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

Eid al-Adha

For those of you who may have missed it, last Monday, September 12 was one of two main Islamic holidays, Eid al-Adha, or Feast of the Sacrifice. You guessed it, it commemorates the willingness of Ibrahim to sacrifice his first born son Ishmael. It also marks the end of the annual Hajj to Mecca.

We live in a predominantly Muslim country (60%), so as soon as the Supreme Court in Saudi Arabia set the date officially as September 12, it became a national holiday. So Mobile Clinic was cancelled, but things were pretty much as usual at the hospital. A hospital, like Las Vegas, never sleeps you know, or takes vacation.

That being said it was pretty much an uneventful quiet day until about 4:30 in the afternoon. Mr. Fobbie came to my office as I was starting to pack things up to go home.

“Mr. Abu is going to Mamamah to attend to Mr. Augustine Conteh”, he told me.

“Oh, why is that? What happened?”

“He was on his way home and was in an accident.”

“Is it serious?”

“I think so, they took him to his house.”

I am a surgeon after all, and so I thought I should go along and check it out for myself, plus I figured it would be a morale booster for Mr. Conteh, who is our head nurse.

Mr. Abu and I quickly got together a few supplies, not having a clue what we would find. Afterwards I realized we left the BP cuff and IV supplies behind. Next time we will try to have an emergency kit prepared.

Pa Sanko, our intrepid driver, the man who has no fear, holding Augustine's older girl, Rachel.

Pa Sanko, our intrepid driver, the man who has no fear, holding Augustine’s older girl, Rachel.

We hopped in the van with Pa Sanko and Mr. Abu had prayer. We desperately needed that prayer. I have spent many hours in the van with Pa Sanko at the wheel. He is a pretty aggressive driver. This time it was the Indy 500 and we were making up for too much time lost in the pits. I buckled in tight, and tried to concentrate on my solitaire game and not count the times we passed one or two cars going our direction while being passed by cars going in the opposite direction. These guys have incredible depth perception, they miss each other by millimeters, or sometimes not.
The vambulance

The vambulance

20 minutes later (of the usual 30 minute trip) we pulled into Augustine’s front yard. Abu and I hopped out and followed the sounds of wailing to the little carport behind the house, where they had held the naming ceremony for Augustine’s baby girl, Sarah.

Mr. Conteh was laid out on the cement on a pink lacy sheet. He was surrounded by probably 50 friends and relatives, many of whom were wailing and wringing their hands. One woman was standing over him pointing to a mass protruding from his bare abdomen. At first I thought he was dead, but then I noticed he was breathing. We did a quick primary survey and found nothing imminently life threatening, other than all the noise and commotion. His pulse was full and strong and didn’t feel too fast. I breathed a sigh of relief as we began the secondary survey.
The mass in his abdomen turned out to be an old hernia, apparently this woman had not seen him before without his shirt, so she thought it was new. He was able to talk fairly normally and answer questions. They said his left leg was broken and it had a traditional splint in place. Abdomen was soft and non tender, chest was normal. Glasgow Coma Scale was 15.

OK, this is good. I really didn’t want my head nurse dying on me in front of all these people, actually I didn’t want him dying on me at all. But I did want him back at the hospital where we could watch him in case something did show up.

I suggested we get him moved to the van, so 5 guys got on the right side of the sheet leaving me and one other skinny Sierra Leonean for the left side. I had visions of this not going well, but it was still better than the Tchadien method of transport; 4 men, each one holding a different limb with the head flopping around loose. We got him in the van without incident and tried to reassure the weeping crowd that he was going to be alright. Unfortunately, it is a van, so he had to sit semi-upright on the seat so we could fit all of him inside.

As we headed out I told Sankoh that Augustine was OK and we could go a little slower. I have always been opposed to accidents involving rescue vehicles, especially if I am inside.

I was now able to talk with Augustine and find out what had happened. He had been on his moto and was turning left onto the road going to Mamamah and failed to see the other motorcycle trying to pass him on his left (very common practice). So the left side of his body took all the force.

As we drove along I reflected on all the people weeping and wailing as they gathered around Augustine as he lay there. I realized that they had seen this before and knew that he was badly injured and for all they knew he was going to die. Augustine is the one who has the good job, so he supports a large part of the family. Their future lay on that sheet. What would happen to them if he died, or was no longer able to work? So it was truly a cry of frightened desperate people who had no control over the situation or the future.

When we got to Waterloo his brother-in law, who had come with us, said he was hungry so we stopped at a favorite cafe and picked up some food. At that point Augustine still looked pretty good, but then he commented that he was tired. I was really hoping that it was all the excitement and the broken leg talking…

At the hospital he was loaded up on a gurney and quickly moved to the private room that had already been prepared for him. I found out later that while we were gone the whole staff had gathered together and prayed for Augustine and for our safety as well. God answers prayer is all I can say.

As we moved Augustine onto the bed I noticed his skin, previously dry and warm was now cool and clammy. Oh boy, direct left side hit, hard enough to break a leg. Hard enough to break a spleen, too? His pulse, once full, regular and slow was now fast and thready. While the staff got things together for starting an IV I got my ultrasound to do a quick scan of his abdomen. I really am not very experienced at these, and frankly not very good, but by God’s grace I quickly found his spleen and it looked pretty good. I didn’t like the black at the end of it though. I looked in the pelvis, a little black around the outside of the bladder. Then I looked at the left abdomen, black in the gutter, and I could see the bowels floating in a black sea. Black on normal mode ultrasound is liquid. In this case blood. Great.

My head nurse has a ruptured spleen. I have no night time OR, yet. I hope and pray he is not one of the few that don’t stop bleeding on their own. Mr. Abu got two IV’s going. I noted that we would need to be talking about the concept of “LARGE” bore IV’s for trauma. But the 22 gauges worked. 500 cc of fluid later he started to look around again and he quit sweating. After a liter he was talking normally and his skin started to warm up. Adequate blood pressure for brain perfusion has always been a favorite of mine.

Augustine feeling much better.

Augustine feeling much better.

I examined his leg and decided he just had a broken fibula, the little bone on the outside of the leg. The main bone, the tibia, was fine. I put a splint on it and then had prayer with him and told him I would be back in a couple hours to check on him.

At home I filled Bekki in and confessed my worries about what I was going to do if he didn’t stop bleeding like the book said he was supposed to. Patients have a nasty habit of not reading the books before coming into the hospital. We are not really set up yet to do surgery outside of regular hours. We are working on it, but it will take some time yet. So she called on her prayer team through e-mail and face book.

About 9:00 pm we went down the hospital and checked in on him. He looked pretty good, awake, alert, pulse good, abdomen soft, no pain except in the leg. I gave the nurses their final instructions and told them to call if he got sweaty again.

I have to confess I did not sleep well that night, waiting for my phone to ring. Praise God my phone stayed silent all night. I hurried down to the hospital early so I could check on him before worship, and was greatly relieved to see him holding court in his room very awake and alert and already busy disobeying doctor’s orders.

The big grin is because he had been eating against my orders.

The big grin is because he had been eating against my orders.

At worship that morning I noticed that Augustine was the scheduled speaker. I told him later that if he really didn’t want to do worship all he needed to do was talk with someone, having an accident was really not necessary. He got a good laugh out of that.

A very relieved Mrs. Conteh holding the baby Sarah, and a shy Rachel standing next to the bed.

A very relieved Mrs. Conteh holding the baby Sarah, and a shy Rachel standing next to the bed.

By Friday he was well enough to go home. Sunday morning at 6:30 my phone rang. Augustine called to thank me for taking good care of him, and to assure me that he was doing OK. I thanked him for calling, but have to confess that my thoughts were more of, “If you really want to thank me, don’t call me at 6:30 on Sunday morning:)”

Intercessory prayer works, it kept us alive during Sankoh’s mad dash to Mamamah, it stopped the bleeding in Augustine’s spleen, it helped us get the IV’s going in time. I cannot praise God enough that I was not faced with doing a splenectomy on him at 2 in the morning. We are not set up to deal with major trauma’s, but by God’s grace our head nurse will be back at work in early October.

It also showed me that we really do need an ambulance. Lights and siren would have been nice. A real ambulance gurney in the back of an ambulance that was already stocked with the supplies we needed would be nicer. As we grow, these kind of emergencies are going to be more common, we need to be ready to meet them. When we do the best we can with what we have, God makes up the difference. When we are just lazy and don’t plan ahead, and don’t work to remedy our deficiencies and ask God for help, it is presumption.

Despite the fact that Bekki did not serve mutton for supper that Monday night, it was an Eid al-Adha I won’t soon forget.

Paul checking Augustine's BP at his home today.

Paul checking Augustine’s BP at his home today.

Epilogue: We visited Augustine today as he lives just a couple hundred yards from our Mobile Clinic in Mamamah. He is doing well. Hemoglobin is stable, he is eating, no dizziness, minimal pain. We praise God for His mercies and healing. sg

A very happy Mr. Conteh on his bed at home, showing off his fancy cast-boot, and sitting up with no dizzyness.

A very happy Mr. Conteh on his bed at home, showing off his fancy cast-boot, and sitting up with no dizzyness.

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

Is A Human Life Worth $200?

I happened to glance out my office window yesterday to the front parking lot of the hospital. I watched bemusedly as a yellow cab pulled in, the front seat passenger got out and opened the right rear passenger door. My curiosity was piqued as I watched him pull out a young man by his arms. As if out of nowhere a crowd appeared and several pitched in to help carry the patient up the steps into the hospital.

It didn’t look good, but it also didn’t look surgical, I hoped. We had just cancelled my one case for the day because the young lady had eaten breakfast so I was looking forward to being able to get caught up on paperwork and other administrative stuff. Not long after I ventured out of my office and ran into Mr. James Abu, our CHO (Community Health Officer, basically a nurse practitioner).

“Doctor”, he said with his usual sly smile, “Doctor, I just admitted a patient with a bowel obstruction I would like you to see.”

“OK, no problem.” This is my usual response whether it is a problem or not, always hoping the lilt in my voice would put a smile on my otherwise sour face (those of you who know me will understand).

I asked if this was the young man they had just brought in. Sure enough it was. So much for being nonsurgical.

We went to the mens ward and found a young man, Sahr, in his early twenties laying on his side facing the wall. He had little ulcers on his right leg. I found out he had fallen from a mango tree some years back and has been paralyzed since.

The history was three days of abdominal pain, nausea and vomiting. Indeed, he looked like a bowel obstruction, distended abdomen, tight, tympanic (sounded like a drum when I tapped), no evidence of an incarcerated hernia and no peritonitis.

Here, our only non-invasive diagnostic is an ultrasound done by a rank amateur (me), so the only real decision is does this patient need an operation and if so, when? Well, he needed an operation, and since the crew was there and anesthesia was present, now was good.

As I walked back to the OR, Mr. Abu stopped me and said, “Doctor, his family has not paid anything yet. What should we do, who will pay the 1.5 million leones ($200) for the surgery?”
My response was simple, “He needs surgery and he needs it now, we will worry about the money later.”

I am done with not treating someone with a life threatening or emergency condition simply because they cannot pay. We will get what payment we can from them later. But as a hospital it is our creed to treat everyone regardless of ability to pay. God will either make up the difference, which so far He has, or we will go under. But I am going home if I have to turn someone out because they don’t have money.

Back to the story. In the OR, I was explaining the necessity of being careful when opening the abdomen on cases like this to the surgical team. Because the abdominal wall is stretched thin and the dilated bowel will be just underneath it is easy to slice into the intestine. (Most teaching of this nature is from personal experience, this was no different). This time though, as I gently opened the peritoneum there was a rush of odorless air. It was followed by thick yellow fluid, 5 liters of it. The surgery people among you know exactly where I am going with this. No bowel obstruction, but instead a 1 centimeter (1/2 inch) hole in the duodenum, just below the stomach. Diagnosis, perforated ulcer.

As I repaired the hole and cleaned him up, I marveled at how far God had brought us in such a short time. A month ago I would never have dreamed we would be ready to do a case like this, but with our new suction and cautery and OR Table and the reorganization of the OR, we were ready. The case went well, and I am happy to say that today he looked as good as anyone can look with an NG tube hanging out their nose. He has a long way to go, and many bad things can happen, but so far a life has been saved by God’s grace.

Sahr the morning after surgery.

Sahr the morning after surgery.

After surgery I met with the family and explained what we found and what we had done. I also shared with them that Sahr was still very ill and needed lots of prayer, and that God is the One that would need to heal him.

In worship this morning Mr. Abu shared the “rest of the story”. In the days since he became ill the family had taken him to traditional healers and other clinics and hospitals. Sahr had been treated with herbs and other local remedies, which I can attest to as I suctioned out a number of pieces of leaves from his abdomen. The family had spent all its money before coming to AHS. They had only enough to pay the 30,000 leones ($5) for the consultation.

Sahr and his nurse.

Sahr and his nurse.

If we had insisted on some payment yesterday before treatment they likely would have put him back in the taxi and driven off, and he would be dead today, instead of being on the mend. And we would never have had the opportunity to point them to Jesus as the Source of healing.

Will Sahr fully recover? Remains to be seen.

Will the family pay? Probably something, although not likely the entire amount.

Will it hurt us financially? Maybe.

Is a human life worth $200? Definitely.

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. On the “Videos” page watch a real Ebola survivor, Dalton Kabia, 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

Mobile Clinic

We had our first mobile clinic on Monday, August 29, 2016. It was the first step in fulfilling our vision of taking healthcare to people in all of Sierra Leone. It was the fulfillment of a commitment we made after meeting with Counsellor Bangura of Ward 154 at the naming ceremony for the daughter of our head nurse. (See the blog posted August 8, 2016.)

The Mobile Clinic Team, Mr. Abu, Erin, and Paul

The Mobile Clinic Team, Mr. Abu, Erin, and Paul

Once we set a date the community outreach team of Mr. James Abu, our Community Health Officer (CHO), and Erin Acosta, our Public Health Volunteer from Loma Linda, worked furiously to prepare. There is a lot of work involved in setting up a mobile clinic. You have to try to predict what diseases you are likely to see, and then gather all the supplies and medications you will need to treat those ailments. You have to prepare all the little things like a scale, a method to measure height, registration forms, a calculator (we forgot that one), portable exam beds, and on and on. Then it has to be all packed up and organized into bins and suitcases so it will all fit into the van along with the mobile health personnel.

Then we had to figure out how to price our services. I foolishly thought we would just use the prices we have here at the hospital, but no, I was informed we couldn’t do that. No one would come to the clinic. Apparently a $5 consult is too much for the villagers. I learned that in fact we should do the consults for free and just charge for the medications. Finally, a compromise was reached. We would do blood pressure checks for free, but there would be a 10,000 SLL (Sierra Leone Leone) ($1.25) charge to see Mr. Abu, and then the patients would have to pay for the medications.

I have to admit I was a little nervous with that plan. While I believe in the concept of mobile clinics and believe that it is important to take health care to those who can’t access it, I also believe in being able to pay the hospital staff at the end of each month. We simply don’t have the resources to be subsidizing a mobile clinic. It has to pay for itself. And I was beginning to doubt that it was possible, given the poverty in the villages. But I was game to try. However, in the Memorandum of Understanding (MOU) we signed with the local government health officials I made sure we could stop the clinics with just a 2 week notice if we found it was too expensive for us run.

Then last week Mr. Bangura, the counsellor (kind of like the mayor for the whole area) of the ward we were going to pulled me aside.

“You should give a small gift to each child who comes,” he told me.

“What kind of gift?” I asked.

“Just a small amount of food, or a small toy is all.” He answered.

Well, I thought he had a good idea. So did the other team members. But where were we going to get the money to buy a small toy for the children, and how were we going to keep from having a riot.

On Wednesday I was sitting in my office mulling this over when I heard the whoosh my phone makes when I have a new email. I opened it up to find a note from Norma Nashed, the President of Restore A Child(RAC). We had worked with them a lot in Tchad, but had had a hard time reconnecting since moving to Sierra Leone. But here was Norma telling me that RAC was sending $5,000 to Waterloo Hospital to help with Children’s programs. Wow, there is not a better program than giving rice to hungry, sick kids. Problem solved, we had money to buy rice to give the kids who came to see us. Moms are happy, we are happy, RAC is happy.

Monday I was up early, for me that is, we were leaving for the clinic at 0800. On the way we picked up the rice and arrived at the village in good time. We then waited for an hour before the man with the key opened up the building we would be using for the clinic. Fortunately, Erin is very organized and so the unpacking and set up went off without a hitch. Soon it was time for Mr. Abu to give the gathered villagers a welcome and health talk, and then, time to see patients.

Moms with their sick kids gathered in the Palava Hut, waiting to see Mr. Abu

Moms with their sick kids gathered in the Palava Hut, waiting to see Mr. Abu

Now, I have to be honest. I really did not want to be there, at the mobile clinic that is. And there was a very practical reason, I didn’t have a job. Everyone else had jobs, Erin would register the patients and collect money, Mr. Abu would see them, and Paul would dispense the meds and give shots. Even Julian had a job as official photographer and videographer. What was I going to do? I had images of sitting in a corner all day, staring off in space.

Little Rachel with one of the dolls Bekki found hidden away in a storage area.

Little Rachel with one of the dolls Bekki found hidden away in a storage area.

Promptly at 10:45 we began with our first patient, and all the job descriptions went flying through the proverbial window. We had two volunteers from the village who helped us out, and it would have been a nightmare without them. We quickly filled new roles as Paul and Theresa registered people and took their vitals, Erin and I became the pharmacy and took the money, and Abraham kind of filled in everywhere, but mostly translated. Only Mr. Abu and Julian kept to their assigned roles.

Another problem soon surfaced. Mothers were bringing their sick children. That was not the problem, the problem was they had no money, or very little money to pay for the needed care. Often the mom would run outside to her husband to get the 10,000 SLL ($1.25) for the consult, but then when it came time to purchase the needed medications they would only have 5,000 or 10,000 SLL for a 20,000 or 30,000 SLL ($2.50 – $3.75) pharmacy bill. The look on those faces would be giving me nightmares if the Holy Spirit had not given me an idea.

Two little girls with their bags of rice already perched on their heads.

Two little girls with their bags of rice already perched on their heads.

I realized that we had money, for children, for sick children. So very quickly we developed a plan. We would ask for the 10,000 SLL for the registration/consult, and another 10,000 SLL for the meds. That way they paid something. It is generally not good to always give things away, people value things they have paid for. Then we would use the RAC money to make up the difference. Most people were able to pay the $2.50, but not everyone.

Two year old Hawa came in with her grandmother from a village a few miles away. Grandma was able to pay the 10,000 SLL, but when she came to the table for the medications for Hawa’s week old cough and fever she had no more money. Now there was no way we were going to turn a little child away without treatment for a lousy $1.25. So we told them the meds were free. Then we gave Hawa her 1 kilogram (2.2 pounds) bag of rice and a little doll, and she was happy and grandma was happy.

Hawa with her grandmother.

Hawa with her grandmother.

It was such a joy to be able to treat these children, and the moms were so grateful for the rice. But we really had no idea what an impact we had made, until the end of the day. After we saw our last patient, a little 4 year-old girl, Mr. Abu shared a story with me.

It seems that this little girl, Princess, had been in the Palava Hut with her mom most of the afternoon. They had been waiting because mom could not get up the courage to go into the clinic because she did not have any money. And so they watched as people came and went all afternoon.
After we saw Hawa, Mr. Abu happened to hear Hawa’s grandmother talking with Princess’s mother. When grandma found out why the mother had not gone into the clinic this is what she said.
“Go to the clinic,” she said, “they have compassion, they will treat Princess even if you don’t have money. Don’t wait.”

And so we had the privilege of caring for little Princess and sending her home with needed medicines and a bag of rice to fill her tummy, because of the compassion and generosity of people who have never met her, and will never meet her, people who live half a world away, but have the love of Jesus in their hearts.

“Let the little children come to Me, and do not hinder them, for the kingdom of God belongs to such as these.” Mark 10:14 NIV

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

TAASLA

Sometimes in life you make snap decisions that turn out great and sometimes not so great, sometimes even terrible. About 4 weeks ago I made one of those snap decisions. This time I believe it was the Holy Spirit who prompted me, because it turned out better than I could ever have hoped for, especially for an introvert like me who relies on Bekki to make the friends and contacts.

One Sabbath evening Pastor Daniel Sandy, our new Sierra Leone Mission President, came by the little guest room to chat with us. There were a couple items of business he was following up on, but mostly it was to talk about the hospital, the mission and the future of the SDA work in Sierra Leone. (Pastor Sandy is a vice-chairman of our hospital board.) In the course of the conversation he mentioned that he was going to Maryland the first weekend of August to attend a campmeeting of the local SDA Sierra Leone ex-pats living in that area.

When he said that, it was like someone flipped a switch in my brain. “I have to be there”, was the thought. Right on heels of that thought were the rational, how, why, who.

How are you getting there?

How are you paying for this?

Why are you going? You weren’t invited.

Who is going? Are you taking Bekki? Are you really going by your introverted self?

Just as quickly came the answers (in order).

By plane.

I don’t know and I don’t care.

I don’t know and I don’t care.

Me. No. Yes

So I hemmed and hawed with Pastor Sandy, wanting to make sure I would not be raining on his parade, asking if, well what would he think, would it be OK if I went with him. He looked at me for the longest time. I thought, “Great, he is trying to figure out a polite way of telling me to stay home.”

But instead he said that sure, I would be welcome. Wow, OK now I had kind of committed myself. But I gave myself an out. I told him I would have to run it by Donn Gaede our board chair and my administrative team here at the hospital. (Read: I am going to sleep on this and see if I still feel the same way in the morning, if not I will save face by having them tell me no. Smart, huh?)

But by morning the impression and desire to go was just as strong. I got the green light from Gaede, Fobbie and Koroma, and started looking at airline tickets. It was definitely a bit more than I wanted to spend, but I was committed now. Besides the conviction was growing that I needed to be there. To be honest, I really didn’t know why. I mean, beyond the dates I knew nothing about this “campmeeting”. I didn’t even have a speaking appointment.

More questions without answers:

Who would be there?

How many?

Would they resent my being there? You know the American white guy showing up uninvited, unannounced.

Would I be able to overcome my natural shyness and be able to smile and not look grumpy all the time?

And so on.

As the time got closer those questions got bigger, especially since I didn’t get a copy of the schedule until 5 days before I was scheduled to leave. When I looked at the schedule my heart sank a bit. I had thought Pastor Sandy was the featured speaker, being the SLM President and all, and I was hoping that since he knew me he would at least introduce me and give me 5 minutes or so to say something about AHS Waterloo. But he was on the program only Sabbath afternoon, doing a Marriage/Family breakout session. I consoled myself that at least one of his daughters would be there and I really wanted to meet one or both as the oldest Jewel is an ophthalmologist and the younger one Jenny, is a CRNA (Anesthetist). Hannah, his wife would be there and I knew her, and so I was looking forward to seeing her. And I would have a bit of time to spend with Ronnie and Kermit Netteburg, so there were good things. And lastly I had gone into this fully informed that it was a $2500 gamble, but one I felt convicted to take.

The Sabbath before we left was the Thanksgiving service I wrote about. It was during Pastor Sandy’s sermon that I began to get an idea of what I was in for. I found out the reason behind the long pause when I first suggested the idea that I would accompany him. He was not trying to figure out a way to say no, he was trying to get his head around the idea that I would be willing to go. I kind of blind-sided him, in a good way. I also found out who was putting on the campmeeting. TAASLA, The American Association of Sierra Leonean Adventists. There would be folks there from all over the US. And Pastor Sandy was excited I was going to join him. OK, so now I had to go. I was pumped. Until…

The devil is always there to throw curve balls isn’t he? Sunday I got an e-mail from Air France. Seems their Cabin Attendants (Stewards and Stewardesses) were on strike July 27 through August 2, and so a lot of international flights were being cancelled. If I wanted to re-book I could do it for free, or even cancel and bank the fare for use within a year.

I was scheduled to leave August 2, on a flight from Freetown to Paris. It seems like African flights are always the ones cut, you know the old thing, “no one cares about Africa.” Seriously if you have a choice of cutting a flight between JFK and Paris or Freetown and Paris, which do you think Air France will choose to cut. And it is not like there are flights out of Sierra Leone every few hours. Not even every day. By now the conviction that I needed to be there was overwhelming, and so we prayed. Bekki got her prayer warriors praying. In worship the next morning, Monday, James Abu led us in a special prayer that my flight would depart as scheduled. I went to the Air France office on Monday to talk with them. They assured me the flight was a go. Although that was better than, “No it is cancelled,” I was still nervous. We kept praying. Tuesday morning I finally got the e-mail that I could check in for my flight, I began to relax. God intervened and Air France cancelled lots of other flights but mine was on time. Praise the Lord.

With the Sandy Family, Pastor Daniel on the Left, then Jewel, Jenny and Hannah.

With the Sandy Family, Pastor Daniel on the Left, then Jewel, Jenny and Hannah.

Pastor Sandy and I went to the airport together. We had two hours to talk and share visions and dreams that we had for Sierra Leone, and just to get to know each other better. The respect I already had for this man just exploded.

The trip across the pond was uneventful, I had a great time with Ronnie and Kermit, enjoyed an Olive Garden Salad, listened to the Marine Band on the Capital Steps, and made a needed trip to the General Conference to deal with some matters.

The weekend song leaders.

The weekend song leaders.

Thursday afternoon I drove up to Hagerstown to Highland View Academy. Registration was from 1-5 pm, I got there a few minutes after 5. No signs, in fact the place seemed deserted. I went to administration and they directed me to the Boys dorm. I went there. Someone was putting a sign up on the door. I went inside. No registration desk, no one in the lobby, but I heard voices down the hall. And there I found Mr and Mrs. Kamara talking with the boys dean. Now one advantage I had the whole weekend is that I kind of stood out, if you get my drift. And my AHS Waterloo Hospital shirt didn’t hurt either. Since it was obvious I didn’t work at the school, and was here for the campmeeting introductions were soon made. When Kamara found out who I was he wrapped me in the biggest bear hug and with tears in his voice welcomed me to campmeeting. That set the stage for the entire weekend.
Mr. Kamara, my first greeter

Mr. Kamara, my first greeter

Jenny Sandy with Mr. Kamara and Jacob Conteh.

Jenny Sandy with Mr. Kamara and Jacob Conteh.

I don’t think I have ever been so completely and unconditionally adopted by any group of people like I was by TAASLA. I was immediately an honorary Sierra Leonean. Most of them had grown up in SL and had gone to school together. This was the first campmeeting they had had in 4 years, and they did indeed come from all parts of the country, even one family from Mexico. So it was a homecoming of sorts. Pastor and I were accorded all the time we needed to share about the gospel and health ministry that is happening at home. We emphasized the close relationship the SLM (Serra Leone Mission), AHS (Adventist Health System) and ADRA (Adventist Development and Relief Association) have in SL. We shared our vision for higher education, ie a university in SL, we shared our vision for the health work, and for the ultimate spread of the gospel.
Pastor Sesay, the new TAASLA President and our weekend chairman.

Pastor Sesay, the new TAASLA President and our weekend chairman.

Greetings from TAASLA!

Greetings from TAASLA!

I got to spend time with the Sandy girls. Jewel, the ophthalmologist, shared with me her vision for starting an eye clinic at Waterloo, and even developing a residency program there. Jenny would love to come and spend time in our OR, helping and doing education. I received invitations to speak at their churches, and may even get a chance to speak at the academy this fall. It was a blessed, inspiring, Spirit filled weekend, that gave me memories I will cherish forever. I count it a privilege and honor to work in Sierra Leone, and to be able to connect with this dear group of ex-pats. Next campmeeting I will be there, and by God’s grace Bekki will be there with me.

Epilogue: Sabbath morning while I was at Campmeeting, Bekki and Erin exited our front gate to find this little gift.

Happy Day

Happy Day


Meet Happy Day, or HD for short. Here when someone says “Happy Sabbath”, the response is “Happy Day”. Since HD was found Sabbath morning, she was named Happy Day. She was extremely malnourished, exhausted and covered with sores. She ate well Sabbath, like a starving little pup, then threw it all up. For two days she barely ate or drank. We started forcing water with coconut milk down her with a syringe and after 36 hours of that she decided enough already and began to eat. She is still skin and bones, but now acts like a puppy, hopping, jumping, playing, barking at the intruder dog in the oven door, and eating like a pig, even getting a bit choosy. You will most likely hear more about our new addition, and her brother who is currently in Erin’s generator shed with his brother and sisters. He will join us when he is weaned. It starts, ominously.

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

FROM NAMING CEREMONY TO MOBILE CLINICS

Mother and baby

Mother and baby

About 6 weeks ago the wife of our head nurse, Augustin Conteh, had a baby, a little girl to be exact. Since we don’t do OB, yet, she had the baby at a nearby health center. Apparently it was a bit rough, but, praise God, mom and baby came through in fine shape.

Here, moms go home as soon as possible after the delivery, but always without giving the new born a name. Maybe the custom has its roots in the high infant mortality, or maybe that is just the way it has always been done. Whatever the reason, the babies are nameless for 10-14 days until the naming ceremony.

Samuel Danqua giving the charge to the family and church to help bring up the child in the Lord.

Samuel Danqua giving the charge to the family and church to help bring up the child in the Lord.

The naming ceremony is a big, huge deal here. And so it was that on a Sunday afternoon we loaded up the hospital van and Fobbie’s car and headed the 18 miles to Augustin’s home for the above noted naming ceremony.
The home where this was held was out in one of the villages, fortunately not too far off the main road as once again we were offroading it and avoiding sinkholes (too big to be called pot holes) in what was left of the pavement to keep the vehicles from being swallowed whole. I kind of understood how Korah, Dathan, and Abiram felt (see Numbers 16), only we had a better outcome than they did. But I digress. We all gathered behind the house under a shelter from the rain and/or sun. Finally after much waiting mom and baby appeared. As is typical around the world baby was passed from woman to woman, finally stopping with Fatmata, one of our nurses who pretty much kept the baby to herself the rest of the program. It would soon be evident why.

With the announcement of each name guests would bring up an offering of money to give the baby or the mother.

With the announcement of each name guests would bring up an offering of money to give the baby or the mother.

The program consisted of prayers and talks by various dignitaries, much like an expanded child dedication service held in Adventist churches. Finally the big moment arrived, the unveiling of the name of the baby, or in this case, names. She was given 3 names, (4 if you include her last name, Conteh):

Sarah-named after the wife of Abraham and mother of nations

Millicent-named after our nurse who died in the Ebola plague

Fatmata-named after one of Conteh’s favorite nurses, and the one who kept the baby with her during the ceremony.

It is actually pretty cool, much thought is put into each name, and each name is special. Unlike “Scott” which really has no meaning to me, other than that is what I answer to. I really have no idea why my parents named me that. I think I asked once but obviously did not get a memorable answer. I think they just like it. Frankly that is why we named Jon and Lindsay, Jonathan and Lindsay, we liked the names. In Jonathan’s case so did half the other parents in our generation, a fact which he reminds us of every time he can.

After the ceremony we were all served refreshments, fried rice with chicken or fish, complete with soda. It was during this time that I was approached by a dignified looking man I would come to know as Ahmad Bangura. Turns out that Mr. Bangura is one of the counselors for the district. He has over 7 wards, each one containing thousands of villagers. He approached me with a request, “Would we please come to this ward, Mamamaw, and establish a mobile clinic?” He explained that the people in only one of his seven wards has access to health care, without having to travel a significant (for them) distance. He told me he had been constructing an administrative building that he felt would be useful for a clinic as well.

He took me to see the building. It looked nice. It was locked and the contractor had the key so we just looked through the windows. I told him I would take it back to the administrative team and the community outreach team at the hospital and get back to him. I have learned not to make promises until I find out the “rest of the story”. This sounded like one of those things with a hidden agenda.

Counselor Ahmad Bangura in front of the building to be used for our mobile clinic.

Counselor Ahmad Bangura in front of the building to be used for our mobile clinic.

On the way back to the hospital I discussed it with Mr. Fobbie, then ran it by James Abu, our director of community outreach, and the one who is in charge of the mobile clinic program. Turns out there really was no hidden agenda. He really wants us to come once a week and see his people. He won’t even charge us rent for using the building. He told me he has pleaded with the government for more health centers or clinics in his wards, but to no avail. They just don’t have the money, or the people to man (or woman) them. So he was told to go find his own source of health care. Thanks to the fact that Augustin Conteh lives there, and thanks to the fact that Mr. Bangura went to SDA schools he knew about our hospital, and so he approached us.

A couple of weeks later we went back for a formal meeting to discuss the possibility further. I expected a small meeting with Fobbie, Abu, me and Erin Acosta, our MPH who is helping establish the community outreach programs with a Bangura, and a couple of the village elders. We (Erin and Mr. Abu) worked furiously to establish a budget and figure how this mobile clinic thing would work without costing us money that we don’t have. The problem is of course we are going to villagers who need health care and medications, but they haven’t got much money to pay for these things.

The appointed day came. Mr. Bangura had called me three times that week to make sure we would be there, and on time. It turned out to be a real all-village meeting. The village leadership was there to be sure, but so were many of the villagers. We all gathered in the Palava Hut, which is exactly what it is for. The Palava huts are basically city hall for the villages. It is where the chief or counselor or village elders meet and discuss issues, they resolve disputes, and carry on the village business. Kind of reminds me of the story of Ruth when Boaz went to the gate of the city to meet with the elders to work things out with Ruth’s nearest kinsman.

The meeting started late of course, as everyone gathered, but it was very serious, there was an agenda, and protocol and everything followed in strict order, making sure that everyone had their opportunity to speak. The first item on the agenda was prayer. Now remember that this was not an AHS led meeting. We start every meeting with prayer, but we are a religious based organization, we are supposed to do that (and we believe in it). This was actually a government led meeting. What took me off guard even more is that there were two prayers. The first by a Muslim representative and the second by a Christian. So we had a Muslim and a Christian prayer. Now I have been told that Sierra Leone is very proud of the fact that the Muslims and Christians here co-exist side by side with no religious discrimination or acrimony. This was, to me, a confirmation of that fact. There was peaceful, happy acknowledgement of the beliefs and ceremonies of both religions, with no attempt to place one above the other. It was really a cool thing to witness.

The village meeting under the Palava Hut.

The village meeting under the Palava Hut.

The meeting went well, other than being long, and pretty much the message was the same, we need you to come have a clinic here, we will support it, and we need it yesterday. As many as possible (which is a surprisingly large number crammed into the new building to look at it and see how we could make it work for a clinic. Abu was happy with it, which is what counts, he is the one who has to run it.

So it looks like we have our first mobile clinic. All because of a discussion after a naming ceremony. There is another meeting with the local district health team, but that should just be a formality. There is no reason for them to nix the plan of their own counselor. We have a few details yet to work out as to inventory of supplies we need to take, and meds we will take and how the pricing structure will work, but the ground work for those is done, so it shouldn’t be too hard. Hopefully we can hold the first clinic by the end of August. And it is not too far off the road so hopefully the van will hold out until we can find the money to purchase a 4WD Pathfinder or 4Runner, God willing.

On the way to the airport (I am attending a Sierra Leone Campmeeting in Maryland this weekend) I spent a good two hours talking with Pastor Daniel Sandy, our new Mission President. He told me of a new SDA clinic in diamond country that would like to be under the AHS umbrella. Hmmm, didn’t know about this one, but that is what we are about, that is our Vision:

To transform the physical, social, spiritual and mental well-being of people in Sierra Leone through the Adventist Health System, as we accomplish our Mission, which is to demonstrate the healthcare ministry of Jesus Christ.

So bring it on, let’s get out of Waterloo, we have got a whole country to reach!!

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