Welbodi Partnership

Freetown Vacancy Announcement: Project Officer

2012-01-21T02:10:00.000-08:00

The Welbodi Partnership will notaccept CVs and cover letters for this position. Please complete anAPPLICATION FORM, otherwise your application will not be considered. Theapplication form can be collected from the Welbodi office at Ola During Children’sHospital during weekday office hours (8.30am-4.30pm), alternatively pleaseemail jobs@welbodipartnership.org to request an application form.

The Welbodi Partnershipactively encourages applications from qualified Sierra Leoneans at home or inthe Diaspora.

FREETOWN VACANCY ANNOUNCEMENT: Project Officer for Welbodi Partnership

Location: Ola During Children’s Hospital, Fourah Bay Road, Freetown, Sierra Leone.

Assignment Length: one year, with possibility to extend.

Salary and Benefits: annual gross salary of up to US$9,000 depending onqualifications and experience.

Reports to: Welbodi Partnership Project Manager.

Application Deadline: 5pm, Friday 3rd February 2012.

Interested candidates shouldplease complete and email or hand-deliver the Welbodi PartnershipApplication Form to: The Project Manager, Welbodi Partnership, OlaDuring Children’s Hospital, Fourah Bay Road, Freetown, Sierra Leone. Email:jobs@welbodipartnership.org

The Welbodi Partnership is aUK-registered charity working with the Ministry of Health and Sanitation, theOla During Children’s Hospital (ODCH) management and other stakeholders tofund, implement and evaluate locally-conceived projects through the SierraLeone Institute of Child Health (SLICH). It forms part of the Government ofSierra Leone’s Strategic Plan for Reproductive and Child Health.

This is an excellent opportunityfor someone who is passionate about improving child healthcare in Sierra Leone.The position offers the opportunity to build skills and work towards assumingprimary project management and monitoring and evaluation responsibilities.

The Welbodi Partnershipactively encourages applications from qualified Sierra Leoneans at home or inthe Diaspora.

SLICH is supported by a grantfrom the Comic Relief Common Ground Initiative. To learn more about us, pleasevisit our website at www.welbodipartnership.org.

Responsibilities The Project Officer works closely with the ProjectManager to ensure that the project objectives and outcomes are monitored, evaluatedand met. This role includes:

1. Working with the Projectmanager to assist ODCH and other hospital stakeholders to develop,submit for funding and approval through SLICH, and implement projects toimprove the quality of care in the hospital.

2. Working with the Projectmanager to develop and implement a system to enable parents and communitymembers to develop and submit their own ideas for improving the quality ofcare at ODCH.

3. Working with the Projectmanager to design and implement the monitoring, evaluation and learning componentsof the project in line with the grant agreement, including sharing informationand lessons learnt with our partners.

4. Working with the Projectmanager to prepare high quality project and financial reports in atimely fashion.

5. Establishing and maintainingclose working relationships with our partners at ODCH, in the Ministryof Health and Sanitation and others to ensure their appropriate involvement andbuy in throughout

6. Maintaining a positiveoutlook at work and working productively in a pressurized environment.

7. Other duties necessary forthe success of the project and of the Welbodi Partnership.

Required Qualifications,Experience and Skills

Bachelor’s degree strongly preferred but other qualifications (such asCommunity Health Officer) with appropriate experience will be considered.

Commitment to the goals and principles of the Welbodi Partnership (please seethe website for details of these: www.welbodipartnership.org)

Training and experience in monitoring and evaluation.

Excellent people skills and a demonstrated ability to work collaboratively withpeople from diverse backgrounds.

Ability to work with flexibility, patience and problem solving skills with afocus, and the presence of mind, to work in sometimes difficult and chaoticcircumstances.

Excellent written and oral English communication skills and interpersonalskills.

Fluent in Krio.

 Excellent computer skillsparticularly in Microsoft Word and Excel.

Preferred Qualifications,Experience and Skills

Professional experience of healthcare and/or development work.

Experience in project management.

Experience in basic financial management.

 Experiencein conducting focus group discussions, carrying out surveys/questionnaires incommunities and presentation of results.

 Fluency in local languages.

PLEASE NOTE: The Welbodi Partnership will notaccept CVs and cover letters for this position. Please complete anAPPLICATION FORM, otherwise your application will not be considered. Theapplication form can be collected from the Welbodi office at Ola During Children’sHospital during weekday office hours (8.30am-4.30pm), alternatively pleaseemail jobs@welbodipartnership.org to request an application form.

The Welbodi Partnershipactively encourages applications from qualified Sierra Leoneans at home or inthe Diaspora.

Season's Greetings

2011-12-22T15:32:00.000-08:00

From everyone at the Welbodi Partnership, Happy Holidays!

Photo credit: Brian Sokol

Voluntary Positions Available for Consultant Paediatricians

2011-12-20T02:31:00.000-08:00

Location: Freetown, Sierra Leone
Assignment Length: Minimum 3 months
Starting Date: To run consecutively from April 2012

As a Consultant Paediatrician with Welbodi Partnership, you would have a direct and significant impact on the quality of care provided to extremely disadvantaged children. You would play a key role in the development of Sierra Leone’s under graduate and postgraduate paediatric training programmes, producing the country’s future leaders in child health.

Job Description

The consultant paediatrician will champion the development of paediatric services, in Ola During Children’s Hospital (ODCH), Sierra Leone’s only specialist paediatric facility. In conjunction with the lead consultant for paediatric training, they will assist in the recently established postgraduate paediatric training programme and in the training of medical undergraduates.

Consultants will have general paediatric clinical commitments, during which there will be opportunities for teaching all cadres of health professionals and students and developing clinical services. They will be expected to contribute their expertise and support in the existing academic programmes.

The assignment will require a minimum of 3 months of clinical work in Sierra Leone. We would welcome applications from those who are able to commit for longer than 3 months.

Responsibilities

The Consultant will be required to fulfil the role of sub-specialist consultant as stipulated by the West African College of Physicians (WACP) for the training of paediatric residents to take their WACP Membership exams, namely:

1. Assist the lead consultant for paediatric training in facilitating postgraduate training by offering educational support to the hospital registrars and active participation in the postgraduate academic teaching programme.

2. Provide general inpatient and outpatient paediatric care. Engage in direct clinical work at a consultant level, running ward rounds and outpatient clinics. To receive referrals relevant to their area of sub-speciality from colleagues within the hospital. Out-of-hours commitments will be limited to telephone advice.

Individual workplans will be determined on appointment, in discussion with Welbodi Partnership and the hospital management team, to include some or all of the following:

3. Additional academic activities: Delivering teaching to doctors, nurses and students at the hospital and involvement with relevant national academic programmes at the College of Medicine and Allied Health Sciences (COMAHS). Conduct and supervise research and audit as appropriate.

4. Clinical service development. Take joint responsibility with ODCH management and staff for implementing medical project work to improve patient care. This could include the development of sub-specialist paediatric services by running specialty clinics, advising on the appropriate equipping of hospital facilities and improving clinical care pathways relevant to their sub-specialty.

5. Other projects targeting child mortality and morbidity in Sierra Leone that are in keeping with the principles of Welbodi Partnership.

Person specification

Essential:
1. Medical degree from a WHO-recognised medical school.
2. Consultant-level or equivalent qualification in Paediatrics – e.g. Fellow of the West African College of Physicians, Certificate of Completion of (Specialist) Training (UK), American Academy of Pediatrics board certification. We will gladly consider other suitable qualifications that are equivalent to FWACP.
3. Professional experience of healthcare in Africa or other low-resource setting.

Desirable:
4. Experience of teaching at postgraduate and undergraduate levels.
5. Demonstrable sub-specialisation or special interest within paediatrics in one of: cardiology, respiratory, haematology/oncology, endocrine, renal, metabolic or infectious diseases.
6. In-depth, substantive knowledge of healthcare policy in developing countries.
7. Excellent people skills and a demonstrated ability to work collaboratively with people from diverse backgrounds in a dynamic and constantly-shifting environment.
8. Excellent written and oral English communication skills.
9. Flexibility, focus, and the presence of mind to work in sometimes difficult and chaotic circumstances.
10. Commitment to the goals and principles of the Welbodi Partnership.

Remuneration

The Welbodi Partnership is a small organisation with limited financial resources.

The positions are on a voluntary basis with no salary or personal allowance. Welbodi are willing to cover the cost of a return flight to Sierra Leone, medical registration and visa application fee, and will provide accommodation and daily transport to and from the hospital. You will need to cover the cost of all other expenses.

Applications

The Welbodi Partnership is a UK-registered charity established to support the provision of paediatric health care in Sierra Leone and in particular the Sierra Leone Institute of Child Health (SLICH). SLICH is a joint project between the Sierra Leone Ministry of Health and Sanitation, ODCH, and the Welbodi Partnership to create a centre of excellence in paediatric care. It forms part of the Government of Sierra Leone’s Strategic Plan for Reproductive and Child Health.

The 150-bedded hospital is located in the poor and densely-populated eastern part of Freetown, where 96% of families living in slum conditions. It treats more than 40,000 patients each year, spread across two inpatient wards, an outpatient department, emergency room, ICU, SCBU and a therapeutic feeding centre. The hospital is extremely under-resourced, however, and providing adequate care is still a challenge.

To learn more about us, please visit our website at www.welbodipartnership.org. For more specific queries about this opportunity or a copy of our FAQs please contact Suzanne at the email address below.

Interested candidates should please send a CV and cover letter to Suzanne Thomas at: suzanne@welbodipartnership.org

Green light from Comic Relief...

2011-11-01T01:19:00.000-07:00

A few months ago Welbodi Partnership was awarded a three-year grant from Comic Relief to support the work we are doing at the Ola During Children’s Hospital. We are happy to say that the funding should be released today, November 1^st. The money from Comic Relief will enable us to support bigger projects that will have a greater impact on the care provided in the hospital. Of course, in leading up to the money being released we have taken the time to improve our financial systems and make processes more robust. We are now ready to GO!

In the next few months, as the grant starts up, we will continue to develop monitoring and evaluation tools. We do not simply want to fund projects and walk away, we want to be able to show three years down the line that the money spent has had a positive impact here at Ola During. We will not only look at the affect on the child mortality rate but also look at the impact of our work on parent satisfaction, staff satisfaction, staff empowerment and the quality of care provided by the doctors and nurses. These are all areas in which we hope to make a positive change. Together with our partners at ODCH and the Ministry of Health and Sanitation we hope to make this grant a huge success.

Learning and Sharing

2011-10-31T06:50:00.000-07:00

Earlier this month, the Welbodi Partnership was invited to present to a meeting of the Sierra Leone Health Development Partners. This group includes representatives from UNAIDS, UNICEF, UNFPA, WHO, the UK Department for International Development (DfID), and Medicins Sans Frontieres (MSF), among others. Becky Cridford presented details of our work and preliminary results from recent research we have conducted on nurse motivation and on health-seeking behavior, particularly the reasons why parents often delay so long before bringing their children to a health facility. The presentation sparked a lively discussion, and those present had many questions, comments, and ideas.These kinds of opportunities to share information with others working in the field are central to our efforts to constantly learn and improve our own work. They also allow us to use our experiences and lessons learned to inform better policy and programming throughout Sierra Leone.Well done, Becky and the rest of the Welbodi team!

The Royal Treatment

2011-10-31T06:22:00.000-07:00

Visit the homepage of the British High Commission in Freetown for a photo of Dr. Sandra Lako from the Welbodi Partnership giving the UK's Princess Anne a tour of Ola During Children's Hospital. I bet you never expected that working for the Welbodi Partnership would mean hobnobbing with royalty, Sandra!

Welbodi Quiz Night

2011-08-03T16:55:00.000-07:00

On Friday the 15^th of July, Welbodi Partnership held a fundraising quiz night, hosted by IMATT in Freetown. Just one week after sending out invitations, we had generated more interest than we could cope with. After asking IMATT to agree to 100 participants, rather than the originally planned number of 80, we started putting addi

tional names on a waiting list. Needless to say, we saw this as a sign that the night would be a success.

The Welbodi team, and a few honorary Welbodies, spent the next week planning and preparing for the night. Quiz questions were thought up, spectacular raffle prizes were arranged, raffle tickets were created, emails were sent back and forth, lists of names were submitted, the hall was set-up, etc. We were determined to make this a spectacular event.

On the evening, as people entered the room, they paid their entrance fee and were encouraged to buy raffle tickets to make a chance at winning some amazing prizes, raising more money for Welbodi. Prizes were varied and included winning 5 movie tickets, a night at the Chimpanzee Reserve, a day’s vehicle hire on the peninsula, a trip to the Africa Mercy to tour the ship and enjoy Starbucks, Splash cash and last but not least meals at various restaurants like O’Casey’s, Roy’s, Atlantic, Independence Bar and Crown Express.

The quiz rounds soon began and teams did their best to come up with the right answers to questions. Rounds varied from questions about sports, science & nature, history, entertainment, general knowledge and world, to picture rounds including popular locations within Freetown and a music round including lyrics in Krio, which was by far the most popular round.

At the end of the night, while the points were tallied, the raffle was drawn. Unplanned, one raffle prize ended up being auctioned off which was great fun with some high bidding taking place between two individuals. Finally, the winners were announced and the first prize went to the team “4 Nations”.

The fundraiser was a huge success and with everyone’s help we were able to raise Le 4,370,000, which is just over one thousand US dollars! This money will be used to continue improving child health care at ODCH. Welbodi Partnership would again like to thank IMATT for hosting, the prize givers for donating prizes and those individuals who made this event a success.

Test your knowledge with some of the questions from quiz night.

1. What is the capital of the newest country in the world?

2. What is the color of hippo milk?

3. What quintessential salone (food) product comes from the Jura region of France?

4. At the end of the 19^th Century, European powers had occupied and ruled over all but 2 African countries. Which two?

5. What is the exact date when Sierra Leone became independent?

Answers are in the comments.

Can you host an event to help raise money for the Welbodi Partnership?

It’s easy, fun, and a great way to contribute to our work in Sierra Leone. Make your own free fundraising website in minutes at JustGiving http://www.justgiving.com/welbodipartnership, and contact us at info(at)welbodipartnership.org if you need information or materials to help make your event a success.

Wi Dae Go! Improving Care at ODCH

2011-08-03T10:08:00.000-07:00

Here are just a few of the many exciting activities keeping our team and partners busy in recent months:

- A new Emergency Room/Intensive Care wing opened, in place of the old administrative wing, thanks to Cap Anamur, a German organization working at ODCH.

- Reconstruction of the neonatal unit began, funded by UNFPA with oversight from Welbodi Partnership. This very exciting and much-needed project will double the size of the unit and provide a separate outpatient consultation room, an isolation room, a place for mothers to stay near their children, and more space overall.

- A team of lab experts from the UK and the Gambia visited ODCH to provided technical advice and training to ODCH lab technicians. This was part of a long-term lab development project between Swansea University in the UK, THET, the British Council, and the Oxted Trust, facilitated by Welbodi Partnership.

- A team of students from King's College London arrived in Freetown in July to work with Welbodi to conduct qualitative research on health seeking behaviour in the communities that surround ODCH. We hope the results will give us more insight as to why children come to the hospital late and help us find ways to tackle those barriers.

- Board members for the Sierra Leone Institute for Child Health (SLICH) had another successful quarterly meeting in July 2011 and approved a number of projects that had been proposed by ODCH staff to improve the quality of care provided at the hospital.

- Postgraduate training for doctors continues to move forward, thanks in large part to input from Nigerian Fellow of the West African College of Paediatrics, Professor Tamra Abiodan, who has been working at ODCH for a year and a half. Starting next month, we will have paediatric consultants volunteering at ODCH for several months at a time to help with clinical teaching. We have our first three volunteers confirmed and are now recruiting for positions for 2012-2013.

- We are also working closely with our partners in the Ministry of Health and Sanitation to establish a paediatric nurse training program. At the same time, we are looking at how Welbodi can work with a local radiologist and radiographer to help them set up a training program in radiography. In the coming years, we believe these training efforts will have an impact on the quality of paediatric care not only at ODCH but nationwide.

Introducing the Newest Welbodi Team Members

2011-08-03T10:02:00.000-07:00

We are very excited to welcome two new members of our team: Dr. Anne Nesbitt and Suzanne Thomas. Both will be joining us in Freetown shortly as full-time volunteers. It is wonderful when such skilled individuals are willing to give their time and energy to Welbodi and to ODCH.

Dr. Anne Nesbitt is a consultant paediatrician with extensive experience in acute and community paediatrics in the UK and Africa. Over the course of her career, Anne has spent more than 11 years in various African countries, including Sierra Leone. We are thrilled to welcome her back to Freetown, where she will be delivering clinical teaching through our postgraduate training program for doctors.

Suzanne Thomas is a pharmacist with expertise in designing, delivering, and evaluating training initiatives for a wide variety of medical professionals, including doctors, nurses, and community health workers. In 2008, she volunteered in Southern Sudan as an advisor and trainer. She will be a tremendous asset to our ongoing training initiatives for staff at Ola During Children’s Hospital.

Welcome Anne and Suzanne!

Would you like to get involved? Contact info(at)welbodipartnership.org to find out how, or see our job posting for volunteer consultant paediatricians.

Help train Salone's next generation of paediatricians

2011-08-03T09:33:00.000-07:00

Voluntary Position Available – Consultant Paediatrician

Location: Freetown, Sierra Leone
Assignment Length: 3 months
Number of positions available: 4
Starting – to run consecutively between June 2012-Aug 2013.

Interested candidates should please send a CV and cover letter by 1st September 2011 to Dr Fred Martineau at: fred(at)welbodipartnership.org

As a Consultant Paediatrician with Welbodi Partnership, you would have a direct and significant impact on the quality of care provided to extremely disadvantaged children. You would play a crucial role in the development of Sierra Leone’s first ever postgraduate paediatric training programme, producing the country’s future leaders in child health.

Job Description

The consultant subspecialist paediatrician will champion the development of their subspecialty in Ola During Children’s Hospital (ODCH), Sierra Leone’s only specialist paediatric facility. They will take a leading role in the recently established postgraduate paediatric training programme, providing educational supervision and expert clinical teaching on their special interest to paediatric residents.

In addition to these two principle roles, the consultant will be expected to take on further responsibilities aimed at improving the quality of paediatric health care in Sierra Leone. This will include general paediatric clinical commitments, teaching all cadres of health professionals and students and the development of clinical services as detailed below.

The assignment will require 3 months of clinical work in Sierra Leone. The successful applicant will be encouraged to contribute to the clinical and educational activities of the hospital before and after this period through the use of e-learning and telemedicine packages.

Responsibilities

The Consultant will be required to fulfil the role of subspecialist as stipulated by the West African College of Physicians (WACP) for the training of paediatric residents to take their WACP Membership exams, namely:

1. Develop and run subspecialist paediatric services. This will include the running of specialty clinics, advising on the appropriate equipping of hospital facilities and improving clinical care pathways relevant to their subspecialty.

2. Take a leading role in the postgraduate academic programme, including the educational supervision of registrars and active participation in the postgraduate academic teaching programme.

Individual workplans will be determined on appointment, in discussion with Welbodi Partnership and the hospital management team, to include some or all of the following:

3. Provide general inpatient and outpatient paediatric care. Engage in direct clinical work at a consultant level, running ward rounds and outpatient clinics. Out-of-hours commitments will be limited to telephone advice.

4. Additional academic activities: Delivering teaching to doctors, nurses and students at the hospital and involvement with relevant national academic programmes at the College of Medicine and Allied Health Sciences (COMAHS). Conduct and supervise research and audit as appropriate.

5. Clinical service development. Take joint responsibility with ODCH management and staff for implementing medical project work to improve patient care.

6. E-learning and telemedicine. Welbodi are collaborating with medicineafrica.com to provide distance-based clinical and educational supervision. These will allow successful applicants to extend their contribution to paediatrics in Sierra Leone beyond their time on the ground and enhance the sustainability of any changes introduced.

7. Other projects targeting child mortality and morbidity in Sierra Leone that are in keeping with the principles of Welbodi Partnership.

Qualifications

Essential:
1. Medical degree from a WHO-recognised medical school.

2. Consultant-level or equivalent qualification in Paediatrics – e.g. Certificate of Completion of (Specialist) Training (UK), Fellow of the West African College of Physicians, American Academy of Pediatrics board certification. We will gladly consider other suitable qualifications that are equivalent to FWACP.

3. Demonstrable subspecialisation or special interest within paediatrics in one of: cardiology, respiratory, haematology/oncology, endocrine, renal, metabolic or infectious diseases.

Desirable:
4. Professional experience of healthcare in Africa or other low-resource setting.

5. Experience of teaching at postgraduate and undergraduate levels.

6. In-depth, substantive knowledge of healthcare policy in developing countries.

7. Excellent people skills and a demonstrated ability to work collaboratively with people from diverse backgrounds in a dynamic and constantly-shifting environment.

8. Excellent written and oral English communication skills.

9. Flexibility, focus, and the presence of mind to work in sometimes difficult and chaotic circumstances.

10. Commitment to the goals and principles of the Welbodi Partnership.

Remuneration

The Welbodi Partnership is a small organisation with limited financial resources.

The positions are on a voluntary basis with no salary or personal allowance. Welbodi are willing to cover the cost of a return flight to Sierra Leone, medical registration and visa application fee, and will provide accommodation and daily transport to and from the hospital. You will need to cover the cost of all other expenses.

Applications

The Welbodi Partnership is a UK-registered charity established to support the provision of paediatric health care in Sierra Leone and in particular the Sierra Leone Institute of Child Health (SLICH). SLICH is a joint project between the Sierra Leone Ministry of Health and Sanitation, ODCH, and the Welbodi Partnership to create a centre of excellence in paediatric care. It forms part of the Government of Sierra Leone’s Strategic Plan for Reproductive and Child Health.

The 150-bedded hospital is located in the poor and densely-populated eastern part of Freetown, where 96% of families living in slum conditions. It treats more than 40,000 patients each year, spread across two inpatient wards, an outpatient department, emergency room, ICU, SCBU and a therapeutic feeding centre. The hospital is extremely under-resourced, however, and providing adequate care is still a challenge.

To learn more about us, please visit our website at www.welbodipartnership.org or for more specific queries please contact Fred at the email address below.

Interested candidates should please send a CV and cover letter by 1st September 2011 to Dr Fred Martineau at: fred(at)welbodipartnership.org

Exciting News: Comic Relief Funds Welbodi

2011-08-02T11:34:00.000-07:00

We are thrilled to announce that we have been awarded a large three-year grant from Comic Relief, a UK-based charity that supports global efforts to reduce poverty and social injustice. These much-needed funds will enable us to greatly expand our work at the Ola During Children’s Hospital (ODCH).

The bulk of the funds will go to support the Sierra Leone Institute of Child Health (SLICH), a collaboration between the Welbodi Partnership, the Ministry of Health and Sanitation, and ODCH. Through SLICH, the Welbodi Partnership funds ideas submitted by ODCH staff for how to improve service provision at the hospital. Alongside this, we will continue to develop desperately-needed postgraduate training programs for doctors and nurses. A small but important part of the grant will be spent to nurture new relationships with local communities, build on our understanding of community health needs, and empower community members to participate in the process of innovating and implementing new approaches to improve child health. Finally, we will invest in developing robust monitoring and evaluation systems to ensure that we track outcomes and remain accountable to the fundamental goal of reducing needless child deaths.

We are extremely excited about this new phase of our work, and we look forward to working with Comic Relief and with our wonderful partners at ODCH and the Ministry of Health and Sanitation to put this new funding to good use.

Hat-tip New York Times

2011-07-24T19:55:00.000-07:00

Last week, the New York Times highlighted some of the opportunities and challenges involved in the Government of Sierra Leone's efforts to provide free healthcare for children and pregnant women.

The article cites early indications that the initiative is having an impact -- including a "214 percent increase in the number of children under 5 getting care at health facilities... and an 85 percent drop in the malaria fatality rate for children treated in hospitals" -- but also enormous challenges. "The health minister, Zainab Bangura, says her country needs 54 gynecologists but has only 4. Likewise, she says, there are only two pediatricians in a nation of over five million people."

Together with our partners, the Welbodi Partnership is working to address this shortage of pediatricians. Two of the Ola During Children Hospital's medical officers recently passed the primary exams for the West African College of Pediatrics and Director of Clinical Teaching Professor Tamra Abiodun is leading a team of fellows providing hands-on training and professional development for these and other young doctors. Meanwhile, we are working towards accreditation through the West African College so that someday soon, aspiring pediatricians from Sierra Leone can qualify as specialists without leaving the country.

Would you like to help? We are always looking for specialist pediatricians to join us in Freetown to help provide clinical training. Contact Emily(at)Welbodipartnership.org for more information.

Ola During Children's Hospital...

2011-07-20T14:38:00.000-07:00

Photos taken with permission from the caregivers.

Happy to say that Okon, Kumba and others are well and discharged home.

Busy Welbodi

2011-07-08T13:53:00.000-07:00

Welbodi is busy. That's my excuse for the lack of blog posts. However, I am happy to report that a lot is happening at the Children's Hospital.

One of our partner organizations transformed the administrative wing into a new ER/ICU wing (thanks CA) which opened about a month ago. Prior to that they built a second story on top of the feeding centre, which now functions as the administrative block.

Welbodi started the reconstruction of the neonatal unit in partnership with UNFPA. This is a very exciting project and will double the size of the neonatal unit! It will also provide space for the mothers to be able to stay near their children. We will have a separate outpatient clinic from the inpatient area. There will be an isolation room. We'll have more space and hopefully soon more equipment as well. It's exciting.

We also had a team of lab experts from the UK and the Gambia at the hospital this week as part of the lab development project that Welbodi facilitates. It was great to see so many hard working people in the lab. The technicians were eager to learn and they were very open to input and advice on how to improve the lab services. Let's hope they keep up the good work.

Yesterday a group of students from King's College arrived in Freetown to work with Welbodi to conduct qualitative research on health seeking behaviour in the community. We hope that the results will give us more insight as to why children come to the hospital late and help us find ways to tackle those barriers.

We've been busy preparing for a Fundraiser quiz night which will take place next Friday. Fun! If you're in Freetown and have not yet given us your name - come! It's Le 50,000 for dinner and a quiz. We'll have fun prizes. It'll be a great night up at IMATT.

Meanwhile we continue to plod along with the postgraduate training program for doctors through the West African College of Physicians, with a lot of input from a Nigerian professor currently based at the hospital. As of September we will bring in visiting paediatric consultants for 3-6 months at a time to help teach the residents at the hospital. Seeing as there will be more Welbodies on the ground, we are buying a new (new to us, second hand in reality) vehicle that seats 7!

We are also helping set up a paediatric nurse training program in collaboration with the Ministry. We believe this will greatly improve paediatric care. The nurses make up the largest workforce in the hospital and it is crucial that they are trained well so that they can provide good nursing care.

Work in the medical records department continues. We are now able to provide the hospital and Ministry with monthly reports as well as quarterly reports. There's still along way to go, but the department has definitely improved over the past year.

Another area that we are involved in is the radiology department. We are working along side a radiologist and radiographer to help them set up a training program in radiography due to a shortage of radiographers in the country. We also hope to be able to source (and find funding for) an x-ray and consumables. Once we have everything in place we can start doing x-rays. This too will have an impact on patient care.

All in all, it's a busy time. At times it seems like we are not getting anywhere, but when you look back over the past year, it is obvious that the hospital has definitely improved. Yes, there is still a lot to do, but we are moving forward. Small small. One step at a time.

If you would like join Welbodi in improving paediatric care you can donate to the cause at: http://www.justgiving.com/welbodipartnership

Start of reconstruction of the neonatal unit.

Lab expert from Wales training one of the Sierra Leonean technicians

Why do children come so late?

2011-06-13T13:28:00.000-07:00

One night, not too long ago, four children died in the emergency room at the Children’s Hospital. Two of them had been sick for more than two weeks before coming to the hospital for treatment and sadly, both children died within a few hours of admission. They had simply come too late.

Day after day in the emergency room at Ola During Children’s Hospital, parents arrive with extremely sick children, often on the verge of death. It is not uncommon for a mother to come in with a child gasping for breath, or a child who is extremely pale, or is unconscious or with extremely cold extremities and in shock. Occasionally they even come with a child who has (unknowingly to them) died en route. It is tragic.

Why are these children reaching the hospital so late? Is it ignorance or a lack of knowledge? Do they not realize how sick their children are until it is too late? Are there additional financial barriers even though health care is now free, like the cost of transport or a family’s loss of income during the time they are in hospital? Maybe people do not know about free health care. Or maybe it is inconvenient to come because the mother has other children at home. Are there other family pressures that keep them from coming to the hospital? Or is it because they can buy any medication they want at pharmacies located on every street corner? Is it due to traditional beliefs embedded with witchcraft and other (in our minds) bizarre ideas? It could be because the family thinks the child is ‘country sick’ and in need of herbal medicine, rather than ‘hospital sick’ and in need of ‘western medicine’. Is it because of the hospital’s reputation of children dying here? I suppose it is probably a combination of these things, and more, and to be honest it will be difficult to find out in most cases.

I had hoped that with the introduction of free healthcare for children under five years old, parents would come to the hospital sooner rather than later. Ideally they should come to the hospital when the child is mildly or moderately ill and get treatment at an earlier stage. For many, that just does not seem to happen. They tend to come when they are very sick. Is it that since free healthcare, the children who would have otherwise died at home in silence are now accessing the hospital in the final hours of their illness? It is hard to know.

Still, the majority of the children coming to the hospital have treatable diseases like malaria, pneumonia, anemia and diarrheal disease. These are all diseases that can be cured (and better yet prevented) if treatment is started on time. But in the cases in which treatment is delayed, unfortunately the chance of survival plummets. We do what we can, with our limited resources but often cannot save the children coming in so late. Of course, our (emergency) care needs to be improved. I will not deny that, but I also know that if some of these children would show up at a hospital in the developed world, they would not survive either. Sometimes they are just too sick and close to death.

So what can we do? If only we had more insight into why children come to the hospital so late. Maybe if we understood why families are not coming to the hospital quickly, we can look into ways to remove the barriers and encourage a change in behavior. Maybe with some more time and results from a survey on health seeking behavior in nearby communities we will have more of an idea. Time will tell. For now, we need to continue to improve the services at the hospital so that optimal care can be given. We all need to try even harder, stay motivated and work together in order to give these children the best care possible in this challenging setting. And we need to advocate for more sensitization within the communities to encourage parents to come to the hospital sooner. There is a lot of work to do.

Coordination and clinical work

2011-05-31T09:24:00.000-07:00

A lot of the work the Welbodi Partnership does is to coordinate and facilitate projects and training programs within the hospital. Our aim is capacity building – helping others to improve their skills rather than coming in to solely provide patient care. We believe that in the long run more patients will receive high-quality treatment and have better outcomes if we focus our current efforts on improving the services delivered in the hospital. That is why we have engaged in projects like electricity and water supply, the medical records/data collection and reporting system, the laboratory services, nursing care, the triage and emergency process, and training for the doctors.

This does mean that my job as a medical coordinator, although diverse, does not leave much room for clinical work. As I am trained as a doctor, that is not always easy. Fortunately, for my own professional development and to see how hospital systems are or aren’t functioning, I try to do some clinical work. However, usually my role as coordinator keeps me so busy, I don’t make it to the wards. If I do make it, it’s usually just to see a few patients. I decided that for now it is best not to do ward rounds on a ward because it is unlikely that I will be available to the nurses and patients for the rest of the day due to meetings and other responsibilities.

The last few weeks have been so busy, I have really only been able to see a few patients on the ward adjacent to our office, so it has been good to be able to be involved with patients a bit more on other wards.

It started one evening when I happened to be at the hospital and ran into a family with a very sick child looking for the Emergency Room. The child was admitted and stabilized but unfortunately remained in a very critical condition. Sadly, the infant died in the course of the following day. I was again hit by the reality of the mortality figures in this country. And I realized again that although it can be very rewarding to do clinical work, it is also pretty tough.

I was also involved in the case of an infant admitted a few days ago. With a hemoglobin of 3.5 g/dL, the child needed blood urgently. Fortunately there was a relative who was able to donate and the child received blood soon after admission. After that it was a waiting game. Thankfully, the next day the child looked much better. However, unfortunately the child had not received all of the prescribed medication within the first 24 hours of admission because something went wrong with the supply. So, I wrote a prescription for the missing medication and later checked up on the child again again. The child was stable and I expect will make a good recovery. Now, if I can only convince the mother to stop giving the child hot water and encourage her to exclusively breastfeed I will be really happy!

I love the clinical work and honestly do miss it, but I also have to admit that it can be quite frustrating. Yes, there have been many improvements over the last few years, but there is still a long way to go. I think all of the clinicians in the hospital would agree that clinical work in the hospital is challenging. The patient numbers can be high, working hours can be long, (once a week when on-call overnight the doctors work for about 30 hours straight) and the cases coming to the hospital are often quite severe, which means that on a daily basis one is faced with children dying. For doctors and nurses alike this can be very demoralising. Yet somehow, everyone must continue. Despite the frustrations, spending time on the wards gives me more insight into how the various systems (pharmacy, lab, blood bank, nursing, medical records, doctors) work (or not) and how they have improved (or not) over time. The barriers and delays to achieving good patient care become more apparent. This information can in turn re-start the thought process and refinement of how Welbodi continues to work alongside hospital management and other partners to improve systems within the hospital with the overall aim to improve pediatric care. And that is when I put my coordinating hat on again!

First posted @ http://blogs.bmj.com/bmj/2011/05/31/sandra-lako-coordination-and-clinical-work/

#4 Photo of the week: Ward 3

2011-05-17T09:43:00.000-07:00

“Ward 3 - Ola During Children’s Hospital”

Happy birthday Sierra Leone - and happy birthday free healthcare!

2011-04-28T13:12:00.000-07:00

Believe it or not, it was one year ago that the Government of Sierra Leone launched a new free healthcare initiative for pregnant and lactating women and children under five. This photo essay in the Guardian shows some of the patients and health facilities that have benefited from this policy.

This week also marks Sierra Leone's 50th anniversary of independence. As the country honors this occasion with reflection, patriotism, and lots of celebration, we at Welbodi celebrate along with Mama Salone, and hope that the next 50 years will bring continuing improvements in the lives of her many children, young and old.

World Malaria Day 2011...

2011-04-25T15:20:00.000-07:00

Today is World Malaria Day and unfortunately, although a preventable disease, malaria still kills many people in the developing world. At the children's hospital I work at, we see malaria cases everyday. Some cases are very severe; the children are literally on death's doorstep and other cases are mild and improve with oral medication. As you can imagine, the disease has a major impact on child health in Sierra Leone.

In November of last year, we had 999 inpatients in the hospital and in that month (as often is the case) malaria was the most common reason for admission, followed by chest infections, diarrheal disease and anemia (unrelated to malaria). Sadly, children die at the hospital on a daily basis. In November, 54% of the hospital deaths were attributed to malaria. In November 67 children died at the Children’s Hospital as a result of complicated malaria. We obviously have our work cut out for us. Having said that, I do believe that the staff at Ola During is working hard to do their part in combating malaria. The staff, management and partners of ODCH and the Ministry of Health and Sanitation must be commended for their ongoing efforts to improve healthcare. The laboratory has definitely improved and more blood smears are being examined for malaria. Thanks to one of the partners in the hospital, malaria treatment is readily available. Improvements in the triage and emergency system mean that children receive their treatment more promptly. There is still a lot to be done, but progress is being made.

The theme for the fourth World Malaria Day is Achieving Progress and Impact. The theme recognizes the international community's renewed efforts to make progress towards near zero malaria deaths by 2015. We’re not there yet, but I like to believe that things are improving. Hopefully the country of Sierra Leone can tackle issues like: distribution and use of insecticide treated nets, prompt diagnosis, appropriate treatment, etc. Various barriers play a role, such as: cultural/traditional ideas impacting use of nets and quick presentation of child to a health facility, lack of experienced laboratory technicians, lack of rapid diagnostic tests, inconsistent supply of ACT medication or quinine, etc.

Hopefully, health education in the communities, training in health facilities (lab and medical staff), and improved supply chain will decrease the number of deaths related to malaria in Sierra Leone. The day that there are near-zero malaria deaths in the country will be a day to celebrate for sure. Count me in…

(see: http://www.worldmalariaday.org)

#3 Photo of the week

2011-04-18T03:07:00.000-07:00

"Emergency Triage Assessment and Treatment workshop with the nurses at Ola During Children's Hospital - a partnership with ABM in Wales"

Oxygen for the feeding center

2011-03-30T10:14:00.000-07:00

Last week Monday the final four oxygen concentrators from the “Operation Oxygen” campaign made it to Ola During Children’s Hospital. Thanks to all of you who contributed generously to this campaign. Of course, it was a bit of an epic journey to get the shipment from the airport to the hospital, but after many phone calls, negotiations, and bribe avoiding tactics we managed. Unfortunately getting shipments out of the airport or port is still a big hassle for most non-governmental organisations (NGOs).

This past Saturday I went to the Children’s Hospital, to deliver large bags of leftover bread rolls that the Africa Mercy wanted to give away. Fortunately there was plenty to go around for all of the patients and staff. While I was there, I thought I would assemble the oxygen concentrators, label them, and test them to make sure they were in good working order. All of the units worked, and so four more oxygen concentrators were ready to roll.

Today, I thought it would be good to bring a concentrator to the therapeutic feeding centre. After all, they have never been able to give oxygen there and they do often have severely malnourished children with severe pneumonia, or other illnesses causing respiratory distress. Up until today, malnourished children needing oxygen were sent to the ICU for admission; meaning their feeds were (unfortunately) not monitored as well as they would be in the nutrition unit.

After checking with matron in the morning, I went to the feeding center to tell the nurses they would receive a brand new oxygen concentrator, and they were delighted. They have been asking for oxygen on their ward for their patients for months now.

Since there is an oxygen concentrator in the feeding centre, it means that the malnourished children in need of oxygen can remain there and receive both oxygen as well as 3 hourly feeds of F-75 or F-100 milk, along with the other medical care they need. Being able to keep these children in the nutrition unit will hopefully improve care and will prove to be yet another small step in the right direction. We do realise of course, that in some cases children may need to stay in the ICU for more intensive monitoring.

Unfortunately, when the power went off later in the day, we realised that the feeding centre is not yet connected to the back-up generator provided by Welbodi and so the oxygen concentrator stopped working. Our next aim is to make sure the feeding centre gets connected to that generator. Small steps. One at a time. We’ll get there someday.

First posted @ http://blogs.bmj.com/bmj/2011/03/30/sandra-lako-oxygen-for-the-feeding-centre/

#2 Photo of the week

2011-03-29T07:40:00.000-07:00

"Five children with Burkitt's Lymphoma receive treatment on the ward"

The Burkitt's Program is a partnership between Ola During Children's Hospital and Mercy Ships.

World Water Day in Freetown...

2011-03-23T01:37:00.000-07:00

On my way to Spur Road this morning I walked past a group of children scooping murky water out of the gutter into some buckets. These buckets were then lifted to their heads and carried home. Further down the road there was another group of people, huddled around a standpipe. 45 yellow five-gallon containers were lined on either side, ready to be filled. This is daily life in Freetown.

Can you imagine having to use gutter-water to clean your dishes or wash your clothing? Can you imagine having to stand in line for hours, waiting for your turn at the standpipe? Can you imagine having to walk for miles with a bucket of water on your head?

I cannot.

Although we have had some major problems at our house, we still manage to get some five-gallon containers filled. Yes, it takes time, but it doesn’t take us hours. And yes, I have to carry it up three flights of stairs, but at least it is not three miles. It is not the same, but it gives me a glimpse of what life must be like for the average person here. Clean water is so essential yet still so difficult to access.

Today is World Water Day, an observance day that grew out of the 1992 UN conference on Environment and Development. This year’s theme is Water for Cities, which highlights the connection between rural and urban areas. Water flowing into cities generally originates in rural areas, and it is in those areas that water should be protected and managed well. Water is affected by climate changes, industrialization, natural disasters and rapid urban growth.

Did you know that most of the world’s population lives in cities? 3.3 billion people. Meanwhile the urban landscape continues to expand and expanding slums represent 38% of the growth. City populations are increasing faster than city infrastructure can adapt leading to critical water shortages.

Freetown is a city with more than 1 million people that struggles to provide its residents with the water they need. The Guma Valley Water dam that supplies the majority of the city was originally set up to serve a population of 300,000. It is no wonder that water access and availability are poor. Not only are households affected by water shortages, so are businesses, schools, Ministry buildings, restaurants and hospitals.

The Ola During Children’s Hospital has had water problems for many years now. Since Welbodi Partnership started working at the hospital since 2007, we have tried to address this situation many times but unfortunately the water problems are complex. When one battle is won, another battle arises. But we will continue because the situation is serious. Poor hygiene practices in the hospital lead to an increase of infections on the wards, which in turn lead to longer hospital stays and unavoidably more deaths. Something needs to be done.

Can you imagine one bucket and one bar of soap on each ward of 40 patients for all of the nurses and caretakers to wash their hands? Can you imagine how hard it is to keep the linen and beds clean? Can you imagine how hard it is to clean up after sick children? Can you imagine working in a hospital where water rarely comes out of the tap?

The situation is serious.

One of the problems is that Guma supplies water only a certain number of times per week. This is done throughout the city to ration the water, ensuring that each area in the city at least has some water at some point. For hospitals, this is not adequate. We think that the long-term solution might be to connect the hospital to the main water pipeline on Kissy Road. Maybe. Honestly, we are not 100% sure if that would solve the problem but it seems like the best shot. We hope to work together with hospital management, the ministry, partner organisations, and the water company to see if this is possible.

Last year Welbodi Partnership installed four 5-thousand litre water tanks above the elevator shaft with the aim that when Guma supplies water we can at least store a large amount, so that each ward will have some running water all the time. The most recent project included adding more inlets to the water tanks so that the fill-up time would be quicker and the tanks would fill up to the brim. A project we are about to commence is to install one 5000-litre water tank on the ground level, which will provide more storage of water. We will also use the water pump purchased by Welbodi in the UK to pump water from the new storage tank to the top level because when Guma does supply water, the pressure is often too low and the water does not reach the top floor. We hope that this latest water project will be a success. However, ensuring that water supply is sustainable is important, and so we also plan to partner with an organisation that may be able to get qualified engineers to assess the water situation and come up with long-term solutions.

Solving the water problems at the hospital sure seems like an ongoing battle, but I like to think that slowly we are winning ground. I look forward to the day that the water supply at the hospital will be unlimited and the residents of Freetown will have access to the water they desperately need.

Statistics taken from http://www.worldwaterday2011.org/

First posted @ http://blogs.bmj.com/bmj/2011/03/22/sandra-lako-world-water-day-in-freetown/

Sandra Lako is a doctor from the Netherlands who previously spent four and a half years in Sierra Leone setting up and managing a pediatric outpatient clinic with an organisation called Mercy Ships. After a year at home, she returned to Sierra Leone to volunteer as medical coordinator with the Welbodi Partnership, a UK based charity supporting the only government-run children’s hospital in a country where 1 in 5 children do not reach the age of five.

24,600 km across Africa on a bicycle to support Welbodi

2011-03-20T12:45:00.000-07:00

People have gone to great lengths to support our work, but this may well be the lengthiest length yet.

One year and 8 months after leaving London on a bicycle, the intrepid Helen Lloyd has reached Cape Town, the southern tip of the African continent. Read her amazing tales of biking across Africa and of all the fascinating people she met along the way - including the Welbodi team in Freetown. Then visit her JustGiving site and support her fundraising appeal on behalf of the Welbodi Partnership.

Thank you Helen, and congratulations!

Would you like to raise money for the Welbodi Partnership while enjoying the open road? It's not 24,600 km across Africa, but we do have spaces available in the London Bupa 10k on May 30th. Visit our race page for more information or to sign up to run.

#1 Photo of the week

2011-03-15T09:54:00.000-07:00

Operation Oxygen was a success.

2011-03-10T00:37:00.000-08:00

Over the Christmas holiday $11,760 was raised for oxygen concentrators for the Children’s Hospital in Sierra Leone. This is enough for at least 8 new concentrators. Last year I was amazed to raise $5,000 for our water charity, this year I’m blown away. Friends, family, churches, and strangers have all given generously to this cause. Thank you!

With only 6 oxygen concentrators at the Children’s Hospital before, children had very limited access to oxygen. Often one machine was shared between 4 children. Obviously this was not sufficient. Imagine how parents in the UK would react if they knew their sick child was only receiving ¼ of the oxygen that he or she needed. Unfortunately parents in Sierra Leone do not have much choice. Thankfully, with the money donated to the Welbodi Partnership, through my church, my justgiving campaign, and other donations from the UK, we were able to buy 11 oxygen concentrators. Seven of them arrived at the hospital a week and a half ago, the other four are due to arrive in the next two weeks. This means that we have more than doubled the number of oxygen concentrators in the hospital. Hopefully we can use each concentrator for one or two children, rather than three or four, increasing the amount of oxygen each child receives. I am certain that this will have an impact on child survival in the hospital.

Like everything else here, a bit of effort was involved in getting the concentrators to the hospital. The concentrators were sent by DHL to Lungi airport, which meant that after attempting to get duty free concession from the Ministry (but failing) I headed to the airport with one of the Ministry’s procurement officers. I left home at 6am to be at the hospital by 6:45am, ready to leave by 7 am to catch the 8 am ferry across to Lungi. All went well and even the paperwork seemed to be moving along until I was told there was a small problem. Because the shipment had been sitting at the airport for more than a week we were told we had to pay a significant fee. The fee was very high and of course, we had not been informed that this fee existed. After explaining that the concentrators were for the government run Children’s Hospital and some further discussion, we finally got an okay. The paperwork was (slowly) signed off, and the concentrators were released. Time was ticking away and we literally pulled up to the 11 am ferry just before it was set to leave the terminal. We made it back to the hospital around 1 pm and offloaded the concentrators. The next morning one of my colleagues and I assembled the concentrators, we tested them, marked them, and delivered them to the wards. It felt like Christmas. I was so happy and so were the staff. Before we knew it, the machines were switched on, blowing out oxygen, and children were benefiting.

Sandra Lako is a doctor from the Netherlands who previously spent four and a half years in Sierra Leone setting up and managing a pediatric outpatient clinic with an organisation called Mercy Ships. After a year at home, she returned to Sierra Leone to volunteer as medical coordinator with the Welbodi Partnership, a UK based charity supporting the only government-run children’s hospital in a country where 1 in 5 children do not reach the age of five.

First posted @ http://blogs.bmj.com/bmj/2011/02/23/sandra-lako-operation-oxygen-was-a-success/

Deadline extended - Join our team!

2011-02-16T17:33:00.000-08:00

Do you know a healthcare or management professional who would like to join our team at the Ola During Children's Hospital in Freetown? We have extended the deadline for our year-long volunteer Programme Manager positions. We are looking for healthcare professionals (nurses or medical doctors) and individuals with management experience, particularly hospital management or in another healthcare setting.

For details, please see our earlier postings here and here.

We will be considering applications on a rolling basis, so please apply ASAP for consideration and circulate widely to friends and colleagues. This promises to be an exciting year for the Welbodi Partnership and for the Ola During Children's Hospital, and you can be a part of that!

Interested candidates should send a cover letter plus resume or CV to emilyATwelbodipartnership.org.

Life-saving blood...

2011-02-12T09:48:00.000-08:00

While driving past an NGO hospital last week a friend read out a sign painted on the hospital wall stating that patients need to come with their own blood donors. He thought that was very odd but having been here for years it didn’t seem strange to me. I suppose in the developed world, one would not see such a sign.

Every day children come to the hospital with severe anemia, mostly due to malaria. So, not only do they need to receive anti-malarial medication, they often need blood transfusions as well. Unfortunately it can take up to hours if not days for some of the children to receive blood. The reason for this is that the blood bank runs on a donor replacement system.

Basically, a family member needs to donate a unit of blood to the blood bank in exchange for a unit of screened blood that is stored in the fridge, which will go directly to the patient. Meanwhile the blood donated by the family member will be screened and if uninfected, it is stored in the fridge and used for a patient needing blood at a later time. It sounds simple but unfortunately in practice, the system does not always work. The main problem is that there is often no family member willing to donate; either no one but the mother is around or relatives do not want to donate. And for some reason the blood bank often refuses to take blood from the mothers.

I do not know why, but in general Sierra Leoneans do not like to donate blood. They either assume that by donating they will get infected with something, or are worried about the HIV screen or various other things. This is a problem because it means a child will not receive blood from the bank because the unit taken out is not going to be replaced. And, in all fairness to the blood bank, if this happens too often the blood bank will be depleted.

I have seen in the Emergency Room and ICU countless children in urgent need of blood. Children literally come in with a hemoglobin as low as 1 or 2 g/dL. Some of these children will die if they don’t receive blood within the first hour. It is for these cases that I will take the child’s blood sample and blood request form to the blood bank and ask for a unit from the screened stock, explaining how critically ill the child is. I do end up getting the blood but not without hesitation. And in all fairness, I totally understand the concern because the more we make exceptions, the more relatives will refrain from donating, assuming we will arrange for them to get blood without having to replace it. This is obviously not sustainable.

In December I was asking for blood so often that I decided it was time to replace some of the blood myself. It was time to donate. So, together with Shona (VSO doctor) we headed to the blood bank on a Friday afternoon after lunch thinking we would be in and out in no time. I should have known better. Although it took a while, I have to say we had an interesting experience.

We wanted the technician to go through the usual procedure to make sure we were fit to donate so he proceeded to check our hemoglobin with the Hemocue. Unfortunately it was not working. He pulled out a color card, which literally was a piece of paper with various shades of red painted on it. I questioned this method and suggested he use the centrifuge for a spun hematocrit. We were rather unfortunate once again as the blood spilled out of the capillary tubes while spinning in the centrifuge. What are the odds? Since I had recently had my blood checked at home, I knew my hemoglobin was okay and we decided to go ahead with the donation.

After the blood grouping, we reclined on the two makeshift beds and got as comfortable as we could knowing a large bore needle was about to be put into our veins. We were more at ease when the technician started playing Christmas tunes from his cell phone. He inserted the needle with ease and it was amazing to see my blood flowing into a blood bag, knowing that it could potentially save a child’s life. It felt incredible to be able to help in such a tangible way and be a part of a child’s healing process. It also made me feel good to know I was giving a unit to the blood bank rather than just taking.

I later learned that my blood had been given to two different children and although I don’t know who they are or what the outcomes were, I know that I helped those children. I will definitely donate as often as I can at Children’s and I definitely recommend that people come to the hospital to donate blood. It is a very worthy cause. Seriously, if you come and donate let me know and I’ll buy you a coke while you recover. And, if you’re not in Sierra Leone, donate at your local blood bank. A unit of blood can impact someone’s life. It can mean the difference between life and death.

First posted @ http://blogs.bmj.com/bmj/2011/02/11/sandra-lako-life-saving-blood/

Volunteers wanted! Healthcare managers

2011-01-07T02:24:00.000-08:00

Voluntary Position Available – Programme Manager (Hospital Management)
Location: Freetown, Sierra Leone
Assignment Length: 1 year
Application Deadline: 31st January 2011
Starting: July 2011 (starting date may be flexible)

Job Description

The Programme Manager will provide technical leadership and contribute to the development and implementation of ongoing and new programme activities aimed at improving the quality of paediatric health care in Sierra Leone, starting at the country’s only specialist paediatric facility, Ola During Children’s Hospital (ODCH).

Responsibilities

The Programme Manager will be responsible for the design and implementation of hospital management programme work. You will be one of two volunteer Programme Managers working under a Medical Coordinator who is already in place. The role includes:

1. Needs assessment and planning: Work closely with the management at ODCH and where appropriate the Ministry of Health and Sanitation, to analyse barriers to the delivery of timely and effective healthcare for children and develop ongoing plans to address these barriers.

2. Implementation, monitoring and evaluation: Take joint responsibility with ODCH management and staff for implementing, monitoring and evaluating work to address management issues in the hospital. This may include coordinating and delivering in-service training for hospital management and other staff.

3. Teamwork: Work closely with the national and international staff and volunteers who comprise the Welbodi Partnership team, including contributing to planning, monitoring and evaluation, fundraising and reporting processes.

Qualifications

1. At least two years’ experience working in hospital management is highly desirable, although candidates with other relevant experience in delivering or managing healthcare will also be considered. Additional postgraduate qualification in international development, public health or public policy is highly desirable.
2. Professional experience of healthcare in Africa.
3. In-depth, substantive knowledge of healthcare policy in developing countries.
4. Excellent people skills and a demonstrated ability to work collaboratively with people from diverse backgrounds in a dynamic and constantly-shifting environment.
5. Excellent written and oral English communication skills.
6. Flexibility, focus, and the presence of mind to work in sometimes difficult and chaotic circumstances.
7. Commitment to the goals and principles of the Welbodi Partnership.

Applications

The Welbodi Partnership (WP) is a UK-registered charity established to support the provision of paediatric health care in Sierra Leone and in particular to support the Sierra Leone Institute for Child Health (SLICH). SLICH is a joint project between the Sierra Leone Ministry of Health and Sanitation, the Ola During Children’s Hospital, and the Welbodi Partnership to create a centre of excellence in paediatric care. It forms part of the Government of Sierra Leone’s Strategic Plan for Reproductive and Child Health.

Ola During is Sierra Leone’s only specialist children’s hospital, located in the poor and densely-populated eastern part of Freetown. More than 15,000 patients are treated at the hospital each year, spread across three inpatient wards, an outpatient department, emergency room, ICU and a therapeutic feeding centre. The hospital is under-resourced and providing adequate care is still a challenge.

To learn more about us, please visit our website at www.welbodipartnership.org.

We are seeking individuals to fill the role of Programme Manager described above. You will work as part of a team of three international volunteers at ODCH. You will also be part of the wider Welbodi team, including the charity’s Directors in the UK, USA and Freetown, our Fundraisers and a network of local and international partners.

Interested candidates should please send a CV and cover letter by 31st January 2011 for the attention of: Dr Emily Spry.

emily@welbodipartnership.org

Further important information for applicants

The Welbodi Partnership is a small organisation with limited financial resources. To keep our overheads low, this position has been filled on a voluntary basis over the past 3 years.

We will provide you with an apartment shared with other Welbodi Partnership international volunteers and transport to and from the Hospital on a daily basis. We can also contribute towards cost of travel to Sierra Leone, visas, and medical insurance. However, all other living costs will be your responsibility.

Although Sierra Leone is a very poor country, it is surprisingly expensive to live an expatriate lifestyle. It is possible to by a local meal of rice and sauce for just a few dollars, but an individual pizza in one of the Western-style restaurants costs $12. The minimum that you will need in living costs is around $300 per month, with many spending around $500 per month.

As Programme Manager of the Welbodi Partnership, you would have a direct and significant impact on the quality of care provided to children both at ODCH and throughout the paediatric healthcare system. You would be part of building a relatively new organization from the ground up, of identifying and implementing high-impact interventions -- including quality training for Sierra Leone's young doctors and nurses -- and of building a foundation for lasting change. You would join a committed core team and would be responsible for leveraging the contributions of a wider network of volunteers and partners to bring significant and lasting change to ODCH and the public healthcare system.

Volunteers wanted! Healthcare professionals

2011-01-07T02:18:00.000-08:00

Voluntary Position Available – Programme Manager (Healthcare Professional)

Location: Freetown, Sierra Leone

Assignment Length: 1 year

Application Deadline: 31^st January 2011

Starting: July 2011 (starting date may be flexible)

Job Description

The Programme Manager will provide technical leadership and contribute to the development and implementation of ongoing and new programme activities aimed at improving the quality of paediatric health care in Sierra Leone, starting at the country’s only specialist paediatric facility, Ola During Children’s Hospital (ODCH).

Responsibilities

The Programme Manager will be responsible for the design and implementation of medical programme work. You will be one of two volunteer Programme Managers working under a Medical Coordinator who is already in place. The role includes:

1. Needs assessment and planning: Work with management and staff ODCH (and the Ministry of Health and Sanitation where appropriate), to analyse barriers to the delivery of timely and effective healthcare for children and develop ongoing plans to address these barriers.

2. Implementation, monitoring and evaluation: Take joint responsibility with ODCH management and staff for implementing medical project work. This will include coordinating and delivering in-service training for healthcare workers. Your focus will be on capacity building rather than delivery of clinical care.

3. Teamwork: Work closely with the national and international staff and volunteers who comprise the Welbodi Partnership team, including contributing to planning, monitoring and evaluation, fundraising and reporting processes.

Qualifications

1. A medical or nursing degree, with at least two years’ experience working in health care, is highly desirable, although candidates with other relevant experience in delivering or managing healthcare will also be considered. Additional postgraduate qualification in international development, public health or public policy is highly desirable.

2. Professional experience of healthcare in Africa.

3. In-depth, substantive knowledge of healthcare policy in developing countries.

4. Excellent people skills and a demonstrated ability to work collaboratively with people from diverse backgrounds in a dynamic and constantly-shifting environment.

5. Excellent written and oral English communication skills.

6. Flexibility, focus, and the presence of mind to work in sometimes difficult and chaotic circumstances.

7. Commitment to the goals and principles of the Welbodi Partnership.

Applications

The Welbodi Partnership (WP) is a UK-registered charity established to support the provision of paediatric health care in Sierra Leone and in particular to support the Sierra Leone Institute for Child Health (SLICH). SLICH is a joint project between the Sierra Leone Ministry of Health and Sanitation, the Ola During Children’s Hospital, and the Welbodi Partnership to create a centre of excellence in paediatric care. It forms part of the Government of Sierra Leone’s Strategic Plan for Reproductive and Child Health.

Ola During is Sierra Leone’s only specialist children’s hospital, located in the poor and densely-populated eastern part of Freetown. More than 15,000 patients are treated at the hospital each year, spread across three inpatient wards, an outpatient department, emergency room, ICU and a therapeutic feeding centre. The hospital is under-resourced and providing adequate care is still a challenge.

To learn more about us, please visit our website at www.welbodipartnership.org.

We are seeking individuals to fill the role of Programme Manager described above. You will work as part of a team of three international volunteers at ODCH. You will also be part of the wider Welbodi team, including the charity’s Directors in the UK, USA and Freetown, our Fundraisers and a network of local and international partners.

Interested candidates should please send a CV and cover letter by 31^st January 2011 for the attention of: Dr Emily Spry.

emilyATwelbodipartnership.org

Further important information for applicants

The Welbodi Partnership is a small organisation with limited financial resources. To keep our overheads low, this position has been filled on a voluntary basis over the past 3 years.

We will provide you with an apartment shared with other Welbodi Partnership international volunteers and transport to and from the Hospital on a daily basis. We can also contribute towards cost of travel to Sierra Leone, visas, and medical insurance. However, all other living costs will be your responsibility.

Although Sierra Leone is a very poor country, it is surprisingly expensive to live an expatriate lifestyle. It is possible to by a local meal of rice and sauce for just a few dollars, but an individual pizza in one of the Western-style restaurants costs $12. The minimum that you will need in living costs is around $300 per month, with many spending around $500 per month.

As Programme Manager of the Welbodi Partnership, you would have a direct and significant impact on the quality of care provided to children both at ODCH and throughout the paediatric healthcare system. You would be part of building a relatively new organization from the ground up, of identifying and implementing high-impact interventions -- including quality training for Sierra Leone's young doctors and nurses -- and of building a foundation for lasting change. You would join a committed core team and would be responsible for leveraging the contributions of a wider network of volunteers and partners to bring significant and lasting change to ODCH and the public healthcare system.

Want to Join our Team? (Update)

2010-12-28T06:54:00.000-08:00

Head of Fundraising and Communications

The Welbodi Partnership is seeking to recruit a head of fundraising team to join their growing team. Welbodi was established to support the provision of paediatric care in Sierra Leone. This is an exciting opportunity to be at the heart of a young and dynamic organisation and to gain valuable experience in fundraising and development. The Head of Fundraising will initially be based for one month in Freetown, the capital of Sierra Leone, to gain an in-depth understanding of our work. After that, she/he will relocate to help establish our London office. The Head of Fundraising will work closely with the Welbodi Directors to design and deliver the organization’s fundraising strategy. The Head of Fundraising will also be supported by a team of 2-4 Fundraising Volunteers.

Job Title: Head of Fundraising and Communications

Salary: The Welbodi Partnership is a small voluntary organization, and as such is not able to offer a salary at this stage. However, the Directors hope that successful fundraising will enable the organization to create a paid fundraising position moving forward. Welbodi will be able to cover some expenses, including travel and living expenses in Freetown, and will provide office space in London.

Location: Freetown, Sierra Leone for one month, then central London

Full-Time / Part-Time: The job must be full-time for the first month in Sierra Leone, but could be part-time thereafter for the right candidate.

Responsibilities:

• Develop and implement both long-term and short-term fundraising strategies.
• Supervise a team of 2-4 Fundraising Volunteers.
• Network with high net worth individuals, such as private business people, philanthropists, and celebrities.
• Build relationships with institutional donors.
• Supervise applications to charity trusts.
• Supervise publicity and social media strategy and presence.
• Gather information from the team at the hospital on recent developments, accomplishments, and other figures.
• Respond to basic requests for information as needed.
• Manage the Welbodi Partnership office in Central London.

Person Specification:

Welbodi is committed to find the right person to join its dynamic and growing team at a leadership level. The Directors are open to people with different types of background and expertise. A successful candidate must:

• Have excellent written and verbal communication skills.
• Have excellent attention to detail.
• Be self motivated and enthusiastic; able to manage own time and work to deadlines.
• Have an interest in development and the cause that Welbodi represents.
• Have excellent relationship management skills, and be able to communicate with people at all levels of an organisation.
• Have excellent organisational skills.
• Have an ability to condense large amounts of information into concise formats, identifying key information needed.

The candidate may or may not have:
• Experience in marketing, public relations, or communications.
• Experience in fundraising or development.
• Experience in the non-profit sector.

The Welbodi Partnership expects that applicants may include communications professionals with an interest in transitioning to the international development or non-profit field; international development or non-profit professionals with an interest in building their fundraising expertise; and others with skills and enthusiasm who want to help Welbodi build a fundraising and communications strategy from the ground up.

Application Process and Deadlines:

CV and covering email to matthew@welbodipartnership.org .

Submit applications as soon as possible but no later than 22nd January 2011. Applications will be processed as they are received, so the position may be filled before that date.

For more information visit our website: www.welbodipartnership.org

A unique Christmas gift...

2010-12-17T01:24:00.000-08:00

Do you want to give something unique this Christmas?

How about giving Oxygen?

Please help raise money for oxygen concentrators for the Children's Hospital in Sierra Leone.

Watch the video and then go to: http://www.justgiving.com/sandralako

MERRY CHRISTMAS on behalf of the Welbodi team.

"Sweet Salone" gives free healthcare to sick kids

2010-12-15T11:23:00.000-08:00

Sierra Leone is known as “Sweet Salone” for her beautiful beaches, lush tropical climate and rich culture. But this small West African country and her people also suffer serious problems, not least poverty and ill-health, made worse by the decade-long rebel war which ended in 2002.

However, there is a spirit of optimism in the country these days that you cannot ignore. In April 2010, the President celebrated Independence Day by making healthcare free for all children up to 5 years old and all pregnant and breastfeeding women. As well as abolishing hospital and health centre fees, the Government provided drugs and supplies and increased doctors and nurses salaries , so that they no longer need to charge their patients.

In a country where so many live in poverty, even small fees prevent people from taking their sick children to the doctor. All too often, children are brought to the hospital so late in their illness that it is difficult to save them. The first few weeks of the free healthcare policy were pretty crazy at the Children’s Hospital, with enormous crowds queuing outside – including many mothers who had perhaps never brought their children to see a doctor before. Things have calmed down somewhat but overall the hospital is certainly much more busy than it was before the fees were abolished!

It was a great privilege for the Welbodi Partnership to support the Government and the Children’s Hospital through these momentous changes and we are impressed by the way that everyone has risen to the challenge. Our focus has been to continue to improve the Triage and Emergency facilities, so that the sickest kids are identified quickly and treated appropriately. Our partners at Abertawe Bro Morgannwyg Trust in Wales have been sending out a training team twice a year to support this work.

Training Children's Doctors

2010-12-15T11:11:00.000-08:00

As you know, one of the biggest challenges for child health care in Sierra Leone is a lack of specialist children’s doctors. There is only one Paediatrician in government service in a country of 6.5 million people, where more than 1 child in 7 dies before their 5th birthday. Meanwhile, there is a new generation of keen young Sierra Leonean doctors who have had no opportunity to formally train to be Paediatricians.

On this front, 2010 has been a very exciting year. Firstly, in January 2010, we brought in Professor Tamra Abiodun, an inspirational children’s doctor from Nigeria. She soon had regular tutorials and clinical teaching in place, and our trainee doctors were finding out that training to be a specialist isn’t easy! Secondly, we are working closely with respected colleagues at the Ministry of Health to help implement both Diploma and Masters programmes in Paediatrics for young doctors.

By October 2010, two of our young doctors were ready to take their first exams under the West African College of Physicians. These exams are rightly feared amongst young doctors in the region, but both of our candidates passed on their first try. Congratulations to Dr Ishmael Turay and Dr Freddie Coker! And good luck to the rest of the group who are taking the same exams in April, under the Lady Vanneck Fellowship.

Training under the West African College of Physicians offers us the opportunity to produce international-standard children’s doctors over the next few years, with Prof Tamra leading the way and other sub-specialists coming in for several months at a time. But there is still much to be done for us to realize this dream.

First, we need to have the hospital officially “accredited” by the West African College of Physicians, which requires further upgrading of various departments and processes. This is our biggest, most exciting challenge for the New Year, with the prospect of several new Paediatricians trained in Sierra Leone by the end of 2012. This project has been generously supported by the Theresa Sackler Foundation and many others, but we do need additional funds to make this dream happen. Please give generously!

Please make a donation on our website! Your support can be a huge help to sick kids in Sierra Leone.

New Developments in 2010.....

2010-12-15T10:45:00.000-08:00

Two exciting new developments underway at the Hospital should dramatically increase doctors’ ability to diagnose children’s problems accurately.

The first is a major revamp of the laboratory, which has been led by Angela Allen of Swansea University and funded by THET, the British Council and the Oxted Trust. As well as new equipment and supplies, laboratory staff have gone to Swansea to receive training in use and maintenance of the new equipment, all of which will be followed up and reinforced over the coming year. This will have knock-on benefits for the national Maternity hospital next door, which shares use of the laboratory.

The second big improvement is the arrival of an Xray machine. Before now, patients requiring an Xray had to travel miles across town to the main government hospital, which was unsafe for the sickest or those requiring oxygen. We are now working to ensure that appropriately trained staff, procedures and supplies are in place.

The Hospital has benefited enormously this year from a back-up generator, generously paid for by RTC Ltd. Power cuts are common and essential equipment, such as oxygen machines, rely on continuous electricity.

Life-saving equipment was also provided for the Baby Unit, where all children under 28 days old are admitted – often directly from the Maternity Hospital next door. The Oxted Trust and others paid for oxygen concentrators and a suction machine, whilst volunteers including Dr Chris Bird, Tina Koso-Thomas and Dr Fiona Ringholz carried out training for the staff.

First Journal Club at the Children's Hospital...

2010-12-14T00:30:00.001-08:00

Today was the launch of the journal club at the Ola During Children’s Hospital. Two professors, seven national doctors and three expatriate doctors sat together in an office for the first meeting of its kind.

The journal club was launched as a part of the postgraduate training program in pediatrics that will hopefully kick off in early 2011 (more on this soon). Similar meetings held in the hospital or soon to be held include the morbidity and mortality review, the tutorial topics, lectures, grand rounds and the perinatal meeting. The momentum for an academic atmosphere is exciting.

The journal article chosen for today’s event was published a mere three weeks ago in the Lancet and depicts a trial comparing intravenous artesunate versus the gold standard of intravenous quinine for the treatment of severe malaria in children. This is a very relevant topic in a country where malaria is endemic. Malaria leads to a high number of hospital admissions and contributes greatly to the death rate in children younger than 5 years. To give you an idea, in October 466 out of 981 new admissions were diagnosed with severe malaria (not all laboratory confirmed) and 45% of the total hospital deaths were attributed to severe malaria.

One of the national doctors gave an excellent summary of the article including the methods, results and discussion points. His summary formed the basis for a discussion by the professor on the importance of criticizing such studies – pointing out both the positive and negative aspects of the trial. As this was the first time to evaluate such trials, she further discussed the research process and involvement of various players in research.

We then moved on to the application of the discussion points to clinical practice in the hospital. This to me is one of the most important parts of these meetings. Yes, it is good to discuss trials and outcomes and point out whether or not the trial was performed well but in the end one needs to analyze whether or not clinical practice is evidence based and whether or not it needs to be adapted.

The outcome of this trial is that intravenous artesunate is superior to intravenous quinine in the treatment of severe malaria with artesunate substantially reducing the mortality rate in children. Artesunate is said to be simple, safe and effective.

This sounds good and it seems like the best thing to do would be to switch to using intravenous artesunate in the hospital, however, in a place where artesunate is not affordable and scarcely available this is not a sustainable treatment option. So, we have to look at what we can do, which is make sure our use of quinine to treat severe malaria is optimal. You see, when reading the article I was reminded that the preferred way of administering quinine is intravenous rather than intramuscular and 8 hourly instead of 12 hourly. So I brought this up. This of course led to an interesting discussion and critical look at our treatment choice.

Yes, the doctors know intravenous is better than intramuscular, however, for various reasons (poor monitoring of a child’s blood sugar, poor monitoring of infusion rates, lack of fluids and other resources, lack of nursing staff) they choose to prescribe it intramuscularly arguing that it is safer in most cases and generally as effective. Of course, they give this 12 hourly to decrease the chance of an injection abscess. We discussed the issue and went back and forth, deciding to consult the guidelines. Seeing as the World Health Organization recently published the 2010 Treatment Guidelines for Malaria it seemed like a good place to look. So, based on the information and the high cost of intravenous artesunate (although a good cost analysis should be done of iv quinine versus iv artesunate), the patients will continue to receive quinine, but 8 hourly. When possible they will receive it as an infusion rather than as an intramuscular injection but in reality we will have to see how that works.

All in all I would say that the journal club was a success leading to a critical look at malaria treatment at the Children’s Hospital, which will hopefully lead to better outcomes for children coming in with severe malaria. This was a good start to the journal club.

Sandra Lako is a doctor from the Netherlands who previously spent four and a half years in Sierra Leone setting up and managing a pediatric outpatient clinic with an organisation called Mercy Ships. After a year at home, she returned to Sierra Leone to volunteer as medical coordinator with the Welbodi Partnership, a UK based charity supporting the only government-run children’s hospital in a country where 1 in 5 children do not reach the age of five.

As posted on the BMJ site: http://blogs.bmj.com/bmj/2010/12/13/sandra-lako-journal-club/

Want to be part of our team?

2010-12-03T08:25:00.000-08:00

Head of Fundraising

The Welbodi Partnership is seeking to recruit head of fundraising team to join their growing team. The Welbodi Partnership was established to support the provision of paediatric care in Sierra Leone. This is an exciting opportunity to be at the heart of a young and dynamic organisation and to gain valuable experience in fundraising and development. You will initially be based in Freetown to gain an in depth understanding of our work. After the initial month you will relocate to help establish our London office. As head of fundraising you will work closely with our directors to design and deliver our fundraising strategy. You will also be supported by a team of interns.

Job Title: Head of fundraising

Salary: Voluntary, with expenses.

Location: Freetown for one month, then central London

Responsibilities

· Develop long term fundraising strategy.

· Network with high net worth individuals.

· Build relationships with institutional donors.

· Supervise applications to charity trusts.

· Gather information from the team at the hospital on recent developments and relevant figures for donor reports.

· Supervise publicity material and social media strategy.

· Responding to basic requests for information.

· Manage our London office including a team of interns.

Person Specification

Good written and verbal communication skills.
Analytical with excellent attention to detail.
Self motivated and enthusiastic, able to manage own time and work to deadlines.
An interest in development and the cause that Welbodi represents.
Excellent relationship management skills, able to communicate with people at all levels of an organisation.
Excellent organisational skills.
Ability to condense large amounts of information into concise format, identifying key information needed.

Application Process

For more information visit our website : www.welbodipartnership.org

CV and covering email to matthew@welbodipartnership.org

we've come a long, long way together!

2010-11-23T01:15:00.000-08:00

It’s amazing to be back.

Things have changed so much that it’s hard to even know where to begin. The last time I walked through Ola During Children’s Hospital, a year and a half ago, all I could see were broken systems, missing equipment, disenfranchised healthcare workers, and dying children. I left Sierra Leone feeling frustrated and somewhat defeated after a year of battling what felt like insurmountable challenges.

Now, the seeds we planted have finally taken root, sprouted, and begun to blossom. All of the pieces are coming together. Government, donors, hospital staff, other NGOs – everyone seems to be working with a level of energy that I’ve never seen before. It’s truly breathtaking.

You enter the newly paved hospital compound, and first are struck by the construction activity which surrounds the entire campus. The feeding center for severely malnourished children has been de-roofed and will soon acquire a second story. VIP latrines are being built around the back of the hospital. Bricks are being laid for the new staff canteen. The main hospital facade gleams with a fresh coat of white paint.

Inside, the changes are even more dramatic. Women and children fill the benches in the registration and triage area. Gone are the days when mothers carrying sick babies would enter a deserted hospital, desperately find their way up to the wards and be forced to beg and bribe for medical attention. Back then, untold numbers of children died without being seen by a doctor, without so much as an IV in place. No record existed of them ever having entered the hospital, having suffered, died. Today, every single child who enters the hospital is registered with a unique patient number, is measured, weighed and has vital signs taken by specially-trained nursing staff.

Triage

The sickest kids go directly to the emergency room, where children lie two to a bed receiving timely care of a quality that is rarely found elsewhere in Sierra Leone. We now have oxygen concentrators, enough for many (although by no means all) who require it; a back-up generator so that power outages don’t cost lives; doctors on call in the hospital 24-7 (with comfortable sleeping quarters and recent government salary increases that allow them to devote their time to government service); a free supply of most essential drugs (for which we have the Ministry of Health and the German Emergency NGO, Cap Anamur, to thank); and a more motivated staff to provide much-needed care. Since the removal of user fees for children under the age of 5 in April, hospital numbers have skyrocketed. The place hums with the energy that is being devoted to the business of saving lives.

The Emergency Room in Action

And we do, indeed, save lives.

I remember the days when the hospital mortality rate was upwards of 20%. We will soon publish data which shows that mortality has almost halved, which represents hundreds of lives saved over the past year alone. It’s a compelling argument in favour of free healthcare, targeted interventions to improve the quality of clinical care, collaboration between government and NGOs, and, crucially, the slowly-slowly locally owned approach that we have tried to demonstrate.

Much to celebrate! And, as always, lots more to be done.

Dr. Toyin Ajayi is a Director of the Welbodi Partnership and spent a year in 2008-2009 working as the Medical Coordinator in Freetown. She will spend the next few weeks at Ola During Children’s Hospital and in the surrounding communities, and will be blogging frequently about her experiences.

Prospects and Challenges of a new x ray unit...

2010-11-19T09:24:00.001-08:00

The Ola During Children’s Hospital is close to having the x ray unit up and running. This is very exciting especially since it has been 6 years since the last x ray was taken at Ola During Children’s Hospital. Can you imagine a hospital without x ray services?

Presently children need to travel across town to Connaught Hospital for x rays. This is often a three-day process. The child receives an x ray request form on day 1, goes to Connaught very early in the morning on day 2, and goes back to Connaught on day 3to pick up the x ray and report. This is an obvious delay in the diagnostic process. Also, for very sick children, having to travel across town is simply not possible because there is no way to transport them safely, especially if they are in need of oxygen. Clearly, there is a need for a functioning x ray unit.

The new x ray unit will complement the ultrasound services in forming the radiology department shared between Ola During Children’s Hospital and Princess Christian Maternity Center.

In June the Ministry of Health and Sanitation promised to deliver an x ray unit to the hospitals. Honestly, I was a bit skeptical. However, they kept their word and mid-July an x ray machine was delivered to the radiology department. Step one was complete. The next step: assembling/installing the unit. This took longer than expected, but was a success. The next hurdle was to connect the new processor to the water supply. Unfortunately this proved too difficult, in part due to lack of high quality plumbing but also due to the poor water supply at the hospital. It was decided that for now the old processor would be used until the water situation has improved.

Now that the x ray unit is ready for use, the department is faced with the biggest challenge yet, namely, the lack of x ray films and developer and fixer solutions. The government supplied central medical store is in short supply and it is uncertain when or where the next stock will come from. To further compound the problem, Connaught hospital can now only give 10 children access to free x rays per day due to their limited supplies. Of course, one can still pay for an x ray but the majority of the families do not have the Le 30,000 – Le 40,000 ($8-10) needed for one x ray. Yesterday there were three children in the feeding center needing chest x rays who have already made the early 5 am trip to Connaught two days in a row and been turned back because the 10 slots for free x-rays for the day were already used up. This is a bit of a dilemma.

So, now I sit here wondering where the supplies will come from and how this department will be sustainable? Will the Ministry step in and be able to help with a constant supply? Will the hospital need to find funds to buy films and solutions from Guinea or possibly even the UK or USA? Will the hospital be able to provide free x ray services for inpatients or will it be on a cost-recovery basis in order to generate income to purchase more supplies? And what is the role of the non-governmental organizations (NGOs) in this? If the NGOs help with the initial supply, how long must they continue supplying and who will sustain this? It is a dilemma and I am afraid I do not have a solution.

So, if anyone does have a solution, feel free to comment. And if anyone out there has a never ending supply of x ray films and solutions that they could deliver to the door of the hospital free of charge, you would be more than welcome to do so.

Let’s hope that the x ray department starts functioning soon. It will improve clinical care for the children and it will also bring the hospital one step closer to accreditation as a teaching hospital. Ola During will move forward one step at a time…

First published on BMJ Group Blogs

Night check at the Children's Hospital.

2010-11-14T11:30:00.000-08:00

It’s 1:00 am. My colleague and I have just returned from a surprise visit to the hospital. Three times a month we do spot checks on the wards; periodically we check during the early or late shifts and occasionally during the night and weekend shifts. The reason for these checks is that the Welbodi Partnership set up a performance-based incentive scheme a couple of months ago to monitor nursing care at the hospital with the aim of improving staff performance and ultimately reducing child mortality.

Unfortunately nursing care at Ola During Children’s Hospital has been suboptimal for a few years. This is due to various reasons, one of which is that for years salaries were low, and nurses were forced to work elsewhere, abandoning their posts at the Children’s Hospital. This caused a dramatic fall in nursing standards. Also, high medical fees meant that patient wards were half-full and patients often could not afford proper treatment and mortality rates were high. This was demoralizing and led to even more nurses not showing up to work. Lack of equipment and supplies worsened the matter.

In April 2010 the free health care initiative was launched for patients under-5 years. This led to more patient admissions and a heavier workload for the nurses. For some, this made it difficult to stay motivated again.

Thankfully, a few months ago the government increased the salaries substantially, which led to an influx of nursing staff. For some nurses that was enough of a motivator to come to work when scheduled and perform well. Sadly for others, this was not enough of a motivation.

The set up of the scheme is to do spot checks using set criteria to monitor the level of care given. The criteria include checking if every bed has a mosquito net, if every patient has a sheet or “lappa” to lie on, and if soap and water are available. We also check if all scheduled staff are present and in uniform, and if equipment is clean and well maintained. Sharps must be disposed of properly. We look to see if patient’s vital signs have been checked, if medication has been given accurately, if the handover book is filled out and the ward is clean and the nurses’ station tidy. The criteria are modified as time goes on and are often linked to what the nurses have been taught in a workshop.

Although the scheme sounds simple, it is actually quite complicated. It looks at a ward’s performance, not an individual’s performance. So, if a colleague does not show up to work, the others on the ward are penalized. If a colleague has not documented medication properly, points are deducted for the ward and everyone is affected. It does not sound fair, but the idea behind it is that nursing care should be based on teamwork. When one person falls, everyone falls. Unfortunately we are not able to monitor each nurse’s individual performance because that would be a full time job. So, we look at the performance of the ward as a team. If one shift functions poorly, then the other two shifts will be affected.

Another issue is that the same scoring method is used on every ward, but every ward has a different workload. Obviously 3 nurses in the observation unit or measles ward will be able to handle their work load of 5 – 10 patients much better than 2 nurses in a general ward with 40 – 50 patients, or 4 nurses in an ICU with 40 patients. Fortunately Welbodi encourages local ownership and makes sure to engage matron’s office in every check. This allows Welbodi and the matron’s office to discuss issues such as the number of nurses posted to each ward and so on. It also empowers matron’s office to enforce rules and the nurse’s code of conduct.

The actual checks are a bit of an adventure, especially on the weekend or in the night. Sometimes I am a little nervous as I don’t know what I will come across. Fortunately tonight was okay. Some things were not so good and definitely need to be improved, but thankfully there were also areas that had improved. Most of the staff was present which was a welcome change from a few months ago. The main issue now is proper administration and documentation of medication but I am convinced that with more training, mentoring, and feedback this too can improve. As I said before, it’s not simple. Constant monitoring and evaluation of the program is crucial to make sure the scheme still works towards improving nursing care. It needs to be a scheme that continues to encourage the nurses and not discourage them. Their job is not easy but it is so desperately needed and we need to help them find a way to regain a passion for what they do- helping the children in Sierra Leone.

From: http://blogs.bmj.com/bmj/2010/10/08/sandra-lako-on-a-night-check-at-the-hospital/

The Death of a Child...

2010-11-14T11:26:00.000-08:00

Last week there was an ultrasound workshop for the medical officers and I thought it would be interesting to join, so I did. The ultrasound room is adjacent to the emergency room so while we were waiting for everyone to arrive the internist and I were reviewing a few patients. There were many really sick children. One infant had been brought in due to rat bites, although I think the child must have been sick prior to the bites because the child was really unwell. Another child was very pale and in urgent need of blood. Another child had a very high fever and was convulsing. It was hectic.

After thirty minutes, the internist decided to begin the workshop, so off we went to talk about the ultrasound machine, the use of ultrasound as a diagnostic tool, etc. Meanwhile, the emergency department was bustling. After the workshop, we left the ultrasound room by way of the emergency room and I noticed two doctors resuscitating a child. However, minutes later they stopped, realizing it was ineffective. As I stood there and watched I could not help but realize that everyone else in the room carried on with whatever it was they were doing. The other caregivers were not paying much attention, nursing staff was preoccupied with other patients and even the child’s mother could not be found in the emergency room. In silence, the child passed.

After the doctors covered the child with a cloth, they slowly moved away, disheartened by what had just taken place. Meanwhile the now lifeless child remained on the bed and to her left and her right, two other children were struggling to stay alive.

Chills ran through my body as I realized again how much death, has become a part of daily life in Sierra Leone. The death of a child, that would bring masses of people to action in both the hospital setting and the home setting in the developed world, goes by almost unnoticed here. Why is that? It is because unfortunately 1 in 5 children do not reach the age of 5 years. It is not that the death of a child has no affect on people, but they react differently than someone from the West might expect. I’m starting to believe their response has to be different, or they will not cope.

The mothers wail to the point of throwing themselves to the ground in uncontrollable sobbing but seem to move on with life more quickly. They are told to “bear,” which means, “to put up with” or “endure.” They are told not to cry. To me this seems inhumane, but there must be reasons for this. Maybe it’s simply because a wailing mother will cause other caregivers to worry more about their own children. Or maybe it is easier for everyone else involved to cope better. Or maybe it is because in a place with so many child deaths, a mother somehow needs to accept that this time it was her child. I am sure that any time a child dies in the Emergency Room, the other mothers present are worried that their child might be next. What an unsettling thought that likely one or two more children will die in the emergency room today.

Of course the doctors and nurses are affected too, but rather than appearing shocked, they sometimes don’t seem phased by it. I am not saying this to be judgmental and obviously do not know what goes on in their minds but I have noticed how demoralizing child deaths are for the staff. Of course it hits them hard, but they tend not to show their emotions. They are frustrated with the lack of diagnostic facilities or treatment options to save a child’s life. They are irritated that caregivers tend to delay so much before bringing their child to the hospital. They are saddened that the health care situation is changing ever so slowly. When a child dies, the doctors and nurses tend to step back in silence. How long can they continue to give their all when the outcome does not seem to change?

Where the average doctors and nurses in the developed world rarely experience pediatric deaths, these doctors and nurses are faced with children dying every single day. How does one deal with children dying on a daily basis? I think that the only way one can continue to work under such circumstances is to distance oneself from the patients and guard one’s emotions. Clearly in a profession devoted to caring for people it is difficult to find a good balance between building a relationship with the patient and maybe even becoming attached to distancing oneself from a patient and becoming indifferent. When faced with death everyday one has to find ways to cope.

I do hope that the staff continues to cope with the dire situation and of course, hopefully one step at a time, the situation at Ola During Children’s Hospital will improve and child mortality will start to decrease. Maybe someday deaths will not be a part of daily life in Sierra Leone. One day. I just hope that until that day comes the doctors, nurses and other staff will continue to endure under such trying circumstances.

Posted by Sandra Lako, Welbodi Medical Coordinator in Sierra Leone

From: http://sandralako.blogspot.com/2010/09/death-of-child.html

Intraosseous access saves lives.

2010-11-14T11:20:00.000-08:00

One afternoon I passed through the emergency room and noticed two doctors hovering over a patient attempting to get intravenous access. As in many of the emergency cases, the patient’s circulation was poor. While one doctor was attempting jugular access, I suggested inserting an intraosseous needle.

Having experience, albeit a year ago when I was last in Sierra Leone in the outpatient setting, I was handed a standard 19-gauge needle and attempted to get access into the tibia of the left leg. Using some force and a screwing motion I felt the needle push through the bone and within a minute or two the needle was in place. I quickly withdrew some bone marrow content, confirming the needle was in the cavity. I then flushed the needle with normal saline to reconfirm the position. Thankfully, a few seconds later the patient received dextrose and a normal saline bolus through the needle in the tibia. What a relief. Now, I could only hope that the insertion of the needle had saved this patient’s life. Since the condition on arrival was very poor, only time would tell what the outcome would be.

I checked up on the patient every day to assess the general condition and was glad to see a little bit of improvement each time I checked. The patient was soon transferred to a general ward and finally, after about a week, discharged home in good condition.

Fortunately intraosseous access did save this patient’s life. And although many people are not as familiar with this procedure, I would definitely advocate that it should be done more often. Contrary to what many people may think, it is actually not a difficult procedure to perform and as long as a sterile environment is created, the doctor is fairly confident and a large bore needle is available, it can be done successfully within a few minutes. The chance of complications is very small if a sterile technique is used and as long as the needle is removed after a few hours. In my opinion, the benefits of this procedure far outweigh the risks and in an emergency setting it is an ideal way of ensuring a quick delivery of fluids, blood, and medication. I am definitely in favor of intraosseous access.

Sandra Lako is a doctor from the Netherlands who previously spent four and a half years in Sierra Leone setting up and managing a pediatric outpatient clinic with an organisation called Mercy Ships. After a year at home, she returned to Sierra Leone to volunteer as medical coordinator with the Welbodi Partnership, a UK based charity supporting the only government-run children’s hospital in a country where 1 in 5 children do not reach the age of five.

From: http://blogs.bmj.com/bmj/2010/09/23/sandra-lako-intraosseous-access-saves-lives/

Help kids in Sierra Leone without leaving your seat

2010-07-26T03:26:00.001-07:00

Vote online NOW for Rebecca Cridford and the Welbodi Partnership to help us win support from the Vodafone Foundation for our work in Sierra Leone.

Rebecca and Welbodi are in the finals (up against stiff competition) and it’s up to the public to choose the winners – so we need your votes NOW! It takes just 60 seconds and could make a big difference to our work supporting pediatric healthcare in Sierra Leone.

The competition ends on Wednesday 28th July 2010, so just a few days left!

What can you do to help?

FIRST: Vote online for Rebecca Cridford through Facebook. Voting closes on Wednesday 28^th July 2010.

THEN: Tell everyone you know to vote as well. Post a link in your status. Message all your friends on Facebook. Tweet or blog about us. Email your friends, family, colleagues. Forward to any listservs or groups you belong to. We have just until noon on Wednesday 28^th July 2010 to get as many votes as possible.

WANT TO DO MORE?: Contact friends who have blogs or who tweet or facebook frequently and ask them to help spread the word. Ask your school or workplace if you can set up a virtual “voting booth” at lunchtime -- all you need is a connected computer. Call your local radio or write a letter to your local paper to encourage others to vote.

Just a few moments of your time can make all the difference.

Read more below about the Vodafone World of Difference contest, the Welbodi Partnership, and our work at the Ola During Children’s Hospital.

Who is Rebecca Cridford?

Becky Cridford is a UK trained nurse with 7 years of experience in the NHS and overseas. She plans to spend a year working with the Welbodi Partnership at the Ola During Children’s Hospital to support the nursing team to further develop the life-saving skills they need, and to put them into practice. Becky applied to the Vodafone World of Difference programme and was chosen out of over 2,500 applicants to go forward to a public vote on Facebook.

What is the Vodafone World of Difference International programme?

Each year, the Vodafone Foundation supports a handful of inspiring people to work for a year with their “dream charity,” while also providing funds and publicity to those winning charities. More than 2,500 people applied this year for just 8 spots, and it’s now down to a public vote to decide which of 4 candidates will win one of 2 remaining spots! The competition closes

Vote now for Becky and the Welbodi Partnership

What happens if Rebecca wins?

The Vodafone Foundation will provide funding for Rebecca’s year volunteering in Sierra Leone. Vodafone will also make a sizeable donation to the Welbodi Partnership, and we will also benefit from significant free publicity in the UK and elsewhere.

Why do we need support for nursing in Sierra Leone?

Nurses are absolutely vital to save the lives of children in Sierra Leone. The Welbodi Partnership is working to support nurses at the Ola During Children’s Hospital in Freetown in various ways, including in-service training, support to nurse managers to improve supervision, and provision of essential equipment and supplies that help nurses to do their jobs better.

One in four children in Sierra Leone die before they are 5 years old (UNICEF, 2009). There is only one government children's hospital in Sierra Leone, which also serves as a training facility for doctors and nurses. The Free Health Care Initiative launched on the 27th of April this year, which made essential health services free to all pregnant women and children under five, was a wonderful step to improve access but has also resulted in a quadrupling of patient numbers. This puts an added burden on the hardworking nurses and doctors at Ola During.

What is the Welbodi Partnership doing to help?

The Welbodi Partnership’s volunteers work in the Ola During Children’s Hospital to provide on-the-ground training and support to the nurses, doctors, and non-medical staff of the hospital, to improve the quality of care and transform Ola During into a center of excellence for training the next generation of pediatric health workers. To learn more, visit www.welbodipartnership.org .

Vote now on Facebook to help Rebecca Cridford and the Welbodi Partnership win support from Vodafone.

Meet Tamra Abiodun, our Director of Clinical Teaching!

2010-06-13T03:54:00.000-07:00

Welbodi had an additional fundraising and communications volunteer in Freetown for the first half of 2010, Katy Willings. She spent two days at ODCH in April, interviewing some of our key team members so that our supporters could get a first hand insight into the amazing work happening on a daily basis at the hospital, and the progress which has been made possible by the ongoing generosity of our donors and volunteers. Freetown bandwidth made uploading the content whilst on the ground in Sierra Leone a pipedream, but now back in the UK, I am (hopefully!) able to share with you the inspiring stories and personalities I encountered.

Apologes for the background noise in the videos, the hospital was reassuringly noisy the afternoon before free healthcare was launched in Sierra Leone, and the Prof's little office was a relative oasis of calm.

29th April 2010: Emily Spry on the launch of the free health care initiative

2010-05-26T05:27:00.000-07:00

Yesterday was Independence Day in Sierra Leone, marking the start of the country’s fiftieth year since independence. It was also the launch of the President’s free health care initiative for pregnant and breastfeeding women and children under 5.

I previously shared with you my frustrations and grumbles as we got ready for the launch, specifically about problems with the allocation of drugs.

In the bigger picture, this is a really bold and important step by the President and by Sierra Leone as a whole.

Making health services accessible to those patients who need them most is a key weapon in the fight to reduce maternal and child mortality.

There have been nothing less than heroic efforts by the Ministry of Health and its funders and partners, who have been busting a gut for months to make this dream a reality.

The launch itself was held at our twin hospital, the Princess Christian Maternity Hospital and afterwards the President made a short tour of the two hospitals, visiting the therapeutic feeding centre, where malnourished children are cared for.

A huge throng of mothers, babies on their backs, had been queuing outside the Children’s Hospital since very early in the morning. Crowd control has been a bit of a challenge, but everyone pitched in with staff and volunteers making sweeps through the crowd to pick out emergency cases.

On Independence Day itself, we saw around 350 patients, around eight times our usual number of patients. There were a similar number today (Wednesday). All the doctors were working flat out in the outpatient department, apart from one in the emergency room and one in the neonatal unit. The wards are full to bursting – three-in-a-bed is now quite widespread. The drug supply problem is being taken seriously and we are expecting a quick re-supply, as many useful outpatient drugs have now run out.

Fingers crossed that the outpatient numbers will calm down fairly soon, as is expected. I’ll let you know how it goes.

22nd April 2010, Emily Spry: The free health care initiative in Sierra Leone

2010-05-26T05:21:00.000-07:00

It is now less than one week until the launch of the free health care initiative in Sierra Leone when, as regular readers will know, government health facilities, such as my own dear Children’s Hospital, will be required to provide free healthcare to children under five, pregnant and breast-feeding women.

The big day is Tuesday 27th April, Independence Day, when the nation will celebrate 49 years since the end of colonial rule by Britain.
Clearly, this is a hugely complex project and myriad things need to come together to make it possible. A good deal of money is being spent by the UK Department for International Development (DFID), UNICEF, and several international non-governmental organisations.

One key step has been to increase health-worker salaries to a living wage, so that it is plausible to demand that they stop charging user fees. This has been done, though negotiations did involve a full-blown strike.

My sources now tell me that the strike was only ended by a secret meeting in which the President agreed to increase salaries further. This apparently will ensure that first year doctors take home $600 after tax, rather than being taxed heavily on a gross salary of that amount.

Of course, the salaries haven’t actually been paid yet and many beleaguered health workers prefer to reserve judgement “until we feel the money in our pockets”.

The second key issue is for the government to supply free drugs and consumables to the hospitals and clinics for the first time in many years.

I’m sure that UNICEF and the others had a strategy for this at some level. Certainly, they have brought several million dollars’ worth of drugs into the country.

For many months now, I have tried to find out which drugs we can expect at the Children’s Hospital, and how much thereof.

Just three days ago, the Hospital Pharmacist finally got a list.

Unfortunately (and AGONISINGLY predictably), whoever wrote the list clearly has no idea what the Ola During Children’s Hospital is (the clue is in the name) and what that might mean in terms of our drug needs.

According to this list, we are to be given the same drugs at the same quantity as if we were a small primary health unit.

Thus, we have been allocated inappropriate drugs and consumables (clotrimazole vaginal suppositories, anyone? Or would you like to have our allocation of drugs used only in childbirth?)

I can’t see any injectible anti-malarials on there, though I’m still hoping that I’m missing something.

And we have been allocated tiny quantities. In a really staggering disappointment, we have been allocated 13 intravenous cannulas. For a hospital that admits around 800 patients a month.

We are trying to engage the relevant people to make changes but, with three working days to go before the launch (and nothing yet delivered to the Hospital), it may well be too late.

Another key to all this is communication. A truck turned up at the Children’s Hospital today, pumping out music and blaring messages about free care.

Who is going to tell an expectant public that it’s only basic healthcare that is free? (if your child needs a second-line antibiotic, you will need to go out and buy it or go without). Who is going to tell them that the 13 cannulas have run out?

I found out today that the President is going to launch free health care at the Children’s Hospital. I’m not sure if that will be a blessing or a curse.

8th April 2010, Emily Spry: Emily Spry is back in Freetown

2010-05-26T05:04:00.000-07:00

If you blinked, you probably missed it, but I’m back in Freetown after a short Easter jaunt to the UK to see my family and a few friends. I was surprised but delighted to be snowed on in the mountains in Wales; at least I can say that I experienced the legendary winter of 2009-2010, no matter how briefly.
When I left, the Children’s Hospital was entirely empty of patients; the doctors and nurses were nearly two weeks into a strike over pay. Several of the administrative staff were beside themselves, as they milled around the empty corridors; they hated seeing the Hospital that way. The only silver lining was that the Environmental Health people got to spray the wards to their hearts’ content, hopefully banishing unwanted insects.

However, the day after I left, the president issued a statement that all those not back at work by the Monday morning would be fired. Frantic meetings followed and eventually the associations agreed; they would go back to work.

It seems that ultimately, the nurses will get around 150 USD per month, with more for very senior nurses, whilst the house officers (i.e. newly-graduated doctors) will get around 600 USD, pre tax. Paying the highest rate of tax plus national insurance, the house officers will take home around 300 USD per month.

The mood seems to be cautiously optimistic. “It’s not what we wanted, but it’s better than nothing,” several people have said to me.

The focus is now moving to the looming day (27 April) when user fees for pregnant and lactating women and children under 5 will be abolished. I would love to say that the Children’s Hospital is ready but it’s not. They are currently trying to create an appropriate store for the free drugs and a dispensary.

For me, triage is the scary part. We expect a huge influx of people coming to get whatever free stuff they can while it’s there, not yet believing that the programme is to continue. The danger is that the emergency cases will be hidden in the crowd.

The great thing about going back to work today was appreciating again the incredible warmth of the people that I work with here. I was only away for a week but everyone welcomed me with huge smiles and hugs and asked me about my holiday, my family, my journey and everything else. It’s so different from the working culture in the UK, where a brief nod would probably have done. After very mixed feelings leaving family and friends at home, today I felt really glad to be back.

26 March 2010, Emily Spry: The Strike Continues

2010-05-26T04:59:00.000-07:00

After 11 days, the total strike of all government healthcare workers in Sierra Leone has finally been elevated to a BBC World Service African news headline.

Yesterday, the President called all the doctors and nurses to a meeting in a room at the Stadium.
I was also indirectly invited, but decided that it would be better to stay away.

As you know, I’m entirely sympathetic of the doctors and nurses, although I do very much regret the suffering the strike is inflicting on those poor people who rely on public healthcare. The Welbodi Partnership has always said that staff must be paid appropriately as an essential part of any attempt to improve healthcare here. It’s common sense that nurses cannot work for the Government in any meaningful way when they are not paid enough to cover their transport costs to and from work.

At the same time, we are only able to work in a Government Hospital because of the approval and cooperation of said Government. I was very keen to avoid being asked to come out for one side or the other in a public meeting!

The meeting took things back to square one. The President’s exhortations and promises did not impress the health workers; they did not even applaud him, which seems like quite a statement in a country where people respect their elders. They rejected his pleas to call off the strike and go back to work.

The strike has apparently also spread “upline” (a lovely phrase left over from the days of the railway, decades ago) to the towns and villages outside of Freetown.

The good news is that yesterday we managed to transfer the last three babies from our bizarre temporary ward at the private hospital. These children were those left behind in Children’s Hospital after the strike was called. They were too sick to go home, so a few volunteers ended up looking after them.

Yesterday, I once again prevailed upon the professionalism and humanity of the wonderful Lieutenant Colonel Foday Sahr, who runs the Military Hospital in Freetown. Although packed to the rafters with those who would normally be treated in the public hospitals, he and his staff agreed to take the three babies and one very anaemic mother.

The small Paediatric ward and Maternity unit at the Military Hospital left a strong impression. The nurses and doctors are present, proactive and communicative; the wards are clean, tidy and organised.

I’m sure that there are many factors contributing to this; the Hospital is resourced directly by the Ministry of Defence, the staff organised in the strictly hierarchical command structure of the military etc. But they also have a great leader – knowledgeable, kindly and determined to improve the services the Hospital provides.

I am going back to the UK tonight for a week. It seems a rather frivolous jaunt in some ways but after 8 months away, it is also very welcome. I’m going to meet my first godson (born in September – he has been patient, as have his parents!), read a decent newspaper, drink real milk and help my sister celebrate her 30th birthday. And I’m going to bring back a lot of parmesan.

“Wi go si back Freetong” (See you later Freetown).

March 23rd 2010, Emily Spry: Sierra Leone doctors still on strike

2010-05-26T04:57:00.000-07:00

Despite my best efforts, I seem to have ended up with four sick babies and a mother with an infected Caesarian wound, all of us stranded in an unused wing of the fanciest hospital in Freetown.

It all started on Wednesday when the doctors and nurses went on strike across the capital. As I have noted before, doctors here are paid around $100 per month and nurses around $50 per month, not enough to live on in Freetown. After the strike was called, there was a flurry of phone calls and between myself, two German NGO nurses, the VSO doctor and an experienced neonatal nurse, who also volunteers almost full-time with me for the Welbodi Partnership.
The gut reaction was for us to step into the breach at the Hospital. At least to review those who were too sick to be discharged and field the Emergency cases. To be heroes.

But there were lots of questions. Safety for one; VSO ordered its volunteers to stay away from the Hospitals, as there could be risks in a situation with angry staff and patients. In fact, no trouble
materialised, but it wasn’t an outlandish concern.

Secondly, and more complicated, the question of whether we should interfere with the healthcare workers’ decision to shut the Hospital down. Who were we to go against their decision? The healthcare workers know the implications of what they are doing; patients will die. But they feel strongly enough that the upcoming abolition of user fees (the President’s Free Healthcare Initiative) cannot and will not work if their conditions of service are not improved to fill the
gap left by user fees. They feel that this is their only chance to force the Government to meet their demands.

This also leads on to what our role should be here. The Welbodi Partnership’s approach is to form a long-term relationship with the Hospital that will bring slow but, hopefully, sustainable improvement. Breaking a strike is a strategy that could seriously damage important relationships and raise questions about our role.

After long discussions and advice from my boss, all of this led to me staying away on Wednesday and I had a prior engagement speaking at a conference on Thursday. But by Friday, I felt that it was time to go and have a look at what was going on.

In retrospect, it seems that the best way to deal with an insoluble ethical dilemma is to stay as far away from it as possible. As soon as I got into the Hospital, I was sucked right back in.

When the strike was called on Tuesday evening, the staff had discharged most of the children, with only the sickest remaining. By Wednesday, there were less than 30 patients left, gathered in the ICU. Somehow, the German nurses and another volunteer ended up caring for these patients between them, with an occasional doctor review. The Military sent a nurse to relieve them on Thursday night. The Head of the Hospital forbade further admissions (not that the skeleton team
could have handled it) and all patients were turned away at the gate.

By the time I arrived on Friday morning, they were exhausted. Some senior nurses were also murmuring about why the Hospital was still open three days after the strike started. So, with the Prof’s help, we swung into action, reviewing, discharging and ringing around to try to find Hospitals that would take some of them.

The Military Hospital generously accepted some patients and we discharged several more. But we were left with four sick babies, all on IV drugs, two of whom were dependant on oxygen. The manager of a private hospital offered us a room with some beds, but had no extra staff; he had already taken around 15 surgical patients from the main Hospital in town. There was talk of a general strike at the Children’s Hospital, so the security and porters would be gone by Monday.

Late on Friday night, we ended up cramming four cots, an oxygen concentrator, boxes of drugs and equipment, four babies, mums, aunts and grandmas and all their stuff into two cars. A friendly local policeman agreed to lead our strange convoy through town on his police motorbike, haring down the middle of the traffic, flashing and beeping (we have no oxygen cylinder, so we needed a quick transfer for the babies dependent on oxygen). I have never crossed traffic-clogged Freetown at such a pace.

I also never quite imagined myself in this situation, especially in my non-clinical role with the Welbodi Partnership. I tentatively think that we have done the right thing. We made sure that the children already admitted to the Hospital were cared for appropriately, though we didn’t accept any new cases.

There is no doubt that sick children will die because of this strike. But I am not here to break the strike of the Sierra Leonean doctors and nurses whose duty it is to care for those children. I believe that I am here to try to help them build a system whereby all children have a better chance at life-saving healthcare. And paying doctors and nurses properly is a must for that to happen.

But it’s a bit of a minefield, to say the least. As I write this, I do wonder if it will sound insane or just plain wrong from another perspective. Do please let me know.

March 18th 2010 Emily Spry: Doctors and Nurses on Strike

2010-05-26T04:53:00.000-07:00

Here in Freetown, both the doctors’ and nurses’ associations have decided to go on strike with immediate effect.

The strike has been precipitated by the Free Healthcare Initiative, which is due to remove user fees for healthcare for pregnant and nursing women and children under 5 years old on the 27th April 2010, Sierra Leone’s Independence Day.
The issues behind it have, however, been brewing for a lot longer.

In the Children’s Hospital, user fees are low compared to many other Hospitals, although still prohibitive for most of the poor families who live in the slums around the Hospital.

Thanks to the contribution of Cap Anamur (German Emergency Doctors) and other partners, patients at the Children’s Hospital pay a one-off consultation free of 15,000 LE (3.8 USD). If they are admitted, drugs and other consumables (IV lines, dressings etc) are free, though many laboratory tests and blood transfusions are still charged for.

The Free Healthcare Initiative was announced by the President in November 2009 and is supported by donors and NGOs including DFID, Save the Children and various UN agencies. Since the announcement, a progressively more frenetic atmosphere has been building up at the Ministry of Health and Sanitation, the Ministry of Finance and in all health-related organisations across the capital. With six weeks to go to the launch, major decisions are still to be taken and many crucial issues are still to be resolved.

The plan is that all user fees for the three vulnerable groups are to be abolished. Huge consignments of drugs and consumables are being shipped in and will (inshallah) be distributed to the patients who need them. Salaries are to be raised for all staff, with incentives for hard-to-fill rural posts. Performance-based incentives are to follow next year.

So, what on earth are the doctors complaining about?

Firstly, doctors and nurses are extremely poorly paid, even by the standards of neighbouring countries, such as Liberia. Junior doctors, when they are fortunate enough to be “absorbed” onto the Government payroll after graduation, are paid around 100 USD per month.

I am paying 550 USD per month for a bedsit. Even taking into account the fact that I have the luxury of relatively constant light and water, and the inevitable “whiteman tax”, it is clear that living in Freetown is not cheap.

Moreover, the user fees actually contribute significantly to the doctors’ income at present. The consultation fees are put into a pool and shared out according to seniority. The Children’s Hospital medical officers get up to 200 USD per month from the user fees pool.

So, using this example, to avoid an income loss with the Free Healthcare Initiative, these doctors will need to be paid roughly three times as much as they are at present.

Moreover, it is the intention of this policy to substantially increase access to healthcare. In other words, there will be more patients and therefore more work. For a doctor who sees 40 or 50 patients a day in outpatients, this is not a very appealing prospect, especially if combined with a loss of income.

The whole initiative is brave and fascinating. There is consensus among those involved in the planning that it has already forced a lot of progress in the healthcare sector here that might never have happened otherwise. For example, cleaning the payroll of “ghost” workers and improving the process for absorbing new staff (previously many worked as “volunteers” for years, awaiting laborious process at various Ministries).

However, it is also a risky strategy and there is a lot of work still to be done, prior to 27th April and after the launch. The drugs may have started arriving in Sierra Leone, but if the doctors and nurses aren’t satisfied, I am not sure what will happen.

A new era at the Hospital?

2010-03-08T11:06:00.000-08:00

Our Medical Coordinator in Freetown, Dr Emily Spry, is writing a blog about her experiences in the Children's Hospital with the Welbodi Partnership.

Read on for the latest installment, about exciting improvements over the past few months...

From: http://blogs.bmj.com/bmj/category/emily-spry/

Over the past month or so, things have been changing fast at the Children’s Hospital, thanks to my new hero, Professor Tamra Abiodun.

As you may remember from my previous posts, there is a desperate shortage of specialist children’s doctors in Sierra Leone. In a country of 6 million people, around 1 million of whom are children under 5 years old, there is only one trained Paediatrician in clinical Government Service. Dr David Baion is the Specialist-in-Charge of our Hospital and therefore has to grapple with enormous administrative, clinical and teaching responsibilities.

At present, there is no training programme in Sierra Leone to produce more Paediatric specialists. Some of the young doctors at the Children’s Hospital have been working there several years and have been on short courses organised by the World Health Organisation and the like. But they have not had access to any formal post-graduate training. Under the West African College of Physicians, it takes a minimum of 4 years to train a Fellow in Paediatrics i.e. someone who could then train others to become Specialists. As things stand, however, no specialist Children’s doctors are being trained to meet the country’s substantial need.

On this background, the Hospital and the Welbodi Partnership felt it would be helpful to bring in a Consultant Paediatrician from elsewhere, who could contribute to teaching for medical students and young doctors.

By happy coincidence, Prof Abiodun, a Paediatric Consultant and Associate Professor, was in town late last year for a short contract with WHO. She happened to meet one of our medical officers, who told her how desperate he and his colleagues were to get further training and one day become Paediatric Specialists themselves. She was moved by their story and a train of events was started that led to her arrival in Freetown in January 2010.

It hasn’t been easy. As you will know from my blogs, the Hospital is often deficient in basic supplies and systems and staff are not adequately trained. Not to mention the potential political minefield of an outsider coming into a Government system, but being paid an “international salary”, way above the pittance that the Sierra Leone Government currently pays doctors.

The great thing about Prof Abiodun is that she has been through all this before; she was a founding member of her department in Nigeria, which has gone on to become a fully-fledged training centre for Paediatrics, accredited by the West African College of Physicians to train specialists. Not only does she know how things can and should be done in West Africa, she has experience of the long road towards the lofty goal of becoming a high-quality Teaching Hospital.

Her personal qualities are as important as her professional experience. She has this bubbling enthusiasm and warmth, combined with a hard-nosed no-nonsense attitude when important issues are at stake, presumably sharpened by many years as a successful African female.

I have learnt a huge amount from her; as much about African values and perceptions as about how to develop high quality Paediatric training. Her faith that we are doing the right thing, gives me confidence and strength when the challenges seem overwhelming.

The changes so far are quite striking. The doctors are on a proper rota, rather than having one poor soul on constant nights. Units previously neglected have daily ward rounds by the doctor responsible. Tutorials and clinical meetings happen three times a week; the doctors prepare these exhaustively. There are twice weekly teaching rounds and a Specialist clinic. The drug formulary is being revised and prescribing practice improved. Most impressive of all though, is the excitement and can-do attitude amongst the doctors. Some have been in the Hospital for a number of years but, for the first time, they feel that they are learning, improving their practice and moving forwards. There is still a long way to go, but it’s fascinating to see what one very optimistic and determined leader can do.

Reaching new heights for The Welbodi Partnership.

2010-03-01T14:21:00.000-08:00

At eight thirty in the morning of the 18th February my sister Katharine Clark reached the summit of Mount Kilimanjaro, after four days of solid trekking whilst fighting the effects altitude sickness. Mount Kilimanjaro is the highest mountain in Africa.

Katharine said, “I thought it was about time to head off on another adventure, Matthew has been working on this charity for nearly three years now so it is about time that I get my butt in gear and help him by climbing a mountain!”

On her way up the mountain Katharine raised £1600 for The Welbodi Partnership.

Katharine, on behalf of The Welbodi Partnership I would like to say thank you very much. I am also greatly relived that you are safely off the mountain!

Matthew Clark
Co-director Welbodi Partnership

If you would like to sponsor Katharine it’s not too late, just click here (http://www.justgiving.com/Katharine-Clark).

Welcome: Professor Runsewe-Abiodun

2010-02-17T01:43:00.000-08:00

The Welbodi Partnership is delighted to have been able to bring Professor Tamra Runsewe-Abiodun to the Children's Hospital.

Professor Tamra is a highly experienced Paediatric Consultant and Associate Professor from Nigeria and has been appointed as the Director of Clinical Teaching at the Children's Hospital.

She is a fellow of the West African College of Physicians, Paediatric Faculty.

As such, she has been re-organising the Doctor's rota and timetable to ensure that they receive high-quality clinical teaching and daily support in their endeavours to improve their own practice and the quality of care at the Hospital.

The doctors are delighted to have her here and we will keep you updated on her progress. It's a very exciting development!

Latest updates from Freetown

2010-02-17T01:40:00.000-08:00

This is the latest edition of a Blog that Dr Emily Spry, our Medical Coordinator in Freetown, is writing for BMJ.com.

...

Most of my job here in Freetown requires skills not covered at Medical school or my GP training thus far. For a start, most of my role here is about management, coordination, and training. But, trying to get things done on behalf of a small charity in a poor country, there are many unusual demands, which are hard to prepare for.

Many of these demands come about because the Welbodi Partnership, the charity for which I volunteer, supports the Children’s Hospital in a rather unusual way.

The Directors of the charity, mindful of others’ failed attempts, tried to find a more efficient and sustainable way to transform the Hospital. The first step was to build relationships within the Hospital and with the Ministry of Health and to spend a lot of time trying to understand in detail the problems and the barriers that keep things from changing for the better.

After some time, they formed a Board which brings together the Chief Medical and Nursing Officers from the Ministry, the Management of the Children’s Hospital and representatives of the Welbodi Partnership. This Board meets every three months to consider proposals put forward by the Hospital for how Welbodi funds should be spent. It also reviews progress on previously-approved proposals.

We had our quarterly meeting last Saturday and around 30,000 USD worth of funding was approved, for projects ranging from improving the water supply, to furniture in the Outpatient Department, to pulse oximeters and suction for the Special Care Baby Unit, to making more basic tests available in the Emergency Room.

It was all immensely cheering. Until I remembered that I now have to help the Hospital implement these projects.

I know from experience that this involves things well beyond my ken. How often in your UK practice have you designed an Emergency patient trolley from scratch and given your drawings to the welder? Only to find that caster wheels with brakes cannot be sourced in Freetown.

Luckily, I only had a single prototype made before committing more money. The nurses politely but firmly stuck the brake-less trolley in the corridor and reverted to the hip-height beds with no sides. Don’t worry, they said, the mothers make sure they don’t fall off.

Fortunately for me, I persuaded my partner to accompany me to Freetown this year. Alex has been volunteering as a small business advisor, helping Sierra Leonean entrepreneurs to get their businesses going. But, knowing his many practical skills and problem-solving nature, little by little, I have inveigled him into the Hospital and its problems. As a result, he spent the whole of this Saturday at the top of the 5-storey high water tower, working with the Hospital maintenance team to fix the water pump. I think it’s a key new skill for me, this inveigling.

Emily Spry is a doctor from London who has taken a year out of her General Practice Specialty Training Programme to live and work in Sierra Leone, West Africa. She is working for the Welbodi Partnership, a charity which supports the main government Children’s Hospital in a country where more than one quarter of children die before their fifth birthday.

Thanks to your donations: More Oxygen for Sick Children

2010-01-25T11:41:00.000-08:00

Thanks to our generous supporters, Welbodi Partnership has been able to buy four smart new oxygen concentrators, which arrived at the Hospital earlier this month.

These fantastic machines provide essential oxygen for up to four sick children at a time and are undoubtedly saving lives every week, if not every day. Prior to this, the Hospital had only four machines and babies and kids who needed oxygen often went without.

Other work-in-progress includes adding four extra water tanks, which will store water for when the mains supply is interrupted (as it often is).

We are also incredibly excited this month to have employed an Associate Professor of Paediatrics from Nigeria, Prof Abiodun, who is charged with guiding the hospital towards teaching hospital standards, so that it becomes the place where Sierra Leone’s future Paediatric doctors and nurses can be properly trained.

Reaching our vision of a centre of excellence for Paediatrics in Sierra Leone is going to take a lot more time, money and effort, with many challenges along the way. But the Hospital and its partners are committed to making it happen, bit-by-bit (or “Small small” as they say in Krio).

Happy New Year

2010-01-15T00:47:00.000-08:00

Dr Emily Spry, Medical Coordinator at the Welbodi Partnership, is writing about her experiences at the Children's Hospital for the BMJ. Her latest blog is below.

http://blogs.bmj.com/bmj/category/emily-spry/

It’s a new year at the Children’s Hospital and everyone is cheerful. The figures from the last months of 2009 suggest that inpatient mortality has decreased substantially, compared to the equivalent period in 2008. We are also more popular; the number of inpatient admissions has tripled over the past six months.

The Children’s Hospital is fortunate to have substantial support from Cap Anamur (German Emergency Doctors), who pay attendance-based monthly incentives to staff and provide free drugs and consumables to all inpatients. But this is not a long-term project and may end as early as July this year. The Welbodi Partnership, which I volunteer for, does not yet have the resources to step in and take over this expensive project, though we are doing our best to seek other options.

The staff rightly dread going back to the dark days of previous years, when children died for lack of drugs that their parents couldn’t afford and staff attendance was much less. As I have said in a previous blog, the junior nurses are paid only 120,000 LE (around 30 USD) monthly by the Government, meaning that, prior to the incentives scheme, many of them had other jobs to make ends meet.

In fact, there are big changes afoot in the whole health care system in 2010. With considerable encouragement from donors and NGOs, the President has announced that health care will be provided free for all pregnant women and children under 5 years old from 27th April 2010, the country’s Independence Day.

We do not yet know how this will work on the ground. Can we hope for an increase in healthcare workers’ Government salaries? Can we expect a regular supply of drugs and essential consumables (e.g. gloves, cannulas etc) to the Hospital?

One thing that seems fairly certain is that the Government intends to eradicate the informal user fees charged in all healthcare facilities.

There’s no doubt that user fees are a barrier to healthcare and everyone agrees that they need to go. The challenge is how to deliver quality healthcare for free in a system that currently relies on those user fees.

At present, a consultation fee (15,000 LE; 3.8 USD) supplements the Hospital running costs and doctors’ wages. The Hospital management faces a long and difficult procedure to get funds or resources from the Ministry and has not had any drug supplies from the Ministry since 2006.

The Government, donors and NGOs are meeting regularly in the coming weeks to devise a plan that we hope will make the President’s promise come true on 27th April 2010. I will keep you updated!

Emily Spry is a doctor from London who has taken a year out of her General Practice Specialty Training Programme to live and work in Sierra Leone, West Africa. She is working for the Welbodi Partnership, a charity which supports the main government Children’s Hospital in a country where more than one quarter of children die before their fifth birthday.

Improving child mortality

2009-12-01T12:47:00.000-08:00

Our Medical Coordinator, Dr Emily Spry, is writing for the BMJ about her experiences at the hospital...

http://blogs.bmj.com/bmj/category/emily-spry/

A relatively newly-posted medical officer told me how she resisted returning to the children’s hospital after her three month stint here as a house officer last year. “It was so awful when the children died, and they died all the time. I went home and cried every night.”

If you believe the stats (which are certainly not bulletproof but hopefully skewed in a fairly consistent way), the inpatient mortality rate has fallen from 15-20% in previous years to less than 7% last month. A large part of the credit must go to German charity Cap Anamur, which has implemented free drugs and basic disposables for all children admitted as inpatients. I’m hoping for further improvement this first month of our Emergency Room, though there are also seasonal variations; we should expect less mortality now that the rains have finished.

The medical officer was pleasantly surprised by how the hospital has changed in the past year, but it’s still tough on those days where several children die. She was particularly frustrated and upset the other morning, when it emerged that a child with meningitis who “passed off” had not been given his antibiotics overnight.

We discussed the different ways of addressing how this had happened and how to prevent future mistakes. Partly as a result, we’ll be restarting the lapsed “medical meetings” next week, which will look at difficult or troubling cases.

But when it came to the issue of trying to establish the details of who had done what on this particular night, she drew back. “I don’t believe in it myself,” she said, “but there are some people here who have special powers. There are people in this side of town where you can pay just ten thousand Leones [less than 2 GBP] and have a curse put on someone. I don’t want someone to have a reason to hate me.”

She related a tale of a friend who developed a severe skin condition that no conventional doctor could diagnose or treat. When she sought the traditional healers’ opinion, he was able to diagnose a curse and cure it with a special potion.

“As I say, I don’t really believe in it myself, but you have to be careful in this country.” She seems to believe it enough to avoid causing problems for a nurse whose neglect or mistake contributed to this child’s death.

Is this a cultural expression of something rather more familiar? No one wants to be seen to rock the boat, to point a finger of blame, because of the potentially dramatic social consequences.

Somehow we need to create an environment and a process through which we can examine what happens and raise the standard of care. It’s just, as always, a bit more complicated than I thought.

Emily Spry is a doctor from London who has taken a year out of her General Practice Specialty Training Programme to live and work in Sierra Leone, West Africa. She is working for the Welbodi Partnership, a charity which supports the main government Children’s Hospital in a country where more than one quarter of children die before their fifth birthday.

Recruiting: Voluntary Medical Coordinator 2010-2011

2009-11-24T06:05:00.000-08:00

Voluntary Position Available – Medical Coordinator
Location: Freetown, Sierra Leone
Assignment Length: One year
Application Deadline: 31st January 2010
Starting – July 2010 (start date may be somewhat flexible)

Job Description

The Medical Coordinator (MC) will provide technical leadership and contribute to the development and implementation of ongoing and new project activities aimed at improving the quality of paediatric health care in Sierra Leone, starting at the country’s only specialist paediatric facility, Ola During Children’s Hospital (ODCH).

Responsibilities

The Medical Coordinator (MC) is responsible for the design and implementation of all medical project work. This includes:

1. Needs assessment and planning: Work with partners in the Ministry of Health and Sanitation (MoHS) and Ola During Children’s Hospital (ODCH), to identify barriers to the delivery of timely and effective healthcare for children and develop ongoing plans to address these barriers.

2. Implementation: Take joint responsibility with ODCH management and staff for implementing medical project work. This may include coordinating and delivering in-service training for healthcare workers, promoting improved clinical standards and supporting the introduction of new technologies and techniques.

3. Monitoring and evaluation: Together the Welbodi Directors and local partners, design and implement systems to monitor the process, effectiveness, and impact of activities on desired outcome measures.

4. Relationships: Work closely with doctors, nurses and other staff in the hospital to ensure good communication between ODCH and the Welbodi Partnership on all issues. Periodically meet with donors, international and local NGOs, and MoHS to update them. Where appropriate, you may develop collaborations and partnerships within broader efforts to reduce child mortality in Sierra Leone.

5. Fundraising: Help the Welbodi Partnership fundraisers to identify funding needs and provide appropriate technical information as necessary in the development of fundraising materials and proposals.

6. Clinical Work. Engage in direct patient care in order to maintain clinical skills and gain first-hand knowledge of the realities of patient care within this environment.
Qualifications

1. Medical or nursing degree is essential with at least two years experience working in health care. Additional postgraduate qualification in international development, public health or public policy is highly desirable.
2. Professional experience of healthcare in Africa.
3. In-depth, substantive knowledge of healthcare policy in developing countries.
4. Excellent people skills and a demonstrated ability to work collaboratively with people from diverse backgrounds in a dynamic and constantly-shifting environment.
5. Excellent written and oral English communication skills.
6. Flexibility, focus, and the presence of mind to work in sometimes difficult and chaotic circumstances.
7. Commitment to the goals and principles of the Welbodi Partnership.

Applications

The Welbodi Partnership (WP) is a UK-registered charity established to support the provision of paediatric health care in Sierra Leone and in particular to support the Sierra Leone Institute for Child Health (SLICH). SLICH is a joint project between the Sierra Leone Ministry of Health and Sanitation, the Ola During Children’s Hospital, and the Welbodi Partnership to create a centre of excellence in paediatric care. It forms part of the Government of Sierra Leone’s Strategic Plan for Reproductive and Child Health.

Ola During is Sierra Leone’s only specialist children’s hospital, located on Fourah Bay Road in the poor and densely-populated eastern part of Freetown. More than 15,000 patients are treated at the hospital each year, spread across two inpatient wards, an outpatient department, emergency room, ICU and a therapeutic feeding centre. The hospital is extremely under-resourced, however, and providing adequate care is still a challenge.

To learn more about us, please visit our website at www.welbodipartnership.org.

We are seeking an individual to fill the role of Medical Coordinator described above, who will work alongside the two Welbodi Partnership Directors in Freetown and in the UK, our Fundraisers and a network of local and international partners.

Interested candidates should please send a CV and cover letter by 31st January 2010 for the attention of: Matthew Clark

info@welbodipartnership.org

Further Important information for applicants

The Welbodi Partnership is a small organisation with limited financial resources. To keep our overheads low, this position has been filled on a voluntary basis over the past 2 years.

We are willing to contribute towards cost of travel, visas, and medical insurance, but you would need to cover your own living expenses.

In order for you to decide whether or not you can do so, we want you to know what to expect in terms of the cost of living. Although Sierra Leone is a very poor country, it is surprisingly expensive to live an expatriate lifestyle. You can get a relatively simple self-contained local-style flat for around $3,000 per year, but it may not have running water (instead you'd find someone to bring you buckets of water each day), frequent electricity (you could buy and fuel a private generator), or modern appliances.

In contrast, a room in a larger, higher-end house in one of the nicer areas of town will likely run you upwards of $400 per month, plus $200-300 more for electricity, water, a cleaner, internet, etc. Likewise, it is possible to by a local meal of rice and sauce for just a few dollars, but an individual pizza in one of the more upmarket Western-style restaurants costs $12. And taking local shared taxis back and forth to the hospital would cost about $1-2 / day, while chartering an individual taxi could run $10-15 per day and buying and fuelling a private vehicle is similar.

As the Medical Coordinator of the Welbodi Partnership, you would have a direct and significant impact on the quality of care provided to children both at ODCH and throughout the paediatric healthcare system. You would be part of building a relatively new organization from the ground up, of identifying and implementing high-impact interventions -- including quality training for Sierra Leone's young doctors and nurses -- and of building a foundation for lasting change. You would join a committed core team and would be responsible for leveraging the contributions of a wider network of volunteers and partners to bring significant and lasting change to ODCH.

The devil is in the detail

2009-11-20T06:12:00.001-08:00

Our Medical Coordinator, Dr Emily Spry, is writing for the BMJ about her experiences at the hospital...

http://blogs.bmj.com/bmj/category/emily-spry/

The devil is in the detail

It might seem odd that the most challenging folk to work with here are not the Sierra Leonean ones. Sometimes the toughest part is dealing with the endeavours of my fellow “whiteman”.

“Development” can be a painful business. It’s painful because of the contrast between what is promised and what is possible, what is dreamed versus what is ever implemented or achieved.

In a country as poor as Sierra Leone, it is so easy to “see” solutions, so easy to make big promises - so much could be fixed with so little, everywhere you turn. Or so it seems.

The truth is, of course, that if it were easy, someone would have done it long ago.

The devil is in the detail, every time. And the details are messy, dirty, tiresome and impossible to uncover from the sanctity of an air-conditioned office.

A classic example is the two giant generators sitting quietly in a building at the back of the Children’s Hospital. Installed during the “rehabilitation” of the Hospital in the early 1990s, just after the war, these were paid for by an African Development Bank loan.

Despite the fact that the regular power cuts leave the hospital operating by candlelight, they have never been used. Why?

Generators of that size use 16 gallons per hour of fuel such that running them would cost 240,000 Leones (around 40 pounds) per hour.

This fuel cost per hour is around the price of employing a full-time nurse for a month. Even if the Hospital received its meagre budget from the Ministry (which it has not so far in 2009), the generators are useless.

Who on earth would buy such a thing with money meant to get the hospital back on its feet? And why are they not held accountable?

In fact, these generators were paid for by Western tax payers. Even more painfully, they are paid for by the ordinary Sierra Leonean who should have got rather more development bang for their aid buck. Every dollar wasted is not just a dollar wasted. It’s a dollar that should have been spent on something better.

Being white here, and particularly British, bring great benefits to one’s self-esteem. Many Sierra Leoneans credit the British army with ending their decade-long war and we are often joyfully hailed as “IMATT” (the remaining British military representatives here) as we drive our old Landrover around town. Strangers regularly thank us for our work, without ever asking what we are actually doing in Freetown.

But when I look at how often the “whiteman” has stood so proud and magnanimous and then failed to deliver, I feel acutely ashamed.

Emily Spry is a doctor from London who has taken a year out of her General Practice Specialty Training Programme to live and work in Sierra Leone, West Africa. She is working for the Welbodi Partnership, a charity which supports the main government Children’s Hospital in a country where more than one quarter of children die before their fifth birthday.

Emergency Room Progress

2009-11-13T04:54:00.000-08:00

Our Medical Coordinator, Dr Emily Spry, is writing for the BMJ about her experiences at the hospital...

http://blogs.bmj.com/bmj/category/emily-spry/

Emily Spry on ER in the Pikin Hospital

Pikin HospitalI am happy and exhausted at the end of the first week of the new Triage system and Emergency Room at the Children’s Hospital. Around 80 children present to the hospital each day and Triage nurses now briefly assess them and rush those with Emergency signs to the new 3-bedded ER. There they are assessed and given emergency treatment by a team of specially-trained nurses and the Medical Officer on call.

After 4 days of training last week, the nurses are showing great enthusiasm. I have seen several cases where their prompt intervention bought the child crucial time, allowing a happy outcome instead of a tragic one. This is particularly the case with the hypoglycaemia associated with malaria and malnutrition. It is hard to describe the buzz you get when a grey, clammy, barely-breathing child wakes up after their dextrose infusion and starts screaming. The nurses had most of the skills and knowledge before, but the ER seems to allow everyone to focus their attention on the sickest children for the crucial first half hour or so after they arrive.

That’s not to say it’s all been plain sailing. It quickly emerged that, despite recent payments to the hospital electricians to renovate the room, none of the plugs in the ER work. Our brand new oxygen concentrator tubing now stretches across from another bay and is trampled on every few minutes. The concentrator also has a two-pin plug; the nurses do a hair-raising trick with a pair of scissors to jam it into the three-pin sockets.

There is no precise system for sharps collection or disposal. Although this part of Africa has a relatively low HIV prevalence, this is clearly still breath-takingly dangerous for all involved. As far as I have been able to ascertain, the standard method of waste disposal in Freetown is to chuck it over the nearest wall, which doesn’t give me great confidence about where our lovely mixed clinical waste is going.

But it’s one day at a time… this weekend I’m buying some plastic buckets so that water for hand-washing can be fetched when the taps go off. Maybe I’ll buy an extension cable and a plug adapter too. At some point in the next few months, I’ll spend a day following the cleaners and pondering how to make a sharps bin that has no resale value (else it will undoubtedly be emptied and recycled somewhere along the chain).

Staffing the new ER was in its first week was complicated somewhat by it coinciding with the Sierra Leone Medical and Dental Association annual conference, in which several of our Medical Officers played a role.

Amazingly for a country of 6 million people, there is only one fully-trained Paediatrician in Government Service in Sierra Leone, Dr David Baion, who is the Acting Medical Director of the Children’s Hospital. The Ministry also allocates 10 other doctors, including 5 newly-graduated doctors on three month placements. The five Medical Officers, two of whom work part-time elsewhere, are the more experienced and mostly hope to stay in Paediatrics, although there is as yet no formal Postgraduate Training available to doctors in Sierra Leone. The Medical Officers graduated between 1 and 5 years ago and some have special roles in treating TB and HIV.

One of the Medical Officers, Dr Freddie Coker, is on permanent night shifts. If you can imagine it, this means that Freddie works every night of the year, except when he can get a colleague to cover for him. What would the European Union have to say about that? With Freddie on nights, that leaves two full-time and two part-time doctors to cover the ER, Wards and Outpatients by day, with the help of the House Officers. When I collapse in a heap after a morning in the ER, I do wonder how they do it.

Emily Spry is a doctor from London who has taken a year out of her General Practice Specialty Training Programme to live and work in Sierra Leone, West Africa. She is working for the Welbodi Partnership, a charity which supports the main government Children’s Hospital in a country where more than one quarter of children die before their fifth birthday.

Emergency Room Opened

2009-11-13T04:45:00.001-08:00

At the end of October, the Welbodi Partnership trained 20 nurses in Triage and Emergency Care, with help from colleagues from VSO, Abertawe Bro Morgannwg NHS Trust Link and Cap Anamur.

The programme was a great success and the staff are now working well in the new Triage and Emergency Room, which opened on the 1st of November.

This is the first time that the Hospital has had an Emergency Room and a robust Triage process for prioritising the treatment of the sickest kids who come to the hospital. The new facilities and equipment, combined with the new skils of the staff, should help give the Emergency cases a better chance of survival.

Emily Spry, our Medical Coordinator, is writing about her experiences at the Children's Hospital on the BMJ website and here are her reflections on the training and nursing at the Children's Hospital from the BMJ site.

http://blogs.bmj.com/bmj/category/emily-spry/

Emily Spry on nursing in Sierra Leone

The nurse steps forward into the circle, putting her hands together. She prays aloud, “in Jesus’ name,” asking that our four day workshop at the Children’s Hospital be blessed, “so that we might put everything that we have learnt into practice.” After a rousing Christian song, we proceed directly to the Muslim prayer. Nearly every nurse who clapped, sang and loudly proclaimed “Amen” now turns her palms to the ceiling and intones in Arabic. Quietly atheist, I vaguely join in with the gestures; luckily no one expects me to know the words.

Such religious tolerance is the norm in Sierra Leone, though I do wonder if my faithlessness would be as well accepted, if I were more open about it. Either way, I’m sure that this society has much to teach, as well as to learn. Someone told me that life is so hard here that the wise hedge their bets; mosque on Friday and church on Sunday. A nurse whose birthday it was told me that she would spend her special day praying that she will see another one next year. With average life expectancy in the 40s, it is perhaps unsurprising that people in their 30s are nervous.

The last day of our Emergency Assessment and Treatment workshop for the nurses this week coincided with pay day. The junior nurses receive 120,000 Leones (around 20 GBP) per month from the government for working a six day week. It’s not enough even to buy rice for an average family for the month, though many nurses are the only breadwinner. At the Children’s hospital, a charity provides a monthly top-up of a further 50,000 Leones (around 8 GBP), still little more than the average monthly spend on getting public transport to work.

Nurses’ neglecting to come to work at all is a major problem at the Children’s Hospital, particularly at night. To make ends meet, staff often take part- or even full-time jobs in private healthcare facilities, on top of their government jobs. The Ministry of Health and Sanitation has central control of staffing, making it hard for the Children’s Hospital to replace those who do not attend.

But, as I consider the small pile of tatty bank notes that the nurses are taking home for the month, I wonder about things the other way around. While some do not attend, most are there, many working longer than their hours rostered. Why do they come to work at all? The Children’s Hospital is trying hard but is chronically under-resourced and treating a poor and sick population; around 1 in 10 children who are admitted die.

As I see it, these nurses are no different to healthcare professionals elsewhere. Yes, they want to be paid; they need to eat and they have families to support. But that’s not the only reason they work here. They are here because of the respect that they get from their community for their skills, even if that means being woken in the night by a neighbour with a sick child. They are here because of the gratitude of parents when a child recovers. They are here because they enjoy the camaraderie with colleagues who have also seen life and death and everything in between.

Emily Spry is a doctor from London who has taken a year out of her General Practice Specialty Training Programme to live and work in Sierra Leone, West Africa. She is working for the Welbodi Partnership, a charity which supports the main government Children’s Hospital in a country where more than one quarter of children die before their fifth birthday.

New Medical Coordinator

2009-11-13T04:40:00.000-08:00

Dr Emily Spry recently started at the Hospital, where she will be spending a year working as the Medical Coordinator.

She is writing about her experiences for the BMJ (British Medical Journal) and we will also post these pieces here.

http://blogs.bmj.com/bmj/category/emily-spry/

Emily Spry’s first impressions of working in Sierra Leone

Pikin HospitalI’m excited to have started at the Ola During Children’s Hospital in Freetown, after hearing so much about it from the Welbodi Partnership, the charity I’ll be working for over the next year.

On first impressions, things at the hospital look good. There are freshly painted wards and uniformed nurses. There are notices on the wall: “Drugs for inpatients are now free” (thanks to a German charity). The outpatient benches are lined with parents and kids, waiting to be called into three consulting rooms. The observation ward is full of children, one loudly fighting off the advances of a nurse brandishing a cannula.

But look beneath the surface, and you start to see the problems. The Pikin Hospital (the name given to the Ola During Children’s Hospital in Krio, the lingua franca of Sierra Leone, meaning children’s hospital) has its outpatient department, three main wards and a newly-introduced intensive care unit.

The ICU would not be recognisable as such to those of you who are used to the hush of ventilators and the banks of machines that go “ping”. “Intensive care” is defined by its relatively high staff-to-patient ratio, but it’s 4 nurses and 4 untrained nursing aides to around 30 sick children, all lined up cross-ways in 10 adult sized beds. The only equipment is a lone oxygen concentrator, with tubing splitting the precious gas four ways, and an oxygen saturation probe to help doctors decide who gets to use some.

Around 10% of the children admitted each day die, usually within 24 hours of admission and usually due to severe malaria, anaemia, sepsis, dehydration, malnutrition or, more often, a combination of several of these.

After a while, you start to see what is lacking. Sitting with the busy medical officers in outpatients, you realise that they have to make decisions without access to even basic investigations. Those they can order, parents may not be able to afford.

As a parent, the odds are stacked against you. The hospital charges a flat fee of 15,000 Leones (around 2.50 GBP or 3 USD). This might sound trivial, but when more than half the population lives on less than a dollar a day, it’s a crippling cost for many. Inpatient drugs are currently free but outpatient drugs must be bought and counterfeit drugs are common.

If you have four kids and one of them is about to cost you the family food budget for the month, it’s not an easy decision to make. If your child has a chronic disease, such as sickle cell disease, and gets ill repeatedly, it’s not hard to see why you might feel unable to follow the doctor’s advice.

So, as soon as you start thinking about this your head starts spinning. Everywhere you look, there are little things that might make a huge difference, things that it might be in your power to influence. What if I went out right now and bought 30 thermometers? What if we could find a way to get people to donate blood? What if we could find a haematological hero in the UK who would come out and set up blood screening? What if I could persuade someone to donate an Xray machine? What if I could train the nurses to recognise the sickest kids and act on it? Where on earth to begin?

And then the doubts also bubble up to the surface. Who will ensure that equipment is used properly? And maintained? What if things are stolen? How would the government-employed laboratory technicians here react if someone tried to set up a parallel service to take away their only income? Will giving the nurses and doctors more work to do really help? Will my NHS-learnt ways of working actually be useful here? Or would they upset a delicate balance that stops everything falling apart? Can I realistically do anything here that will last after I’ve gone? How can we decide the best way to treat kids here when we don’t even have basic diagnostic tests? Could even the best hospital in the world help the children brought by their parents only when they are at death’s door?

Luckily for me, the Welbodi Partnership have spent some years building up their relationship with the hospital and refining an approach that combines their optimistic vision with the patience to grapple with the day to day limitations of the hospital. My project is to set up a Triage system and an Emergency Room, to try to focus staff and resources on the sickest kids each day. It’s going to be interesting…

Thank you to RTC North!

2009-10-14T13:40:00.000-07:00

As part of its 20th anniversary celebrations, RTC North has announced plans to raise £50,000 for The Welbodi Partnership. The company will host a special charity dinner and auction at Ramside Hall Hotel in Durham on November 10 and marked the start of its fundraising efforts by donating £7,700 to buy a new generator.

Since 1989, RTC North has helped thousands of companies introduce new products, helping create jobs, wealth and a better quality of life for the people of Northern England. CEO, Gordon Ollivere MBE, has a longstanding interest in technology for developing countries having worked as a volunteer in Sierra Leone and Nigeria during the 1970s.

“I am delighted to announce that this year we are celebrating 20 years of working with industry, education and government in the North East," said Ollivere.

“Rather than just having a party, our staff felt it would be much better to mark the occasion by undertaking some fund-raising for a worthwhile charity."

Ollivere continued, “Through our NHS Innovations project we work a lot with medical technologies and both this company and the region have historical links with Sierra Leone. The country’s only university used to be a college of Durham University, and its former Pro-Vice Chancellor and first RTC North chairman was John Clarke who wrote one of the first books about Sierra Leone."

“Sierra Leone has some of the world’s worst child health statistics and because the work of the Welbodi Partnership is having such a massive and recognisable impact we have decided to adopt it as our favoured charity.”

RTC North's first donation will fund a much-needed back-up generator to ensure constant electricity for the hospital. “A big issue for the hospital is the electricity supply is very unreliable," explains Welbodi Director Dr. Matthew Clark. "Currently, when the power fails the hospital is plunged into darkness and essential equipment like oxygen concentrators are rendered useless. The generator funded by RTC North will be a great help and we look forward to the company’s ongoing support.”

For more information on RTC North’s charity dinner and auction visit www.rtcnorth.co.uk or email charity.dinner@rtcnorth.co.uk. To donate direct visit the Welbodi Partnership's online donation page.

Introducing an exciting new ODCH partner

2009-10-14T13:36:00.000-07:00

We are delighted to announce more support for the Ola During Children's Hospital (ODCH). Cap Anamur, a German NGO which previously supported ODCH during the war, have also agreed to support the children’s hospital for at least one year. Already Cap Anamur are providing a supply of drugs and are busy repainting the wards. They also have two German nurses and a program director based full-time at the hospital, and all three are working hard to improve care. It is a real pleasure to be working with Llona, Denise and Hassan, and we look forward to collaborating with them over the next year.

The number of patients admitted to ODCH has increased dramatically in recent months. The Government of Sierra Leone has closed down numerous unlicensed clinics and the supply of drugs by Cap Anamur have dramatically boosted patient numbers. This sudden and significant increase in hospital admission has put a strain on existing hospital facilities. The hospital had already opened a very basic intensive care unit, which is now overflowing with patients. Over the next few months, the Welbodi Partnership will be working with ODCH to improve the existing intensive care unit and also open an emergency department.

Celebrate the colors of Freetown with JHill Design

2009-10-07T12:53:00.000-07:00

Need a gift for those summer weddings? Planning ahead for Christmas?

Artist Jennifer Hill’s beautiful Places I Have Never Been series is inspired by her imaginary vacations around the world. These amazing prints capture the spirit and colors of different countries and cities. Each eye-catching design is accompanied by details about the destination, presenting the impressions of different towns and bringing them home.

The collection now includes a wonderful print of Freetown. Not only will this make a great gift for those who hold Sierra Leone dear, it will also help everyone at the Ola During Children’s Hospital.

JHill Design will donate 25% of the proceeds for this print to the Welbodi Partnership. You can buy your print here online:
http://www.jhilldesign.com/products/sierra-leone-city-print

We want to thank JHill Design for such a generous and unique contribution. We hope that you all will enjoy the prints as a reminder and celebration of Freetown.

New Welbodi Partnership Team

2009-10-07T12:48:00.000-07:00

We are thrilled to introduce the new members of our team.

Ishmael Turay – Ishmael is a Medical Officer at the Ola During Children’s Hospital (ODCH), and has been a core Welbodi partner since 2007. Ishmael has now been appointed as the Welbodi liaison officer. He will be responsible for coordinating all volunteers as well as supervising the use of donated equipment and helping to prepare proposals for the SLICH board.

Emily Spry – Emily is a primary care doctor from the UK with a special interest in training health care workers. She will be volunteering in Sierra Leone for a year and her work at ODCH will concentrate on training.

Fiona Ringholz - Fiona is a paediatrican from the UK who will be based at ODCH for one year. The placement has been organised by Voluntary Service Overseas (VSO), but we will be working closely with Fiona to help make her placement as successful as possible.

Sarah Jones - Sarah will be joining Welbodi in October. Sarah previously worked as a fundraiser for The Amy Biehl Foundation, an NGO based in South Africa, and will be working as a full-time fundraising and publicity volunteer for the Welbodi Partnership.

Matthew Clark – Matthew, a co-director of the Welbodi Partnership, will be based at ODCH from September until November. Matthew will be making sure the new team get settled in and overseeing all our work at ODCH.

We bid farewell to a visionary leader, and welcome a new head of hospital

2009-10-07T12:43:00.000-07:00

It is with sadness but with great affection that the Ola During Children’s Hospital and the Welbodi Partnership bid farewell to Dr Muctarr AS Jalloh, who retired in August as head of the hospital. We cannot thank Dr, Jalloh enough for all he’s done for the hospital, nor express how much he will be missed. He has been a core supporter of the Welbodi Partnership and the Sierra Leone Institute for Child Health from the very beginning, and we would never have been able to get off the ground without him.

We won't say goodbye to Dr. Jalloh, because we know he'll stay a friend and supporter. In the meantime, we only hope that our work will be a fitting legacy for Dr. Jalloh’s tremendous commitment to the hospital and the children of Sierra Leone, and we send him all of our best wishes in his new endeavors.

We also want to send a warm welcome Dr. David Baion, the new acting specialist-in-charge, and wish him all the very best in his new position.

Ola During Children’s Hospital Goes Online - Thank You to LimeLine, IMATT, and friends!

2009-10-06T11:13:00.000-07:00

Thanks to LimeLine, one of Sierra Leone's leading internet service providers, the Ola During Children’s Hospital and neighbouring Princess Christian Maternity Hospital now have network connections and free internet service for the next year. This connectivity will help improve the service the hospitals can provide, through online opportunities for staff training and medical research. We are also exploring possibilities for e-medicine and remote consultation by paediatric specialists outside of Sierra Leone.

This generous donation from LimeLine quite literally connects the hospital to the rest of the world! Thank you!

Huge thanks are also owed to other people who donated time, money, and expertise to get the hospitals online.

Thank you to our friends at the International Military Advisory and Training Team (IMATT) in Freetown, who donated materials as well as their expertise to help install the network. We really appreciate the time and resources they have given us.

Finally, a massive thank you to Meghan and Carol Roecklein, who deserve credit both for spearheading this effort and for their time, energy and support along the way. This would never have happened without you!

Launch of the Sierra Leone Institute of Child Health

2009-10-06T11:08:00.000-07:00

Many of you as regular supporters will know we have spent the last 12 months establishing the Sierra Leone Institute of Child Health (SLICH) to improve paediatric care in Sierra Leone.

June marked the official launch of SLICH. Already it has begun to work towards its aims: bringing the right people together, identifying where the need is greatest, and making sure lasting changes happen.

So far we have:

A new proposal process in place

SLICH looks to local people and the staff of the Ola During Children’s Hospital (ODCH) to acquire the best understanding of what the hospital and its young patients need. Staff and other stakeholders are encouraged to submit short proposals for funding and support. The SLICH board – which includes representatives from the Ministry of Health and Sanitation, ODCH, and the Welbodi Partnership – then reviews these proposals at quarterly meetings. Funds for approved projects or supplies are released to ODCH, which must then account for those funds at the next SLICH meeting.

We believe that local planning and implementation are fundamental to our aim to improve paediatric care, and we're very excited about the SLICH funding process as a way to empower the ODCH staff and managers to propose and deliver improvements to their hospital.

Acted upon the following proposals

The first SLICH board meeting took place in June. The approved proposals represented a total budget of Le 91,419,000 (approx $23,000). These are now underway and include:

• Provision of library facilities
• Purchase of a standby generator and construction of a generator house
• Plumbing and electrical repairs
• Accommodation for visiting doctors

Call for new proposals

The second SLICH board meeting was held on 2nd October, and the ODCH staff and managers came up with a fresh round of exciting and important proposals to improve the quality of care and training at ODCH.

Stay tuned for details on these proposals and the SLICH board’s funding decisions for the final quarter of 2009.

A Note from Us

2009-10-06T10:56:00.000-07:00

Dear friends and supporters,

You may have wondered why you haven't heard from us in some time. Our apologies for the long silence -- we've been in a period of transition and have also been extremely busy here on the ground with lots of exciting initiatives.

Over the next week we'll be posting a number of long-overdo updates to this blog, which we'll then pull together into a newsletter. We hope you'll enjoy these updates and thanks as always for your support!

Sincerely,
The Welbodi Partnership

Cyclist “Takes on Africa”

2009-07-12T10:45:00.001-07:00

Would you cycle 20,000 km to raise money for children half a world away?

Helen Lloyd would.

In just a week, Helen departs from the UK on a two-year cycling trip from the tip to toe of Africa, which will end in Cape Town in 2011. The trip is entirely self-funded and all money raised goes directly to the Welbodi Partnership.

We can’t thank Helen enough, and we wish her great luck and wonderful adventures along the way!

To learn more about her trip, visit the Take On Africa website. To donate and support the Welbodi Partnership, visit her JustGiving site. Consider pledging just $0.01 per km she rides, and donate $200 to help save the lives of children at the Ola During Children’s Hospital.

Mothers matter

2009-07-05T11:21:00.001-07:00

Sierra Leone’s First Lady Sia Nyama Koroma – a former nurse – has taken up the cause of reducing maternal mortality. Today, women in Sierra Leone have a lifetime risk of dying in childbirth of 1 in 8. Even that devastating statistic understates the real tragedy, however, because far too often when a mother dies, her newborn child follows soon thereafter. And we don’t need to point out what this means for the other children she leaves behind.

Here is First Lady Koroma writing recently in the Huffington Post, arguing that “It’s Time to Make Mothers a Priority.”

Gifts from the US Embassy

2009-05-29T05:49:00.001-07:00

The American Embassy in Freetown has become one of the newest supporters of the Welbodi Partnership and the Ola During Children’s Hospital.

Here are Embassy staff Lisa Baker and Laura Kustaborder, with ODCH matron Ruby Williams. They came to visit the hospital in April, to hand over the proceeds from a charity Mardi Gras ball the Embassy co-hosted in March to benefit the Welbodi Partnership and other charities. The ball raised more than six million Leones – about $2,000 – and half of this went to the Ola During Children’s Hospital.

Staff of the hospital were grateful for the Embassy’s support. ODCH Specialist-in-Charge Dr. MAS Jalloh (right, with Laura) thanked the Embassy representatives and asked them to remember the hospital in the future. He also assured them that any donations would be well-used.

Since then, the Embassy has begun helping in ways big and small. Ambassador June Carter Perry met with the Welbodi Partnership coordinators to find out more about the organization’s work. Lisa has agreed to help sell Sweet Salone cookbooks, the proceeds from which benefit the Welbodi Partnership, around the Embassy offices. And Laura, the Embassy’s health practitioner, arranged for a donation of new and used medical equipment to ODCH and the neighboring maternity hospital.

This equipment included a portable suction machine, boxes of oxygen masks and nasal cannulas, crutches, and other assorted supplies (see photo, right). She is also working to organize a blood drive for Embassy personnel to benefit the government’s blood services, which struggle with a constant shortage of blood.

We thank the Embassy staff for their support and look forward to a long partnership.

Welbodi Partnership in New York!

2009-05-13T11:32:00.000-07:00

Will you be in New York on May 26, 2009? If so, please join us for an exciting event at the beautiful Fourth Universalist Society of New York. Nobel Prize-winning economist Dr. Joseph Stiglitz and Bloomberg News Editor-at-Large Mr. Robert Friedman take the stage, with a display of photographs by Czech photographer David Lacina for sale. You can check out details below, or find our event on Facebook. RSVP to welbodinyc@gmail.com or by phone at (917) 945-7879. Proceeds benefit the Welbodi Partnership and our work to support paediatric healthcare in Sierra Leone.

Many thanks to Welbodi Partnership supporters Hien Dao and Jimena Zuniga for organizing this event!

Invites you to an evening with

Dr. Joseph Stiglitz

Nobel Laureate and Columbia University Professor of Economics

Discussing "THE $12 TRILLION TRAP: The Economic Crisis, the Obama Administration's Response and Its Global Impact"

Moderated by Bloomberg News Editor-at-Large Mr. Robert Friedman
With an exhibition of photographs of Sierra Leone by Czech photographer David Lacina

May 26th 2009, 7-9 PM
Fourth Universalist Society of New York
160 Central Park West at 76th Street

Please RSVP at welbodinyc@gmail.com or by phone at (917) 945-7879

A minimum donation of $25 is requested. Exhibition photographs will be available for sale at $100. All cash donations and half of sale
proceeds will go towards supporting the Welbodi Partnership, a charity dedicated to improving the provision of pediatric care in Sierra Leone. The event is made possible through the kind support
of Rev. Rosemary Bray McNatt, the Fourth Universalist Society of New York, Mrs. Anya Stiglitz, Mr. Robert Friedman and Mr. David
Lacina.

US donors can make tax-deductible donations to the Welbodi Partnership through FJC – A Foundation of Philanthropic Funds

By check: Please make checks payable to FJC and write “Welbodi Partnership” in the memo line of the check. Checks are accepted at our May 26 event or can be mailed directly to: FJC, 520 Eighth Ave., 20th Floor, New York, NY 10018.

By credit card: Please visit our website http://www.welbodipartnership.org/ to make a donation online.

By cash: Cash donations will be accepted at our May 26 event.

Securing the Pikin Dem

2009-04-22T09:05:00.001-07:00

The Welbodi Partnership is pleased to introduce a guest blogger from the Freetown-based International Military Advisory and Training Team (IMATT). Major G D Hogg of the UK Royal Marines has been volunteering his time over the last few months to help upgrade security at the compound shared by the Ola During Children’s Hospital and the neighboring Princess Christian Maternity Hospital.

With Major Hogg’s help, the hospitals have formed a joint security committee and have identified steps to ensure the safety of patients and staff and the security of equipment and supplies. These include training for the hospital security guards, delivered by IMATT’s own security team. Below is an account from Major Hogg from the first of these training sessions.

The Welbodi Partnership and our hospital partners are grateful to Major Hogg and to his IMATT security colleagues for all their time and effort in planning and executing this project.

***

On Friday April 3, I arrived at the “Cottage” hospital compound housing the Ola During Children’s Hospital and Princess Christian Maternity Hospital with a team of very excited IMATT security officers for the first day of security training for the hospitals’ own security team. The aim of this first day was twofold: to instill a sense of pride and confidence among the hospitals’ security officers; and to introduce them to specific security tactics and procedures.

The day began with a morning of lectures delivered by locally employed IMATT Security Officers covering various topics such as public relations, crowd control, use of equipment, and patrolling techniques, followed by practical training in the afternoon around the hospital site.

It was clear from the outset that the guards were at a novice level regarding some of their procedures and tactics. However, this was overcome by a keen desire to learn and by limitless enthusiasm from all who took part.

This was highlighted during equipment training, which injected a bit of unexpected humor into the day. After receiving a demonstration on how to use hand-cuffs properly, all of the guards were given their own sets to practice with on each other and then keep for future use. After a flurry of activity in which everyone grabbed a set and put them on their respective “partners”, they all realized that the keys were mixed up in a pile at the bottom of the bag.

This all occurred at 11 a.m., at which time I decided to escape for a long lunch to return at 1p.m., when the final student was being “released”.

It was encouraging to see throughout the morning’s lectures and discussion that the guards were sensitive to the issues surrounding security at both hospitals such as the movement of staff at night, single females, and most importantly the patients. To that end, discussion was key when exploring scenarios and at every juncture a robust and workable solution was sought.

The afternoon involved a practical security patrol, where the guards were taken around the perimeter of the hospital site and issues and scenarios were discussed. Here, it was key that a solution to the problems presented, came from the guards themselves, and for most cases they presented intelligent and well thought out answers.

The next phase of the training will involve specific modules in vehicle searching, controlling entrance and exit points of the hospital site and night patrolling (to be conducted during night time hours at the hospital). The IMATT security guards thoroughly enjoyed the chance to stand up in front of a class of students and pass on their knowledge and experience and will be involved in all future training.

The day was a complete success. The guards reacted well to the training and instruction that they were given and showed animated enthusiasm for further training. The purchase of more equipment such as flashlights and night uniforms will be a catalyst to exploit further advances to those made so far.

The Ola During Children’s Hospital and Princess Christian Maternity Hospital Security Team

Welbodi on the road: London

2009-04-01T06:58:00.000-07:00

Recently, Welbodi Partnership representatives traveled to the US and the UK to raise awareness about our work, recruit volunteers and supporters, and raise funds.

Here is a recent news article about an event we held at the Institute of Contemporary Arts in London.

Many thanks to Welbodi friends and supporters Sarah Froome, Krystle Lai, and Yani Tyskerud for their help organizing this event, and to all of you who attended.

Would you like to help organize a Welbodi Partnership fundraising event in your hometown? Please contact us at info(at)welbodipartnership.org to find out how.

Salma Hayek and Sierra Leone

2009-02-13T03:31:00.000-08:00

So it seems that Salma Hayek’s breast is all it takes to get pediatric health in Sierra Leone on the public’s radar.

We should have thought of that a long time ago.

In this ABC News piece, Salma first visits the Ola During Children’s Hospital, Sierra Leone’s only government children’s hospital, where the Welbodi Partnership works to help improve the standard of care provided to sick children. There she watches a week-old baby die a terribly painful (and utterly preventable) death from tetanus.

Tragically, this is not unusual. One in six children in Sierra Leone die in infancy. One in four die before their fifth birthday.

Salma then goes upcountry, to the provincial capital (misleadingly called “a remote corner of the country” by the ABC folks) of Makeni. Once there, she decides to breastfeed a tiny baby whose mother did not have milk to give.

This, of course, is what set the news media and blogosphere abuzz. Famous Hollywood actress gives breast to poor African child. History upended as light-skinned wet nurse feeds dark-skinned child. Bodily fluids shared on camera.

Breastfeeding is incredibly important to the health of young children, particularly in places like Sierra Leone, and is one of the best ways to ensure proper nutrition and protect against illness. And if Salma Hayek’s breast helps raise awareness of the importance of breastfeeding, so be it. (Though I can’t help but point out that Sierra Leoneans are much less abuzz about this than the rest of the world. The vast majority will never see this footage or the headlines that have accompanied it, and in any case have no idea who Salma Hayek is. At the hospital, we turned up the day after this film crew and were told only that some white people had visited the day before; none of the staff knew how famous she was.)

But the film’s focus on breastfeeding and on other preventive measures – specifically a vaccine to prevent tetanus – ignores another reality, one evident in the first few minutes of the piece when Salma watches that tiny baby die in what should be Sierra Leone’s premier pediatric care facility.

The Ola During Children’s Hospital should be in a position to provide accessible, high-quality care to sick children. Parents should come to the hospital early, as soon as their children get sick. Drugs and supplies – at least for the most common illnesses – should be available and free of charge. Nurses and doctors should be properly motivated and trained, and should have the medical tools and enabling environment they need to provide care.

In reality, however, the dedicated staff of the children’s hospital struggle to provide even a basic standard of care. The hospital has no x-ray, rudimentary laboratory facilities, and no back-up power supply. Doctors and nurses are forced to charge impoverished and severely ill patients fees for consultations, laboratory tests, and drugs and supplies in order both to provide the hospital with revenue to meet its running costs, and to supplement their own meager salaries. (A trained and experienced nurse makes less than $50 per month, not nearly enough to feed a family).

These fees mean that many parents wait far too long before they seek medical care for their children, and that too often they cannot afford urgently-needed medical interventions – medicine to treat malaria or pneumonia, a blood transfusion for a severely anemic child, fluids to treat dehydration in a baby with diarrhea. These delays cost the lives of hundreds if not thousands of children each year.

Prevention of childhood illness is absolutely essential, and UNICEF is right to invest in vaccines and the promotion of exclusive breastfeeding.

But even with the best prevention, many children will still get sick. If there is not a pediatric health system capable of providing effective, low-cost treatment for the most common illnesses, the country will continue to lose far too many young lives.

The Welbodi Partnership supports pediatric health care in Sierra Leone by partnering with the Ministry of Health and Sanitation and the Ola During Children’s Hospital. To learn more and to find out how you can help, please visit our website.

Welcome

2009-02-06T07:39:00.000-08:00

Currently, more than one in four Sierra Leonean children die before their fifth birthday, mainly to preventable and treatable illnesses such as pneumonia, diarrhoea and malaria. The Welbodi Partnership aims to give these children a better chance.

We have been working with the Ministry of Health and Sanitation, the Ola During Children's Hospital, and international partners to create the Sierra Leone Institute of Child Health (SLICH). In doing so we have built a unique combination of local presence and international partnerships to support improvements in child mortality and morbidity.

We'll be updating this blog with stories about the staff and patients at ODCH and news about events and fundraising.