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.

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.

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.

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.

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.

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.

​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.

Every year since 2019, Helping Children Worldwide staff, supporters and Board members have attended Christian Alliance for Orphans' Annual Summit.  This international conference draws thought leaders in the subjects of child welfare and child protection from all over the world.  This year, HCW's team was joined by two leaders from the Child Reintegration Centre: David Titus Musa, Senior Consultant for the Transition Coaching and Mentoring Department, and George Kulanda, Case Management Supervisor.  In the US for the first time, these expert practitioners not only attended Summit, they presented, taking their place as global thought leaders on stage at a conference that drew more than 2500 participants from hundreds of countries around the world.

As the Global North partner of a 25 year partnership, it was thrilling for me to see our CRC partners take center stage to share their experience and expertise, and be seen, recognized and sought out for the experts and thought leaders they are.  One major take-away for me was the conviction that our Global South partners need these opportunities to participate in events like CAFO and HCW's own Rising Tides conferences a lot more frequently.  I could say a lot about my thoughts on this - but one thing we're learning at HCW is that it is past time for our local, Global South partners to take the lead.  Here are THEIR thoughts on their first CAFO Summit experience.
-Laura Horvath, Director of Programs and Global Engagement, HCW

David:  Attending CAFO Summit for the first time will always be an unforgettable experience to me as an individual because it’s the largest gathering of professionals I’ve ever attended and I was excited to realize that my expertise was equal to most of the people I came across in our work to transform the lives of vulnerable children. I learnt a lot and I was inspired; the impact was powerful. I realized that the size of your country, geographical location and wealth does not determine your seat at CAFO, but your role as a practitioner and experience brings you honor. I say this because I found myself in two different workshops where there was a mix of a few different nations by introduction, and in my opinion prior to coming to Summit - Sierra Leone was the least of these looking at it from a different perspective. But during the discussion, as I shared my experience on the transition and family reunification model, I realized that I and the CRC have a lot to offer. As a result, many people later pulled me aside to have personal conversations and engage with me further.   At CAFO, everyone is valued and has a seat at the table.

George:  The most surprising thing about CAFO  was being among a multitude of practitioners from across the globe  attending Summit in order to share and receive knowledge and resources with each other.  It shows how committed people are to what they value related to the work  and services they provide for vulnerable children and families in their respective areas.

David:  One thing that was surprising about CAFO, was witnessing such a large number of professionals and leaders coming together from different parts of the world to focus on the mission of caring for vulnerable children [This year, CAFO reported the highest attendance in its 20 year history]. I was just thinking that most people just look out for opportunities to travel and mingle at conferences like this, until I saw how engaged many people were in those CAFO workshops. I was also shocked to witness the deep sense of unity among individuals and organizations with different approaches to caring for children. Although each organization operates in their own specific area of interest, at CAFO the atmosphere was filled with collaboration and shared purpose.

George:  Presenting at CAFO felt like a significant step in taking the global center stage to represent the CRC and Sierra Leone [one of these presentations included 200 in person participants and 1000+ participating virtually from all around the world].  For me, it was a privilege and signified a level of trust and responsibility demonstrated to us by our partners so we could showcase how our work can impact others in the social work space especially in providing services for vulnerable families and children. Personally I felt this was a huge achievement for the work I do and how I can improve on that. 

David:  Presenting at CAFO felt like being part of something much larger than me but it reaffirmed my potential to grow in the field of care transition. I can’t even assume the level of experts that were in the room in our Localization and Mutuality workshop. But sharing my practical experience with cross-cultural partnership in front of them was both humbling and energizing. I am quite sure our stories and insights would help shape the partnership structure of those Global South and  and Global North partners present.

George:  One important/valuable thing learned from CAFO is that we are connected to other practitioners in child welfare and best practices all over the world.  .Another thing I realized is that we (CRC) may not have realized it, but we are on the right track in the work we do to reunify families and strengthen them.  It was good to share knowledge and resources with others.  

David:  From the sessions I attended, I understand that orphanages and temporary care still have a place in most countries, but the most valuable thing I learned is the importance of holistic, family-based care, and much emphasis was laid on the long-term well-being of children in these sessions, that is to grow in a safe, loving and family environments.  We learned a lot, but we also have a lot to teach others in this work.

David:  The biggest takeaways I got from attending and presenting at CAFO:

• The power of collaboration to improve the lives of vulnerable children. Seeing various organizations unite under a shared mission reaffirmed the importance of partnership.
• The critical role of Christians in providing long-term solutions for vulnerable children.
• An emphasis on strengthening families, both preventing children from entering institutional care and supporting reintegration into family-based settings, was a key conversation among participants.

George:  My biggest takeaway from CAFO is that there is still room to learn and share more knowledge.  I'm encouraged that there is possibility of having a global coalition of social work for best practice - this may take some time.

David:  I wish our donors and supporters knew that our ability to attend CAFO was more than just an event, it was a chance to gain more experience and understanding of global best practices in child welfare. Sharing a room with other practitioners to discuss one agenda item, “Improving the lives of children and families” is a very big deal and was incredibly motivating.

George:  The Importance of attending global events in person like CAFO can create and nurture meaningful connections and build on each others potential as practitioners in the global north and south, it as well contributes to our personal growth and development in social work practice on our side especially my country and the families we serve. 

David:  Being able to attend and present at CAFO was really important because it reaffirmed that we are not alone in this work. It reinforced my commitment to the work and it provided practical tools we can use to improve our work.
 This will impact our day-to-day efforts by helping us integrate some of the best practices for supporting families, reintegrating children, and preventing family separation in the first place. The knowledge we gained at CAFO will be shared with the clients and organizations we work with, and we expect it to further shape the way they think as well and reconsider a sustainable model of care for the vulnerable children we all serve.