I am in charge of the outreach program. I make sure the schedule is planned and adhered to when we go on outreach. I make sure the mobile clinic is set up and supervise volunteers and staff to make sure their units are functioning well and doing what they are supposed to do. At the end of the month I ensure all statistics are collated and submitted on time.
Why do I like my job? Ah! It is the passion! It’s really a passion. I like serving people. I like saving lives. I like encouraging people. When they are sick they are stressed and I like to make them feel better. I really like my job as a whole.
This job is very, very important. One, we are targeting vulnerable people, particularly the malnourished children. We have seen that the cases are many so we need to rehabilitate them and help them recover. Many of the protein rich foods are expensive here and families are too poor to afford them. We give them the pikinmix food and health talks to make sure they are helping their children grow. We also do a lot to prevent the malaria prevalence rate, which is so high here. HIV is another area where we can help. Many villages don’t have the facilities so we give them quality counseling and make sure they have access to their medication. Also the prenatal program helps so many people. We advise them to come to Mercy and not give birth at home and give them multivitamins that otherwise they would not get.
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.”
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.
The Child Rescue Centre and Mercy Hospital continue to find ways to partner together to provide care to people in the Bo community. This summer, they worked together to diagnose, treat and then place a deaf and mute child who’d been sleeping on the street. That child, Joseph Deen, now lives with his caregiver, the headmaster at the local deaf school, and is also enrolled in the school.
Recently, on a home visit to two children in the CRC Program (Kula Sesay Lassie and Paul Lassie), CRC Case Managers and Counselors, Rosa Saffa and Emmanuel Lamin realized that their grandmother, Kula Sesay, seemed quite ill. Kula shared that she had felt sick for over a year. Kula has been caring for her two grandchildren ever since their mother, Hannah, died during an epileptic seizure.
Rosa and Emmanuel encouraged Kula to go to Mercy Hospital for diagnosis and treatment. She worried at first about her lack of ability to pay for her treatment, but the CRC staff members were happy to share with her Mercy’s policy to provide care regardless of a patient’s ability to pay. Mercy’s Community Health Officer, Deborah Boima diagnosed Kula with tuberculosis, and provided her with medicines and monthly treatment at Mercy Hospital. Grateful, Kula said, “I am really excited with the support of CRC, my health is now satisfactory.”
In May of 2018, at a regular meeting conducted by the Ministry of Social Welfare and Gender Affairs (MSWGA), Director Mohamed Nabieu was alerted to the case of child in need. According to MSWGA, a 4-year-old boy had been discovered by the local police, hiding in one of the drainage ditches in Bo. He was brought immediately to the Ministry to try to trace his parents. However, this was complicated due to the fact that he was apparently deaf and mute, and therefore unable to communicate any information about his family or home. The Ministry put up signs and made radio announcements, but after several months, no one had come forward to claim him.
It was at that point that the Ministry shared the case with the child protection agencies attending the meeting. After discussing it, the CRC Director Nabieu, Mercy Hospital Administrator Jinnah Lahai and Lead Doctor Sao Amara agreed to take responsibility for the boy. He was brought to Mercy for a proper medical check-up, and the CRC was able to find him a safe and loving foster home with the principal of the local deaf school. The CRC has committed to continue providing for his educational, spiritual and counseling needs, while Mercy will take care of his medical needs.
Named Joseph Deen by his new foster family, he now lives with his foster father, the principal of the Ebert Kakua School for the Deaf, where he is also enrolled. He is learning sign language, and enjoys going to school with children like himself. According to his foster father, Joseph enjoys playing with the other children at school, playing with his toys and helping out with household chores. He enjoys going to his family’s farm and helping there as well. His father shares that Joseph’s happiest time of day is when it’s time to go to school.
23-year-old Baindu Dukullay was identified on an outreach to Flawahun village. She was pregnant with twins and found to have pregnancy induced hypertension. She was treated for the hypertension and referred to Mercy Hospital for future care. She successfully gave birth to two healthy twin girls at Mercy Hospital.
Baindu expressed, “I really appreciate Mercy for their help and keeping myself and my babies safe. They have really been taking good care of people in my village.”
First-time mother Fanta Kargbo, was only 18 years old when she enrolled in Mercy Hospital’s Prenatal Program at one of the outreach team’s trips to her village in Bandajuma in July. Ever since then, she has attended each monthly outreach to check the progress of her pregnancy, and was encouraged to give birth at Mercy when the time came.
She arrived at Mercy one morning in October, experiencing labor pains (which had been going on for some time). She was suffering from prolonged labor and finally gave birth to a healthy baby boy after 5 pm. According to the Mercy’s State Certified Midwife, Christiana Tommy, “it was not easy because she is a first time delivery. She was having trouble pushing and we had to encourage her. We thank God for her being at Mercy where we were able to provide her so much assistance. There were five of us helping her!”
When asked what the fate of Fanta and her baby would have been had she attempted to give birth in the village, the normally cheerful midwife became unusually solemn. “It would have been a problem because she was having difficulty pushing and she needed help. They would have forced her to push and that could have led to a fistula or even the death of the baby. We were able to encourage her, give her a catheter, and stitch up her tear so that she did not get fistula or any other problem.”
Christiana is referring to a basic lack of qualified personnel in the villages. While a village may have a Traditional Birth Attendant (TBA), this person is someone who likely has very little to no formal education (not even primary school), but has some basic training in childbirth, and can deliver under normal, uncomplicated circumstances. Many of the village clinics do not have midwives or TBAs, and may only be staffed by a nurse not necessarily trained in childbirth.
Fanta, clearly still exhausted the next day, was also very excited to welcome her new baby into the world. She could not stop smiling as she shared, “I am okay now, thanks to Mercy. I am so happy that my baby is safe."
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.