Saturday, January 12, five Mercy staff attended the "Helping Babies Breathe" training held in the Great Hall at the CRC. The training, arranged by Carol Nelson of Rural Health Initiative was led by neonatologist Dr. Sulaiman Sannoh. Dr. Sannoh, a native of Bo, is currently working in New Jersey.
Helping Babies Breathe teaches the initial steps of neonatal resuscitation to be accomplished within the first few moments after birth. The practice saves lives and gives a much better start to many babies who struggle to breathe at birth. The HBB curriculum was designed to specifically meet the needs of resource limited environments. HBB neonatal resuscitation techniques that have been shown to reduce neonatal mortality by up to 47% and fresh stillbirths by 24%.
Mercy's lead midwife, Hawa Koroma, found the training highly effective. "We were taught how to help babies breathe in case you deliver a baby that has a heartbeat, but is not breathing. We were able to practice using a NeoNatalie newborn simulator, which was very much like a real newborn. Mercy was able to keep three of these simulators as well as a wide variety of face masks and supplies we did not have in the maternity unit. Most of us had learned these techniques, but this was good practice, and we love having the new equipment."
On Friday, January 18, Mercy Hospital officially launched its Electronic Medical Information System (EMIS) - a database which will enable the hospital to use electronic medical records to track patient data. The first electronic records management system in the country, the database will have a positive impact on patient care as it will be much easier to access a patient's history and chart. Hospital Administrator, Jinnah Lahai, is thrilled about this new addition to Mercy. “It has added more value to Mercy in comparison to other facilities. It will lead to greater transparency and data security."
Joseph Lamin and the Mercy Laboratory team, has led the effort in creating the software that will be used. District Medical Officer, Dr. Roland Carshon-Marsh, is working closely with Mercy to supervise compliance with standards for medical records management and confidentiality. While paper will no longer be used for data entry, communication, or analysis, every electronic medical records system maintains redundant electronic and paper record back up copies - and Mercy's EMIS is no exception.
Once the electronic information system is fully operational, all units of the hospital will contribute to it, enabling all patient information to be stored electronically. The EMIS also tracks drug and supply inventory and staff shift time logs. EMIS produces valid research data on diagnosis as well as effective interventions and treatments. Under the current system, patients are tracked by a patient number, but if they forget or lose that number, the staff is forced to either sort through thousands of patient cards or start a new chart. Starting a new chart is easier, but it means the loss of all patient history that preceded it. The new system will make communication between units instantaneous which will mean that patients are able to receive input on their care from a variety of Mercy staff in real time.
Registration of patients will include fingerprint identification as an element to permit accurately matching patient charts with medical histories. Sierra Leone has a high rate of illiteracy and poor records in villages. Patients often do not know how to spell their names or have current address information or know their date of birth. Paper records often become damaged and unreadable or lost. Fingerprint identification mitigates against all of these challenges.
Creating reports based on the data will be much easier and more accurate. The database will greatly reduce the chances of error and leave more time for analyzing data and refining programs instead of painstakingly gathering numbers. Data will also be collected from the outreach programs, which will help Mercy identify trends in who is seeking care at Mercy or its outreach, what are the most concerning diseases, and how programs can be altered to best suit the needs of the community.
Lamin projects that the Mercy staff will be comfortable using the system within two weeks of its mid-January launch, and adept by week six. Mercy Dr. Sao Amara, is looking forward to the system becoming fully operational, “it will help with tracking patients, increase financial accountability, reduce patient wait times, assure patient confidentiality and and allow staff to be informed about patient status quickly.”
Henry Kebbie works at the Child Rescue Centre (CRC) as the Assistant Coordinator for the Sponsor A Child Program. Henry is also responsible for a caseload of 70 children supported by the CRC’s programs. Engaged to be married soon, Henry is the proud papa of a young daughter. Henry’s story is unique in that he was a child supported by the CRC’s Child Support Program, which provided health and education support from primary through secondary school. After graduation, he applied for and won a Promise Scholarship which enabled him to attend university. Graduating with honors, Henry holds a Bachelor of Science in Social Work from Njala University.
Henry credits his being a CRC student with his path toward becoming a social worker. “It has always been my desire to be a social worker so that I could return to work with an organization like the CRC which is working to save helpless families and especially destitute children,” Henry says. Henry applies the lessons he’s learned to his work with the children on his caseload. “I always encourage them to take their studies very seriously, as I did,” he says. “I went through the same program at the CRC, and now I am working for the CRC. I believe it is important that children are educated and grow up to be a good example for others, just like I am.”
Henry Kebbie was drawn to social work out of a desire to help people - particularly those who are vulnerable. At the Child Rescue Centre (CRC), Henry found an opportunity to help the most vulnerable children and their families. He was deeply interested in community development and wanted to engage in work that would have a deep, lasting and positive impact. Being a case manager for vulnerable children and their families helps him see that impact every day. Henry finds the work at CRC particularly rewarding because of the CRC’s vision and focus to give something positive to the community of Bo.
Henry’s deepest hopes for the children on his caseload are that they all do well in school and find a bright future, and that they all know how deeply they are blessed by God.
Written by Dr. Laura Horvath, Helping Children Worldwide Program Development Specialist
In August, newly-elected Sierra Leone President Julius Maada Bio announced the launch of the Free Quality Education Programme (FQEP) for 1.6 million primary and secondary children across Sierra Leone, with an increased budget allocation of 21% of the National Budget in August of this year, up from 12.5% in 2016. The first phase of the program went into effect on September 17th, and President Bio has said that the program will take five years to fully implement, though the government has committed to funding this program for at least 10 years. An FQEP Coordinator shared with Sierra Leone News that the government has paid tuition subsidies to over 4,000 schools amounting to 28 million leones.
There are three types of schools in Sierra Leone, private, government, and government-supported. All schools in Sierra Leone require that students pay tuition and various school fees. These can include fees for furniture, classroom materials, extra classes, and other supports the school needs to function. Additionally, families must cover the cost of required uniforms, textbooks and all other learning materials. The first phase of the FQEP provides only tuition, a few exercise books (composition notebooks), pens and pencils; and this only applies to schools that are either government or government-assisted schools. Even these schools must apply to receive FQEP benefits, and some schools are still awaiting government approval. Some of the CRC students are enrolled in schools to which the program does not apply, but these students will be transferred to schools that do in the fall of 2019. Kindergarten is not covered by the program, nor are private schools, so the CRC is bearing the tuition costs for these students. Government-supplied exercise books and other necessary learning materials are also in limited supply, so once these supplies run out, the remainder must be provided for by the parents (or in our case, the CRC).
The rollout of the plan has not been without its challenges. The promise of tuition-free education has caused enrollment to skyrocket, and many schools have been forced to turn students away for lack of space. Teachers in Sierra Leone sometimes go without a paycheck at all for months at a time; new teachers may not show up on the government rosters for up to two years - and cannot be paid until they do. Although the plan stipulates an increase in teachers and teacher pay, it has not been clear about how or when this will be addressed, or how schools are to manage increased enrollments and higher student/teacher ratios, and according to the Sierra Leone News, teachers report no change in their pay.
“The government is collecting millions of dollars for this program from donors, but we, the teachers don’t see any extra,” one teacher shared with Sierra Leone News. Parents report being asked to pay additional fees to support teachers whose names are not yet on the government payroll (since the government does not pay teachers until they are officially on the payroll, and this can take up to two years). “Some schools are not yet phased in,” says CRC Director, Mohamed Nabieu. “It’s also important to understand that ‘Free Education’ is not universal. There are many villages that don’t even have a school.” The CRC staff reports that the increases in class sizes have led to the addition of new fees as well. Some of the schools attended by CRC students are now asking for “furniture fees,” to help to cover the cost of desks for newly enrolled students.
An additional wrinkle has developed that directly impacts UMC schools, even those that are government-supported. “Not all schools apply,” explains Mohamed Nabieu, “and it’s not clear which schools apply and which do not.” For example, according to the United Methodist News, “while the new UMC school in Kabala awaited government approval and funding, all but 12 students transferred to government approved schools so their parents would not have to pay fees for administrative costs.” Bishop Yambasu acted quickly and was able to provide funding to cover these fees for the Kabala school, but it seems that many religious schools, even those that are government-supported, have not yet been approved for the program, and may not be.
In related news, on November 28, US Ambassador to Sierra Leone Maria Brewer spoke at the launch of the McGovern-Dole International Food for Education School Lunch Project in Kabala. In partnership with USDA and Catholic Relief Services, this project seeks to aid the government of Sierra Leone in scaling up a national school lunch Program. The project will invest $25 million to expand the provision of daily school meals to nearly 70,000 children, as well as support improved school infrastructure, training and literacy over a period of four years (Sierra Leone has a total of 1,600,000 students currently enrolled in primary and secondary education). The package will include capacity building of teachers, rehabilitation of primary schools, construction of water wells and boreholes. This program is focused on areas in the northern part of the country.
While having the government provide free tuition to approved schools is extremely helpful, it doesn’t cover all the education-related costs associated with school. In addition to providing tuition for CRC students in non-approved schools and those enrolled in kindergarten, the CRC continues to provide school uniforms, textbooks, learning materials and all school fees for all of the students in the program. The CRC also provides others kinds of educational support to students in the programs, including tutoring, exam prep classes, life skills and other types of training, computer classes and workshops, career and guidance counseling. Parenting classes and workshops are also provided to parents of students in CRC programs, and extremely vulnerable families are encouraged to enroll in the CRC’s microfinance program for basic economic and budget training and the opportunity to receive a microloan to launch or improve a small business. Case Managers and Counselors provide ongoing support to students as well through home and school visits, and both individual and family counseling opportunities.