After serving as the Child Rescue Centre Director for more than two years, Mohamed Nabieu couldn’t leave the CRC and Sierra Leone without a very unique farewell. He took the opportunity to take the hardworking staff on a well-earned holiday but also ensured that the time spent away would continue to build the skills and capacity of the team by including time to continue refining their leadership skills. The event lasted for two days in February at Kent Beach.
Mrs. Olivia Fonnie, the Director of Christian Education\Specialized Ministry to Children, was on hand to present on the topic “Work Ethics,” explaining the importance of workplace ethics and providing examples. Fonnie also spoke about ways to demonstrate a strong work ethic, and discussed examples of ethics violations in the workplace. The presentation was followed by a highly interactive discussion among the staff.
Mohamed Nabieu’s presentations based on Patrick Lencioni’s work were on the five dysfunctions of a team,and the four disciplines of a healthy organization. Nabieu shared the dysfunctional interactions that can make an organization inefficient and ineffective, and urged the staff to embrace the four disciplines of healthy organizations instead. Staff were encouraged to continue to develop their skills in working cohesively, maintaining organizational clarity, communicating and even over-communicating, and reinforcing clarity through human systems.
The presentations shared by Mrs. Fonnie and Mr. Nabieu are built on an ongoing practice of weekly leadership discussions where staff read and reflect on various leadership materials in order to continue to be an organization of excellence.
Mercy Hospital’s Dr. Sao Amara, and Sister August Kpanabaum completed training in surgical obstetric training; specifically cesarean section, in the Phillipines. Sister Kpanabaum shared that they learned from several different lecturers covering a range of skills and topics related to obstetrics and maternity surgeries. Along with lecture and classroom time, Dr. Amara and Sr. Augusta were able to engage in hands-on training including practicals on various incision techniques, sterilization of instruments and the maintenance of a sterile theater and surgical field. Four students in the course came from Sierra Leone, 1 from Urban Centre Freetown, one from Rotifunk hospital, and two from Mercy Hospital. Other students in the course hailed from Zimbabwe, Nigeria, Liberia.
To read more about the training, check out this article from UMC Mission!
Mercy received a blood bank on April 19, but is still in need of a solar system to ensure that the surgical ward, blood bank and Electronic Medical Information System has 24 hour power. Please contact firstname.lastname@example.org if you can help.
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."
The CRC welcomed all of the children in its program to their annual Sponsor-A-Child Christmas parties on December 20 and 21st. This included the 20 children from Fengehun Village. CRC case managers also visited Pujehun village to bring gifts and a small celebration to the CRC students there.
Each student was presented with an inflatable solar light, a wristband and some toiletries. Students also enjoyed food and drinks, and a nativity play performed by students in the CRC program. HCW Missioner, Chris Davis was able to attend one of these parties and offer his services in assisting with the party.
For the first time, parents were encouraged to attend and assist with serving food and drink. The staff entertained parents and their CRC students with a skit designed to teach them how to form stronger attachments with each other.
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.
Ministry of Social Welfare and Gender Affairs praises CRC for their contributions in nation building
The Sierra Leone Ministry of Social Welfare and Gender Affairs (MSWGA) is the government agency in charge of ensuring that vulnerable children and people are cared for appropriately. As a child welfare organization, the Child Rescue Centre participates in monthly meetings held by the MSWGA. These meetings allow MSWGA representatives and the leaders of various organizations involved in the care of vulnerable children like the CRC, Joshua Child Care, and SOS Children’s Home to share information, best practices, and to receive updates.
At a regular meeting held in October, the MSWGA commended the CRC for the work it has done in the areas of child protection, education, health, child safety, final reunification of children in the residential program, and the microfinance program.
“The Child Rescue Centre has been very proactive in addressing child welfare issues in the Bo District,” says Michael James, Senior Social Service Officer in Charge of Trafficking. James shared that the Ministry considers the CRC an exemplary child welfare program, particularly in the fairness and lack of bias of its intake practices. He particularly cited the case of Joseph Deen, a deaf child that the CRC and Mercy stepped in to help, reflecting that the CRC does not discriminate against any child in need regardless of circumstance.
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.
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."