Sierra Leone
I just arrived back to Monrovia after spending the last 6 days in Sierra Leone, which is the country just to the west of Liberia. I was able to fly with the UN's World Food Program, which is luckily a free flight for those on business. It was a little 10 seater plane that allowed for great viewing of both countries because we flew at less than 10,000 feet. I really didn't know much about Sierra Leone until I got there and was amazed to see mountain after mountain and beautiful hills, valleys, and rivers. The city of Freetown is where the Mercy Ship's land-based program, called New Steps, has a house for the rehab employees.
Mercy Ship's also has helped to fund the building of the Aberdeen Clinic and Fistula Center, which is where women who have had fistulas (holes in the bladder) come to get surgical repair and care. I remember being very fascinated by this life-changing surgery after watching an Oprah special on the Fistula Center in Addis Ababa, Ethiopia. I contacted them and was interested in joining their team, but decided against it because it was a 2 year or more commitment. This center was designed after the one in Addis and we went for a visit on Sunday. The women who come to this center and also the ones who come to the ship have often gone for years wearing a piece of cloth between their legs due to the constant dripping of urine. Many of them have been shunned by society and even their families and often hang their heads and don't make eye contact with anyone.
The fistula doesn't allow them to stop and start the slow of urine using their muscles and therefore, the muscle also has to be re-trained after surgery. According to the nurses who try to teach this,it is a very difficult concept for the ladies to grasp, due to general lack of education and biology and complete lack of knowledge of how the body works.
The women stay for 2 weeks to heal and to ensure that the bladder begins to function properly. At the end of 2 weeks, they have a "Dress Ceremony" where they are presented with a new lapa (wrap around skirt) and new blouse to symbolize the beginning of a new life for them.

The New Steps Center is located about an hour out of town due to the fact Mercy Ships was given a nice plot of land there. The center started about a year ago and is run by a physical therapist and 3 rehabilitation therapists.
This picture is of Geraldine, Alfred, Rosemary, and Richard.


The rehab therapists are Sierra Leonians and have had 2 years of schooling in rehab. They treat many types of patients, but the majority of the ones I saw while I was visiting where polio, arthrogryposis (like this little boy, Samuel),

and cerebral palsy. There are many diseases here that we don't see much of at home due to the lack of immunizations available here and poor nutrition. My role at New Steps was to teach the rehab therapists how to make hand splints. I was shocked to find that they had been given Orthoplast as a donation, which is exact same splinting material I had used at Kleinert-Kutz for years. The 4 days of teaching was very successful and I feel like the therapists really learned alot. They surprisingly catch on really fast for the limited exposure they have had to splinting, possibly because they use their hands for so many things we have machines to do for us. They also have a large prosthetics and orthotics center for making artificial legs and braces for those affected mainly by neurological problems. The Sierra Leonian men who work here were also trained by long-term medical volunteers.
One day, we went into the village to see a little boy with severe cerebral palsy and because his mother is blind, it makes it difficult to transport him to the center. It was quite interesting to have to make my splint, as I need hot water and here they have no running water or electricity.
The little boy's sister helped me by getting water from the well and heating a pot of water on coals on the front porch. Several bare-breasted women sat on the front porch and laughed while I, the strange white lady, dipped the plastic in the pot and sweated so much it ran in my eyes and soaked my clothes...



While I was visiting, we also got to visit the beach one day, which was very relaxing and quite different from the mostly deserted beaches of Monrovia.