A MEMORY FOREVER

About a month ago Aminata came to our hospital with abdominal pain. She had been sick for some time so we treated her as usual for typhoid and malaria, but she did not improve. She had what felt like a mass in her low abdomen so I did an ultrasound and found what I thought was large irregular ovarian cyst.

Whatever it was she was clearly deteriorating and needed an operation despite her weakened condition. At the time of surgery I found a huge pelvic abscess. No ovarian cyst, just lots and lots of pus. I never could identify for sure the source, so I washed her out, put drains in and closed her up. And prayed. Before, during and after the operation. Because often that is what is needed as much or more than the surgery itself.

Now, more than a month later, Aminata is about ready to go home. I closed her wound last week and she is off all her antibiotics. She has been a special patient, she has a ready smile, and a sharp wit. She loves to laugh. She loves to dance, with me. One day she was sitting outside her room on the veranda and when she got up to walk back inside she grabbed my hand and started to dance with me, just to show how much better she was feeling. I must say we were a hit with the rest of her large family, the other patient families and the staff who were around to see it. She has promised me one more dance before she goes home.

Kai-Kai , the little stuffed rodent.

Today she surprised me with a little stuffed rodent of some sort, complete with spectacles (glasses for the younger readers). It is adorable. She told me it was for my office so I would never forget her, as if I ever could. I was moved to tears (well as close as I get to tears anyway). I named the little guy Kai-Kai and he is sitting on my desk in my office and watches over everything I do.

Her gesture was especially meaningful because in 60 days Bekki and I will be making a major change in our lives. We are leaving Africa and going back to the US on permanent return. (If you don’t want to count it out, it comes to April 22, 2018.) I have taken a job on the faculty of the Physician Assistant School at the Kettering College of Medical Arts, and the next term starts on May 7. I have to be honest I am very excited about this opportunity, it is a career change I have been wanting to make for a long time, and Kettering has a great program and a fantastic staff. Plus, it is a bit like coming full circle as Bekki and lived there in the late 1980’s during my surgical residency. And our son Jonathan was born right next door at Kettering Medical Center.

That being said, there are many things I will miss after we are gone. Things like the absolutely best pineapple in the world (I kid you not), fresh papaya from our own tree, the cashews and groundnuts (peanuts). I will miss the special songs we have in Salone, “Welcome, Welcome, Welcome” and “Tell Poppa God Tenki”, to name a couple of my favorites. The acoustics in the Outpatient Department are amazing and when the staff really get going on a hymn they know well, the music is heavenly. But mostly I will miss the people here. People I have come to know and love and respect.

In fact, the leadership here has asked us to continue to be involved with the hospital, be their US Ambassadors if you will. And Bekki is coming back in May to finish up the building projects she is supervising.
But let’s be honest, there are a lot of things we won’t miss. It has been a hard four plus years for us here in West Africa, we have aged a lot. We have been separated from family and friends. In fact, Bekki and I agree it has been the hardest thing we have ever done in our lives. Are we ready to go home? Yes. Would we do it again, even knowing all we know now? Yes a million times over. Neither of us would trade our time in Africa for anything.

Lindsay, ever the teacher, teaching anatomy to the staff.

Being the melancholy sort, I often wonder how much of an impact I really have made here in Sierra Leone and in Tchad. I know that many of the administrative changes I have made will fall by the wayside after I leave. But this morning Lindsay, our daughter visiting us from Taiwan for Chinese New Years, reminded me of my patients. She reminded me of the privilege I have had for over four years, really over 30 years, of being God’s hands as He has worked through me to bring healing to suffering people.

That is why the simple gift of a stuffed animal touched me so deeply. It is not just Aminata that little Kai-Kai (the stuffed rodent) will remind me of. It will remind me of all the patients that have allowed me to be a part of their lives, in Kettering, in Tillamook, the L-C Valley, Tchad and now Sierra Leone.

Kai-Kai will go home with me on April 22, and will sit on my desk in my office at KCMA, and will remind me of what a special life I have been granted as a physician, surgeon and missionary for Jesus.

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 (still) welcome volunteers.

-Scott Gardner

MABINTY

The RAC Mobile Clinic Team, Sanko, Paul, Kadiatu, Mr. Abu, and Shawn Hannah, KCMA PA Student

The Restore a Child Mobile Clinic team heads out from the Adventists Health System-Sierra Leone, Waterloo Hospital each Tuesday and Wednesday, taking medicines to children in villages with no access to health care. The following story is told in the words of James Abu, our beloved CHO (Community Health Officer) and head of our mobile clinic program.

Mr. James B. Abu, CHO, Director of the Mobile Clinic Program.

This child, Mabinty Kanu, age 3, was seen during one of our mobile clinic sessions in a village called Masentigie. According to the mother, the child had been having a fever on and off for one week, which became continuous over the last two days before we were there. In addition, she was coughing and vomiting after every meal. Her abdomen was distended and she was obviously seriously anemic. She was so helpless that she could not stand without support.

Mabinty Kanu, sitting on her mother’s lap with an IV hanging from a Mango Tree.

I asked the mother, “Why have you kept this child at home until now?”

The mother’s reply was, “I had no money to take her to the hospital. To get even what we eat is a problem. I have been giving her some native treatment, but it does not help.”

I asked about the father and she told me he ahs separated from her and does not even visit to know how Mabinty is doing.

Mabinty was quickly examined by another PA student from Kettering, Olivia Kwiatkowski, and given emergency treatment with IV fluids and antibiotics. A motorbike was hired and she was transported to the Adventist Health System—Waterloo Hospital, where Mabinty was admitted and laboratory investigation confirmed the severe malaria and anemia. Treatment that had begun in the field was continued and she was transfused with whole blood.

Mabinty on the road to recovery, sitting up on her hospital bed.

By God’s grace she responded well to treatment and 2 days later she was discharged to home with oral medication. The mother was so happy and was crying as they left, saying, “Thank you for saving my child’s life. I pray that God will continue to bless you.”

Ready to go home!! Praise God!!

We shall be making a follow-up visit on her after one week to see how she is doing. But she would not be alive today with the Restore a Child Mobile Clinic Program.

James B. Abu, Community Health Officer
Restore a Child Mobile Clinic Supervisor

Truly this child would not be alive today if it were not for the mobile clinic program. And the mobile clinic program only functions because of donations given through Restore a Child and our other faithful supporters. Thank you and God bless each of you.

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

A CULTURAL AWAKENING

One day last month I realized I was homesick. Now I have been in West Africa for four years, you would think I would be over homesickness by now. But nonetheless I realized I really missed America. What made it even more bizarre is why. I missed Christmas. I missed the lights, the store displays, the music, the movies, the programs, the concerts and even the parties. This is the original Grinch talking here, just ask Bekki. It bugged her to no end as I would bah-humbug my way through the holidays, until the last week when suddenly I went all in.

Julian putting our up our 32 year old Christmas tree.

But Christmas, even though it is a national holiday, does not exist here, not really. I did see some lights on a partly constructed building coming back from the airport the week before Christmas, but that is it. We have done our best to overcome this deficit, we had the volunteers up and had a Christmas tree decorating party, I have tried to play Christmas music when I could get the electronics to work, we hung the stockings with care, even on the elephant’s trunk. But, alas, it is just not the same when you are all alone in your festive spirit.

Even the Elephant head has it’s own stocking.

The gang at the Christmas Tree Party, Bekki, Ian and Heather, Julian, Eric, JP, and Dr. Donn Gaede.

The Adventists here don’t do Christmas, I was told. The other Christians do, just not the Adventists. The Muslims are obviously not really into it either. But for us Adventists it means no Christmas carols at church, minimal if any decorations, and certainly no mention of it. (On the Sabbath before Christmas I did preach on the Magi, however.) It all added up to a homesick missionary longing for Bing Crosby and Danny Kaye, dreaming of a White Christmas.

Finding myself in a bit of a snit, I decided to find out why Adventists don’t celebrate Christmas. The answer was not what I expected. It is simply that we don’t know that Jesus was born on December 25 so why should we celebrate Christmas? I also heard that Christmas is too materialistic and commercialized as the other reason. But the main one is that Jesus was almost certainly not born on December 25.

As I pondered this I became more and more annoyed. First, I don’t like the logic. I will grant you Jesus was almost certainly not born on December 25, truth is we don’t know when. So, the logic here is, if we don’t know the date, let’s throw the whole thing out and ignore it. My logic says that since we don’t know the date, pick one, and December 25 happens to be very convenient because literally the whole world is celebrating and talking about the birth of our Savior. So what if you don’t like the commercialism, then don’t do the gift exchange thing, but what an evangelism opportunity. Everyone is at least thinking a little about Jesus, between eggnog and wrapping presents, so capitalize on it. Don’t just ignore it. Everyone already thinks we are practically Jews because we go to church on Saturday, this is not helping convince them we are Christians too.

That was my logic and my rather convincing argument, or so I thought. I tried it out on a few of my Sierra Leonean SDA friends. I didn’t get very far. They thought my logic was senseless. I thought their logic was senseless. We are still friends because we could agree to disagree.

To my credit, even though I was annoyed, I dropped it. When in Sierra Leone do as the Sierra Leoneans do, the Adventists at least, that’s my motto.

Two nights ago I was leaving the hospital to head home and a short, well dressed older man stopped me asking for Dr. Koroma. I told him Dr. Koroma was on leave until February, could I help him? We were in the back so he asked about the lab/pharmacy building. I explained what it was and then pointed out the chapel currently under construction, surreptitiously patting myself on the back as I am rather proud of our construction projects.

“The chapel is just for Seventh-day Adventists?” he asked.

“No, it is for all faiths, even Muslims”, was my reply.

He then proceeded to quote scripture to me, “Remember the seventh-day Sabbath of the Lord your God.” I was pretty impressed. This man was obviously well educated, or at least well read. I didn’t recognize him, so I asked if he was Christian. No, he is Muslim he told my quite proudly.

It was at this point that he dropped the bombshell.

“Why do Christians celebrate Christmas when they know that is not Jesus birthday?” he asked. Going on he pointed out that at least Muslims know Mohamed’s birthday.

I was ready, had my argument all primed and loaded.

“Well, since we don’t know the exact day He was born on, what difference does it make then which day we choose to celebrate His birth? The alternative is not celebrating His birth at all?”

Had him. There is just no beating that kind of logic.

Unless you are West African.

“If you don’t know the day, you should not celebrate any day.”

We spent the next five minutes going back and forth, basically repeating our arguments, but getting nowhere. He had me, I had him, but we were playing in two different worlds.

But, I had an ace in the hole, if you don’t mind my mixed metaphors.

“Seventh-day Adventists don’t celebrate Christmas,” I told him triumphantly.

“What? That’s not true.”

I looked over at Pa Cole who was sitting there quietly, probably loving every bit of this interchange.

“Tell him”, I said.

“It’s true, we don’t celebrate Christmas for that very reason.” Pa Cole backed me up.

The man’s entire demeanor changed. These were Christians he could understand, Christians he could relate to. None of this crazy American idea of just pulling any date out of thin air to celebrate the birth of your sect’s prophet.

And the crazy American understood. It’s their culture, it’s their logic, and it gives us one more part of the bridge between Christianity and Islam.

I am still homesick for Christmas, and the first Christmas I am back home I am going to go nuts, we are going to drive around and look at the lights, we are going to watch Christmas movies, go to hear the Messiah, go to school programs, attend every Christmas party we get invited to. I told Bekki I am getting a 25 foot tree.

But now I see that for this culture where the logic is different (not wrong, just different) and there is such a strong Muslim influence, the Adventists here have a valid point.

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

A RAY OF LIGHT

For four years now I have been living in the stronghold of the devil. For those of you living in Christian countries it is almost impossible to describe. Everything up is down, inside is outside, evil rules. The locals tell us the country is 65% Muslim, 35% Christian. However, when the chips are down and things are not going well, all but the most devoted Christians and Muslims abandon their faith and their God. They return to their native roots, consulting the witch doctors and performing the traditional rituals.

It is election season here in Salone. No less than weekly we are told stories of the horrors that accompany this every 5 year event. The ten year old neighbor of one of our nurses did not come home from school one csday. Three days later his dismembered body appeared on the doorstep of his home. He was almost certainly murdered in a Satanic ritual carried out by a sorcerer at the behest of some politician (or political party). I was told about eight men murdered and cannibalized in another ritual killing, presumably for the same goal, to be elected. No one is safe here, everyone is afraid. Orphanages keep their kids from school because orphans are a prime target. After all who cares about finding out why an orphan went missing.

However, this country is not Godless, people true to Him exist, shining out like that ray of sunshine coming through a break in the clouds on a rainy day, or for the millennials like the bright beam of the LED on their phone lighting their path on a dark night. One such ray of light is Albert Cole Jr., the son of our most faithful security guard.

Albert Jr. is all of 17 or 18 years old. The sweetest young man you will ever meet. Always with a smile on his face, always singing one of the hymns out of the SDA hymnal. In fact we could give him almost any number in the hymnal and he could sing that song without looking it up. I can reliably do that with two hymns, #1 “Praise to the Lord”, and #530 “When Peace Like a River”. Albert could do that with probably 75% of the hymns.

I remember one of our hikes up Mount Erin with the youth of the church, Albert was with us. He was always the odd one, you know the type, sweet, the adults love him, but the other kids, well he never quite fit in. So, on this hike he brought his drum and was beating on it as we hiked up the very steep hill (Tillamook friends, think King Mountain), he was leading us in singing “I’m pressing on the upward way, new heights I’m gaining every day; Still praying as I onward bound, “Lord, plant my feet on higher ground.” It was Albert who suggested we pray together as we stood at the top and looked out over the plain below us.

We first met Albert because of one of his many little side business, quite the little entrepreneur, that young man. He sharpened our knives for us. Then he has become well known to our volunteers, and to us because of his role as a retail seller of African clothes. He has sold me most of my African shirts. Every time we get new volunteers, I set up an appointment with Albert to come to our house in the evening and sells shirts and dresses. Good stuff for a reasonable price, no haggling. But what with living in one of the five poorest countries in the world you would think Albert would save his money for himself, or at least spend it on a new smart phone or fancy shoes. Not Albert. He used his money to buy things for his AHS church. He called Mr. Danquah, our district evangelist last night, all excited. He had made the last payment on some musical instruments for the youth. They are coming tomorrow.

Albert likes to come to the house in the evening to visit, often just to say “hi”, or show us his grades. He will come into the house and Bekki gives him a glass of water and cookies if she has them. It is funny to watch him try American food, it is clear by his facial expression that he is really not sure about it, but he is always gracious. He stays for a bit and then heads on his way, just leaving his ray of light wherever he goes, shining through the darkness that is this world.

That beautiful ray of light given to us by God went out sometime early this morning. His family found him face down. He had a seizure disorder and all we can figure is that he had a major seizure and maybe he choked on his tongue, maybe he vomited and aspirated, maybe he fell and hit his head. We will never know. All we know is he was here, and now he is not, and his bright beam will be sorely missed.

The question always comes up, “Why, God, why?” Why young, dear, sweet Albert whose true religion puts the rest of us to shame, who never hurt anyone or anything, why has God let his light go out and the evil or sorcery continues. Everyone around the world wrestles with that question, everyone reading this blog has wrestled with that question. Its just that during my time in West Africa I have had to face that question on a far more regular basis than I ever did before. The only answer I can come up with is, there is no answer. Sometimes it is clear why, but most of the time it is not evident why this happened. And as unsatisfying as that is, it is reality. God never promised us answers on this earth, He only promised to be there with us through the valleys and on the mountains, and that someday all would be made plain, but until then He just asks us to trust Him.

Albert Cole, Jr. on one of our hikes up Mount Erin, this time without his drum. Unfortunately, the drive with my other pictures of Albert on it was stolen from our house last month.

They say a butterfly flapping its wings in the Amazon basin can cause a hurricane in the Atlantic. If that is true then the brightness of Albert’s ray of light should have equally far reaching consequences. Albert’s light is out, his seat on the aisle right front row will be empty, the world will be a noticeably darker place. But that just means the rest of us need to let the light of Jesus shine through us, wherever we are, to make up for it.
When Albert wakes up from his post-ictal sleep, he will have no more seizures, he will have a collection of musical instruments waiting for him that will exceed his wildest imaginations, and he will sing with the angels, and we will join him- “when we all get to heaven, what a day of rejoicing that will be. When we all see Jesus, we’ll sing and shout the victory.” Amen.

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

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

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

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