PROJECTS 2

In April of last year we held a two day strategic planning meeting. We came out of it with a bold, and to many minds, ridiculous, vision and plan. And I of course was one of those who thought, “It can’t be done,” at least not anytime soon. Well, I thought I would just let you know what has happened to that Strategic Plan and how God apparently views it. I am telling you it is His doing, not ours.

Accounting/Finance

Julian, our CFO, is also a vocalist, here he is singing in the choir.

Our accounting system has consisted of income and expense reports done on Excel. In early December I added up all the income since we re-opened in November 2015, and compared that to all our recorded expenses. When I looked at the cash we had on hand and the difference between our income and expenses we were missing 50 million leones ($7,500). A quick search revealed a stack of expense vouchers in the accounts office that stood 6 inches high. Surprise, surprise, they totaled up to almost 50 million leones. It was good to account for the money, but it also meant that all our income/expense reports were bogus as were the decisions we had made based on them.
“Before they call, I will answer”, “I know the plans I have for you.”

Julian getting badly beaten at checkers. Good thing he doesn’t gamble.

Last July we received notice that Julian Marin, a young man from Columbia, wanted to come volunteer with us. He was actually answering the call we had put in for an assistant for Bekki. However, he was way overqualified, Bachelors and Masters degrees in accounting, finance and computers. Shortly after arriving here he told us he could help us develop an accounting system. He spent the fall months writing the software and then it went on line in December. In December he took on the position of Chief Financial Officer of our Adventist Health System.

Julian is laying the cornerstone of the new guest house he is raising money for.

Now we have a working accounting system, we have Julian watching over the accounts department to make sure we don’t have a repeat of the expense voucher fiasco, and we can get accurate reports when we need them, and we know how much money we have, or how much we owe, what our true financial picture with just a few key strokes.

Extension

Mission Direct is an NGO out of the UK (like a non-SDA Maranatha) that has projects all over the world, building schools, orphanages, bakeries and helping hospitals. They have worked with us for 10 years, and have done most of the building of the current hospital, including the guest rooms that are in constant use by our volunteers. Well, a few years ago, pre-ebola, Mission Direct constructed a new wing (lovingly referred to as the extension) for the hospital, with 2 wards, Labor and Delivery Suite, and 5 private rooms. The project reached a stand-still however as funds became an issue.

Nevertheless, this is Africa, and partially finished is usable, so we have been using the unfinished private rooms and the one of the wards is the temporary home to physical therapy. But, the extension needed finished. We figured it would take $20,000 to finish it off. Where would the money come from? Praise God for the Winifred Stevens Foundation. They included the extension in their grant!

New women’s and Pediatric Ward.

We got to work and re-did the electrical and plumbing, bringing it up to a better standard, we got rid of the steep slopes in the corridor that made moving patients not only difficult but dangerous, we got the leaks in the roof fixed, tiled the wards and made the private rooms worthy of the name.

In March a Mission Direct team was here and we had a special grand opening ceremony with them and the Conference officials and local dignitaries. The extension is open for business!!

Opening ceremony for the extension with Pastor Daniel Sandy, the Sierra Leone Mission President, and local dignitaries.

The first women’s and pediatrics ward is typically close to full. Physio continues to use the other ward until we get them into their new building. Four of the five private rooms are open for business, with Mr. Danquah our Director of Spiritual Ministries is using the fifth room as an office.

Physical Therapy

Samson doing physio in the Palava Hut, April 2016.

It was just 14 months ago that we opened a new service at AHS, Physiotherapy as it is called here. Samson Idowu from Nigeria has brought his special skills to serve our patients. He uses a combination of massage and strengthening exercises to get people up and on their feet again.

Sonya Bradburn, Occupational Therapist from Tillamook, Oregon working with patients in the physio department.

He rightly has pointed out that many of the patients suffer from PTSD due to the Rebel War or Ebola and mostly they need a loving touch, prayer and encouragement. We often have people come in to the hospital unable to walk or move their upper limbs. After just a few days working with Samson and his assistant Zainab, many are functional again.

Samson working in the Physio room of the finished extension.

We have been blessed to have occupational and physical therapists from the US come and work with our team. In May we will have a massage therapist from Canada for 3 weeks. These specialists all bring new skills and education to our physio team, and the rest of the nursing staff.

Thanks again to the grant from the Winifred Stevens Foundation we are in the process of constructing a new home for Physio. The building will include a general treatment room, a massage therapy room, patient changing rooms and a storage room. A special bonus is the new office for our manager and secretary, which will free up needed space in the hospital.

Pharmacy/Lab

The HIV Counseling Center, and site of the new Pharmacy and Lab.

Our pharmacist does her best to work out of a 4X12 foot closet, and although the lab is in a larger room, it too is undersized. Both departments need more room and stable power so they keep medications and certain reagents refrigerated. In addition, we need a blood bank. Currently patients who need a blood transfusion have to find a donor, and then once a match is found, blood is taken from the donor, placed in a transfusion pouch and directly transfused into the patient. That system does have some merit. There is no question that fresh whole blood is better for you than aged blood components, such as packed red cells. However, it only works for chronic or semi-acute anemias. Any patient who is actively bleeding and needs a transfusion right now, is out of luck.
But to have a blood bank requires stable electricity with battery backup. We are on our way to the electricity part with the recent purchase of a 15kva diesel generator. This way we now have power 18 hours a day. We will need some battery back-up for the lab and pharmacy though, to make sure their refrigerators never go above a certain temperature.

One of the Mission Direct Teams from the UK.

But what about the rooms themselves? Enter our old friends, Mission Direct, from the UK. They have agreed to take on, as much as they can, the project of adding on to, and remodeling our HIV counseling center. The foundation is done, the slab is poured and a team in coming the second week of April to continue on with the walls. As God sends the money they will send the teams to get the job finished.

The walls are up!

Mission Direct Team members hauling block in the hot African sun.

For more frequent, up to the minute short updates please follow us on Instagram or on Facebook, we are Scott N Bekki Gardner.

For those of you who are new to our blog please look around at the other pages, the “About” page tells a bit of who we are and our background, the “Definitions” page explains some terms that are used that some of you may not be familiar with, such as GC or AHI. The “Timeline” gives an idea of where we will be throughout the year, and the “Video” page has a video Bekki made of Koza Hospital as well as the videos she has made of Moundou, and now we are adding videos of Sierra Leone. Watch a real Ebola survivor tell his story. Watch our community health officer explain why the staff agreed to work in the Ebola Red Zone even after they lost 2 staff members to Ebola. There is also the Surgical Pictures Page, but be forewarned, it has some very graphic pictures, so if you don’t like blood and guts, stay away from that page. On the Projects and Donations pages you can find the projects we are working on and how to donate to the project that touches your heart. Finally, if you like our blog and want to receive each new post directly to your e-mail, please sign up with your e-mail in the subscribe box. It doesn’t cost anything, there is no commitment, it just makes it easier to follow us.

We welcome volunteers.

-Scott Gardner

Projects-Chapter 1

Last Sabbath, April 1, marked the one year anniversary for Bekki and I to be in Sierra Leone. The experience here has been very different than our experience in Tchad, but one thing hasn’t changed, God’s providence. As we reflect over all that God has done at the Adventist Health System in Sierra Leone we are humbled and privileged to be a small part of it. This is the first in a multi part series detailing how God has blessed in the last year.

The Strategic Plan Team from April, 2016

In April of last year we held a two day strategic planning meeting. We came out of it with a bold, and to many minds, ridiculous, vision and plan. And I of course was one of those who thought, “It can’t be done,” at least not anytime soon. Well, I thought I would just let you know what has happened to that Strategic Plan and how God apparently views it. As all that I am going to tell you is His doing, not ours.

Doing our SWOT (Strengths, Weakness, Opportunities, Threats) Analysis led by Master of Public Health, Erin Acosta

OR Upgrade

You may recall that when we arrived I found Dr. Koroma doing amazing operations under very adverse conditions. Inadequate light, no cautery, no suction, an OR table that was frozen in one position, an untrained anesthetist who did not know the most basic airway maneuvers, just to name a few. Oh yea, a super tiny table-top dental autoclave that barely worked, and four other autoclaves that did not work at all. The OR area was packed with outdated (I mean 25 years outdated) items, including suture, and other materials. The minor room was home to four nonworking typewriters, and most rooms were so full of junk it was difficult to open the door.

Our very empty and bleak OR.

After many sweaty hours we were able to get the usable material separated from the unusable, the good from the bad if you will. (And we got the typewriters cleared out.) AHI, Brothers Brother Foundation and Healey Foundation helped us get a new OR table (that works!!!), suction and cautery.

Remy with the autoclave he repaired for us.

Remy Hirschy from Geneva got one of the other autoclaves working for us. Then a grant from the Winifred Stevens Foundation came through allowing us to put in windows that blocked the dust from coming inside, do some badly needed repairs, and I just ordered a new full sized steam autoclave, made specifically for use in mission hospitals, and a generator that will allow us to do surgery after hours.

The moving crew with the new OR Table.

And, last, but not least, Emanuel Soffa completed his anesthesia training course and is now serving as our permanent anesthetist. To help round out his education, Dr. Tim Mercer, Anesthesiologist, LLUSOM Class of ’85 (a great class) came over with his wife Connie, who is a PACU nurse, and did more education with him and set up a PACU protocol for our nurses. We had another team of CRNA’s from Asheville, NC led by Mason McDowell, of Bere Hospital fame, come in March to continue that training and the training of our nursing staff.

Team Tarheel (from Ashville, North Carolina) working with Soffa on spinal technique.


Stores

Bekki was overwhelmed when she was given the monumental task of organizing and inventorying the stores, or warehouse. It is a 40 X 48 foot structure made of termite eaten studs and tarpaulin, it is stuffed with supplies. Again, some useful, much of it not useful. Much of it from Ebola days. We have enough Ebola PPE (personal protective equipment) to last for 20 years.

The state of the stores (central supply), before Bekki took over.

But, in her usual quiet, organized way she started the job. She got several young men who came to be known as Mrs. Scott’s guys to help her as they sorted, cleaned and discarded. Doug Abbot, a nurse from California, came to us for a year, and he has cheerfully taken on the role as her assistant (read taken over the job). He has taken over the inventory process, and does his best to make sure we don’t run out of supplies. Buford SDA Church near Atlanta Georgia helped us with funds to convert an unused area into a mini-warehouse that we climate controlled to preserve the material.

Now in her air conditioned office, Bekki is surrounded by neatly stacked and organized supplies.

So now we have some idea of what we have, and things that have been donated are being used before they outdate, or go bad. Our next goal is to take the three 40 foot containers we have and use them as the walls of a permanent 40X48 warehouse, part of which will be climate controlled. We can then return the current storage space to it’s intended purpose of labor and delivery.

Stay tuned for Part 2.

For more frequent, up to the minute short updates please follow us on Instagram or on Facebook, we are Scott N Bekki Gardner.

For those of you who are new to our blog please look around at the other pages, the “About” page tells a bit of who we are and our background, the “Definitions” page explains some terms that are used that some of you may not be familiar with, such as GC or AHI. The “Timeline” gives an idea of where we will be throughout the year, and the “Video” page has a video Bekki made of Koza Hospital as well as the videos she has made of Moundou, and now we are adding videos of Sierra Leone. Watch a real Ebola survivor tell his story. Watch our community health officer explain why the staff agreed to work in the Ebola Red Zone even after they lost 2 staff members to Ebola. There is also the Surgical Pictures Page, but be forewarned, it has some very graphic pictures, so if you don’t like blood and guts, stay away from that page. On the Projects and Donations pages you can find the projects we are working on and how to donate to the project that touches your heart. Finally, if you like our blog and want to receive each new post directly to your e-mail, please sign up with your e-mail in the subscribe box. It doesn’t cost anything, there is no commitment, it just makes it easier to follow us.

We welcome volunteers.

-Scott Gardner

THE ACCIDENT

(I wrote this some time ago, but never posted it.)

The call came in Sunday afternoon, November 27, the call I had been dreading that is. Pa Sanko had been in an accident with the van. I was dreading it because I knew how Pa Sanko drove, like a Sierra Leonean, but more importantly I knew how the others on the road drove. It really was not a question of if but when there would be an accident. This is why we pray so sincerely each time we set out on a journey.

The problem is that the van is our source of transportation, it is how we get people to and from the airport, it is how our mobile clinic team goes out, it is how we get to Freetown. Mr. Fobbie has his car sure, but often both are in use. Plus the van holds a lot of people and a lot of material. It is a true work horse and will make our job much more difficult without it. I had been dreading this day since April.

Sanko had been bringing home a group of women from the yearly women’s retreat at Masiaka. They tell me (I was not invited) that it had been a great weekend, very spiritual, and they were singing and praising as they neared Waterloo. Suddenly an Okada (motorcycle taxi) pulled out from among the traffic waiting to cross the highway. He pulled right into Sanko’s path. Sanko had no time to react or stop, and the van plowed into the moto. The unhelmeted passenger, a woman in her 50’s went flying off the bike. The driver fled, leaving a badly damaged motorbike and an unconscious, bleeding woman on the pavement.

Our poor van with the smashed nose. It is still in the shop, they are trying to find a radiator for it.

A crowd quickly formed around the van and the accident scene. The windshield on the van was smashed as was the radiator. The location of the accident had to be a God thing. It happened a hundred yards from the Emergency Clinic, and the local police station. There is an Italian NGO who has a very nice Emergency hospital in Freetown, and most accident victims are taken there. They have an orthopedic surgeon on staff (the only one in the country), and all care is given for free. They have also established several Emergency clinics, like the one close to the accident scene where accident victims are taken, triaged and first aid rendered, before being taken in their ambulances to the main hospital in Freetown. So the woman was quickly taken to the Emergency clinic where she was found to be unconscious, with an open depressed skull fracture. Fortunately, everyone in the van was fine.

The second serendipity is that the local police station is also located within a hundred yards of the accident. Sanko was immediately taken to the police station and placed in protective custody. At that point it was not clear if the woman would live or die, or how serious her injuries were. Mob justice is alive and very well in West Africa. In Tchad we were taught that if you were in an accident, especially if it appeared someone died, or might die, even if it was not your fault, you do not stop. You drive to the nearest police station. If you stop, the crowd will at best beat you to within an inch of your life, at worst kill you. This is not a joke, it is real. We were driving through a suburb of Freetown and noticed a commotion. Turns out some sap had tried to steal something and had been caught. They were beating the tar out of him, quite literally.

So, although this was a moment I had been dreading, God was way ahead of us. When we had our strategic planning meeting in April, one of the plans was to add a 4 WD vehicle and an ambulance. I, the skeptic, went along with it, thinking maybe in a year or two we would find the money for another vehicle. I really did not believe we had a prayer of getting an ambulance. But then in late September the Loma Linda Auxiliary chose us as one of their projects. That was great, they typically raise enough to give each of their projects $10,000. I was pretty happy. But they typically finish their fund raising by the following spring, and distribute the funds in April or May. Bekki and I had never met these ladies before, so when we were at the Global Health Conference in Loma Linda in October we asked if we could meet them. So it was that Friday afternoon we ditched out of the meetings and had spaghetti and mizithra cheese (not available in SL) with the leadership of the Auxiliary at the Redlands Spaghetti Factory. We got a chance to tell them the story of our little hospital, and they were so touched that they gave us the $10,000 on the spot. Furthermore, they really wanted to money to go for a 4 WD vehicle. They were very specific on that.

Our staff with the new Nissan XTerra, thanks to the Women’s Auxiliary of Loma Linda University.

I let Fobbie and Koroma know the good news. They wasted no time and found a used Nissan XTerra in great condition, never driven in Africa, imported from Germany. It was 4WD, manual and diesel. An unbelievable combination. And they purchased it literally days before the accident.

We were taking Dr. Gaede, our board chairman, to the airport in the new Nissan and were able to stop by the hospital and police station. It was there that I got a first hand taste of how quickly things can get out of hand. Mr. Fobbie, Mr. Abu and I had walked over to the Emergency Clinic to try and check on the woman, but as we got to the entrance her family showed up, and recognized some of our ladies that had been in the accident. I am not sure what was said that acted as the spark, but suddenly I was in the middle of a major fight. The relatives were pushing and shoving and shouting, others were pushing back. Thank God that within seconds the police were there coming between the groups, getting people separated and kept the fight from escalating. I got out of there as quickly as I could. I kind of stand out if you know what I mean. And white skin is often a flashpoint when tempers are already thin.

Sanko was held for a couple of days, then had to report daily to the police office for a week or so until the police finished their investigation. The driver of the Okada never showed his face again. Neither did the owner of the motorbike. The Okada’s are usually owned by someone other than the driver, and if it was the driver’s fault the owner never comes to claim the bike, figuring he would be required to pay damages for the vehicle as well. I asked why they couldn’t track down the owner through the motorbikes registration. Ask a stupid question…I was told, yes that is possible, but you have to pay the police extra to do it. We have a saying for that TIA (This Is Africa). Eventually the police decided it was not Sanko’s fault and so he is not in trouble. The XTerra is working out great (I even drove it last Sabbath), and there was enough money left over from the Auxiliary donation to get the van fixed.

What about the injured woman? You will have to wait for the next blog.

For those of you who are new to our blog please look around at the other pages, the “About” page tells a bit of who we are and our background, the “Definitions” page explains some terms that are used that some of you may not be familiar with, such as GC or AHI. The “Timeline” gives an idea of where we will be throughout the year, and the “Video” page has a video Bekki made of Koza Hospital as well as the videos she has made of Moundou, and now we are adding videos of Sierra Leone. Watch a real Ebola survivor tell his story. Watch our community health officer explain why the staff agreed to work in the Ebola Red Zone even after they lost 2 staff members to Ebola. There is also the Surgical Pictures Page, but be forewarned, it has some very graphic pictures, so if you don’t like blood and guts, stay away from that page. On the Projects and Donations pages you can find the projects we are working on and how to donate to the project that touches your heart. Finally, if you like our blog and want to receive each new post directly to your e-mail, please sign up with your e-mail in the subscribe box. It doesn’t cost anything, there is no commitment, it just makes it easier to follow us.

We welcome volunteers.

-Scott Gardner

WHAT I LOVE ABOUT MY LIFE IN SIERRA LEONE

Life is hard here. Harder than I could have imagined from our short 1 month trips to Bere before becoming full time missionaries. Hot all the time, constantly sticky with sweat except when it is just pouring out of my skin, constantly harassed by little kids and adults begging for money, trying to navigate cultural land mines every day, always having to concentrate 110% to make sure I understand what is being said, living in a beautiful land spoiled by trash, these are just a few of the things that make life here difficult for a soft American “glamper”.

But, there are so many things that fill my heart with joy, I thought I would list some of them, no particular order, and not an exhaustive list:

Listening to the staff sing, “When we all get to heaven”, it means so much more here where life on earth ain’t that great.

Having almost all the staff together each morning for morning worship, which starts with British precision at 08:30.

Listening to the morning worship talk as a junior staff member shares what our mission statement means to him, “demonstrating the healthcare ministry of Jesus.” They have caught the importance of our mission and vision and core values.

The blessing of each new item added to the hospital, from blood pressure cuffs, to cars to generators. All are blessed with a special prayer and dedicated to God’s service.

Seeing patients and families attending morning worship.

Being in my office at 4:30 in the afternoon on Wednesday and Friday and hearing the singing start as our call to worship for prayer meeting and Vespers respectively.

Singing “Welcome, welcome, how do you do” to visitors each Sabbath in church and to welcome our new volunteers.
The cheery good morning I get each morning from the canteen staff as I walk to the hospital.

Having a Board of Directors that takes their job seriously and thoughtfully, and supports us.

Having AHI to turn to for help and support, each one of whom is a jewel in their own right.

Having a mission President who is honest, trustworthy and understands the relationship between the church and it’s hospitals.

Having an air conditioner in my office and in my bedroom.

All of our volunteers, short term, long term, they keep us young and going.

Hearing the Muslim call to prayer (yes you read that right), from a distance, as it softly and musically flows through the evening air.

The cool ocean breeze.

The beach

The sunshine

The chance to work with people who have been through so much, suffered so much loss and still can laugh and smile.

Being a part of saving a life.

Having a chance to do something for others that I know they could never do on their own, not for lack of intelligence or skill, but lack of opportunity.

Seeing jaw dropping pathology. I have a saying, “If the locals are taking pictures, you know it is bad.”
Practicing with little fear of malpractice.

Being able to sleep every night.

Being able to do pretty much all your shopping from the car as you sit in traffic in Freetown because all the vendors pass by selling everything from fruit, nuts and popcorn to mops to cell phone cords to cell phones.

A solid administrative team.

Eating roasted cashews and peanuts everyday.

Eating the best pineapple in the world every day, and papaya and mangoes and guava.

Having a cleaner who makes 300,000 leones a month pick up a 5000 leone bill I accidently dropped and putting it on my desk instead of just keeping it.

When a patient who came with necrotizing fasciitis (flesh eating bacteria) in their neck because of a cavity in a tooth, looks you in the eye and says “Thank you for saving my life”.

Praying before every surgery.

Praying before every car ride.

Having friends, good friends, all over the world.

Speaking French

Seeing God perform miracles

“Snapping” the kids and moms in the villages and then hearing their shrieks in of delight when they see their picture on my phone.

Hiking up Mount Erin behind the hospital on Sabbath afternoons with Doug and Julian and volunteers and Africans who choose to join us.

Being able to share this adventure with my best friend and soul mate.

Happy Sabbath.

For more frequent, up to the minute short updates please follow us on Instagram, we are Scott N Bekki Gardner.

For those of you who are new to our blog please look around at the other pages, the “About” page tells a bit of who we are and our background, the “Definitions” page explains some terms that are used that some of you may not be familiar with, such as GC or AHI. The “Timeline” gives an idea of where we will be throughout the year, and the “Video” page has a video Bekki made of Koza Hospital as well as the videos she has made of Moundou, and now we are adding videos of Sierra Leone. Watch a real Ebola survivor tell his story. Watch our community health officer explain why the staff agreed to work in the Ebola Red Zone even after they lost 2 staff members to Ebola. There is also the Surgical Pictures Page, but be forewarned, it has some very graphic pictures, so if you don’t like blood and guts, stay away from that page. On the Projects and Donations pages you can find the projects we are working on and how to donate to the project that touches your heart. Finally, if you like our blog and want to receive each new post directly to your e-mail, please sign up with your e-mail in the subscribe box. It doesn’t cost anything, there is no commitment, it just makes it easier to follow us.

We welcome volunteers.

-Scott Gardner

Three Holes

Our mission at AHS-SL (Adventist Health System-Sierra Leone) is to demonstrate the healthcare ministry of Jesus Christ. It has occurred to me that Jesus was actually more interested in healing people’s souls, than their bodies. Consider the story of the paralytic in Mark 2, Jesus forgave his sins first, then healed his longterm paralysis. And it really makes sense, I mean saving someone’s life is great, but what does it really do? It just pushes back the date of death a bit, but we all die eventually. I am all for relieving suffering, but after the treatment most people just get sick again, the relief is rarely permanent. But, if we can save a soul for eternity, wow, now that is something altogether different.

And so, at AHS we are trying to make ministry a big part of what we do as a mission hospital. Enter one Samuel Danquah. A diminutive Ghanian who worked in our accounts department. However, it was clear to all around him that his heart and natural gifts were in ministry, not in numbers. He was already one of our district evangelists (read lay pastor), overseeing 8 churches in the area. When it came to spiritual things at the hospital, the staff, even our chaplain, looked to Mr. Danquah for leadership (everyone here is Mr., or mommy, or aunty, or pa, you don’t call anyone except the young people by their first name).

Three months ago I tried to approach him about taking over the spiritual ministries at the hospital and the attempt fell flat. It probably was a good thing, because in the ensuing three months we have developed a clearer vision of where we want our spiritual ministries to go. And so we tried again. This time, it was an all out effort, Dr. Koroma talked with him over a 2 week period, I enlisted Pastor Sandy our mission president to talk with him. And we brought in the big guns, we prayed that the Holy Spirit would speak to his heart and lead Mr. Danquah and us in the right direction. And probably equally important, I stayed out of the conversation. It worked. Around the first of December he accepted the position of Director of Spiritual Ministries for AHS-SL.

He was officially to start the new job January 1, but he has wasted no time in taking on the new responsibilities. He has already found himself a temporary office and outfitted it. We have been able to fill his position in accounts with people already in place, so that transition has been an easy one. And in his first two weeks he has presided over three holes.

The first hole, for a too tiny casket.

The first hole, for a too tiny casket.

Last week I wrote about the first hole. He was the presiding elder at the funeral of the little son of one of our nurses. Fortunately, the next two were much better. In line with our increasing spiritual emphasis at the hospital, and due to the fact that our morning worships are full and overflowing, with not enough seating, it has become more urgent that we have a chapel for the hospital. Oh yea, also staff who are on duty, ambulatory patients and family members cannot attend Sabbath morning services because the school room where the AHS church meets is too far away. No, we need a real chapel, a place to have morning worship, Wednesday evening prayer meeting, Friday vespers and Sabbath School and Church. We need a place anyone can go, at any time and meditate and pray.
Site of our new chapel and the second hole.

Site of our new chapel and the second hole.

A couple of weeks ago Bekki mentioned it on facebook and we received a seed donation of $1000. That was enough to get us started. The second of the three holes was dug, this time for the foundation of our new chapel. We are moving forward in faith that God will bring in the needed funds to get it built. We have set a crazy goal of having it finished by the rains that will come in May.

Mr. Samuel Danquah, preparing to baptize the cornerstone of the chapel with cement.

Mr. Samuel Danquah, preparing to baptize the cornerstone of the chapel with cement.

I have had the privilege of participating in a couple of ground breaking ceremonies in the US, but we don’t do that here, we have a “Laying of the Cornerstone” ceremony. So it was that last Wednesday we interrupted Executive Committee to have the cornerstone ceremony. And of course our own Mr. Danquah led out, along with Pastor Moiba, the executive secretary of the SL Mission. Like everything else here, it was very spiritual and very ritualized. It was really cool. There was singing, prayers, and speeches, including multiple expressions of how long they had been waiting and longing for a real chapel. Then, starting with Pastor Moiba, the various dignitaries deposited some concrete on the stone laid in the corner of the hole for the foundation. Over the last week, work has continued on the foundation, and it will keep rising as money comes in.
Dr. Koroma adding his load of cement.  He got the words right.

Dr. Koroma adding his load of cement. He got the words right.

Yesterday Mr. Danquah presided over the third hole. This one is the foundation of the new physical therapy building. When we first arrived in April, physio was meeting in a gazebo. With the rains they moved indoors to an unfinished ward in an unfinished wing. But they really needed their own place.

In June we were encouraged to apply to the Winifred Stevens Foundation for a grant to help us with one of our projects. I asked Linda Spady, the chairwoman of the foundation, which project she recommended. She suggested we apply for all three, upgrade to our OR, complete the unfinished wing (extension) and construct a physio building, then let the board choose the one that spoke to their hearts. I still get goosebumps when I recall the moment I got the e-mail telling me that the board had not chosen one of the projects, but had agreed to help us with all three. So the theatre (OR) is being upgraded, the extension is being finished which will double bed capacity, and we are beginning construction on our physical therapy building.

The chief of Waterloo adds his comments and blessing to the construction of the new physio building.

The chief of Waterloo adds his comments and blessing to the construction of the new physio building.

Fast forward now to yesterday, it was again the ceremonial laying of the cornerstone, this time for the physio building. Again the hospital leadership, the mission leadership, and dignitaries from the town of Waterloo, including the chief, the press, were all there. The ceremony was very similar, and just as meaningful. Physical therapy is such a blessing to these people. They have such physical lives, lifting and carrying impossible loads, and they have sore muscles, joints and bones. Physical therapy and massage therapy relieves much of that pain.

The third hole, Pastor John Moiba, Executive Secretary of the Sierra Leone Mission, starts us out by placing the first dollop of cement on the cornerstone of the phyiso building.

The third hole, Pastor John Moiba, Executive Secretary of the Sierra Leone Mission, starts us out by placing the first dollop of cement on the cornerstone of the phyiso building.

As each dignitary lays cement on the cornerstone it is important to dedicate the stone and symbolically the building to God. For the Muslims it is done in the name of God. For the Christians it is done in the name of the Father, the Son, and the Holy Ghost. Just like a baptism, but with cement rather than water. Last week I messed it up, not realizing that those words are an important part of the ceremony. To my credit, I am a fast learner, and I got it right this time. I only hope that my omission on the chapel will not diminish the blessing. Thankfully God knows the heart, and can overlook a novice’s mistake!

So, 10 days, three holes, and a very busy Director of Spiritual Ministries. But thanks be to God for His comfort in times of sorry, and His blessings on our efforts to emulate the healthcare ministry of Jesus through the spiritual ministry represented by our chapel and through the physical ministry represented by our physio building.

The whole group at the Cornerstone ceremony of the physio building

The whole group at the Cornerstone ceremony of the physio building

For those of you who are new to our blog please look around at the other pages, the “About” page tells a bit of who we are and our background, the “Definitions” page explains some terms that are used that some of you may not be familiar with, such as GC or AHI. The “Timeline” gives an idea of where we will be throughout the year, and the “Video” page has a video Bekki made of Koza Hospital as well as the videos she has made of Moundou, and now we are adding videos of Sierra Leone. Watch a real Ebola survivor tell his story. Watch our community health officer explain why the staff agreed to work in the Ebola Red Zone even after they lost 2 staff members to Ebola. There is also the Surgical Pictures Page, but be forewarned, it has some very graphic pictures, so if you don’t like blood and guts, stay away from that page. On the Projects and Donations pages you can find the projects we are working on and how to donate to the project that touches your heart. Finally, if you like our blog and want to receive each new post directly to your e-mail, please sign up with your e-mail in the subscribe box. It doesn’t cost anything, there is no commitment, it just makes it easier to follow us.

We welcome volunteers.

-Scott Gardner

SHOWERS OF BLESSING?

“There shall be showers of blessing;
This is the promise of love;
There shall be seasons refreshing,
Sent from the Savior above.

Showers of blessing.
Showers of blessing we need;
Mercy drops round us are falling,
But for the showers we plead.”

We closed worship this morning singing that song. We had just been told that the three year old son of one of our nurses had died Saturday evening. After the song Mr. Fobbie, our administrator, told us about the funeral arrangements.

I had seen him Thursday afternoon in consult, to do an ultrasound. Seems that he had not urinated since Monday. His mom carried him into my office and he lay quietly on the table while I did the ultrasound. That was bad sign number one, normal three year olds don’t lay still on an exam table, they kick and scream. Numbers 2, 3 and 4 were the lack of urine in his bladder, his huge kidneys and the fluid in his abdomen. All together they told me this kid was in big trouble, a hemoglobin and malaria test and urinalysis were not going to make the diagnosis for me, and in any case we have no treatment for renal failure.

Dr. Koroma suggested sending him to a pediatrician in Freetown when I gave him the ultrasound results, and I heartily agreed. Friday afternoon he urinated, and Saturday morning he was transferred into Freetown and Saturday evening he passed off (died).

This afternoon we went to his funeral. I have been to several wakes in Africa, where one just visits the family, but this was my first funeral. In many respects, it was very similar to an American Adventist funeral, but with some definite African twists, for instance starting three and a half hours late, and it was held outside behind the little boy’s house. But, food was served while we waited for the arrival of the casket, there was praying and singing, and encouraging words about God’s love and care and our hope of the resurrection, and yes, lots of crying. The hardest thing was seeing his 5 year old cousin screaming and crying, “Cousin, come back; Cousin, come back.”, when he saw the casket for the first time.

In October, the wife of our cashier was brought in unconscious and all swollen after delivering her baby at home. We don’t have OB yet, so the family chose traditional over the government maternity center. My guess is she had eclampsia and crashed after delivery. She died shortly after coming in to the hospital, leaving our cashier a widower with two older children and a newborn. He faithfully comes to work everyday. Bekki thinks he has lost weight, I am not so sure. His expression has not changed in the 8 months we have been here, before or after the death of his wife. I have never seen him smile.

We have a staff of 45 employees, and two of them lost immediate, young family members in the last 2 months. And we nearly lost our head nurse in September. And this morning we sang, “Showers of Blessing.” I don’t know anybody who would equate these losses with “Showers of Blessing.”

Death is universal in this world, it is not unique to Sierra Leone, Tchad, or anyplace in West Africa. And it causes pain and anguish among the living whenever and wherever it strikes. These stories are not unique, in fact I bet pretty everyone reading this has lost a child or spouse, or is close to someone who did. But none of that makes it any easier.

This quarter in our Sabbath School classes (same as Sunday School only on Saturday for the Seventh-day Adventists in the group) we are studying the book of Job and the question of human suffering. And after nine weeks the conclusion I have come to is that there is no good answer. There is nothing you can say to a mother who lost her only child or a husband who finds himself alone with a newborn. There is no explanation, no “greater good”, no “cosmic purpose”, no “reason”. And saying that “God wanted them,” doesn’t sound that great either. It just makes God out to be some selfish Being Who wants a bigger harem of angels.

A point was brought out this week that if a reason or excuse for the evil that exists in this world could be found, then it’s existence would be justified, and it would cease to be evil. There is no reason, no excuse for evil or death. (Great Controversy pp. 492, 493)

It was brought out today at the funeral that Paul admonishes us to “In everything give thanks.” Really? I had never heard that text used at a funeral before. How do you give thanks for the death of a three year old? How do you sing about showers of blessings before announcing his funeral?

I don’t think you do. I don’t think you give thanks that an innocent just lost his life. I think you give thanks that Jesus conquered death on the cross. I think you give thanks that God accepts us as we are, and accepts the death of Jesus as payment for our sins. I think you give thanks that Jesus is coming back and that He promised to raise our loved ones back to life. I think you give thanks that Jesus promised to restore us to the perfect state of pre-fall Eden. I think you give thanks for the eternal life He promises.

Those are the showers of blessing that fall around us all the time while our hearts are breaking at the evil and death we see in this world. “Even so, come Lord Jesus.” (Revelation 22:20)

For those of you who are new to our blog please look around at the other pages, the “About” page tells a bit of who we are and our background, the “Definitions” page explains some terms that are used that some of you may not be familiar with, such as GC or AHI. The “Timeline” gives an idea of where we will be throughout the year, and the “Video” page has a video Bekki made of Koza Hospital as well as the videos she has made of Moundou, and now we are adding videos of Sierra Leone. Watch a real Ebola survivor tell his story. Watch our community health officer explain why the staff agreed to work in the Ebola Red Zone even after they lost 2 staff members to Ebola. There is also the Surgical Pictures Page, but be forewarned, it has some very graphic pictures, so if you don’t like blood and guts, stay away from that page. On the Projects and Donations pages you can find the projects we are working on and how to donate to the project that touches your heart. Finally, if you like our blog and want to receive each new post directly to your e-mail, please sign up with your e-mail in the subscribe box. It doesn’t cost anything, there is no commitment, it just makes it easier to follow us.

We welcome volunteers.

-Scott Gardner

Koidu Town-Home of the Blood Diamonds

Koidu is the chief city in the district of Kono, in the far eastern area of Sierra Leone. It is home to the mining industry, mostly diamonds and gold. Kono is famous as the site for the documentary movie “Blood Diamonds”. Money from the sale of the diamonds have funded many a war, including Sierra Leone’s own Rebel War of the 1990’s. But others have profited as well, hence much blood has been shed because of wealth generated by these gems.

Diamond Mining in Koidu

Diamond Mining in Koidu

But Koidu and the Kono district is also home to another group of “Gems”, loyal dedicated Seventh-day Adventists who have a burden for their fellow man. This last June the men’s group of the Koidu SDA Church got together and brainstormed. “What can we do for the church and the community? More specifically, how can we impact their health and well-being?”

Our guest house in Koidu.  It was really nice.  Great birding spot too.

Our guest house in Koidu. It was really nice. Great birding spot too.

It so happens that the health and temperance leader of the church, one Boko-Lincoln, is a pharmacist and has his own store. He has been in the community since 1967, so is very well known. As is common here in this country of limited medical resources, he operates a simple clinic out of his pharmacy. So he evaluates and treats patients according to his knowledge level.

Before we get too self-righteous about a pharmacist practicing medicine I must point out that it is a lot better for him to be using the medical knowledge he has to help the overburdened local doctors and nurses, rather than for people to access the health care from the traditional healers. Reference my last post where I described pulling leaves out of my patient’s abdomen, the herbs the traditional healers used to treat Sahr’s perforated ulcer.

Greetings from the Koidu Church

Greetings from the Koidu Church

Bekki reading off the results of the offering competition between the men and women (guys won by about 2,000 leones, 38 cents)

Bekki reading off the results of the offering competition between the men and women (guys won by about 2,000 leones, 38 cents)

So it was that Boko-Lincoln suggested that they open a small pharmacy in the church, and sell the medications on a cost-recovery basis. The goal was not to make a profit, but to make good quality medications available and affordable to the local church first then the local population. Now it is possible to buy pretty much all these drugs at the local market, but the problem is you have no idea what you are buying. Is it really penicillin? Maybe. Maybe not. Who knows, and who cares, except for the family of the patient who just died because they bought and took bogus medications. You get the point.

Koidu Church and their dispensary table with BP cuff, thermometer, and meds

Koidu Church and their dispensary table with BP cuff, thermometer, and meds

The rest of the church was excited about this new health care initiative. I should also point out that as Health and Temperance leader, Boko-Lincoln is not idle, he gives a weekly health talk at church as well as leading out in this small dispensary. Soon the day came to unveil the dispensary. The church invited our mission president, Pastor Daniel Sandy, to attend.

At the grand unveiling ceremony with Pastor Sandy being the keynote speaker, it came up that they would really like to have an Adventist Health System Clinic in their area. Pastor Sandy told me about it as we traveled to the US together for the TAASLA campmeeting. The whole concept fits in very well with our vision to transform the health of all people in Sierra Leone. So as soon as I returned we began contacting the leadership in Kono District. A meeting was set up for Friday and Sabbath, September 9 and 10.

It was a long 5 hour drive over some horrendous roads (well they don’t actually qualify as roads, wide advanced motocross trails is more like it). But we spent a delightful Friday evening hearing what they are doing to evangelize and help the people who live in their community. We worshipped together on Sabbath morning and in the afternoon visited the churches 5 acre property, as well as an unfinished building that would work well for a clinic. We finished the visit with a meeting with the Parma Chief, the top chief in the area.

Meeting with the Parma Chief (on my right) and the other village leaders.

Meeting with the Parma Chief (on my right) and the other village leaders.

The first two criteria any community has to meet in order for us to consider them as an AHS clinic site are:

There has to be a need. We are not going to open a clinic next door to another health facility, be it government or private. There are so many areas without health care, we need to focus on them first.

And, two, there has to be strong community support, not just the church, but the community as a whole. Koidu meets both these qualifications. The nearest health facility is several miles away over very difficult roads. And based on the meetings we had with the church people and the community leaders there is very strong support.

But there is a third criteria. We want to know how the Adventist church community and health care community plan to use the clinic to follow the vision of AHS, to improve the physical, spiritual, mental and social well-being of their communities. These clinics are first and foremost a way to improve the spiritual and physical health of their people. Secondary is an income stream, uh OK, reality is it is probably further down the list.

The unfinished clinic building

The unfinished clinic building

Inside the building

Inside the building

They are well on their way to demonstrating a strong affirmative on all three points.
We really don’t know where this will go. The building needs finished and then Adventist healthcare workers need to be recruited. But the great news is that it is God’s work, when He is ready for AHS-Koidu Clinic to open, it will open. We just have to be prepared to march through the door when He opens it.

Mining is still active in Kono District. I don’t know how the profits are used, but it would not surprise me if there are still a few blood diamonds. But for us it really is irrelevant. What matters is there are people who need health care and they need Jesus.

Bekki practicing carrying wood on her head.  Put that woman to work!!

Bekki practicing carrying wood on her head. Put that woman to work!!

For those of you who are new to our blog please look around at the other pages, the “About” page tells a bit of who we are and our background, the “Definitions” page explains some terms that are used that some of you may not be familiar with, such as GC or AHI. The “Timeline” gives an idea of where we will be throughout the year, and the “Video” page has a video Bekki made of Koza Hospital as well as the videos she has made of Moundou, and now we are adding videos of Sierra Leone. Watch a real Ebola survivor tell his story. Watch our community health officer explain why the staff agreed to work in the Ebola Red Zone even after they lost 2 staff members to Ebola. There is also the Surgical Pictures Page, but be forewarned, it has some very graphic pictures, so if you don’t like blood and guts, stay away from that page. On the Projects and Donations pages you can find the projects we are working on and how to donate to the project that touches your heart. Finally, if you like our blog and want to receive each new post directly to your e-mail, please sign up with your e-mail in the subscribe box. It doesn’t cost anything, there is no commitment, it just makes it easier to follow us.

We welcome volunteers.

-Scott Gardner