Morning Worship

Three years ago, or so, wow it does not seem possible, I wrote a blog about worship in Tchad. Well it is time to write one now about worship in Sierra Leone. It is similar but also very, very different.

First the similarities, morning worship starts the day. Day shift and night shift are all expected to attend. The only staff exempted are those working the afternoon/evening shift. We sing, pray, a staff member gives a talk, and often we have “contributions”, comments about whatever the topic was.

We don’t do the handshake thing that was so big in Tchad, probably due to Ebola. That scared the Sierra Leoneans from any physical contact. And the singing here is much better. These guys can carry a tune, and harmonize. Then too, we have worship in the OPD (Out Patient Department) which has awesome acoustics. When the staff ramp it up on their favorite hymns it is positively heavenly.

The Staff doing morning stretches.

Led by JP

And worship time is very structured, Monday is administration day, so a staff member talks about their job, like say a cleaner (janitor), explaining what they do with their time, and often share some of their frustrations. There is usually then a long discussion where the most vocal staff voice their opinion on the topic, usually positive, but sometimes if it is perceived that the staff member is whining unnecessarily, they will be called on it.

Tuesday and Thursday are health talk days, so a clinical staff member will give a treatise on hypertension or diabetes or nutrition, or any health related topic. Lately the focus has been on waste management, and this morning our waste management officer (he is also our anesthetist, seems to me like a natural combination) talked again about proper waste disposal. You know like, putting sharps IN the sharps container, not on the lawn. And putting soiled bloody dressings in the proper dust bin (waste receptacle). Little thing like that. In fact, just last week the Waste Management Team did a skit for worship on that very topic, what waste goes where. This is a good thing to talk about in a country that seems to believe that any public place is a garbage repository, and that the entire country is one giant urinal.

Our Waste Management Team doing their best to get the staff to put the medical waste not only in the trash, but in the right trash.

Wednesday and Friday are reserved for more traditional worship talks, which are often very thought provoking, others, well, not so much. But by and large, morning worship is a great time of fellowship and comradeship.
After worship we have the all important announcements, what committee is meeting that morning in my office, or what our upcoming schedule is. And after worship time is when we celebrate staff birthdays, births, and provide support to those who have lost loved ones. It is the time when we welcome new volunteers, or new staff with our “Welcome, Welcome” song, and it is the time when we say good-by to those who are leaving us. It is the time that the staff receive their certificates for attending and completing educational classes taught by our volunteers.

Nurse Karin giving Mr. Conteh his Certificate of Achievement.

The Loma Linda University Pharmacy Team with their Sierra Leone plaques, signed by the staff.

It is the time when we bless new additions to the hospital, from little things like dressing supplies and point of care hemoglobin monitors to larger items like physio beds, cars and even autoclaves. I have come to love this AHS tradition. It emphasizes the fact that everything we have here, everything we do here is for the glory of God, it is by His hand that we survive and function, and we owe it all to Him. So everything large or small is dedicated to be used to His honor and glory and in His service.

Blessing our new Physio table from the UK.

A particularly difficult farewell as the Peter Turay gives a heartfelt testimony about his brother Douglassss Turay at Douglasssss’s farewell.

Morning worship is held, as I mentioned, in the OPD, so it is not uncommon to have patients and families attend worship with us. What is unusual is what happened last week. Two patients wanted to share their testimonies with the staff after the announcements.

The first was Omo. She is a very brave woman who first came to us with a diabetic foot. It was really bad looking, but seemed to be viable and she was walking on it, so I did my best to save her foot. Sadly, the infection got out of control and started to spread up her leg. By the time we got her to surgery we had to do a high calf amputation and leave it open to let the infection drain out. It made me regret my earlier decision to not push for the amputation sooner. Anyway, when it came time to close the wound I had to explain to her that I could not save the knee. A below knee amputation would not leave enough length of bone below the knee to support a prosthesis, or be anything but in the way. Understandably, she was pretty upset. But she pulled it together and we got the job done, and her wound closed.

Omo

That morning she stood there on one leg, supporting herself with the walker and led the staff in singing “To God Be the Glory.” She then proceeded to praise God for His mercy, love and grace. I was so moved. Here was this woman who had just lost her leg, praising God in spite of it all. We are pretty good at praising God when He heals us, saves us or delivers us, but after losing a leg in a place that does not make it easy for the handicapped. Never saw that in America.

Then a couple of days later, an old Muslim man wanted to share his testimony. He is recovering from a stroke and is still very weak, but he managed to walk a few steps and he too started to sing,, “Tell Papa God Tenki (thank you)”. It is a Sierra Leonean favorite, but I didn’t realize the Muslims sang it too. The staff joined in lustfully as they say here. It is a praise chorus, “Tell God thank you for what He does for us, He saved us, He does everything for us.”

Our Muslim brother leads us in singing, bring those hands together.

Paul tells us in everything to be content and to give thanks for all things and in all circumstances. I would do well to learn from a woman with one leg and an old Muslim man.

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

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

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

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

THIS IS WHAT FAITH LOOKS LIKE

This is what faith looks like.

This is what faith looks like.

Yesterday I posted this picture on Instagram (you who are our facebook friends can follow us on Instagram to get immediate news and pictures) with the caption that read, “This is what faith looks like.” I promised a blog to share the rest of the story, well here it is.

In late May while we were still in the US I sent an e-mail to Joseph Fobbie, our manager, suggesting that for our physical therapy building it would be good if he and the rest of the AHS (Adventist Health System, Waterloo Hospital) team there in Waterloo did some fundraising with the Adventists on the peninsula and with the local community. That way everyone gets involved and takes ownership of the project and it is not just the westerners coming in and taking over.

Proposed Physio Building

Proposed Physio Building

Fobbie thought it was a good idea and e-mailed me back that he would maybe arrange a dinner and invite lots of people. I was pleased, frankly, with whatever he thought they would do. When we returned in June I got quite the surprise that first Sabbath morning. The plan now was to have a Thanksgiving Praise service on July 30 and take up a thank offering for the construction of the physio building. But there was more, Fobbie already had everyone organized into committees, the decorating committee, the music committee, the program committee, etc. And every week at church and during the week at the hospital he made sure the committees came together and did their planning and preparation work.

And work they did, a lot of it. I was pretty impressed as I sat back and watched them go at it. I purposely stayed out of this as it was 100% Sierra Leonean and the last thing they needed was some American messing things up. My role was to sign invitation letters and donation envelopes by the hundreds, these were then passed out and everyone was encouraged to invite at least 5 people.

Last week was a blur of last minute preparations, choir practices and the expected hiccups and trials. Remember it is still rainy season and for 8 days we had about 8 total hours of no rain. Travel was difficult and wet, so the organist didn’t make it one afternoon for practice. Other people on the program couldn’t make it at the last minute. You know the usual disasters that happen with big programs like this.

Friday afternoon was beautiful and Fobbie told me that Sabbath was going to be nice, too. Sabbath morning about 3 am it started to rain. Now, often it will rain for 2 or 3 hours then let up and mist for a while, then rain again, but not this time. It was still raining heavily when I let Brima, our night guard, out of the compound at 6:45. During my morning prayer I pleaded with God to stop the rain. I peaked, it was still raining. At breakfast at 8:15 we prayed again that God would stop the rain so people could and would come to the service. It was still raining as I cleared the table.

This was a “the devil is behind it” rain. Heavy, steady, with rivers running down the middle of the roads, making it very difficult for people to get around. At 8:50 am we headed up to the rented conference hall through the rain. Even with umbrellas we got wet. We arrived promptly at 9:01, I had opening prayer so I figured I had better be on time. Actually I think Mr. Fobbie had me do opening prayer so I would be on time.

Anyway, we arrived in the rain to a dark conference hall. Maybe 4 people were there. It was 2/3 full of probably 150 empty chairs, no lights, no fans, no congregation. Bekki and I were both sick at heart. Mr. Fobbie, and the whole hospital had worked so hard for this program, to get it just right, and now it seemed that the rain would keep everyone away, and it would all be for naught.

About then a truck came in with some of the young men from the hospital bringing a load of more chairs. Inwardly I sadly smiled and shook my head. There was no way they were going to fill the chairs already set up, let alone bring in more. This was crazy, but it was their crazy, not mine. That was when I took the picture, thinking, “Now that is faith, the substance of things hoped for and not yet seen” (Gardner’s paraphrase of Hebrews 11:1).

Since we had nothing better to do we helped dry off chairs and set them up in nice neat, empty rows. And we folded several hundred programs, thinking they would make nice paper airplanes later on. About 9:50 the man came to start the generator so now we at least had lights and fans. And people started to slowly trickle in. At 10:15, 75 minutes late, we started the singing, and as I sat on the platform and looked out over the audience I smiled, there were probably a good 40 or 50 people there. Scattered about so it didn’t look quite so empty. By the time lesson study started and the children were sent off to their program folks were starting to use those extra chairs we had set up and hospital staff were having to find seats in the front section for late comers. This is what it looked like by the end of lesson study as the rain finally stopped and the trickle of people became a stream then a steady river.

A full house

A full house

You know all those extra “faith” chairs, and all the programs destined to be paper airplanes? Good thing we had them, they all got used. Every chair was full with people sitting on the two outside verandas, the proverbial packed house. About 11 the rain stopped and the sun even came out for a bit, kind of a smile from heaven on our service.
Even the verandas were full.

Even the verandas were full.

One of the patients sharing his story with Samson (in the white AHS shirt) our Physical Therapist.

One of the patients sharing his story with Samson (in the white AHS shirt) our Physical Therapist.

It was the longest Sabbath School I have ever attended, over 5 hours, but it was so great. Testimonies were shared how God had used the hospital and physical therapy to help people, the story of the faithfulness of God and the staff from the days in Masanga through to the formation of AHS and its dark days were told again. Staff shared the ways God had blessed the hospital, bringing doctors and staff and funds at just the right times through the years. Choirs and musical groups sang praises to God of His faithfulness.
Dr. Koroma sharing his journey with AHS.

Dr. Koroma sharing his journey with AHS.

The Christ the King Church Choir during the processional.

The Christ the King Church Choir during the processional.

We showed pictures of the proposed physio building and the floor plan and explained what a blessing it would be to the hospital and the community, and then we had one of the more impassioned, energetic appeals for an offering I have ever seen. People came forward with 5,000; 10,000; 30,000 leones, some pledged a million leones, or 2 million. The goal was to raise 20 million leones in offering and pledges. But when it was done and the representatives from the 11 churches represented, the AHS staff and Sierra Leone communities abroad had given their pledges God had moved hearts to raise 35.5 million leones (just over $5,000)!!

Peter Koroma calling for the offering.

Peter Koroma calling for the offering.

In recognition of giving each person was pinned by an AHS staff member with a little lapel feather.

In recognition of giving each person was pinned by an AHS staff member with a little lapel feather.

When you consider that most of the people there make less than $150/month in salary it was a staggering amount of money to raise in one service. It removed in my mind any doubts about the cooperation from the Sierra Leone mission, especially as Daniel Sandy the Mission President gave a wonderful sermon on the giving our best to Jesus and on what AHS means to the SDA church in Sierra Leone. It removed any doubts I might have had about the commitment of the individual members to the health work here in Sierra Leone. It removed any questions I might have had about the willingness of the people here to do all they can for themselves. This whole program was theirs, they did it all, they did not need or want any help from us missionary types. And finally, whatever doubts or questions I have had about whether we are on the path God wants us to be on, headed in the direction He wants us to go, those doubts are gone, those questions are answered.

Joseph Fobbie, our business manager, with a huge smile as people came forward to support the hospital.

Joseph Fobbie, our business manager, with a huge smile as people came forward to support the hospital.

My question for you, our friends and readers from all over the world, can we match that $5,000 raised yesterday? We have over 200 followers on our blog, with more facebook friends, that comes to less than $25/person. Bekki and I will send the first $100 toward that goal. If you feel so moved, please send it to Adventist Health International and mark it for AHI-Waterloo-Physio building (details are on the donations page of this website.)

Faith is moving a hundred chairs in a pouring rain into a dark building with no one there, believing that they will come because God is with you.

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