Life as a volunteer in Makeni

There is a great network of volunteers living in Makeni. There are people from all over the world doing work in various sectors. Most of us gather at a restaurant/bar or someone’s house for dinner/drinks every day. We frequent the Apex Hotel because it has a swimming pool, internet cafe, and the generator is always running (we can charge our electronics).
One of the cultural aspects that we all struggle with is the unrelenting attention that we get from the local people whenever we leave our houses. As a white person, you are constantly being yelled at (“opoto!” –white person) and greeted by everyone you meet along the street. The majority of people ask us for money or food, and many of them demand that we give them our personal articles (e.g., “Give me your hat. Give me your skirt.”) I actually miss the anonymity that we have in Canada. The people are very friendly and enjoy talking with us and they are very poor.
I climbed one of the small mountains surrounding Makeni and enjoyed the view of the city.
We hand wash our clothes and hang them to dry in our back yard.
We go to the market every day to buy fresh vegetables, fruit, rice, bread, spices, and eggs because we have no refrigeration. All of the daily activities, such as eating, bathing, and laundry are really time consuming and take up most of my time.
They make fresh ground nut (peanut) paste by grinding the nuts at the market.

Makeni Government Hospital

Photos:

1)The laundry room where the ladies wash the extremely limited linens.

2)The Kitchen where the ladies make tea for breakfast, bread for lunch, and rice for supper for the patients.

3)The operating room where they perform cesarean sections and "minor" surgeries.

4)The femal adult ward. The female ward has 9 beds and the male ward has 19 wards. They put mattresses on the floor if there are more patients. There is also a maternity ward, a paediatric ward, a HIV clinic, antenatall clinic, outpatient clinic, an eye clinic, and a tuberculosis clinic.

5)The only water pump that serves the hospital with the hospital shown in the background. The water must be carried to the wards in buckets.

Nursing and Makeni Government Hospital

The Makeni Government Hospital is unbelievable!! They basically have nothing. They don’t even have running water to wash their hands. The few registered nurses that are “employed” by the hospital actually have to volunteer for the first 2 years of their career because the government says it doesn’t have enough money to pay them! Some of these registered nurses don’t show up to work at the hospital because they work at other jobs (mostly with international NGO’s) where they can actually make money. There’s a Sierra Leone Nursing Board, which licences nurses, but there is absolutely no regulation or anyone to hold the nurses accountable!! The standards of nursing are nonexistent! The hospital I work in has no policies or protocols! The majority of the staff is health care aids who have had no training. They do the job of nurses because there aren’t enough trained nurses. The nursing aids pretty much do anything they want to, which is mostly nothing at all. The nurse manager strolls around the hospital and does nothing that she’s supposed to do. There is no documentation! The nurses/aids perform patient care without recording what has been completed. Many things that the doctor has ordered do not get transcribed properly, if at all, and many things are not carried out, or they are done far too slowly (sometimes a day or two later). The nursing aids are transcribing orders and administering medications without having any training.I am working with a wonderful nurse from England, Suzie. She has been here since May and has spent most of her time trying to fix the problems that exist due to lack of management.... absenteeism, stealing hospital supplies, scheduling, etc. She’s also developed and implemented various tools for the nurses and aids to use (eg. admission assessment form). She’s started doing teaching sessions on how to measure vital signs and other basic nursing care. Together, we are going to develop some nursing protocols for the hospital. We are also going to develop a number of practical nursing care teaching sessions and deliver them to the nurses and aids in the hospital. We really have our work cut out for us but I’m excited about the challenge!

My first day at the hospital

I'm going to be shadowing and observing all the the different departments of the hospital for the first few weeks of my time at the Makeni Government Hospital. The men who work in the lab were great and showed me how they do some of their tests. Currently, the lab is located in an open air verandha (shown in the photo) because the real lab is under repair. They had a table set up where the patient visits for collection of blood, or they deposit other samples (sputum, urine, stool). At the other end of the table, they process the samples for basic tests, such as hemoglobin level, malaria, HIV. They have a microscope to observe for parasites and ova. It was all very basic, but it was interesting to see how they get the results. I'm not sure how accurate all these tests are.
I also observed the area where they do all of the patients' dressing changes. They do not use pain medication (partly due to lack of resources and partly due to cultural beliefs that the patient must deal with the pain). I became very nauseous and broke down in tears after watching a couple of children screaming and a man who was writhing in pain during their dressing changes. I expected this to be really tough, but I'm really going to find it challeging to deal with the conditions and practices here!!

Creepy crawlies and unsitely skin

I’m still managing to stay healthy, but I understand that it’s only a matter of time before you get sick with something or other in Sierra Leone. The majority of volunteers have had malaria at least once and some have had typhoid, bronchitis, and other wonderful illnesses. The only thing I’ve encountered is a wicked heat rash (or what I hope is a heat rash) on my hips, elbows, and eye lids. The temperature here is usually around 35 Celsius, but it’s the beginning of the dry season and the temperatures are on their way up. When it gets to be 45 degrees, I’m going to look like a freak;-) I’m just happy that it’s not bed bugs, which are rampant here.
The cat continues to be a wonderful pest control expert but I had to contend with a monster spider in the bathroom today!! I’ve been told that they can be much bigger but I hope never to encounter one. It was at least 4 inches in diameter (including the legs). AHHHHH!!! I chased it around the bathroom with a can of insecticide, screaming the whole time;-)