Autoclave

Life lesson 452: When one is in Pittsburgh, PA, make the two hour drive to Erie, PA to actually look at the autoclave before you buy it.

I had no idea the autoclave, was soooo big. It did not look that big in the picture. It is so big we can just autoclave the patient and the instruments together, eliminating the need for prepping. We are pretty sure we now have the biggest, baddest autoclave in all of Sierra Leone, and probably in West Africa. My staff is thrilled, I am, well, frankly embarrassed.

Bekki showing just how big this sucker is.

OK, to back up a bit. Part of the grant from the Winifred Stevens Foundation for the OR upgrade was to be used to purchase a new autoclave. When I came they were trying to sterilize the instrument packs in an ancient dental desktop autoclave that barely worked. As in you have to manually turn it on and off to keep the temperature in the right range. Remy Hirschy got one of our other non-functioning autoclaves to work, but it drips hot water all over the floor when we use it, and it too is a desktop model, so it is fine for a small clinic, but not a real OR, like ours!

Luke Hingson at Brothers Brother in Pittsburgh, PA got us in touch with Rick King who runs Chosen International, a company that refurbishes autoclaves, puts on a new boiler and then renders them “West Africa proof”, with the proper current and plugs etc. They come in several sizes, but the two full size ones were the same price, so go for the big one, right?

Healey Foundation, a Catholic NGO out of New Jersey, who has helped us ship things over here agreed to give us some space on their next container, so it made the move from Pennsylvania to New Jersey, then on the boat to Sierra Leone. We got the call Wednesday morning that they were offloading the container and wanted to know what we wanted done with our crates. Fobbie went to the wharf to check it out.

He called me, “Dr. Scott, the crates are big, we need a crane to unload them.”

I was pretty cool with that, I had been warned the crate was large. Notice I said crate. I was a bit surprised Fobbie said crates, but I just figured it was the oxygen concentrators Loma Linda had sent, and only one crate needed a crane.

Fobbie arranged for a truck with a crane to transport the crates to the hospital. They arrived just as we were starting prayer meeting at 4:30 pm. Two HUGE crates sat on the back of the flat bed truck. Not large, massive. 4000 pounds between them. The oxygen concentrators were with Fobbie in the back of the Xterra. We had no idea what was in the second crate. Turns out the police wanted to know as well.

The truck with the MASSIVE crates on the back. The chairs unfortunately were not for us.

In the the next 24 hours we experienced an absolutely awesome, incredible set of miracles.

Miracle 1: They got both containers off the truck and on the ground without dumping them. They had only one strap around the containers, which was fine for one direction, but containers are 3 dimensional objects hovering in space, even if you have side-to-side covered, they can still fall end-to-end, or vice-versa. And when they tried to lift the big one, the wood bottom of the crate started breaking up. It was clear these guys were pros, but also clear that they were making this up as they went. Bekki and I? Silently praying. We have seen too many unloading disasters in West Africa to not be aware of the risks.

Unloading the big crate, notice the bottom starting to separate.

Unloading the small crate, yea, one direction is supported, but it can still fall to the side.

Miracle 2: Getting them unpacked and moved into the hospital, without damage. I wish you could see the video. I will put it on the blog site next time we are in the US. It was the ultimate tug of war as about 15 guys fought against 2500 pounds of autoclave and gravity as they pushed and pulled this thing up our amusement park ride steep ramp into the hospital. It cleared the first two doors with an inch or two to spare. We only had to take out one door and wall to get it into it’s new home.

Ultimate tug-of-war with Joseph as the anchor.

We had our usual prayer of dedication and blessing Thursday morning before we unpacked the crates and moved them inside. Part of that prayer was that God would send His angels to protect the contents from harm as we moved them inside. God answered that prayer. There is no doubt in my mind that angels excelling in strength surrounded our autoclave as it was heave-hoed up the ramp.

Miracle 3: No rain. We are in the teeth of rainy season, it is raining more often than not, especially at night. And this is not a little sprinkle, man, it pours, it gusts, it storms. Tuesday night, Wednesday morning and early afternoon it rained, beaucoup. Mid afternoon, the clouds parted and the sun came out. As they unloaded the truck it was clear, but it was too late in the day to do anything more. So we put tarps over the wooden crates and prayed.

All night I listened for the rain, it is easy to hear it on the tin roof. No rain. The morning dawned bright and clear. After worship, we gathered outside for the blessing and pictures. No rain. For 2 hours every able bodied man pried apart plywood and 2X4s under blue skies. No rain. The ramp was dry as they heaved it up into the hospital.

Not 5 minutes after getting the last of the autoclave pieces under cover it began to rain. Two hours later we had as big a storm as we have had this year. The water was overflowing the drainage ditches. The autoclave? Warm and dry. The ramp? Now a slip and slide.

Jesus calmed the storm on Lake Galilee. He held off the storm over Waterloo Hospital just as long as we needed.

The second crate? We were happy to be able to tell the police it was just more parts of the autoclave, the boiler and a rack to put the instrument packs on.

Next time, I will take the time and go look at the merchandise, but thank God that He doesn’t hold our stupid human mistakes against us.

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

KABIA – PART II

Last Sabbath I posted a blog about our lab technician, Amadu Dalton Kabia. Because of the power of the internet and social media, and the faithfulness of Christians everywhere, people were praying for Kabia in homes and churches literally around the world. We received responses from Taiwan, the Philippines, Europe and the Americas. Since then I have received a number of requests for an update.

Earlier this week I had a chance to sit down with Kabia and hear from him what happened.

As you recall he had been ill for a couple of weeks and just didn’t seem to be improving. Or, he would get better then relapse. Last Friday morning at 5 am, after a difficult night sleeping, his family came to take him home. He just wasn’t improving here at the hospital and it was time to do something else.

Kabia tried to resist, but as he told me, they were his elders and so he really had no choice but to obey. He was told they were going to take him to another hospital, but instead, he was taken directly home. As he suspected, once he arrived home plans were made to take him to the native healer. I addressed the problems with that in the last blog. He flatly refused to go, elders or not. So, they brought the native healer to him.

This lady has a lipoma on her left shoulder that I took off this week. However, notice all the scars. These are cuttings from the native healers, presumably to get rid of the evil lipoma on her shoulder.

At that point, he was not feeling well at all, but was with it enough to resist the power of the witch doctor in his heart. He said they did some kind of ceremony which he was unable to describe. They told him his illness was all due to the man we had fired earlier this year. He told them he didn’t even work with that guy, and had nothing to do with the firing. He told them if they could give him some natural remedies, herbs and such, to make him feel better, that would be fine. Otherwise, he said, forget it. With that, they left, presumably to leave him to his fate.

From that point on, he began to improve. By Monday he was strong enough to come back to the hospital and do a little work but mostly he rested and hung out with his friends. Tuesday, he did a bit more, and so on. I told him to come late, leave early, whatever he needed to do, but make sure he rested. Much of the burden has fallen on Sallie, his assistant in the lab. She has been able to do many of the tests, as they are automated ones, or use test strips. But those tests that require a microscope are harder and she is not really trained to do it. But, here in West Africa, you try anyway, you do your best, you never give up. So, we would find Sallie huddled at the microscope, just shaking as she tried her best to read the slides. She was so relieved when I told her she didn’t have to do that. I told her to Just do the tests she knows how to do.

At this time, Kabia is much better, still a little weak and tired, no doubt partly due to his Ebola history. But he looks bright (healthy), and he has his smile back. I am so proud of our lab, they really went through the testing fires this month and came out shining.

This is our lab crew, Michael on the left, Sallie on the right and Kabia in the middle. A truly indomitable group!

The devil is strong here, but the power of our God, unleashed by the prayers of the saints around the world, is stronger than all the forces of hell for those who submit to Him.

“Submit yourselves then, to God. Resist the devil, and he will flee from you.” James 4:7 NIV

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

OUR STRUGGLE IS NOT AGAINST FLESH AND BLOOD

Yesterday at the end of worship the entire staff stood up and held hands, making sure there was an unbroken circle, and we prayed for one of our own. Our lab technician, our Ebola survivor, was ill. He had been ill for a couple of weeks, and wasn’t responding normally to treatment. It could be because he kept going back to work too quickly, and wasn’t getting enough rest, or because he really never let us finish an adequate course of treatment, or maybe he has something else wrong that we can’t diagnose, or maybe it is a result of his Ebola history. There is some thought that Ebola survivors are relatively immune comprised. Whatever the reason, he just wasn’t getting better.

However, that is not why we were praying. We were having this special season of prayer because at 5 am that morning his family had shown up and taken him from the hospital against his will. The staff did not need to be told what this probably meant. When families come and forcibly remove someone from the hospital they typically are planning to revert to the default–take the patient to the natural healer. Every village, every community has at least one natural healer. These are not naturopaths as we understand them. No, these are witch doctors in every sense of the word. I actually had no idea how evil these men and women are until just recently.

The AHS family was upset because just three weeks ago we buried the Seventh-day Adventist wife of a prominent staff member whose family had taken over her medical care. The husband shared with me the story.

Josephine had been ill for several weeks. The labs tests were all normal, and there was nothing wrong on physical exam, except she didn’t feel “bright”, meaning she was weak and tired. Different medications were tried without much success. Now, it has to be said that this happens in the US as well. Patients have some unknown malady that doesn’t respond to treatment. Eventually they get better, most of the time, or something shows up to steer us in the correct direction. However, in Josephine’s case the family was not going to wait. So, they took her home. Her family is not Christian, although to be honest, it really would not have made much difference. I have observed that whether you are Muslim or Christian, when the going gets tough the vast majority of them will revert to their animist roots. And who do they turn to for medical help? The natural healers.

So, these guys were brought in. What I am about to tell you will sound made up,like something out of a horror novel, but it is not, I assure you it is real. First, they found some masses or lesions at various locations on her body. These were removed. Without surgery, without incisions or scars. Cutting, actual cutting with a knife, and blood letting is a very common treatment here. Many of my patients have multiple scars on their bodies as the result of natural treatments. But then they reached into her abdomen and pulled out the real source of the problem, a snake like creature, 8-9 inches long, with a discernable head and tail, that was moving. I have seen the picture of it. It was fortunately destroyed so it would not bother anyone else.

I asked if there was a scar. I was concerned these guys had made a hole in her intestine and not closed it and she had died from sepsis. I was informed that these natural healers have magic and the wound just closes over spontaneously and very quickly, leaving no trace of a wound.

Josephine seemed to recover some after her “natural” treatments. But then 4 Sabbaths ago her family called the husband saying that she was very ill. She was brought to the hospital and died a few hours later, at the age of 39.

Did she die because of the natural treatments or despite them? Did she have some unknown ailment that was to doom her no matter how she was treated? We will never know. But what I can assure you is that as soon as the natural healers became involved with all their magic and potions, God was pushed out. How can God answer the prayers of the church for healing when the devil is involved? Who is going to get the credit if He does work a miracle?

It was with those thoughts in mind that we prayed about our lab tech. I am sure most everyone in the room knew the stakes involved. It is extremely unlikely the family took him from the hospital to try to get him into one of the fancy expensive European hospitals in Freetown, or that they are going to airlift him to France for treatment.
He knew as well, what was in store for him, which is why he vehemently protested leaving the hospital. But individuals here have no say, it is the family, specifically the ranking member of the family who decides for everyone.

So we prayed, we prayed that somehow God would intervene and the family would allow him to come back to the hospital, allow us to continue treating him. We may not have much for diagnostics or treatment options, but we have something greater than that, we have the Great Physician. And in this war, that is worth more than all the soldiers, all the armaments, all the captains and all the kings.

Here, the evil, the darkness is so “in your face”, so blatant it is impossible to miss. But it is just as real in the “developed” world. We just call it by other names, or we rationalize it away with our smart scientific theories and ideas, but the evil is there.

I don’t know how this will end, but I know God will not force Himself where He is not wanted, so ultimately it is up to us, we choose which side we will be on. And that is a decision we all have to make, whether we live in Sierra Leone, Tchad, France, England, the US, or any other country in this world.

I am happy to report that we just received a message from our faithful lab tech wishing us a Happy Sabbath, and telling us that he is home and will not let anyone mislead him. Praise God, but, he will need all the power of heaven to stand against the will of his family.

“For our struggle is not against flesh and blood, but against the authorities, against the powers of this dark world and against the spiritual forces of evil in the heavenly realms.” Ephesians 6:12 NIV

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

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

We welcome volunteers.

-Scott Gardner

PROJECTS 3

In April of last year we held a two day strategic planning meeting. We came out of it with a bold, and to many minds, ridiculous, vision and plan. I of course was one of those who thought, “It can’t be done,” at least not anytime soon. Well, I thought I would just let you know what has happened to that Strategic Plan and how God apparently views it. And all that I am going to tell you is His doing, not ours. This is Part 3 of a Three Part Series.

Chapel: Our mission is to demonstrate the healthcare ministry of Jesus. But Jesus did more than just heal people’s bodies, He healed their souls. In fact, that really is what it is all about. It is nice to help someone feel better for a time, but we all die eventually don’t we? So then what happens? If we have done nothing for their eternity, we have failed them. That is why we have put a strong emphasis on our spiritual ministries department, and that is why we have made construction of a chapel on the campus a high priority.

The AHS church plant currently meets in one of the school rooms across from the hospital. It works OK, but it is too far for staff on duty to attend services, and too far for families and patients to join us. Furthermore, the outpatient department where we hold our morning worship is packed each morning with just the staff. It was clear we need our own chapel, as part of the hospital complex.

The Chapel waiting for the roof, which will come after the Physio Building is done.

A site was chosen and a 40X48 foot chapel floor has been poured. We also have a 20X20 foot room attached to the chapel that will service as patient and staff library and conference room. Very soon, by the grace of God, the walls will begin to rise and hopefully by the end of 2017 we will be in our new chapel.

The AHS church members are working hard to furnish the new chapel. The first model pew has been constructed, and they currently have funds for another 15 pews. A new pulpit and desk have already been fabricated and are in use now. Much work remains, but soon there will be a house of prayer for all, that will be open any time during the day that people need a place for meditation and prayer.

Vehicles: O ye of little faith. How Jesus could have been saying that about me. A year ago when our strategic planning committee met we discussed the need for hospital vehicles. At the time we had a Toyota 12 passenger van which served us well, but we needed a 4WD vehicle, especially for our mobile clinics which reach village well off the main roads. But the committee did not stop there, oh no, they felt that as a hospital we needed an ambulance as well. I clearly remember thinking, “Where are we going to get a 4WD vehicle, let alone an ambulance too?”

In November, 2016 the women’s auxiliary from Loma Linda donated the money for the 4WD vehicle. It came at just the right time too, because not 2 weeks after we licensed that vehicle the van was involved in an accident that has knocked it out of commission for 4 months now. (Hopefully it is coming home the first week of April.) Our Nissan XTerra has been a little workhorse for us, taking our mobile clinic team to places no vehicle should go.

Blessing the new (to us) Nissan XTerra.

But the ambulance, where to get an ambulance? About the same time our friends from French speaking Europe, specifically AMALF which is the Adventist French speaking medical association found a Mitsubishi that, thanks to Remy Herschey from Geneva, was able to be retrofitted as an ambulance. It landed here in Salone the last week of March, so there you have it. Less than a year from the strategic planning and we have all the vehicles under our roof, so to speak.

Our Mitsubishi Ambulance,

Mobile Clinic/Community Outreach: Before Ebola AHS had an active mobile clinic program. They had a large ambulance that could serve as a small clinic, and the staff would take it on outreach missions. The ambulance had seen better days and was sold to a man who had plans for it, I guess. Really it was not in usable shape. But…we wanted to revive our mobile clinic program.

The elected head (Councilor) of a large area with many rural villages about 15 miles from here came to us, imploring us to come to his villages and do mobile clinics. If you could see the roads these people have to travel on you would understand how difficult it is to get to medical care unless it is in your village.

So, Mr. Abu, our Community Health Officer (CHO) and Erin Acosta, our Public Health volunteer, got to work and set up a mobile clinic program. It is quite a production with everything organized into tubs and boxes, complete with collapsible tables and chairs so all will fit in a vehicle. A pharmacy formulary was carefully chosen and then modified as we had needs and all the meds prepackaged in unit doses for easy and rapid dispensing. The mobile clinic goes out every week to a different site and usually sees around 30-40 patients, although some days as many as 120 have been seen. It should be noted though, that this is not a “screening clinic” as many mobile clinics are that see 200-300 patients in a few hours. This is a full clinic where we obtain demographic data, full vitals, consultation and dispensing of medications, dressings and injections as needed.

Mobile Clinic Team packed up and ready to go.

Early on it was clear that the population most in need of care was the children, it also became clear that the people in these small villages are desperately poor and are often faced with the choice of food or medications, and even $2 or $3 is too much. Thanks to a grant from Restore a Child we were able to develop a charity mobile children’s clinic. For 3000 leones ($0.40) each children are evaluated and treated and given a 1 kilogram bag of rice. Restore a Child underwrites the expenses with a grant (gift) for which we and the people in rural Sierra Leone are grateful. The program is wildly popular as now mothers and fathers can bring their sick children to the mobile clinic knowing that they will be able to get care.

Little one getting checked in

This year we expanded the mobile clinic to a more traditional screening clinic, for hypertension. Hypertension is a huge problem for Africa, and as the “silent killer” most people have no idea they have it. Once a week the mobile clinic team goes out (now in the ambulance) to one of the markets or some other well populated, busy place and sets up their free Blood Pressure Clinic. They will usually screen 140 to 180 people and find about 20 to 30 people with high BP, sometimes very high. The staff carry BP meds with them which is then dispensed for those willing to start treatment. Thanks to the generosity of some of our supporters we also have funds to assist those who need the medications but can’t afford them. The staff then do lifestyle teaching and encourage the folks to follow up, either at the hospital or at least at the next BP screening.

A little guy with his bag of rice on his head.

Remote Clinics: I have often repeated the story of my first day at Waterloo Hospital. Everywhere I saw ”AHS”, which I learned stood for “Adventist Health System”. I tried to find out where the other facilities were located, since “System” implies more than one hospital or clinic. I was told, with a smile, that there aren’t any, yet. But since 2000 when AHS was created, they have been praying, planning and hoping that someday they would be a system. And in fact, the vision statement of AHS gives us a clear mandate to provide care to all people in Sierra Leone, not just those around Waterloo.

It was not long after we arrived that the first call came in. The Adventist Church in Bo, in central SL, wanted to re-open their clinic. It had closed down during Ebola and they felt the time had come to try it again, this time under the AHS umbrella.

About that time we were approached by an NGO out of the UK, Home Leone, which is in the process of building a 380 unit village for inhabitants of the slums in Freetown. Part of the village plan is a clinic, and they wanted to know if AHS would manage it.

Then a couple of months later we received word that the Adventists in Kono District, better known as the site of the “Blood Diamonds” story, were asking if we would consider opening an AHS clinic in their town of Kimbadu, on the outskirts of Koidu.

Three potential new clinics was a bit overwhelming, but AHS had learned to keep moving as long as God seemed to be leading, and see where He would take us. We had no idea where we would get the money for the necessary capital expenditures in Bo and Kimbadu, but as we spread the news, the SDA elementary school in Simi Valley was touched by the story of Bo and took it on as their mission project. Then the Loma Linda University School of Medicine Class of 2019 adopted AHS as their class mission project, specifically raising money for the Kimbadu clinic. Finally, our relationship with Home Leone has continued to grow, as we are sharing resources to benefit both organizations in our mutual quest to help the people here.

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

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

We welcome volunteers.

-Scott Gardner

PROJECTS 2

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

Accounting/Finance

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

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

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

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

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

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

Extension

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

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

New women’s and Pediatric Ward.

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

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

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

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

Physical Therapy

Samson doing physio in the Palava Hut, April 2016.

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

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

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

Samson working in the Physio room of the finished extension.

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

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

Pharmacy/Lab

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

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

One of the Mission Direct Teams from the UK.

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

The walls are up!

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

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

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

We welcome volunteers.

-Scott Gardner

Projects-Chapter 1

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

The Strategic Plan Team from April, 2016

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

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

OR Upgrade

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

Our very empty and bleak OR.

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

Remy with the autoclave he repaired for us.

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

The moving crew with the new OR Table.

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

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


Stores

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

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

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

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

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

Stay tuned for Part 2.

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

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

We welcome volunteers.

-Scott Gardner

THE ACCIDENT

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

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

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

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

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

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

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

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

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

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

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

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

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

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

We welcome volunteers.

-Scott Gardner