prosthetic Center also located at our compound. A newly formed non-profit, EMPACT, composed of emergency medicine paramedics, physicians and fire fighters is sending two paramedics form Bainbridge Island, WA with us. They will be assessing 5 government hospitals in regard to Emergency Medicine. From this they will determine which will be their focus for the next year. They will work independently with our GGM SL team in Freetown sending their own teams. We are extremely excited about this endeavor.

While we are in Sierra Leone we ask that you follow our travels. Go to the home page of our web site, and click on our link. A link will also be emailed prior to our departure on October 1. Once again to each of you we thank you for your prayers, thoughts and support. Together “We CAN Change Lives, One Goal at a Time”. Thanks for helping us make a difference to the disabled population as well as the general population of Sierra Leone, West Africa.

Thanks to all of you, our donors, for your financial and prayer support. Without it, we would not be able to continue our work. Current update: * Our clinic continues to be open 2 days a week but will open to 3 days a week in October thanks to your generous donations.

* We have a new CHO (community health officer) at the clinic. Our previous CHO gave notice due to an ill family member

* We are currently finalizing plans for our October medical team to travel to Sierra Leone. That team will be comprised of physicians, surgeons, PT/OT, paramedic, nurses and auxillary help. In my next team report I will give more details on what we hope to accomplish.

* GGM USA has been asked by the Sierra Leone Ministry of Health to hold a 3 day work shop for all 219 CHO's within the country. We will review during the conference the WHO Community Education Program that will then be used for health teaching across the entire country. This is an incredible opportunity to help educate the community at a country wide level.

* Currently the GGM USA medical board is working on a power point teaching presentation for the workshop. It will cover the most deadly diseases in Sierra Leone: diarrhea, malaria, sexually transmitted diseases, and upper respiratory infections. A flow chart for treatment management will also be presented. We will review basic biology 101. What is an infection and how the body fights infection. Given enough time we will also review the steps for how to perform a basic physical exam.

* Current Needs: $10,000.00 needs to be raised by September 30 to allow us to hold the 3 day work shop in Freetown. Any assistance would be greatly appreciated! We are in need of a vehicle to transport critically ill pateints to neighboring hospitals. We are hoping to supply CHO's with the basic needs for a physical exam including Stethoscopes, BP cuffs, penlight and notebook. Any assistance or donations in this area would be greatly appreciated.

Thank you once again for your continued support.


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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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