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.)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.
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.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.
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.
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.
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