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Published: September 24th 2013
The arrival of Mother...and lots of toys
A very warm hello to everyone, we hope this finds you all well, after what we gather has been a wonderful summer in the UK. Thank you, as ever to those who have written, it is always wonderful to hear from you!
The rainy season is coming to an end here, but the nightly thunder storms remain very impressive and if we leave any electrical device plugged in, it will blow up! We left Masanga yesterday after an emotional farewell to staff, patients and our cat, and have a few days on the beach to gather our thoughts. Time has flown by! We were spoiled in our last week with a surprise party, touching gifts and kind words and prayers. We had a general staff meeting to hand over the keys to the car and we even had our own little party which encompassed singing, dancing and games, mainly "emergency vs physio vs english vs danish", which seemed to go down well with everyone. We were given some very fetching lappa which reflected our honeymoon status (see photos…).
Our cat, Asaila, has been re-housed with Dr Claudia and Matthyjs who have his sister as their cat,
Kissy road traffic...
So tight even pedestrians can not get through...
so I think he will be fine. Jo has handed over the running of the Physio dept to a volunteer Danish physio called Magbritt, and another Plymouth doctor, Aatish, has taken over the reins in Emergency. There is a visiting surgeon from Sheffield, Lesley, teaching the surgical trainees and two medical students from Plymouth, Sean and Laura helping out all over the hospital, so it is a good time to leave.
The next batch of surgical trainees starts next week, with one of the existing CHOs having been chosen, and the ones that started when we arrived in April are now doing Caesarian Sections unsupervised. The CHO students that I was teaching for three months all passed their exams but sadly we could only employ one, even though all three applied to Masanga for a job. We have committed ourselves to contributing towards the education for some of our colleagues and patients so will be keeping in touch with Masanga and may even return.....! Rubes is currently running well and will hopefully continue to do so for some time! We are now using public transport, which is a shock to the system and we will cross
I thought I felt something in my shoe... No comments about toe two please.... Pre-existing deformity....
to Liberia in a few days to continue our travels.
We have had a very rewarding time at Masanga. Professionally, it has had it's frustrations, but also many happy moments. Having spent a night earlier in the week providing some one to one intensive care to a septic little one, with adrenaline and fluid boluses and CPAP via the Waters circuit, it was great to see her sat up and feeding as we left Masanga. But after the small generator broke and we couldn't run the oxygen concentrator overnight on the big generator due to financial constraints, we had to sit back whilst another little one succumbed to a pneumonia. Another little one with some sort of muscular dystrophy seems destined to have a poor outcome, about which we can do little, whilst Baby Claudia, born at 28 weeks, is now 7 weeks old and doing well after a period of sepsis.
The orthopaedics out here remains very basic after we ran out of chemicals to develop X Rays weeks ago. There are many children walking round with casts on probable soft tissues injuries, just in case there is a fracture underneath.
The fractured tibias are realigned by eye and casted, and the suspected femoral fractures put in traction to restore length and correct rotation, and our outcomes have been quite good! The physio dept makes the functional result a lot better, even if the X Ray would look shocking!
It has been fascinating living and working in the thick of day to day lives, and we have been impressed by the desire of people to want to continue their education to improve their prospects. Unfortunately the government does not provide student loans, and all costs have to be met up front, which is the main barrier. Micro- finance and affordable loans have yet to become readily available out here.
Whilst Claudia and Marieke, the other two doctors have both had children named after them, (one actually called Baby Doctor Marieke!) mainly for their obstetric interventions, Sean the medical student also managed to have a namesake, as quite possibly the first Baby Sean in Sierra Leone. Slightly less impressively, Jo and I have had two puppies at the Masanga Farm named after us, but we had to ask!
money that has already been very kindly donated (thank you so much for the massive generosity shown) to the physio department (also known as the Room of Hope) Jo has been able to open the department, install electricity, build a physio bridge over the drainage ditch to facilitate wheelchair access from the hospital without epic lifting, install rehab steps, parallel bars, buy mats and balls, and phase three, the renovation of the functional rehab room, is underway. We appeared in the Tavistock times which was great publicity and this will hopefully lead to a few more pennies. More photos of the department to follow.
So our own phase three has begun, after the journey out and the period at Masanga. We have from now until Christmas to explore a little more of West Africa and southern Africa. Touch wood, we will remain in good health, although Jo has now de-wormed herself five times….
Love to all and we look forward to hearing from you soon X
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