Leaving Sierra Leone

by Heather Quinn

We had a good day off yesterday. We spent the day in Freetown doing a few errands such as meeting with the solar panel contractor, and going to a local pharmacy. There was a nice pool at the hotel that we took advantage of. We took a walk along the beach and swam for an hour or so in the ocean. The water was warm, the sun was setting, and the views were beautiful.

The team at the beach in Freetown, SL

There were multiple soccer teams practicing and others selling things. At one point we look up from swimming and see Phebian amidst a newly formed soccer game. They were playing around her. We move down the beach a little to get out of their way. Phebian told us that she uses to come to the beach as a family outing. We had a great time talking and just having fun! 

We get cleaned up and head for dinner. As we were talking, Phebian tells us a story of a young girl, 15 years old now, who her parents - out of complete desperation to send her to school - agreed to give her to an older man in marriage in order for him to pay the school fees. She was 12 at the time and the parents told the man to not lay hands on her until she's 18. She was sent away to live with him. Unfortunately, she got pregnant at age 13 and had to stop going to school. This girl now lives with Phebian's  family on her compound and Phebian has agreed to assist her with the school fees. She got her back in school after begging the principle - an old school friend - to allow her back in even though she was behind. Without advocacy, this girl would never had a chance. Phebian says this sad situation is common because of the poverty and lack of ability to pay for school fees. We got to meet this young girl while visiting Phebian's family. She was a sweet girl with a precious child. 

As I write this, we are sitting here now at Lungi airport waiting for the flight to Brussels then to Newark then to Buffalo. Apparently we will gain 6 hours in time. We hope to sleep on the flight. We got off at nine today after a good breakfast with birthday cake to celebrate Vicki's birthday. The water ferry left at 11 and we wanted to plan enough time to travel through the congested Freetown city. We got there by 10 and waited patiently to leave. The views were amazing. Blue sky, shining, hit sun, and green rolling mountains. We observed the smog over the Freetown city and commented on the garbage everywhere. The sanitation has been a huge problem that we have noticed. There has been a lack of adequate bathrooms and water in both the city and villages. We laugh as we remembered our 'bush breaks' as we called them instead of 'pit stops.' That's probably TMI but it's true. The ferry began the 45 minute journey across the bay from Freetown to Lungi. During this trip a Muslim then Christian preacher take a turn on the mic yelling their views to the passengers. Thankfully, they stopped mid way and some young men started selling their Sierra Leonian music videos while giving previews on a small TV. There were people selling their goods everywhere. We made it to the airport with plenty of time and stopped for lunch. 

After, we say our goodbyes and hugs all around. We agreed that our trip was productive and successful in Jesus' name. We realize that without God, this mission would not go on or succeed. Phebian gives a hug to all and thanks everyone for the prayers. I've given her plenty of hugs, kisses and squeezes while being here.  We all have. We are grateful to be coming home but can't wait to come back to Sierra Leone.

Semi-Final Thoughts

by Vicki Ip

As we begin the process of deconstructing and reconstructing all the layers and pieces gathered on this trip, this complex puzzle, fabric called Sierra Leone keeps stirring more questions than answers.

When I view the courage and tenacity with which Phebian is fighting her way through an extremely broken country with many broken systems, I am reminded that one person really can contribute a lot to this world even if the task seems mammoth. And, when more than one person comes to the same calling, the impassable diamond mine with barbed wire and electric fences can perhaps one day be conquered.

I thought Barton Street humbled me. Sierra Leone has brought me to my knees. What a beautiful country, with beautiful people trying to emerge from atrocities that humankind has inflicted upon it! Why do these themes keep repeating itself in the developing world, and no less in the "developed" world? How does one stay hopeful and committed to the cause? The cause of loving thy neighbor. The cause of treating others as we would want to be treated. These are simple tenets, but we are far from keeping this life simple. So we keep trying.  People like Phebian, people like you, places like Jericho. We collectively keep fighting the good fight.

The preparation to return home and to stay home will be as important as it was for the journey here. As frustrating and disillusioned one can become, if anything, our spirit has been bolstered, empowered, inspired by all the things that can be done today for a better tomorrow.

We look forward to sharing with all of you soon.

Traveling Back to Freetown

by Heather Quinn

We eat a big breakfast of beans, eggs, spam, and bread before packing up our things for our travel to Freetown. We say goodbye to Uncle Bens staff. One of the staff members had approached me last night and in broken English says 'shoulder pain.' Upon further questioning, it turns out he has a large under arm abscess which he proceeds to show me in the middle of the dinning hall. We called Phebian to bring antibiotic for him before we leave for Freetown. We say a prayer and hit the road. 

The first stretch was very bumpy and we dodge potholes left and right. We came up with a new slogan for Toyota. "No road. No problem. Toyota Tundra." We decided that we could shoot some video footage of our truck handling the pond sized pot holes filled with water and sell it to Toyota for profit for our project. Not a bad idea, right? This truck has been a huge blessing. About an hour into the drive we saw two people approaching us screaming and running on the road towards our vehicle. We slow down to find out the story. Apparently, they were riding on the back of a motorbike and the driver asked them to step down while he maneuvers around the pot holes. Just as they got off, the driver sped away with their belongings. We felt bad but there was nothing we could really do. Phebian says this is very common, unfortunately. 

We continued on our way for another hour when we came across a traffic jam of 3 trucks stuck in the mud preventing people from passing. We got out to survey the situation. After 30 minutes of negotiations, we decided to wait it out. To turn around and go all the way back and around to the other route would put us back 2-3 hours. We patiently waited and witnessed a volunteer pit crew push and pull the big bus out of the mud. It was the main vehicle in the way and was quite a sight. After, we jumped back into the Toyota and Mohamed steps on the gas to get us through the mud pit. Once again, our truck handled beautifully and we were able to pass through. We saw ahead in the distance, another bus stuck in the mud. Mohamed decided to take a detour through a few yards - asking first of course - dodging rice laid out and children. This may sound dangerous but we were going about 5 miles an hour. No rice or children were injured. 

After safely navigating that excitement we settled in for the bumpy ride until Makeni which is were the road turns to pavement. It felt like heaven as we finally - 3 hours later - made it to the paved road. We were joking that we will have 'abs of steal' as we were bopping around in the back trying to steady ourselves over the bumps. A short time later, we heard a grinding noise under the truck. Mohamed decided to stop in a village where there was a mechanic. We pulled up to what looked like a parking lot with a tent in it. Thankfully, they have a mechanic and assessed our situation. We needed a new break pipe. We spent about an hour there and as we were waiting children are running up to us, then they stop and stare. We felt like we were on display and I suggested that we make up a dance routine for entertainment. We decided against it and just asked the children their names and ages. They of course wanted us to 'snap' them which means take their picture. 

Once our truck was fixed we pile back in and continued on our way. About an hour later we came into a village that was clearly stirred up and people were running down the road. We saw a short ways ahead that there was a piece of heavy equipment tipped over on the side of the road with people frantically searching around it. After slowing down, Kirk jumped out of the car to assess if there are injured people. The rest of us sit tight until Phebian says 'Heather let's go.' I followed her down the the hectic situation and we found out that the heavy equipment had fallen off the back of the truck it was on. There was someone riding on top and he was no where to be found. He was either thrown or under the equipment. Kirk searched around the area and couldn't find any evidence of life. The only place left was under the equipment. We said a silent prayer and get back into our truck to continue our journey. This type of accident is unfortunately too common here. It was a sad thing to witness and from what we could tell it had just happened before we pulled up. 

We approached Freetown and the traffic started to thicken. Phebian suggested we take a shorter route through the mountains but the road was not quite finished, although passable. We were cruising along fine when we noticed a traffic jam up ahead. Another car stuck in the mud. By this time it was 6pm and we had been traveling for 8 hours. We stopped to assess the situation. We were literally on the side of a mountain cliff. We got some great pictures keeping in mind that one false move and it's down you go. There was a bulldozer trying to help the stuck car but it was taking along time. We heard from other bystanders that the road continues to be a challenge even beyond this point. Since darkness was falling we decided to turn around and not take our chances on the risky road. We decided to brave the city streets of Freetown that we were trying to avoid. The streets were crazy - narrow, congested, slow, polluted, people everywhere, horns honking - worse than New York City by far. After 1.5 hours we finally made it to a hotel which will be our home for the next two nights. We were famished at this point and decided to go eat right away. It's 9pm by the time we arrived. 

We are exhausted from the 12 hours of travel and all the crazy accidents we witnessed that day. We were also grateful that we made it safely and in one piece - truck and all. God is good.

Last Day in Koidu

by Heather Quinn

Today was our last in Koidu. We had a leisurely start to the day. We ate spam and bread for breakfast, a very common breakfast here. We went on our way to Koidu hospital for a tour. We met the second medical doctor named Dr. Sheik Mohamed who arrived two weeks ago in Koidu. He will be assisting Dr. Levy with patient care. He did his training in Freetown. He says the number one thing he needs in the hospital is sterile OR equipment. The most common surgical cases are c-sections and hernia repairs. They call the OR a theater. That totally confused me the first time I heard that. We saw the microbiology lab, the pharmacy, the pediatric suite, the OB suite, the women/men's medical/surgical suites, the PT department, prosthesis making department and the TB/leprosy clinic. We saw a group of nurses in training as well as a CHO in training. Everyone was very friendly. It's just so sad the conditions of the facility. They really are trying to make do with what they have. 

After our tour, we met with the district medical officer of the Kono district. He was more than thrilled to meet us. He will be signing our NGO status papers. We were able to gather some epidemiology stats while there. After that we stopped by our medical office to get the microscope and did some organization of meds. We also talked finances and got the portable scanner working. In total, we saw 314 patients over the past 4 village medical clinic days. We made over 2 million Leones from the registration fees. While we were out we stopped by a volunteer group meeting that is living in Koidu near our land. They volunteer cleaning up their town by cutting grass and picking up trash on the grounds of the hospital. They provide free English, technology, computer programming, and other classes for youth. They were a great community activist volunteer group. They fully embraced our medical clinic proposal and agreed to help us build the structure once it's time. We were encouraged to meet this group and to see them helping their community. 

Today was a good last day. The thing I'll remember the most about Koidu is the friendly and welcoming people. Their waves and smiles have been so precious. I will definitely miss this town and the people. I can't wait to come back.

Beautiful sunset at Uncle Ben's

Sunday Change of Pace

Heather Quinn

Today is Sunday and we are taking a day of rest. It's a nice day here and we had a leisurely breakfast. We drank some mango juice this morning and it was delicious! It was a nice change from water.  There was a huge rainstorm last night in which we think there was some flooding because we heard a big commotion in the middle of the night. After breakfast, Kirk and Olivia are reviewing and comparing the village notes in regards to public health. Vicki is going through our medical 'notes' that we stayed up late last night organizing into binders by village in order to identify the top medical diagnosis and treatments provided. I am sitting outside reading my devotional and enjoying the views. There is a group of young boys in the distance playing some sort of game with a ball that I recognize but don't know the name of it. Phebian is attending to the family of the patient who passed yesterday. We plan on going exploring in Koidu today to check out if it's possible to buy mosquito nets and material for birth kits. Phebian has a few patients lined up for later so we will go to our office in Koidu and possibly see the land. Our team is doing well. 

Jaima Village Teaching Day

Heather Quinn

Phebian, Mohamed, and Pastor Joshua picked us up today and we stopped at the local pharmacy for a medication run. We are finding that a lot of the medications are cheaper to buy in Koidu. There are certain meds that are cheaper to get in the US and send. Kirk has been keeping a list of these cost comparisons. After we stop, we head on to Jaima for a half day of teaching. Jaima is by far the most advanced, cleanest, and healthiest communities. They have a nurse and CHO (community health officer which is equivalent to a PA) that staffs the medical clinic. They also have a lab tech and provide rapid malaria, gonorrhea, H.Pylori, typhoid, and pregnancy tests. They have a working microscope that they use to test stool for worms and have a fully stocked pharmacy. The nurse is the chiefs wife and she really advocates for her community and the medical clinic. There are several nurses in training there. 

As we arrived, we are greeted with the typical Sierra Leone greeting of children screaming "white man" and the village leaders lined up to shake our hands. We meet everyone we should and go through our round of introductions. There is a good turn out from the community for the meeting. Phebian introduces us to the community and then we begin our teaching session. I presented CPR, Kirk - helping babies breath, and Vicki - helping babies breath. They seemed receptive and the TBA's (traditional birth attendants) sat front row to see the demonstration. There are 7 of them in the community. Like I mentioned before, the TBA's are under scrutiny from the SL government to not do home births. The truth of the matter is, most births do end up happening at home by TBA's.

Teaching in Jaima village - the TBA's

During this visit, I was able to interview 2 hernia repair cases - one woman and one man who had the procedure done within the past month or two. They were so happy and grateful to have this simple procedure done. I look forward to sharing these interviews. I also interviewed Pastor Joshua so that everyone can get to know him better. He's been so amazing on this trip. During our visit in Jaima, there was a slight miscommunication there about the purpose of our visit. We had to make the touch decision of not seeing patients there even though they wanted us to. It was either we treat all or none. That was not the purpose of our visit and we made the tough decision to not hold a clinic there. We encouraged the community to go to the well run medical center for their health needs and that Phebian will continue her monthly visits there. Phebian told us that they believe that our medication "is better" and that they will wait in line for us to "touch them." We enjoyed our visit to Jaima. On the way back, we made plans to meet with the program director of World Vision in the Kono district to talk about their clean water project. We are meeting with her tomorrow on the way to Wama Village.

Phebian with a young man s/p hernia repair

Tomorrow is our last clinic day and we look forward to meeting the Wama village community. Thanks for the prayers, they are felt. God is so good!

Medical Clinic in Tombodo

by Heather Quinn

Here is the latest update! Tomorrow is our day of rest. Please continue to pass along the emails via MEDENT or via listserv and to keep us in prayer. Thanks so much. We miss everyone at Jericho. We are learning a lot and are a great team!

It's hard to believe we've been here for a week. The time has been full and fulfilling. Today we went to Tombodo village to do a medical clinic. We got there by 930 this morning and set up quickly to begin our day. The CHO welcomed us and opened up the village medical center for us to use. Pastor Joshua had gone ahead to register patients prior to our arrival. He had ten registered when we got there. The day went smoothly and we treated almost 60 people. There were a lot of chronic conditions today like HTN, gastritis, and arthritis. There wasn't as many acute care cases as the other days. We saw some TB vs Pneumonia cases, suspected malaria, and intestinal worms. The clinic was peaceful and not as overwhelming. There were four TBA's in which three of them were helping us translate and dispense meds.

Community Meeting at Tombodo

As I was seeing patients today I would ask them their age. I soon realized it seemed like most people were guessing at it. Phebian informed me that most people don't know their real age. Can you imagine? The government came around a few years ago and gave everyone 'an age' in order for then to be able to vote in the political election. Like I mentioned yesterday, this village was attacked by Liberian rebels who occupied the village and set up the headquarters in the chiefs house for several years. They destroyed not only lives but the water and electric system as well as the road going into Koidu. It used to take 15 minutes to get from Koidu to Tombodo and now it takes over an hour. 

The young boy I mentioned yesterday who is in school, studying hard, and remembers the rebel invasion, had written a letter to Phebian politely asking for money for school fees. His hand writing was perfect and his letter was well written. Phebian thought about it over night and today agreed to give him the money for school with the hopes of hiring him for our medical clinic. He's 19 years old and he is almost done with High School. It costs $75 for a child to attend school which doesn't include school fees or uniforms or books. This fee is near impossible for families who earn $2 per day and have multiple children. The children love school here and often excel in their classes. Some go to Koidu which is the nearby town in order to receive a better education. Most of the teachers in the village volunteer their time. As I mentioned yesterday, Tombodo was the most beautiful village with the scenery. It was such a great day there and we made the trip back early to our hotel. While in the village, we received word from Kai -Phebian's brother-  that the hospital patient had passed away. He was comfortable and surrounded by family. We had a moment of silence and reassured Phebian that we did all we could. She knows it deep down but she's still affected by this. The funeral will be tomorrow. 

We plan on resting, reading, and relaxing tomorrow. Thanks for the prayers. We are missing our friends, family, and colleagues back home. You are in our prayers. 

Tombodo Village

Heather Quinn

Today we went to visit, tour, and meet with the community and their leaders at Tombodo. It was the bumpiest ride yet and it took 45 minutes. The leaders seemed concerned about the health and well being of their community. They stated that their main problem is their lack of clean water supply. They know that the main reason that they keep getting sick is because they have contaminated water. The CHO in the community really wants to partner with us. The medical clinic was really nice (it's all relative - in comparison with the other village clinics) with a good supply of medications for pregnant women and children. It was nice to meet the community and do our education training of CPR and birth kit demonstration. 

While on the village tour, I spoke with a young 19 year old man who told me that this village was especially hurt by the war. It was attacked by Liberian rebels and he was 10 years old when his family had to flee. They fled for 5 years. Both of his parents are still alive but are injured from the war. He is in school and studying hard. He wants to be a teacher. His English was really good and he ended up staying with us for some time. This village had the prettiest views because of the rolling hills and folliage but there were war remnants all around. 

Today was a hard day emotionally for me. We stopped by the government hospital to see our patient there who is deteriorating fast. He is now unresponsive and unable to eat or drink. We gathered around his bed for a prayer. As pastor Joshua prayed and committed this mans life into Gods hands, the tears started to flow and I had to hold back from sobbing. I was holding Phebian as we prayed because it was clear she was bothered. She had done so much for this man medically and with great compassion. We realized that it's in Gods hands now and his time to pass on unless there is a miracle. As I looked around the men's ward at the frail and sad looking patients, I had to leave because my heart was breaking and I felt ridiculous crying so hard. I think I cried most of the car ride to the village. This had affected all of us on some level and we all were feeling the sadness and helplessness of the situation. Being in the hospital has been the hardest thing for me so far. We stopped in to visit the man after our day in Tombodo. He continued to decline and we decided comfort measures was the best thing for him. We met some of his family who looked hopeless but grateful for our help. Since the hospital has no comfort care medication, we vow to go buy him some at the pharmacy so that his last breaths on earth are not as painful. Phebian's dad had stayed with the patient all day, attending to him and trying to feed him. He agreed to stay a little longer until Phebian could return with the pain medication. We made a pharmacy run and then headed back to the hotel. Phebian dropped us off and told us to get some rest tonight.

We will have a busy clinic day tomorrow. Keep us in your prayers.

Medical Clinic in Tefaya

Heather Quinn

Today was the first day we had a hot shower and it felt great! We've learned to adapt and take quick cold showers. It was after a long 9 hour day doing the medical clinic in Tefaya. We were greeted by 100 patients ready to be seen. We unloaded and set up our supplies/meds quickly and got started. I was at the pharmacy station with Isatu who is a native TBA (traditional birth attendant). She was the 'pharmacy tech' working with me and served as my interpreter. She learned quick. Vicki and Kirk started seeing patients. 

Vicki and I switched about half way through. We saw a lot of tropical illnesses like malaria, possible schistosomiasis, and intestinal worms. We also saw other chronic conditions like asthma, HTN, and GERD. There were some other cases as well like abscess, broken bones, and hernias. I saw a patient with a basketball size inguinal hernia. He worked in the diamond mine for years. He was added to our hernia repair program list. We've been keeping track in each village. I followed up with four men who had inguinal hernia repairs in Aug/Sept of 2013. The surgeries went well. The incisions are all healed and not painful. They are moving their bowels normally. I video interviewed the first man who had his hernia repaired. He said, 'thank you and thank God for you.' He's referring to Jericho Road and our presence in Sierra Leone. He was smiling ear to ear. I might have seen two active cases of TB vs Pneumonia and told them to go to Koidu hospital for TB testing. We saw well over 100 people and didn't leave until 8pm. Olivia had a great and successful day in the village interviewing people and getting the tour. We made the 1.5 hour ride back to Uncle Bens. 

What hit me most today was that people walk for miles to come seek healthcare and medication. The will wait for hours to be seen. Phebian told us that they will often forgo seeking treatment bc the drive to Koidu is long and expensive. Then when they get there they are not guaranteed treatment or good care. That's why they flock to us when we arrive. They trust us and our care plus the relationship Phebian has with the villages is credible.  I can just tell in their faces that they don't feel valued. I wanted to cry as I watched Isatu explain medications to an elderly gentleman who held them in his hands like they were gold. These medications were so precious to him and he listened intently to the directions on how to take them. The children that came through seemed so serious and as soon as they received a lollipop, their faces lit up. Kids are the same everywhere. I'm distraught at the injustice and exploitation of the Sierra Leonian people. Phebian says that the diamond mine does not guarantee payment after a days work. People could work all day and never get paid but since there is no other option, they will take that chance. It's just so unfair. It makes me want to do more to help and pray harder. Thank you for the prayers. We definitely need them. We are tired today but doing well overall.

Tafaye Village

by Heather Quinn

Today we got up a little later to go to the Tafaye village. Phebian has been doing a community focus group there made up of village leaders from different groups like Christian, Muslim, women, children, and the tribes. They have a lot they want to improve in their village like education, sanitation, and health.

Children in Tafaye village

When we arrived at the village, we were greeted by a crowd of school children who started jumping up and down for joy that we were there. We couldn't help but take their picture and I took a video of them. There zeal is contagious! The village leaders came to greet us as well and we were escorted down to the village center for the community meeting. We did a round of introductions and were welcomed with cheers. They gave us fresh bananas and oranges to snack on. They were yummy! After the introductions, we proceeded with the community education. I started the session with CPR for the community. After, the TBA's come up front to meet us and they sat sit close up. The men were then kicked out of the area but most chose to leave as Olivia taught about the birth kits. The women were so interested and asked some good questions about the birthing process. Kirk taught an impromptu emergency birth plan lesson. The TBA's really connected with this and we could tell they learned a lot. Vicki then taught about helping babies breathe. A storm blew in just as we were finishing and we were escorted to a building where they served us lunch. It consisted of onions, Irish potatoes, and bread. It was good!

TBA's in Tafaye village

Since we wanted to go see the man in the hospital, we left the village early. It was an hour back to Koidu. The long bumpy car rides have caused us to really spend quality time together. Imagine Kirk, Vicki, Olivia and I in the back seat of the truck with Phebian riding in front with Mohamed, the driver. The windows are down as we speed down flat roads and slow down over potholes. The truck is awesome and handles the roads so well! Pastor Joshua had been riding in the truck bed and has been a trouper. On the way, we met a man who Phebian knew and she told us after that he is a volunteer who fixes the roads. We were so impressed at his initiative. We noticed that there are just so many people out and about, sitting outside their huts, walking to the wells or marketplace, cooking, cleaning, chilling wood, and washing clothes. When we drive by and people spot us they wave and yell 'white man' which I can't remember the Creole word for that. It literally feels like we wave at everyone. We've met so many people with employable skills yet they can't find paid work like carpenters and teachers. 

We arrived at the Koidu hospital and I was shocked at the conditions. Tears started to well up in my eyes as we walked into the men's ward to see our patient. It's basically a large room with cots, no dividers or curtains, and a mosquito net over the cots. It doesn't look clean. It barely seems humane to me. Kirk checked out the patient and the nurses aid gave a a quick update. He's doing better but not great. Clinically, his lungs are more clear than yesterday and it's hard to tell if his abdominal swelling has gone down. We met the charge nurse and the only medical doctor staffing the hospital at this time. No one seems to really know what's going on with the patient. The documentation is poor. We plan to check on him tomorrow. Phebian continues to advocate for him. We plan to spend more time at the hospital another day. We stopped by a local pharmacy to buy some meds and our JRM office for medical supplies. It's so cool to see all our supplies / equipment from the crate in our storage space. It's a nice area! We got to meet Kai who is Phebian's brother. He does a lot of errands for Phebian and even transports patients for her while she's out at the villages during the days. He hopes to come out to one of the villages with us. We got back to uncle bens earlier today, had a nice dinner, and went to bed early. We were warned by Phebian that the clinic tomorrow will be well attended so we need to get some rest. We took her advice. 

Dr Vicki and Dr Kirk Update

By Vicki Ip 

A big hello and hugs from Sierra Leone!  We just had our first clinic and had to close up with flashlights.  Its been an amazing journey already, the warmth and graciousness of the people are unparalleled.  Phebian is so amazing.  The love she has for the people and her work are so inspiring.  After a long day, an hour and a half ride back to Koidu, Phebian and Kirk traveled to the Koidu hospital to visit one of her very sick patients.  He had a hernia repair about a month ago but now has hepatosplenomegaly, ascites, pulmonary edema, and is becoming confused.  He has schisto and Kirk suspects liver failure, ascites and CHF from schisto.  The man is only in his 30s.  Phebian has been so worried over him and invested in him and if she didn't get his brother to take him for and abdominal ultrasound a couple of days ago....

There could not be a better ambassador for the Sierra Leonians than Phebian.  I swell with admiration for her.  God is definitely walking this entire journey with her as we have all been witness to. We will keep the updates coming.

In love and faith,
Vicki and Kirk

Medical Clinic in Kangama

by Heather Quinn

After a good nights rest, we ate breakfast and packed up for our hour and a half drive to the Kagnama village. Before we started off, we said a prayer as a group. We planned to do a day long medical clinic there in the health center and continue to gather public health information. Today was a Muslim holiday so the children didn't have school and a lot of businesses were closed. About 60% of the SL population are Muslim and 40% are Christian. 

On our way to the village, Phebian received a call from the CHO in Koidu hospital that is caring for one of our patients who had a hernia repair a month ago. A month post op he developed abdominal distention and swelling. Today he developed fluid in the lungs and delirium. Phebian gave the phone to Kirk to give some orders for care. The MD was out of the hospital today and won't return until tomorrow. Kirk gave orders to give LASIK, stop IV fluid, and monitor output. He's being treated for worms and malaria as well. He spikes fevers every few hours. We promised to go visit him after the clinic today and keep him in prayer. It seemed like he's in acute liver and heart failure with previous worm and malaria infections. Unfortunately the X-ray machine was broken at the hospital so there was no way to verify the diagnosis. The sonogram was done yesterday and showed an enlarged liver and abdominal fluid. In the US this would have been more easily diagnosed and treated. 

We arrived at Kangama at 11am. We already had patients waiting for us. We set up a 'pharmacy' in which I was the pharmacist with Alfred. He was my assistant and interpreter. Kirk and Vickie started seeing patients. We had 85 registered by the time we got there. People walked as far 7-10 miles to seek medical care. The village midwife registered the patients. Pastor Joshua was with Vicki interpreting. Phebian was with Kirk assisting him. Olivia went out into the community to gather data on water sources, community programs, the role of the midwife and TBA's (traditional birth attendants), and other important information. 

We took a quick lunch break around two. Vicki and I switched positions. I saw patients with Pastor Joshua and she acted as the pharmacist with Alfred. The most common things we saw were malaria, intestinal worms, HTN, constipation, skin rashes, cysts/abscesses, lipomas and headaches from dehydration and dizziness probably from either anemia or HTN. It was an interesting day. There was one case I saw in which a 25 yo female had a c-section in 2006 with her first baby and since then had no period and no subsequent pregnancies. She did have pain over the incision site but no other GU symptoms. My suspicion was adhesions in the uterus preventing her from getting pregnant or getting her period. I explained this to her then prayed over her and gave her vitamins and Tylenol for pain. After discussing this case with Phebian, it turns out that in SL sometimes the provider will remove the uterus without telling the patient if a c-section goes wrong. I was shocked at this! How horrible!! Now I know the likely reason of her complaint. I wish we could confirm with a sonogram but we can't. My heart goes out to this young girl. These are the types of things that the people have to deal with. I couldn't help but think that the people look really worn out, that life is hard - I could see it in their faces. Whether they are dealing with emotional or physical or social hardships. Life looks hard. 

We all felt like today was a huge success and we had a lot of fun! Even though the reality of their life is hard, they are loving and welcoming people. It's so humbling and endearing to interact with them. They wanted us to stay longer in their village. We told them politely that we'd love to but we have several other villages to go to. Today we probably saw over a hundred patients. Kirk went to visit the really sick hospital patient who seemed to be doing okay. There wasn't much charted in his chart as far as his treatment and the CHO didn't seem to know much. He was in training and doing the night shift. Pastor Joshua prayed over the patient. Phebian was really advocating for this man's care. She truly cares for her people in need. Tomorrow we plan to go see him again on our way to the Tafaye village. We will do community education there. A good change of pace from the hectic medical clinic day today. After we returned to Uncle Bens, we had a good evening debriefing and just hanging out. 

We love it here. God is with us. Keep us in prayer.

Kangama Village

by Heather Quinn

We woke up at 7 to eat a warm breakfast and get packed up for our day in the new village. We did some sorting and packing of supplies and meds the night before. There is a possibility that we may stay the night in the village at the Chiefs house. We each packed up a bag of our personal belongings in case that happens including our mosquito nets. Phebian, her father, Pastor Joshua, and Junior meet us in the morning to load the truck. On the way to the village we stop to exchange money at the local bank. Unfortunately, they only take 100's and 50's and we only received equal exchange for the 100 dollar bills. The 50 dollar bills we received half the exchange rate. We were disappointed but it's okay. We have more than enough so we are grateful. On the way, we stop for gas and some baguette bread. The bread is so fresh - crispy on the outside and light and fluffy in the middle. As we were stopped, I asked a young boy his name. He said 'alphamatata' and he's 12 years old. I told him my name and he said 'Thats a beautiful name. I love you as a friend.' I smiled and said 'I love you as a friend too.' That just melted my heart. His smile, laugh, and pleasant spirit. We continue on our way, windows down, listening to Caribbean music, and dodging puddles. It's a beautiful day - partially cloudy with sub peaking through and cool, humid air.

Children in Kangama Village

 We stopped in Jaiama village on the way and saw the Aha-Mass clinic run by an RN. There is a men's ward, women's ward, lab with microscope, and reception area. There is a student nurse in training. We also met the first man who received a hernia repair. He was so grateful and had a big smile on his face when we met him. We met the chiefs wife named Masbona and she showed us around the clinic that she helped start. They have 2 SECHN's, 2 CHO's, and 2 MCHA's. On our way out, we met the mother of the young boy who also got a hernia repair. He's doing well. Phebian tells us that Jaiama was the first village to have medical missionaries and primary schools. The VP's wife is from Jaiama as well. It's primarily a mining village of gold and diamonds. According to Phebian, the paramount chief gets a portion of the profits and puts that money back into the community. It shows because it's a well kept and organized village with a water pipeline coming from the damn to homes, the school and medical clinic. 

Me and a young lady in Kangama

As our bumpy drive continues, we came across two others - one man and one women who received hernia repairs. When they saw the truck pull through their section of the village, they ran out to meet Phebian. We arrived in the Kangama village after 2 hours. Upon arrival, Phebian met with the village elders. We met a few and one of then named me SaKangama. Sa means first and Kangama is the village name. They had a community meeting for us and welcomed us to their village. Some of the elders gave us a tour of the entire village including the medical clinic building, the primary and secondary schools, and the world vision office. We played with children, talked with village leaders, and did our community health presentations. The turn out was about 50-60 people who attended. We did a CPR, helping babies breathe, and birth birth kit demonstration. They seemed engaged and asked some good questions. There was an RN, CHO (community health worker), and two TBA's (traditional birth attendants) at our presentation. We look forward to working with them at the medical clinic tomorrow. Our clinic starts at ten and we plan to leave Uncle Bens at 8am. It's an hour and a half drive. 

We had a great day today and our team is still in good spirits. Please continue to keep us in prayer.

Travel to Kono

by Heather Quinn

We started the ten hour drive to the Kono district at 9:30 AM. We took a new route that we heard had paved roads through Makeni. This was mostly true and we only came across two check stop and a few road blocks. Our driver did a great job navigating. The countryside is beautiful with lush greenery and rolling hills. The sun is coming out and the dirt looks reddish in color. 

It took us two hours to get to Makeni where  we made a pit stop. The folks are friendly and we were bombarded with people selling their goods. Makeni is where the paved roads end and the dirt roads, filled with pot holes, begin. Thankfully it is not raining.

About 5 hours into our trip we got out to stretch our legs. During this pit stop, a van packed with people pulls up to say hi to us. It turns out that one of the passengers is a student nurse that Phebian knows from the hospital. She is a good hearted woman who desires to work with us when she is done. It was so cool meeting in the middle of jungle. Our journey continues and it's back onto the dirt roads we go. It had rained last night and I've never seen puddles this big. Our truck did awesome! We were joking that we could film a Toyota commercial here and all the proceeds could go for our project! It started raining after we crossed over into the Kono district and we only had to deal with it for half hour. We saw a handful of cars and trucks tipped over or stuck in the mud. Thankfully, we didn't get stuck and we made it to Unce Ben's in only 7 hours. I believe this is record time for any trip! 

Uncle Ben's is a nice bed and breakfast. We got settled in, sorted meds and talked about tomorrow's plans. We are going to a new village but the name escapes me. They approached Phebian about working with her (us). It's an hour and a half south of Koidu. We look forward to building relationships there. The team is in good spirits and really enjoying the time. It's good to be here. Keep us in your prayers.

Our team with the JR sign!

Bumpy roads of Sierra Leone 

We Made It!

by Heather Quinn

We made it to Sierra Leone! The trip was uneventful except for having to sprint through the Chicago airport in order to not miss our connecting flight to Brussels. We made it with 20 minutes to spare before take off. 

After 17 hours of air travel and a short drive, we arrived at a guest house for the night. It was a nice and neat place with a high fence and barbed wire with shards of glass on the top.  The guest house staff was friendly and accommodating.  We caught up with Phebian and Pastor Joshua and then settled in. The reunion with Phebian was filled with shouts of joy and lots of hugs. We ate a nice meal of fried chicken and French fries, then called it a night. We were exhausted from the long but successful journey. We received all our luggage without difficulty! The medical clinics will happen! 

We slept well on a cozy bed with a mosquito net over us. The morning came quickly and we woke up to a nice breakfast and instant coffee. We ate our fill and started to confirm the plans for our two week mission trip. Pastor Joshua and Phebian led our discussion of how to best use our time. The weather was dry but cloudy and we got all packed up for the long ten hour trip to Kono. We said a prayer and our goodbyes at the guest house.  We piled into the truck with four of us in the back and PastorJoshua in the flat bed with our all luggage. The driver, a young man named Mohamed, had cleaned the truck and made water available for us. Phebian sat in the front with our microscope on her lap. It made it intact! We stopped for gas and to fill our trucks tires with air. It was a busy day in Lungi with people milling about and others selling their products at the market. Our team was excited and ready to go to Kono. We are anticipating the two week journey and can't wait for our mission to begin. Wait, it already has! More to come.

Team's arrival in Sierra Leone

At the Anselm guest house

Getting Ready to Leave

by Heather Quinn

Our team is getting ready to depart for Sierra Leone this Friday (10/11) at 4:30pm. We will have a long journey to our destination including 14 hours of air travel and 10 hours of ground travel. We have been preparing and planning extensively medically and spiritually for the past 4 months. We are as prepared as we can be states side but realize that once we are in country, anything can happen. We are ready to be flexible and adaptable. 

It continues to rain in Sierra Leone. We got word from Phebian that it is extremely muddy right now making ground travel difficult. We will be bringing rain gear. Our packing has begun and tomorrow we do the final "weigh in" of our luggage. We each have one medical and one personal suitcase filled with either supplies or gear.

While there, we plan to do 4 medical clinic days and 4 educational days in each of the 4 villages we are reaching out too. The educational days will include teaching the healthcare workers from each village about the use of the birthing kits, helping babies breath, basic adult CPR, and a teaching topic of their choice. Through these educational sessions we hope to learn from them about certain health topics as well. We also hope to get to know the villages and what their individual health/social/basic needs are. We plan to do the medical clinic the next day. We've been reading up on and learning about tropical diseases and the treatments of them. We are bringing medications to restock our "pharmacy."

The rest of the days will be filled with doing investigative work on resources in country such as water sources, ways to get medications, visiting pharmacies/health clinics, and getting to know the people we are serving/working along side. 

Please continue to pray for our team and this mission. Without God, we can not succeed. He's led us and blessed this mission thus far. It's in His hands. We are a light in the darkness and the salt of the earth. With that comes challenges and obstacles but with Jesus we are "more than conquerors" and will overcome any opposition.   

In His Service,

Heather A. Quinn