Mercy Hospital is pleased to welcome Dr. Aruna Stevens to the staff. Aruna is an original alumnus of the Child Reintegration Centre residential program who was rescued from the Bo street as a small child in the wake of the Sierra Leone civil war. Aruna graduated from the University of Sierra Leone College of Medical and Allied Health Sciences and completed his housemanship (residency) at the University of Sierra Leone Teaching Hospital Complex.
"Today is a start of a childhood dream that I had to be a doctor to serve people, but specifically my people of Bo and its environs. I'm very humbled for this opportunity and grateful to Helping Children Worldwide, the Child Reintegration Centre, the United Methodist Church Sierra Leone Conference, and Mercy Hospital," Aruna says.
Cesarean section deliveries save lives
The busy Mercy staff continues to deliver babies, through normal deliveries and cesarean deliveries when necessary. Since the operating suite opened in 2018, the hospital has been able to provide life-saving emergency c-section procedures, saving the lives of mothers who are not able to deliver vaginally.
The need for cesarean sections can be aggravated by a range of issues such as delays in accessing the appropriate level of care, and transportation delays. Sierra Leone has one of the highest maternal mortality ratios in the world, with 11 mothers dying of pregnancy-related complications for every 1000 live born babies. The ability to perform c-section procedures at Mercy Hospital is a critical element of the global movement to reduce maternal mortality.
Simple hernia procedures save the lives of babies and toddlers
Two-year-old Saidu's family brought him to the hospital suffering from an inguinal hernia, a condition that Mercy sees very often, possibly due to premature birth. Untreated, inguinal hernia can lead to permanent intestinal damage.
Successful surgery was performed on Saidu to correct the hernia. His family couldn't afford to pay for the life-saving procedure for their son, and were grateful for Mercy's excellent care, which was provided for free.
Inguinal hernias look like a bulge or swelling in the groin or scrotum, and may be seen more easily when the baby cries. A hernia can develop in the first few months after a baby is born. It happens because of a weakness in the abdominal muscles. To correct the hernia, the surgeon puts the loop of intestine back into the abdominal area and stitches the muscles together.
The Mercy outreach team identified a toddler with inguinal hernia. Little Saidu was transported to Mercy Hospital where surgery was successfully performed by Lawrence Kargbo, surgical health officer, to correct the condition. Saidu made a full recovery under the care of Mercy staff and was released to his grateful mother.
About 3-5% of healthy, full-term babies may be born with an inguinal hernia and one third of infancy and childhood hernias appear in the first 6 months of life. In premature infants, the incidence of inguinal hernia is substantially increased, up to 30%. Children in Sierra Leone and other parts of the developing world may be more prone to conditions like inguinal hernia due to conditions that may be caused by inadequate maternal and infant care.
When Fatmata, age 22, came to her appointment at Mercy Hospital's prenatal clinic, she had a very high fever and was vomiting. Diagnosed with severe malaria, she was admitted and treated with anti-malarial injections. By the end of the day, Fatmata was much improved and was released from care.
Pregnant women are at high risk of dying from the complications of severe malaria. Malaria may also cause spontaneous abortion, premature delivery, or stillbirth, and is responsible for about one third of preventable low birth weight babies.
Shortly after being discharged, Fatmata returned to the hospital in labor and delivered a healthy baby girl. "I especially appreciate the maternity staff for their hard work," Fatmata said. The patient says she chose Mercy because she had attended the hospital's prenatal clinic for her previous pregnancies.
Mariatu, age 37, collapsed into unconsciousness and was brought to the hospital by her family, where she was diagnosed with severe anemia caused by malaria. She received a blood transfusion of two whole units and antimalarial drugs. Mariatu made a full recovery and was released. "Words cannot express how happy I am," Mariatu says. "I really appreciate the team work."
Sierra Leone has one of the highest rates of malaria infection in the world. The country's entire population is at risk of the disease and it is one of the leading causes of death and illness. Young children are particularly susceptible to infection, illness and death from malaria, which contributes to close to twenty percent of child mortality. The Ministry of Health and Sanitation has committed to reducing new cases of the disease up to 40 percent by 2020, which will require dedicated action from government, partners, health workers, and communities.
On Friday, January 18, Mercy Hospital officially opened the doors of its long-awaited Surgical Wing. The celebration included remarks from various dignitaries and Mercy leadership, a welcome song performed by Mercy staff, the Act of Dedication performed by Bishop Yambasu, an official ribbon-cutting and tour of the new surgical wing, and refreshments. Bishop John K. Yambasu, District Medical Officer Dr. Roland Carshon-Marsh, UMC Health Coordinator Catherine Norman, UMC Bo District Superintendent Reverend Francis Charley, Chairman of the UMC Health Board Dr. Dennis Marke, and HCW Executive Director Melody Curtiss each shared remarks at the ceremony.
Reverend Charley opened the ceremony with prayer, stating that “this hospital is a state of the art hospital and is going to provide facilities and treatment for patients in the country and even beyond.” Bishop Yambasu shared that this day is the result of “the passion, dedication and commitment of our friends from the United States. Helping Children Worldwide has been involved in our work with the Child Rescue Centre and Mercy Hospital for more than 20 years.” Catherine Norman reflected on Mercy's history, saying “almost 13 years ago, a one-room health clinic with two health staff was established to provide first aid, nutrition and basic health care to the children of the CRC. In 2007, the building in front of us was transformed into Mercy Hospital. I am glad that today, the dream of a functional surgical building has come true. With this building, Mercy Hospital has now been empowered to provide quality care not only to the Bo, but the entire district, and even beyond.”
The Bishop performed the official Act of Dedication, asking God to “graciously accept this building which we now dedicate to thee, to thy service, and to thy glory, that in it skill and tenderness may unite to bring health and cure to those who come for aid…. Grant that those who come here in weakness may be made strong, that those who come in pain may find relief, and that those who come in sorrow may find joy and gladness.”
On behalf of HCW, Mrs. Curtiss recognized the contributions of all of its donors, particularly the large bequests of Ebenezer United Methodist Church in Stafford, VA, without whose generosity the wing would not have been built, and the Peterson Family Foundation, who sponsored the shipment of surgical supplies and equipment necessary for an operating theatre. Mrs. Curtiss also recognized the special contributions of Mercy Laboratory Technician, Joseph Lamin, who is heading up the launch of Mercy Hospital’s new Electronic Medical Information System (see story at bottom of newsletter).
Mercy’s surgical wing includes two operating theatres, a recovery room, decontamination room, sterilzation room, male and female changing rooms, medical supplies storage, reception and doctors’ consultation rooms. Second floor includes a private and semi-private wards, male and female wards, conference room and ICU. Mercy’s surgical program will operate on a limited capacity, as they await the arrival of a blood bank. Until this important piece of equipment arrives, Mercy will continue to provide the surgeries that it always has, now in a new, state-of-the-art surgical facility. Dr. Amara continues to work with Dr. Boima (a COMAHS professor and surgeon) to assist in surgeries beyond his current level of expertise, and now that those surgeries can be performed at Mercy, other staff will benefit in training opportunities as well.
Qualified surgeons who wish to perform surgeries at Mercy with Dr. Amara’s assistance, will be welcomed for the purpose of providing Mercy staff with teaching opportunities. This will include medical teams from overseas from time to time. Nonprofits utilizing Mercy OR for their own medical missions will do trainings as part of the privilege of performing surgeries at Mercy, and leave behind unused equipment and supplies for future use by Mercy.
Project CURE is scheduled to provide training in obstetrics and critical care to Mercy staff this year, and Dr. Amara and Matron August Kpanebaum will be attending GBGM training in obstetrics and Cesarean-sections in February-March.
Lead contractor, Maada Salia handed the keys to Mercy Hospital’s new OR wing over to the staff on Monday, November 5th. Over the weekend of November 1st, the Mercy staff worked tirelessly to load in the equipment and supplies delivered in September by Project CURE, and ensured that the wing was ready for operations. Dr. Boima, a well-known surgeon in Sierra Leone and Dr. Amara’s mentor declared the wing and its two operating theatres “excellent” and “the nicest in Bo.” “I am very happy that the OR is now completed which means that the referral cases for surgery such as obstructed delivery and c-sections will now be treated here, “ said Dr. Amara, Mercy’s chief medical officer. “Before, the space was so limited we were very restricted in what we were able to do. Now, there are many more possibilities to help the community.” Head Matron Sister Augusta Kpanebaum agreed, “We have been waiting for this day a long time. We will be able to attend to cases instead of referring, especially maternity. We are so ready to go and want to thank our partners for the initiative. We are all very grateful!"
On Thursday, November 8, the first surgeries to be performed in the new OR were done by doctors affiliated with the Praise Foundation team in conjunction with trainings they are providing to Mercy staff in critical care management, obstetrics, and ultrasound. Like all medical professionals working at Mercy, PRAISE Foundation staff were required to provide medical credentials information to the Medical and Dental Counsel prior to performing surgeries at Mercy. Over the course of the first two days of operations in the new OR wing, 56 surgeries were performed by the Praise Foundation team with assistance from the Mercy staff, most of these were hernia operations and other minor surgical procedures.
Mercy will operate through the end of 2018 on a limited capacity, as they await the arrival of a blood bank and an anesthesia machine later this year. Until these important pieces of equipment arrive, Mercy will not be able to perform major surgeries, but will continue to provide the surgeries that it always has, now in a new, state-of-the-art surgical facility. Likewise, Mercy staff does not yet have the expertise to perform more complex surgeries such as c-sections. Dr. Amara will continue to work with Dr. Boima (a COMAHS professor and surgeon) to assist in surgeries beyond his current level of expertise, and now that those surgeries can be performed at Mercy, other staff will benefit in training opportunities as well.
Qualified surgeons who wish to perform surgeries at Mercy with Dr. Amara’s assistance, will be welcomed for the purpose of providing Mercy staff with teaching opportunities. This will include medical teams from overseas from time to time. Nonprofits utilizing Mercy OR for their own medical missions will do trainings as part of the privilege of performing surgeries at Mercy, and leave behind unused equipment and supplies for future use by Mercy. The PRAISE team has already demonstrated the value of simply having the facility with the collaborative spirit of Mercy Hospital available in their community.
Additional training for Mercy staff is also being planned. Project CURE is scheduled to provide training in obstetrics and critical care, and Dr. Amara and Matron August Kpanebaum will be attending GBGM training in obstetrics and Cesarean-sections in February of 2019. The official ribbon-cutting ceremony will take place on January 18, 2019.
Though progress on construction came to a halt during the recent presidential elections in Sierra Leone, the finishing touches are at last being completed on the expansion at Mercy Hospital.
The electrical wiring and three air conditioners have been installed. These units are a critical part of keeping patients and doctors comfortable and safe during surgical procedures. The remaining items to be completed are primarily cosmetic; finishing the ceilings, installing light fixtures, covering pipes, installing doors for the operating rooms, finishing the ramp, and completing the waiting area.
Additional facility issues at Mercy have also been addressed. One of the things Mercy has wanted to do for a long time is to better ensure the security of the compound. Mercy was able to use some savings to build a wall behind the hospital, extending from the Child Rescue Centre on one side, to the old wall that surrounds UMC Urban Centre on the other to create a U shape. The new wall will limit the number of people who use Mercy’s grounds as a pass through, and help the hospital secures its own and patients’ property. It will also strengthen disease control by allowing staff to monitor people entering the compound, and ensuring everyone washes their hands as they pass through the guard station. If a contagious disease breaks out, Mercy will be in a much stronger position to contain infection and protect patients and staff.
New fencing was also installed around the ash pits and garbage container, to ensure proper containment of hazardous materials.
Mercy Hospital's new Chief Medical Officer Dr. Sao Amara, is settling in well at the hospital. Dr. Amara enjoys working closely with the staff, and is excited about the operating room. He is currently hard at work developing a list of equipment needed to get the OR up and running.
Dr. Amara has training and expertise in surgery, and is particularly interested in maternal health and surgery. These skills are especially critical for the hospital's expansion to include an operating theater.
Dr. Amara's interest in maternal and child health is what initially drew him to Mercy, so he is excited to be working with the prenatal and nutrition programs, and plans to go on outreach after the elections. Recently, Dr. Amara co-led a staff training on pregnancy-induced hypertension with Matron Augusta Kpanabaum.
Dr. Amara received a Bachelor of Medicine and Surgery from the College of Medicine and Health Sciences in 2014, and is awaiting the results of his Masters of Public Health from Njala University. Dr. Amara should feel right at home at Mercy, having graduated from the Bo Government Senior Secondary School.
Dr. Sao K. Amara, Mercy’s new doctor and surgeon, and Matron Augusta recently engaged the Mercy maternity staff and Chief Health Officers on strategies for dealing with prolonged labor.
As they await the completion and equipping of the new wing and operating suite, the Mercy Hospital staff is focused on building staff skills that will help prepare the entire team to work together. Through regular on-site workshops and telemedicine, the staff continues to build their skills and knowledge.