Tonight I am sitting out on a balcony overlooking the ocean in
Freetown. It is 8 pm and we just arrived back in Freetown after an
encouraging and productive visit to the Kamakwie Wesleyan Mission
Hospital and then a long and dusty 8 hr trip back to Freetown.
First Freetown. What a city! Home to over one million people squeezed
in between the ocean to the west and mountains to the east. There are
people everywhere and one is bombarded by a cacophony of sights,
sounds and smells that I am sure are unique to this city. Horns
beeping constantly, people crowding the narrow streets, motorcycles
everywhere, the smell of open sewage and burning trash and the ocean
all mixing together.
There are no traffic lights, stop signs or markings for pedestrian
crossings. It looks to me like a free for all. Tomorrow we will
navigate this city with Phebian and Pastor Joshua hoping to tour the
government hospital, visit the vice president, connect with our bank
and meet with the Christian Health Association of Sierra Leone. It
should be a fun day.
Last night and then this morning we stayed at the Wesleyan Mission
Hospital in northern Sierra Leone in a village called Kamakwie. We had
a worthwhile and productive visit. This mission hospital was founded
54 years ago by Wesleyan missionaries from the USA. In fact we saw a
plaque today of the opening dedication of the hospital and Dr. Warren
Woolsey ( well known and beloved Houghton College emeritus professor)
was one of the speakers 54 yrs ago! This hospital was primarily funded
and staffed by American missionaries for the first 30 years but over
the past 20 years and especially since the war it has transitioned to
now being owned by the Sierra Leonian Wesleyan church and today is
100% self sustaining. There is only one American missionary remaining
and she is a nurse practitioner and midwife. But the faithfulness of
those early medical missionaries lives on today through this hospital
We were much encouraged by this hospital. Compared to the district
government hospital in Koidu this hospital seems functional. They have
X-ray machine, sonogram, 24/7 electricity, two OR theaters that are
air conditioned and a dental suite and someone who can do eyeglasses.
They have some creative community based programs including a feeding
clinic for malnourished children, a microenterprise loan program for
women and a fulltime Chaplain. Like all the hospitals here their
biggest ward is for kids. Kids die to often in Sierra Leone.
In this hospital they do not presently have any doctors but instead
they have 4 RN nurses who act as the surgeons doing c-sections, hernia
repairs and emergency abdominal laparotomies. And they seem excellent
and well trained. This region has the lowest maternal mortality rates
in the country and the HIV rates here are 2% compared to Kono where is
20-30%. They also see very few cases of measles. The main killer still
Phebian made some good connections. She will come back to this
hospital later this year for an extended period to get further
Finally a word about sustainability. Obviously we will need to raise
money in USA to build the clinic, support Phebian and for initial
operating costs. This is our primary task now. But being here, seeing
Phebian work, visiting the mission hospital give me great hope that
within 5-10 years our medical work will be self sustaining. This is
our goal. Here is how I think it can happen...
1. Like the mission hospital ( and like JRFP in Buffalo) Phebian will
charge people for the care she provides. In fact this week she charged
most of the pts we saw a small fee to be seen. We collected $295 US
dollars for seeing over 300 people. In Buffalo this does not seem like
much money but here it is something. Now Phebian will buy more
medicines to replenish her stock and thus already there is a self
sustaining component to our work. Charging the patient is the primary
way the mission hospital at Kamakwie sustains itself.
2. Build a working relationship with the government medical system. At
the government hospital malaria meds are free to kids. We are hoping
they will include our work as an approved site and give us free
3. Build working relationships with NGOs working in Sierra Leone
already. World Vision has a base in Koidu. They may be able to help us
with certain meds and also help us with health education, training and
other community development programs. Samaritans Purse sometimes sends
a free container of medical supplies to the Wesleyan Mission Hospital.
We will contact them. We also are connecting with the Christian Health
Association of Sierra Leone to see how they can support Phebian
4. Invest in infrastructure that lowers operating costs. Last summer
the mission hospital installed a solar panel electrical system( the
sun is one of this countries most consistent resources) and as a
result they have decreased their use of diesel fuel from 160 gallons
per month to 60 gallons and now have 24/7 electricity for their
hospital. This is good for the environment and good for budget.
5. Finally the mission hospital is building a solar powered water
purification system that will allow them to generate clean water for
themselves and also to sell water and ice to the community. This would
be a great project to invest in at our clinic providing clean water
and jobs and an income for our medical work.
One more point that I failed to mention earlier and
will be most appreciated by the JRFP folks who are
reading these emails. In my opinion if nurses in Sierra Leone are
doing c-sections with excellence then surely our well trained and
exceptional medical assistants in Buffalo (Nigesse, Aester, Han Moe,
Melissa and Aung) should be able to give kids shots. I am worried that
when I return to Buffalo I will be a terrible medical director who
will no longer care passionately (as you all know I did) about
meaningful use measures, HIPAA regulations, medical liability issues
or FQHC policies. Maybe you guys should just fire me now to be safe.
But I do promise to continue to lead Jericho Road towards caring for
the "least of these" in Buffalo and now in Sierra Leone and hopefully
someday in countries like Congo and Sudan. To demonstrate the love of
Jesus through word and deed to those Jesus loves the most.
Our team is well. It will be great to come home. Pray for Phebian who
misses her family terribly but is so committed to this mission