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news and announcements

How CRC targets interventions to strengthen and keep families intact

11/30/2024

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The Child Reintegration Centre’s Case Management Team is focused not just on meeting the needs of vulnerable families in its program, but designing interventions that help those families move gradually toward their own independence and self-sufficiency.  The goal is always to ultimately release these families as soon as they are ready to stand on their own two feet both relationally and financially.

But how do Case Managers know what a family needs, and what will help them the most?

The Williams family is just one family on CRC Case Manager Abdulai’s caseload.  Recently, Abdulai conducted an assessment of the Willaims’ family needs using a tool he frequently uses to assess the family’s needs in 8 different domains, called the Family Status Index (FSI).  The FSI allows Abdulai to not only identify what the Williams family might need at any given point in time, but also to track how they’re progressing in these key areas and becoming stronger as a result of the CRC’s targeted interventions on their behalf.

Abdulai realized that the family has been resilient in the face of multiple challenges, but they needed a little more support if they.  Two key areas of immediate concern included food insecurity and ability to receive a regular income.  As a petty trader of charcoal, Mrs. WIlliam needed funding to buy more supplies.  As the sole caregiver for her two grandchildren, she was struggling to make ends meet and contemplating sending the children to her sister so they could get more to eat, but Abdulai, recognizing that the children are well-bonded and deeply attached to their grandmother identified key interventions that CRC could provide to keep this family intact and prevent the need for separation.
​

CRC provided some raw materials for Mrs. Williams to make and sell charcoal, but they also enrolled her in a two-day financial Literacy Training course so that she can learn to manage her finances as well and make the most of the resources CRC has provided.
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Mercy Hospital's Diabetes Clinic is Taking Off!

11/14/2024

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While significant strides have been made in combating malaria and other infectious diseases in Sierra Leone, a growing public health challenge is emerging: the rise of chronic diseases such as diabetes. A recent Lancet study revealed that over 445 million people worldwide lack access to life-saving diabetes medication. This disparity is particularly pronounced in low and middle-income countries, where treatment rates are as low as 10%. This double burden of infectious and chronic disease demands a multifaceted approach to healthcare.
This World Diabetes Day, we want to recognize the life-saving work that Mercy Hospital is embarking on to tackle this issue. Below is a write up from Mercy’s Diabetes Clinical Team, which includes Matron Augusta Kpanabum, the new Doctor. Morie Vandi, and Nurse Monica Sheriff, who supervises the diabetes clinical activities:
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Matron Augusta Kpanabum, Doctor. Morie Vandi, and Nurse Monica Sheriff getting things set up for Thursday clinical day.
The Mercy UMC Hospital Diabetic Clinic was established in July 2024 following the visit of Misti Levya and her team of missioners. The clinic was created after free diabetes and hypertension screenings organized by the outreach team highlighted an urgent need for dedicated diabetes care in Sierra Leone. Recognizing this need, the team started the clinic with a vision to provide free, quality care to diabetes patients who would otherwise have limited access to proper management and treatment.
Since its inception, the clinic has provided critical support to diabetic patients across Sierra Leone, becoming one of the few hospitals in the country offering free diabetes care. Through the generosity of Insulin for Life USA, they have received free insulin, glucose meters, test strips, and other essential diabetic supplies. This support has allowed us to reach patients from even the most distant parts of the country, including Freetown, the nation’s capital. Patients from these areas make periodic follow-up visits, demonstrating the clinic's wide-reaching impact.
“Starting a clinic like this was crucial for a country like ours, where many individuals are unable to afford the continuous care diabetes requires. The commitment of Misti Levya and her team, and the support from Insulin for Life USA, has been a game-changer for our patients.”--Dr. Morie Vandi, Medical Doctor-in-Charge
The diabetic clinic operates weekly, providing the following essential services:
  • Outpatient consultations: Patients receive regular evaluations, medication, and guidance on lifestyle management.
  • Health Education and Counseling: Patients are educated on diet, physical activity, and glucose monitoring by our dedicated diabetic nurses.
  • Screening Services: Blood glucose, HbA1c, and lipid profile screenings help to monitor and adjust care as needed.
  • Complication Screening: The clinic offers early screening for neuropathy and other complications.
  • Medication Management: They provide insulin and diabetic supplies free of charge, thanks to Insulin for Life USA. However, oral medications for Type 2 diabetes, which are not covered, remain a challenge due to high out-of-pocket costs for patients.
“Having a diabetic clinic at Mercy Hospital is truly a blessing, especially for those living with the condition. Considering the costs involved in purchasing insulin, glucose meters, and testing strips, this service has significantly reduced the financial burden on patients, allowing them to use their funds for other basic needs.”--Matron Augusta Kpanabum
Since July 2024, the clinic has seen a significant influx of patients:
  • New Registrations per Month:
    • July 2024: 45 patients
    • August 2024 to October 2024: Averaged 20 new patients per month
    • Total Registered: 113 patients to date.
  • Follow-Up Visits: Approximately 70% of patients return for monthly follow-ups, showing the clinic’s strong influence on adherence.
  • Patient Demographics: Our largest group of patients are aged 45-60, many with long-standing Type 2 diabetes and early complications.

Their early outcomes highlight the clinic’s effectiveness:
  • Initial Fasting Blood Glucose: At registration, the average fasting blood glucose for patients with type 1 diabetes was 18.4mmol/L, reflecting poor diabetes control (Healthy levels are between 3.9-5.6 mmol/L).
  • Improved: As of October 2024, the average FBG for type 1 diabetes patients has reduced to 11.3mmol/L.
  • Blood Pressure Management: Over 80% of hypertensive patients show improved control through dual Type 2 Diabetes and Hypertension management.
“Many of our patients arrive feeling hopeless. With consistent guidance and support, we’ve seen transformative changes in their confidence and health. They know they’re not alone.”--Nurse Monica Sheriff, Diabetes Clinical Nurse
While they’ve made remarkable progress, some ongoing challenges persist:
  • Medication for Type 2 Diabetes: Unlike insulin, Type 2 diabetes medications are not readily available through donations, leading to high out-of-pocket expenses for many patients, which hampers their management.
  • Resource Limitations: The only diagnostic tool available for free is the Fasting Blood Glucose and Post-Prandial Blood Glucose. The other diagnostic tools like HbA1c, Fasting Lipid Profile, Kidney Function Test are needed for full complication screenings, but are however not done by the majority of our patients due to the high out-of-pocket expenditure.
  • Patient Education: Low literacy rates among some patients make it challenging for them to follow complex treatment and lifestyle recommendations.
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Matron delivering patient education at the clinic.
The clinic has set the following goals to enhance service delivery:
  • Enhanced Screening: They have introduced fasting lipid profile, kidney function and more comprehensive complication screenings to better assess and address patient needs.
  • Community Outreach: They aim to extend educational and screening services to neighboring communities, identifying individuals who may be undiagnosed or untreated.
  • Staff Training: Ongoing training for their staff will ensure the highest level of care for our patients.
  • Electronic Records: They’ve begun storing patient records digitally to improve accuracy and continuity of care and understand the management trend.
  • Comprehensive Care: With over 80% of our patients affected by type 2 diabetes, they’re hoping to expand comprehensive screening and management services for them. Having new services like fasting lipid profiles and kidney function tests covered by the clinic will help us better monitor and manage complications.
​“Our patients benefit immensely from the resources we’re able to provide, but there’s still a gap when it comes to Type 2 diabetes medications. The financial burden for these medications is a heavy one, and we are seeking ways to bridge this gap.”​--Dr. Morie Vandi, Medical Doctor-in-Charge
The diabetic clinic at Mercy UMC Hospital has made a profound difference since it opened in July 2024, saving lives, reducing complications, and building a support network for diabetic patients throughout Sierra Leone. Thanks to Insulin for Life USA, Helping Children Worldwide, and Misti Levya and her team's vision, they are offering free care and helping to rewrite the future of diabetes care in Sierra Leone.
​While Helping Children Worldwide has traditionally focused on maternal and child health, our partnership with Mercy Hospital has enabled us to support the strengthening of the broader health system. Mercy Hospital's decision to establish a diabetes clinic is a testament to their deep connection to the community, as they recognized the growing prevalence of diabetes among their patients. This initiative also highlights the strength of our partnership, as Mercy Hospital sought our support in developing this project. Importantly, however, this clinic represents their growing independence, demonstrating their ability to identify needs, develop solutions, and implement them on their own. We remain committed to supporting Mercy Hospital in their ongoing efforts to strengthen maternal and child health and the overall health system, while also celebrating their ability to pursue new opportunities independently. We are excited to witness their evolution and support their future endeavors.
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Introducing Dr. Morie Vandi, Mercy Hospital's Newest Physician

11/12/2024

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While Dr. Aruna Stevens is currently pursuing a degree in public health at Tulane University School of Public Health and Tropical Medicine in the United States, Mercy Hospital is pleased to welcome Dr. Morie Vandi as the interim physician. Dr. Vandi has already made a positive impression on the hospital staff and patients alike.

Dr. Vandi has a Bachelor of Medicine, Bachelor of Surgery degree from the University of Sierra Leone, a diploma in Tropical Medicine and Hygiene, and a Masters degree in Tropical Medicine and International Health from the London School of Hygiene and Tropical Medicine at the University of London.


​Although Dr. Stevens’ absence will be felt, we are excited to welcome Dr. Vandi to the Mercy Family. Dr. Vandi's arrival at Mercy Hospital brings a fresh perspective and a wealth of medical expertise. We are confident that his leadership will contribute to the hospital's continued success in providing compassionate and effective care. To learn more about Dr. Vandi and his approach to medicine, please read the interview below.
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Tell us a little bit about yourself, where you grew up, went to school, etc.
I grew up in Freetown, Sierra Leone where I developed a deep interest in healthcare early on. I went to the Sierra Leone Grammar School before pursuing my medical education at the College of Medicine and Allied Health Sciences, University of Sierra Leone, where I earned my primary medical qualification. 

What drew you to medicine as a career?
Growing up, my father was a nursing officer and my mother a pharmacy technician, which is where my interest in a healthcare career began. When I lost my father to a health condition while still in primary school, my commitment to becoming a medical doctor was solidified. I knew then that I had to do everything it took to help save lives.
Why did you choose to return to Sierra Leone after completing your education?
I chose to study Tropical Medicine and International Health because I was determined to make a meaningful impact in providing healthcare across the Global South. Growing up in Sierra Leone, the complexities of the healthcare system became increasingly evident, especially during my house job in public hospitals and my voluntary work in underserved communities. These experiences deepened my understanding of the challenges and further fueled my commitment to addressing them.
What are you most excited about in your new role?
I’m most excited about the opportunity to lead a team dedicated to improving healthcare in a resource-limited setting. I’m particularly eager to implement systems that will enhance patient care and streamline hospital operations. This role allows me to drive initiatives that will strengthen our clinical services and expand our maternity and child health services. It’s rewarding to be in a position where we can make a tangible difference in the lives of the people we serve and help strengthen the Sierra Leone health system as a whole.
What are your personal and professional goals for the next five years?
In the next five years, my personal and professional goals are focused on making a meaningful impact in both healthcare delivery and education. Professionally, I aim to strengthen Mercy UMC Hospital by expanding its capacity, improving patient outcomes, and enhancing the quality of care. I also plan to engage in research on health systems strengthening, and tropical medicine and to collaborate with global partners to address healthcare inequities.
On a personal level, I want to continue growing as a leader, leveraging my role as the Executive Director of Novel Health Initiative, Sierra Leone to promote medical education and wellbeing, while building stronger healthcare networks locally and internationally. Additionally, I aspire to pursue further studies and obtain advanced training in health care management, and Tropical Medicine which have been growing interests of mine, so I can contribute to policy changes that address the health challenges in Sierra Leone and beyond.
What challenges do you anticipate facing in your new role, given the remote location and potential limitations in resources?
Working in Freetown has its own set of challenges, but working in Bo, a more remote setting, presents even greater obstacles. Timely delivery and restocking of essential items like medications, laboratory reagents, and equipment can be difficult. Just recently, I prescribed Azelastine, an antihistamine eye drop, for a patient with an allergic eye condition, but he was mistakenly given Atropine, a steroid at one of the local pharmacies. His symptoms worsened, and thankfully, he returned to the hospital. However, many patients might not return and instead seek care elsewhere.
Another challenge we face is the limited availability of diagnostic tools and financial constraints. Low-income countries are undergoing a shift from infectious diseases to a higher burden of non-communicable diseases. I have already seen at least 10 cases of cardiovascular events in a month, including strokes and heart attacks. The entire region of Bo does not have a CT scan, and even if one were available, many patients would be unable to afford it, preventing them from receiving appropriate care.
Cultural beliefs also pose barriers to healthcare delivery. We do our best to communicate with patients and their families, but service provision is still heavily impacted by these factors. Despite our efforts, challenges remain in providing the level of care our patients need.
What health conditions are near and dear to your heart and why? How do you see yourself addressing these issues at your new role?
Malaria, respiratory infections, HIV, and TB are conditions that I am deeply familiar with, having received additional training in Tropical Medicine. These illnesses have a particularly devastating impact on women and children, and it brings me immense joy to see a child who arrives at the hospital lethargic but is up and running around the ward the very next day after treatment.
Diabetes is also a condition close to my heart, as I have family members affected by it. This personal connection drives me to spend extra time educating patients on the importance of controlling their blood sugar and managing their health proactively.

What are your long-term goals for improving healthcare access and quality in this region?
In the not-too-distant future, I see Mercy Hospital as the principal referral center of the southern region and beyond.  I envision expanding our bed capacity to accommodate a greater number of patients, ensuring that we can provide timely and effective care to those in need.
A key aspect of this vision is to offer all essential services in one location, making healthcare more accessible and affordable for our community. By streamlining services, we can enhance patient satisfaction and create a more efficient healthcare delivery system.
I also aim to position Mercy Hospital as a model that other healthcare facilities in the region can emulate. By showcasing best practices in patient care, resource management, and community engagement, I hope to inspire a collective movement toward improving healthcare standards across the southern region.


​With Dr. Maury Vandi at the helm, Mercy Hospital is well-equipped to continue providing high-quality care to the community. His dedication to patient well-being and his passion for medicine are evident in his work. We are fortunate to have him as part of our team.
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