Thursday, December 22, 2011
Tuesday, December 20, 2011
Voluntary Positions Available for Consultant Paediatricians
Assignment Length: Minimum 3 months
Starting Date: To run consecutively from April 2012
As a Consultant Paediatrician with Welbodi Partnership, you would have a direct and significant impact on the quality of care provided to extremely disadvantaged children. You would play a key role in the development of Sierra Leone’s under graduate and postgraduate paediatric training programmes, producing the country’s future leaders in child health.
Job Description
The consultant paediatrician will champion the development of paediatric services, in Ola During Children’s Hospital (ODCH), Sierra Leone’s only specialist paediatric facility. In conjunction with the lead consultant for paediatric training, they will assist in the recently established postgraduate paediatric training programme and in the training of medical undergraduates.
Consultants will have general paediatric clinical commitments, during which there will be opportunities for teaching all cadres of health professionals and students and developing clinical services. They will be expected to contribute their expertise and support in the existing academic programmes.
The assignment will require a minimum of 3 months of clinical work in Sierra Leone. We would welcome applications from those who are able to commit for longer than 3 months.
Responsibilities
The Consultant will be required to fulfil the role of sub-specialist consultant as stipulated by the West African College of Physicians (WACP) for the training of paediatric residents to take their WACP Membership exams, namely:
1. Assist the lead consultant for paediatric training in facilitating postgraduate training by offering educational support to the hospital registrars and active participation in the postgraduate academic teaching programme.
2. Provide general inpatient and outpatient paediatric care. Engage in direct clinical work at a consultant level, running ward rounds and outpatient clinics. To receive referrals relevant to their area of sub-speciality from colleagues within the hospital. Out-of-hours commitments will be limited to telephone advice.
Individual workplans will be determined on appointment, in discussion with Welbodi Partnership and the hospital management team, to include some or all of the following:
3. Additional academic activities: Delivering teaching to doctors, nurses and students at the hospital and involvement with relevant national academic programmes at the College of Medicine and Allied Health Sciences (COMAHS). Conduct and supervise research and audit as appropriate.
4. Clinical service development. Take joint responsibility with ODCH management and staff for implementing medical project work to improve patient care. This could include the development of sub-specialist paediatric services by running specialty clinics, advising on the appropriate equipping of hospital facilities and improving clinical care pathways relevant to their sub-specialty.
5. Other projects targeting child mortality and morbidity in Sierra Leone that are in keeping with the principles of Welbodi Partnership.
Person specification
Essential:
1. Medical degree from a WHO-recognised medical school.
2. Consultant-level or equivalent qualification in Paediatrics – e.g. Fellow of the West African College of Physicians, Certificate of Completion of (Specialist) Training (UK), American Academy of Pediatrics board certification. We will gladly consider other suitable qualifications that are equivalent to FWACP.
3. Professional experience of healthcare in Africa or other low-resource setting.
Desirable:
4. Experience of teaching at postgraduate and undergraduate levels.
5. Demonstrable sub-specialisation or special interest within paediatrics in one of: cardiology, respiratory, haematology/oncology, endocrine, renal, metabolic or infectious diseases.
6. In-depth, substantive knowledge of healthcare policy in developing countries.
7. Excellent people skills and a demonstrated ability to work collaboratively with people from diverse backgrounds in a dynamic and constantly-shifting environment.
8. Excellent written and oral English communication skills.
9. Flexibility, focus, and the presence of mind to work in sometimes difficult and chaotic circumstances.
10. Commitment to the goals and principles of the Welbodi Partnership.
Remuneration
The Welbodi Partnership is a small organisation with limited financial resources.
The positions are on a voluntary basis with no salary or personal allowance. Welbodi are willing to cover the cost of a return flight to Sierra Leone, medical registration and visa application fee, and will provide accommodation and daily transport to and from the hospital. You will need to cover the cost of all other expenses.
Applications
The Welbodi Partnership is a UK-registered charity established to support the provision of paediatric health care in Sierra Leone and in particular the Sierra Leone Institute of Child Health (SLICH). SLICH is a joint project between the Sierra Leone Ministry of Health and Sanitation, ODCH, and the Welbodi Partnership to create a centre of excellence in paediatric care. It forms part of the Government of Sierra Leone’s Strategic Plan for Reproductive and Child Health.
The 150-bedded hospital is located in the poor and densely-populated eastern part of Freetown, where 96% of families living in slum conditions. It treats more than 40,000 patients each year, spread across two inpatient wards, an outpatient department, emergency room, ICU, SCBU and a therapeutic feeding centre. The hospital is extremely under-resourced, however, and providing adequate care is still a challenge.
To learn more about us, please visit our website at www.welbodipartnership.org. For more specific queries about this opportunity or a copy of our FAQs please contact Suzanne at the email address below.
Interested candidates should please send a CV and cover letter to Suzanne Thomas at: suzanne@welbodipartnership.org
Tuesday, November 1, 2011
Green light from Comic Relief...
A few months ago Welbodi Partnership was awarded a three-year grant from Comic Relief to support the work we are doing at the Ola During Children’s Hospital. We are happy to say that the funding should be released today, November 1st. The money from Comic Relief will enable us to support bigger projects that will have a greater impact on the care provided in the hospital. Of course, in leading up to the money being released we have taken the time to improve our financial systems and make processes more robust. We are now ready to GO!
In the next few months, as the grant starts up, we will continue to develop monitoring and evaluation tools. We do not simply want to fund projects and walk away, we want to be able to show three years down the line that the money spent has had a positive impact here at Ola During. We will not only look at the affect on the child mortality rate but also look at the impact of our work on parent satisfaction, staff satisfaction, staff empowerment and the quality of care provided by the doctors and nurses. These are all areas in which we hope to make a positive change. Together with our partners at ODCH and the Ministry of Health and Sanitation we hope to make this grant a huge success.
Monday, October 31, 2011
Learning and Sharing
The Royal Treatment
Thursday, August 4, 2011
Welbodi Quiz Night
On Friday the 15th of July, Welbodi Partnership held a fundraising quiz night, hosted by IMATT in Freetown. Just one week after sending out invitations, we had generated more interest than we could cope with. After asking IMATT to agree to 100 participants, rather than the originally planned number of 80, we started putting addi
tional names on a waiting list. Needless to say, we saw this as a sign that the night would be a success.
The Welbodi team, and a few honorary Welbodies, spent the next week planning and preparing for the night. Quiz questions were thought up, spectacular raffle prizes were arranged, raffle tickets were created, emails were sent back and forth, lists of names were submitted, the hall was set-up, etc. We were determined to make this a spectacular event.
On the evening, as people entered the room, they paid their entrance fee and were encouraged to buy raffle tickets to make a chance at winning some amazing prizes, raising more money for Welbodi. Prizes were varied and included winning 5 movie tickets, a night at the Chimpanzee Reserve, a day’s vehicle hire on the peninsula, a trip to the Africa Mercy to tour the ship and enjoy Starbucks, Splash cash and last but not least meals at various restaurants like O’Casey’s, Roy’s, Atlantic, Independence Bar and Crown Express.
The quiz rounds soon began and teams did their best to come up with the right answers to questions. Rounds varied from questions about sports, science & nature, history, entertainment, general knowledge and world, to picture rounds including popular locations within Freetown and a music round including lyrics in Krio, which was by far the most popular round.
At the end of the night, while the points were tallied, the raffle was drawn. Unplanned, one raffle prize ended up being auctioned off which was great fun with some high bidding taking place between two individuals. Finally, the winners were announced and the first prize went to the team “4 Nations”.
The fundraiser was a huge success and with everyone’s help we were able to raise Le 4,370,000, which is just over one thousand US dollars! This money will be used to continue improving child health care at ODCH. Welbodi Partnership would again like to thank IMATT for hosting, the prize givers for donating prizes and those individuals who made this event a success.
Test your knowledge with some of the questions from quiz night.
1. What is the capital of the newest country in the world?
2. What is the color of hippo milk?
3. What quintessential salone (food) product comes from the Jura region of France?
4. At the end of the 19th Century, European powers had occupied and ruled over all but 2 African countries. Which two?
5. What is the exact date when Sierra Leone became independent?
Answers are in the comments.
Can you host an event to help raise money for the Welbodi Partnership?
It’s easy, fun, and a great way to contribute to our work in Sierra Leone. Make your own free fundraising website in minutes at JustGiving http://www.justgiving.com/welbodipartnership, and contact us at info(at)welbodipartnership.org if you need information or materials to help make your event a success.
Wednesday, August 3, 2011
Wi Dae Go! Improving Care at ODCH
- A new Emergency Room/Intensive Care wing opened, in place of the old administrative wing, thanks to Cap Anamur, a German organization working at ODCH.
- Reconstruction of the neonatal unit began, funded by UNFPA with oversight from Welbodi Partnership. This very exciting and much-needed project will double the size of the unit and provide a separate outpatient consultation room, an isolation room, a place for mothers to stay near their children, and more space overall.
- A team of lab experts from the UK and the Gambia visited ODCH to provided technical advice and training to ODCH lab technicians. This was part of a long-term lab development project between Swansea University in the UK, THET, the British Council, and the Oxted Trust, facilitated by Welbodi Partnership.
- A team of students from King's College London arrived in Freetown in July to work with Welbodi to conduct qualitative research on health seeking behaviour in the communities that surround ODCH. We hope the results will give us more insight as to why children come to the hospital late and help us find ways to tackle those barriers.
- Board members for the Sierra Leone Institute for Child Health (SLICH) had another successful quarterly meeting in July 2011 and approved a number of projects that had been proposed by ODCH staff to improve the quality of care provided at the hospital.
- Postgraduate training for doctors continues to move forward, thanks in large part to input from Nigerian Fellow of the West African College of Paediatrics, Professor Tamra Abiodan, who has been working at ODCH for a year and a half. Starting next month, we will have paediatric consultants volunteering at ODCH for several months at a time to help with clinical teaching. We have our first three volunteers confirmed and are now recruiting for positions for 2012-2013.
- We are also working closely with our partners in the Ministry of Health and Sanitation to establish a paediatric nurse training program. At the same time, we are looking at how Welbodi can work with a local radiologist and radiographer to help them set up a training program in radiography. In the coming years, we believe these training efforts will have an impact on the quality of paediatric care not only at ODCH but nationwide.
Introducing the Newest Welbodi Team Members
Dr. Anne Nesbitt is a consultant paediatrician with extensive experience in acute and community paediatrics in the UK and Africa. Over the course of her career, Anne has spent more than 11 years in various African countries, including Sierra Leone. We are thrilled to welcome her back to Freetown, where she will be delivering clinical teaching through our postgraduate training program for doctors.
Suzanne Thomas is a pharmacist with expertise in designing, delivering, and evaluating training initiatives for a wide variety of medical professionals, including doctors, nurses, and community health workers. In 2008, she volunteered in Southern Sudan as an advisor and trainer. She will be a tremendous asset to our ongoing training initiatives for staff at Ola During Children’s Hospital.
Welcome Anne and Suzanne!
Would you like to get involved? Contact info(at)welbodipartnership.org to find out how, or see our job posting for volunteer consultant paediatricians.
Help train Salone's next generation of paediatricians
Location: Freetown, Sierra Leone
Assignment Length: 3 months
Number of positions available: 4
Starting – to run consecutively between June 2012-Aug 2013.
Interested candidates should please send a CV and cover letter by 1st September 2011 to Dr Fred Martineau at: fred(at)welbodipartnership.org
As a Consultant Paediatrician with Welbodi Partnership, you would have a direct and significant impact on the quality of care provided to extremely disadvantaged children. You would play a crucial role in the development of Sierra Leone’s first ever postgraduate paediatric training programme, producing the country’s future leaders in child health.
Job Description
The consultant subspecialist paediatrician will champion the development of their subspecialty in Ola During Children’s Hospital (ODCH), Sierra Leone’s only specialist paediatric facility. They will take a leading role in the recently established postgraduate paediatric training programme, providing educational supervision and expert clinical teaching on their special interest to paediatric residents.
In addition to these two principle roles, the consultant will be expected to take on further responsibilities aimed at improving the quality of paediatric health care in Sierra Leone. This will include general paediatric clinical commitments, teaching all cadres of health professionals and students and the development of clinical services as detailed below.
The assignment will require 3 months of clinical work in Sierra Leone. The successful applicant will be encouraged to contribute to the clinical and educational activities of the hospital before and after this period through the use of e-learning and telemedicine packages.
Responsibilities
The Consultant will be required to fulfil the role of subspecialist as stipulated by the West African College of Physicians (WACP) for the training of paediatric residents to take their WACP Membership exams, namely:
1. Develop and run subspecialist paediatric services. This will include the running of specialty clinics, advising on the appropriate equipping of hospital facilities and improving clinical care pathways relevant to their subspecialty.
2. Take a leading role in the postgraduate academic programme, including the educational supervision of registrars and active participation in the postgraduate academic teaching programme.
Individual workplans will be determined on appointment, in discussion with Welbodi Partnership and the hospital management team, to include some or all of the following:
3. Provide general inpatient and outpatient paediatric care. Engage in direct clinical work at a consultant level, running ward rounds and outpatient clinics. Out-of-hours commitments will be limited to telephone advice.
4. Additional academic activities: Delivering teaching to doctors, nurses and students at the hospital and involvement with relevant national academic programmes at the College of Medicine and Allied Health Sciences (COMAHS). Conduct and supervise research and audit as appropriate.
5. Clinical service development. Take joint responsibility with ODCH management and staff for implementing medical project work to improve patient care.
6. E-learning and telemedicine. Welbodi are collaborating with medicineafrica.com to provide distance-based clinical and educational supervision. These will allow successful applicants to extend their contribution to paediatrics in Sierra Leone beyond their time on the ground and enhance the sustainability of any changes introduced.
7. Other projects targeting child mortality and morbidity in Sierra Leone that are in keeping with the principles of Welbodi Partnership.
Qualifications
Essential:
1. Medical degree from a WHO-recognised medical school.
2. Consultant-level or equivalent qualification in Paediatrics – e.g. Certificate of Completion of (Specialist) Training (UK), Fellow of the West African College of Physicians, American Academy of Pediatrics board certification. We will gladly consider other suitable qualifications that are equivalent to FWACP.
3. Demonstrable subspecialisation or special interest within paediatrics in one of: cardiology, respiratory, haematology/oncology, endocrine, renal, metabolic or infectious diseases.
Desirable:
4. Professional experience of healthcare in Africa or other low-resource setting.
5. Experience of teaching at postgraduate and undergraduate levels.
6. In-depth, substantive knowledge of healthcare policy in developing countries.
7. Excellent people skills and a demonstrated ability to work collaboratively with people from diverse backgrounds in a dynamic and constantly-shifting environment.
8. Excellent written and oral English communication skills.
9. Flexibility, focus, and the presence of mind to work in sometimes difficult and chaotic circumstances.
10. Commitment to the goals and principles of the Welbodi Partnership.
Remuneration
The Welbodi Partnership is a small organisation with limited financial resources.
The positions are on a voluntary basis with no salary or personal allowance. Welbodi are willing to cover the cost of a return flight to Sierra Leone, medical registration and visa application fee, and will provide accommodation and daily transport to and from the hospital. You will need to cover the cost of all other expenses.
Applications
The Welbodi Partnership is a UK-registered charity established to support the provision of paediatric health care in Sierra Leone and in particular the Sierra Leone Institute of Child Health (SLICH). SLICH is a joint project between the Sierra Leone Ministry of Health and Sanitation, ODCH, and the Welbodi Partnership to create a centre of excellence in paediatric care. It forms part of the Government of Sierra Leone’s Strategic Plan for Reproductive and Child Health.
The 150-bedded hospital is located in the poor and densely-populated eastern part of Freetown, where 96% of families living in slum conditions. It treats more than 40,000 patients each year, spread across two inpatient wards, an outpatient department, emergency room, ICU, SCBU and a therapeutic feeding centre. The hospital is extremely under-resourced, however, and providing adequate care is still a challenge.
To learn more about us, please visit our website at www.welbodipartnership.org or for more specific queries please contact Fred at the email address below.
Interested candidates should please send a CV and cover letter by 1st September 2011 to Dr Fred Martineau at: fred(at)welbodipartnership.org
Tuesday, August 2, 2011
Exciting News: Comic Relief Funds Welbodi
The bulk of the funds will go to support the Sierra Leone Institute of Child Health (SLICH), a collaboration between the Welbodi Partnership, the Ministry of Health and Sanitation, and ODCH. Through SLICH, the Welbodi Partnership funds ideas submitted by ODCH staff for how to improve service provision at the hospital. Alongside this, we will continue to develop desperately-needed postgraduate training programs for doctors and nurses. A small but important part of the grant will be spent to nurture new relationships with local communities, build on our understanding of community health needs, and empower community members to participate in the process of innovating and implementing new approaches to improve child health. Finally, we will invest in developing robust monitoring and evaluation systems to ensure that we track outcomes and remain accountable to the fundamental goal of reducing needless child deaths.
We are extremely excited about this new phase of our work, and we look forward to working with Comic Relief and with our wonderful partners at ODCH and the Ministry of Health and Sanitation to put this new funding to good use.
Monday, July 25, 2011
Hat-tip New York Times
The article cites early indications that the initiative is having an impact -- including a "214 percent increase in the number of children under 5 getting care at health facilities... and an 85 percent drop in the malaria fatality rate for children treated in hospitals" -- but also enormous challenges. "The health minister, Zainab Bangura, says her country needs 54 gynecologists but has only 4. Likewise, she says, there are only two pediatricians in a nation of over five million people."
Together with our partners, the Welbodi Partnership is working to address this shortage of pediatricians. Two of the Ola During Children Hospital's medical officers recently passed the primary exams for the West African College of Pediatrics and Director of Clinical Teaching Professor Tamra Abiodun is leading a team of fellows providing hands-on training and professional development for these and other young doctors. Meanwhile, we are working towards accreditation through the West African College so that someday soon, aspiring pediatricians from Sierra Leone can qualify as specialists without leaving the country.
Would you like to help? We are always looking for specialist pediatricians to join us in Freetown to help provide clinical training. Contact Emily(at)Welbodipartnership.org for more information.
Wednesday, July 20, 2011
Ola During Children's Hospital...
Friday, July 8, 2011
Busy Welbodi
Monday, June 13, 2011
Why do children come so late?
Day after day in the emergency room at Ola During Children’s Hospital, parents arrive with extremely sick children, often on the verge of death. It is not uncommon for a mother to come in with a child gasping for breath, or a child who is extremely pale, or is unconscious or with extremely cold extremities and in shock. Occasionally they even come with a child who has (unknowingly to them) died en route. It is tragic.
Why are these children reaching the hospital so late? Is it ignorance or a lack of knowledge? Do they not realize how sick their children are until it is too late? Are there additional financial barriers even though health care is now free, like the cost of transport or a family’s loss of income during the time they are in hospital? Maybe people do not know about free health care. Or maybe it is inconvenient to come because the mother has other children at home. Are there other family pressures that keep them from coming to the hospital? Or is it because they can buy any medication they want at pharmacies located on every street corner? Is it due to traditional beliefs embedded with witchcraft and other (in our minds) bizarre ideas? It could be because the family thinks the child is ‘country sick’ and in need of herbal medicine, rather than ‘hospital sick’ and in need of ‘western medicine’. Is it because of the hospital’s reputation of children dying here? I suppose it is probably a combination of these things, and more, and to be honest it will be difficult to find out in most cases.
I had hoped that with the introduction of free healthcare for children under five years old, parents would come to the hospital sooner rather than later. Ideally they should come to the hospital when the child is mildly or moderately ill and get treatment at an earlier stage. For many, that just does not seem to happen. They tend to come when they are very sick. Is it that since free healthcare, the children who would have otherwise died at home in silence are now accessing the hospital in the final hours of their illness? It is hard to know.
Still, the majority of the children coming to the hospital have treatable diseases like malaria, pneumonia, anemia and diarrheal disease. These are all diseases that can be cured (and better yet prevented) if treatment is started on time. But in the cases in which treatment is delayed, unfortunately the chance of survival plummets. We do what we can, with our limited resources but often cannot save the children coming in so late. Of course, our (emergency) care needs to be improved. I will not deny that, but I also know that if some of these children would show up at a hospital in the developed world, they would not survive either. Sometimes they are just too sick and close to death.
So what can we do? If only we had more insight into why children come to the hospital so late. Maybe if we understood why families are not coming to the hospital quickly, we can look into ways to remove the barriers and encourage a change in behavior. Maybe with some more time and results from a survey on health seeking behavior in nearby communities we will have more of an idea. Time will tell. For now, we need to continue to improve the services at the hospital so that optimal care can be given. We all need to try even harder, stay motivated and work together in order to give these children the best care possible in this challenging setting. And we need to advocate for more sensitization within the communities to encourage parents to come to the hospital sooner. There is a lot of work to do.
Tuesday, May 31, 2011
Coordination and clinical work
A lot of the work the Welbodi Partnership does is to coordinate and facilitate projects and training programs within the hospital. Our aim is capacity building – helping others to improve their skills rather than coming in to solely provide patient care. We believe that in the long run more patients will receive high-quality treatment and have better outcomes if we focus our current efforts on improving the services delivered in the hospital. That is why we have engaged in projects like electricity and water supply, the medical records/data collection and reporting system, the laboratory services, nursing care, the triage and emergency process, and training for the doctors.
This does mean that my job as a medical coordinator, although diverse, does not leave much room for clinical work. As I am trained as a doctor, that is not always easy. Fortunately, for my own professional development and to see how hospital systems are or aren’t functioning, I try to do some clinical work. However, usually my role as coordinator keeps me so busy, I don’t make it to the wards. If I do make it, it’s usually just to see a few patients. I decided that for now it is best not to do ward rounds on a ward because it is unlikely that I will be available to the nurses and patients for the rest of the day due to meetings and other responsibilities.
The last few weeks have been so busy, I have really only been able to see a few patients on the ward adjacent to our office, so it has been good to be able to be involved with patients a bit more on other wards.
It started one evening when I happened to be at the hospital and ran into a family with a very sick child looking for the Emergency Room. The child was admitted and stabilized but unfortunately remained in a very critical condition. Sadly, the infant died in the course of the following day. I was again hit by the reality of the mortality figures in this country. And I realized again that although it can be very rewarding to do clinical work, it is also pretty tough.
I was also involved in the case of an infant admitted a few days ago. With a hemoglobin of 3.5 g/dL, the child needed blood urgently. Fortunately there was a relative who was able to donate and the child received blood soon after admission. After that it was a waiting game. Thankfully, the next day the child looked much better. However, unfortunately the child had not received all of the prescribed medication within the first 24 hours of admission because something went wrong with the supply. So, I wrote a prescription for the missing medication and later checked up on the child again again. The child was stable and I expect will make a good recovery. Now, if I can only convince the mother to stop giving the child hot water and encourage her to exclusively breastfeed I will be really happy!
I love the clinical work and honestly do miss it, but I also have to admit that it can be quite frustrating. Yes, there have been many improvements over the last few years, but there is still a long way to go. I think all of the clinicians in the hospital would agree that clinical work in the hospital is challenging. The patient numbers can be high, working hours can be long, (once a week when on-call overnight the doctors work for about 30 hours straight) and the cases coming to the hospital are often quite severe, which means that on a daily basis one is faced with children dying. For doctors and nurses alike this can be very demoralising. Yet somehow, everyone must continue. Despite the frustrations, spending time on the wards gives me more insight into how the various systems (pharmacy, lab, blood bank, nursing, medical records, doctors) work (or not) and how they have improved (or not) over time. The barriers and delays to achieving good patient care become more apparent. This information can in turn re-start the thought process and refinement of how Welbodi continues to work alongside hospital management and other partners to improve systems within the hospital with the overall aim to improve pediatric care. And that is when I put my coordinating hat on again!
First posted @ http://blogs.bmj.com/bmj/2011/05/31/sandra-lako-coordination-and-clinical-work/
Tuesday, May 17, 2011
Thursday, April 28, 2011
Happy birthday Sierra Leone - and happy birthday free healthcare!
This week also marks Sierra Leone's 50th anniversary of independence. As the country honors this occasion with reflection, patriotism, and lots of celebration, we at Welbodi celebrate along with Mama Salone, and hope that the next 50 years will bring continuing improvements in the lives of her many children, young and old.
Monday, April 25, 2011
World Malaria Day 2011...
Today is World Malaria Day and unfortunately, although a preventable disease, malaria still kills many people in the developing world. At the children's hospital I work at, we see malaria cases everyday. Some cases are very severe; the children are literally on death's doorstep and other cases are mild and improve with oral medication. As you can imagine, the disease has a major impact on child health in Sierra Leone.
In November of last year, we had 999 inpatients in the hospital and in that month (as often is the case) malaria was the most common reason for admission, followed by chest infections, diarrheal disease and anemia (unrelated to malaria). Sadly, children die at the hospital on a daily basis. In November, 54% of the hospital deaths were attributed to malaria. In November 67 children died at the Children’s Hospital as a result of complicated malaria. We obviously have our work cut out for us. Having said that, I do believe that the staff at Ola During is working hard to do their part in combating malaria. The staff, management and partners of ODCH and the Ministry of Health and Sanitation must be commended for their ongoing efforts to improve healthcare. The laboratory has definitely improved and more blood smears are being examined for malaria. Thanks to one of the partners in the hospital, malaria treatment is readily available. Improvements in the triage and emergency system mean that children receive their treatment more promptly. There is still a lot to be done, but progress is being made.
The theme for the fourth World Malaria Day is Achieving Progress and Impact. The theme recognizes the international community's renewed efforts to make progress towards near zero malaria deaths by 2015. We’re not there yet, but I like to believe that things are improving. Hopefully the country of Sierra Leone can tackle issues like: distribution and use of insecticide treated nets, prompt diagnosis, appropriate treatment, etc. Various barriers play a role, such as: cultural/traditional ideas impacting use of nets and quick presentation of child to a health facility, lack of experienced laboratory technicians, lack of rapid diagnostic tests, inconsistent supply of ACT medication or quinine, etc.
Hopefully, health education in the communities, training in health facilities (lab and medical staff), and improved supply chain will decrease the number of deaths related to malaria in Sierra Leone. The day that there are near-zero malaria deaths in the country will be a day to celebrate for sure. Count me in…
Monday, April 18, 2011
#3 Photo of the week
Wednesday, March 30, 2011
Oxygen for the feeding center
Last week Monday the final four oxygen concentrators from the “Operation Oxygen” campaign made it to Ola During Children’s Hospital. Thanks to all of you who contributed generously to this campaign. Of course, it was a bit of an epic journey to get the shipment from the airport to the hospital, but after many phone calls, negotiations, and bribe avoiding tactics we managed. Unfortunately getting shipments out of the airport or port is still a big hassle for most non-governmental organisations (NGOs).
This past Saturday I went to the Children’s Hospital, to deliver large bags of leftover bread rolls that the Africa Mercy wanted to give away. Fortunately there was plenty to go around for all of the patients and staff. While I was there, I thought I would assemble the oxygen concentrators, label them, and test them to make sure they were in good working order. All of the units worked, and so four more oxygen concentrators were ready to roll.
Today, I thought it would be good to bring a concentrator to the therapeutic feeding centre. After all, they have never been able to give oxygen there and they do often have severely malnourished children with severe pneumonia, or other illnesses causing respiratory distress. Up until today, malnourished children needing oxygen were sent to the ICU for admission; meaning their feeds were (unfortunately) not monitored as well as they would be in the nutrition unit.
After checking with matron in the morning, I went to the feeding center to tell the nurses they would receive a brand new oxygen concentrator, and they were delighted. They have been asking for oxygen on their ward for their patients for months now.
Since there is an oxygen concentrator in the feeding centre, it means that the malnourished children in need of oxygen can remain there and receive both oxygen as well as 3 hourly feeds of F-75 or F-100 milk, along with the other medical care they need. Being able to keep these children in the nutrition unit will hopefully improve care and will prove to be yet another small step in the right direction. We do realise of course, that in some cases children may need to stay in the ICU for more intensive monitoring.
Unfortunately, when the power went off later in the day, we realised that the feeding centre is not yet connected to the back-up generator provided by Welbodi and so the oxygen concentrator stopped working. Our next aim is to make sure the feeding centre gets connected to that generator. Small steps. One at a time. We’ll get there someday.
Tuesday, March 29, 2011
#2 Photo of the week
Wednesday, March 23, 2011
World Water Day in Freetown...
On my way to Spur Road this morning I walked past a group of children scooping murky water out of the gutter into some buckets. These buckets were then lifted to their heads and carried home. Further down the road there was another group of people, huddled around a standpipe. 45 yellow five-gallon containers were lined on either side, ready to be filled. This is daily life in Freetown.
Can you imagine having to use gutter-water to clean your dishes or wash your clothing? Can you imagine having to stand in line for hours, waiting for your turn at the standpipe? Can you imagine having to walk for miles with a bucket of water on your head?
I cannot.
Although we have had some major problems at our house, we still manage to get some five-gallon containers filled. Yes, it takes time, but it doesn’t take us hours. And yes, I have to carry it up three flights of stairs, but at least it is not three miles. It is not the same, but it gives me a glimpse of what life must be like for the average person here. Clean water is so essential yet still so difficult to access.
Today is World Water Day, an observance day that grew out of the 1992 UN conference on Environment and Development. This year’s theme is Water for Cities, which highlights the connection between rural and urban areas. Water flowing into cities generally originates in rural areas, and it is in those areas that water should be protected and managed well. Water is affected by climate changes, industrialization, natural disasters and rapid urban growth.
Did you know that most of the world’s population lives in cities? 3.3 billion people. Meanwhile the urban landscape continues to expand and expanding slums represent 38% of the growth. City populations are increasing faster than city infrastructure can adapt leading to critical water shortages.
Freetown is a city with more than 1 million people that struggles to provide its residents with the water they need. The Guma Valley Water dam that supplies the majority of the city was originally set up to serve a population of 300,000. It is no wonder that water access and availability are poor. Not only are households affected by water shortages, so are businesses, schools, Ministry buildings, restaurants and hospitals.
The Ola During Children’s Hospital has had water problems for many years now. Since Welbodi Partnership started working at the hospital since 2007, we have tried to address this situation many times but unfortunately the water problems are complex. When one battle is won, another battle arises. But we will continue because the situation is serious. Poor hygiene practices in the hospital lead to an increase of infections on the wards, which in turn lead to longer hospital stays and unavoidably more deaths. Something needs to be done.
Can you imagine one bucket and one bar of soap on each ward of 40 patients for all of the nurses and caretakers to wash their hands? Can you imagine how hard it is to keep the linen and beds clean? Can you imagine how hard it is to clean up after sick children? Can you imagine working in a hospital where water rarely comes out of the tap?
The situation is serious.
One of the problems is that Guma supplies water only a certain number of times per week. This is done throughout the city to ration the water, ensuring that each area in the city at least has some water at some point. For hospitals, this is not adequate. We think that the long-term solution might be to connect the hospital to the main water pipeline on Kissy Road. Maybe. Honestly, we are not 100% sure if that would solve the problem but it seems like the best shot. We hope to work together with hospital management, the ministry, partner organisations, and the water company to see if this is possible.
Last year Welbodi Partnership installed four 5-thousand litre water tanks above the elevator shaft with the aim that when Guma supplies water we can at least store a large amount, so that each ward will have some running water all the time. The most recent project included adding more inlets to the water tanks so that the fill-up time would be quicker and the tanks would fill up to the brim. A project we are about to commence is to install one 5000-litre water tank on the ground level, which will provide more storage of water. We will also use the water pump purchased by Welbodi in the UK to pump water from the new storage tank to the top level because when Guma does supply water, the pressure is often too low and the water does not reach the top floor. We hope that this latest water project will be a success. However, ensuring that water supply is sustainable is important, and so we also plan to partner with an organisation that may be able to get qualified engineers to assess the water situation and come up with long-term solutions.
Solving the water problems at the hospital sure seems like an ongoing battle, but I like to think that slowly we are winning ground. I look forward to the day that the water supply at the hospital will be unlimited and the residents of Freetown will have access to the water they desperately need.
Statistics taken from http://www.worldwaterday2011.org/
First posted @ http://blogs.bmj.com/bmj/2011/03/22/sandra-lako-world-water-day-in-freetown/
Sandra Lako is a doctor from the Netherlands who previously spent four and a half years in Sierra Leone setting up and managing a pediatric outpatient clinic with an organisation called Mercy Ships. After a year at home, she returned to Sierra Leone to volunteer as medical coordinator with the Welbodi Partnership, a UK based charity supporting the only government-run children’s hospital in a country where 1 in 5 children do not reach the age of five.
Sunday, March 20, 2011
24,600 km across Africa on a bicycle to support Welbodi
One year and 8 months after leaving London on a bicycle, the intrepid Helen Lloyd has reached Cape Town, the southern tip of the African continent. Read her amazing tales of biking across Africa and of all the fascinating people she met along the way - including the Welbodi team in Freetown. Then visit her JustGiving site and support her fundraising appeal on behalf of the Welbodi Partnership.
Thank you Helen, and congratulations!
Would you like to raise money for the Welbodi Partnership while enjoying the open road? It's not 24,600 km across Africa, but we do have spaces available in the London Bupa 10k on May 30th. Visit our race page for more information or to sign up to run.
Tuesday, March 15, 2011
Thursday, March 10, 2011
Operation Oxygen was a success.
Over the Christmas holiday $11,760 was raised for oxygen concentrators for the Children’s Hospital in Sierra Leone. This is enough for at least 8 new concentrators. Last year I was amazed to raise $5,000 for our water charity, this year I’m blown away. Friends, family, churches, and strangers have all given generously to this cause. Thank you!
With only 6 oxygen concentrators at the Children’s Hospital before, children had very limited access to oxygen. Often one machine was shared between 4 children. Obviously this was not sufficient. Imagine how parents in the UK would react if they knew their sick child was only receiving ¼ of the oxygen that he or she needed. Unfortunately parents in Sierra Leone do not have much choice. Thankfully, with the money donated to the Welbodi Partnership, through my church, my justgiving campaign, and other donations from the UK, we were able to buy 11 oxygen concentrators. Seven of them arrived at the hospital a week and a half ago, the other four are due to arrive in the next two weeks. This means that we have more than doubled the number of oxygen concentrators in the hospital. Hopefully we can use each concentrator for one or two children, rather than three or four, increasing the amount of oxygen each child receives. I am certain that this will have an impact on child survival in the hospital.
Like everything else here, a bit of effort was involved in getting the concentrators to the hospital. The concentrators were sent by DHL to Lungi airport, which meant that after attempting to get duty free concession from the Ministry (but failing) I headed to the airport with one of the Ministry’s procurement officers. I left home at 6am to be at the hospital by 6:45am, ready to leave by 7 am to catch the 8 am ferry across to Lungi. All went well and even the paperwork seemed to be moving along until I was told there was a small problem. Because the shipment had been sitting at the airport for more than a week we were told we had to pay a significant fee. The fee was very high and of course, we had not been informed that this fee existed. After explaining that the concentrators were for the government run Children’s Hospital and some further discussion, we finally got an okay. The paperwork was (slowly) signed off, and the concentrators were released. Time was ticking away and we literally pulled up to the 11 am ferry just before it was set to leave the terminal. We made it back to the hospital around 1 pm and offloaded the concentrators. The next morning one of my colleagues and I assembled the concentrators, we tested them, marked them, and delivered them to the wards. It felt like Christmas. I was so happy and so were the staff. Before we knew it, the machines were switched on, blowing out oxygen, and children were benefiting.
Sandra Lako is a doctor from the Netherlands who previously spent four and a half years in Sierra Leone setting up and managing a pediatric outpatient clinic with an organisation called Mercy Ships. After a year at home, she returned to Sierra Leone to volunteer as medical coordinator with the Welbodi Partnership, a UK based charity supporting the only government-run children’s hospital in a country where 1 in 5 children do not reach the age of five.
First posted @ http://blogs.bmj.com/bmj/2011/02/23/sandra-lako-operation-oxygen-was-a-success/
Thursday, February 17, 2011
Deadline extended - Join our team!
For details, please see our earlier postings here and here.
We will be considering applications on a rolling basis, so please apply ASAP for consideration and circulate widely to friends and colleagues. This promises to be an exciting year for the Welbodi Partnership and for the Ola During Children's Hospital, and you can be a part of that!
Interested candidates should send a cover letter plus resume or CV to emilyATwelbodipartnership.org.
Saturday, February 12, 2011
Life-saving blood...
While driving past an NGO hospital last week a friend read out a sign painted on the hospital wall stating that patients need to come with their own blood donors. He thought that was very odd but having been here for years it didn’t seem strange to me. I suppose in the developed world, one would not see such a sign.
Every day children come to the hospital with severe anemia, mostly due to malaria. So, not only do they need to receive anti-malarial medication, they often need blood transfusions as well. Unfortunately it can take up to hours if not days for some of the children to receive blood. The reason for this is that the blood bank runs on a donor replacement system.
Basically, a family member needs to donate a unit of blood to the blood bank in exchange for a unit of screened blood that is stored in the fridge, which will go directly to the patient. Meanwhile the blood donated by the family member will be screened and if uninfected, it is stored in the fridge and used for a patient needing blood at a later time. It sounds simple but unfortunately in practice, the system does not always work. The main problem is that there is often no family member willing to donate; either no one but the mother is around or relatives do not want to donate. And for some reason the blood bank often refuses to take blood from the mothers.
I do not know why, but in general Sierra Leoneans do not like to donate blood. They either assume that by donating they will get infected with something, or are worried about the HIV screen or various other things. This is a problem because it means a child will not receive blood from the bank because the unit taken out is not going to be replaced. And, in all fairness to the blood bank, if this happens too often the blood bank will be depleted.
I have seen in the Emergency Room and ICU countless children in urgent need of blood. Children literally come in with a hemoglobin as low as 1 or 2 g/dL. Some of these children will die if they don’t receive blood within the first hour. It is for these cases that I will take the child’s blood sample and blood request form to the blood bank and ask for a unit from the screened stock, explaining how critically ill the child is. I do end up getting the blood but not without hesitation. And in all fairness, I totally understand the concern because the more we make exceptions, the more relatives will refrain from donating, assuming we will arrange for them to get blood without having to replace it. This is obviously not sustainable.
In December I was asking for blood so often that I decided it was time to replace some of the blood myself. It was time to donate. So, together with Shona (VSO doctor) we headed to the blood bank on a Friday afternoon after lunch thinking we would be in and out in no time. I should have known better. Although it took a while, I have to say we had an interesting experience.
We wanted the technician to go through the usual procedure to make sure we were fit to donate so he proceeded to check our hemoglobin with the Hemocue. Unfortunately it was not working. He pulled out a color card, which literally was a piece of paper with various shades of red painted on it. I questioned this method and suggested he use the centrifuge for a spun hematocrit. We were rather unfortunate once again as the blood spilled out of the capillary tubes while spinning in the centrifuge. What are the odds? Since I had recently had my blood checked at home, I knew my hemoglobin was okay and we decided to go ahead with the donation.
After the blood grouping, we reclined on the two makeshift beds and got as comfortable as we could knowing a large bore needle was about to be put into our veins. We were more at ease when the technician started playing Christmas tunes from his cell phone. He inserted the needle with ease and it was amazing to see my blood flowing into a blood bag, knowing that it could potentially save a child’s life. It felt incredible to be able to help in such a tangible way and be a part of a child’s healing process. It also made me feel good to know I was giving a unit to the blood bank rather than just taking.
I later learned that my blood had been given to two different children and although I don’t know who they are or what the outcomes were, I know that I helped those children. I will definitely donate as often as I can at Children’s and I definitely recommend that people come to the hospital to donate blood. It is a very worthy cause. Seriously, if you come and donate let me know and I’ll buy you a coke while you recover. And, if you’re not in Sierra Leone, donate at your local blood bank. A unit of blood can impact someone’s life. It can mean the difference between life and death.
Sandra Lako is a doctor from the Netherlands who previously spent four and a half years in Sierra Leone setting up and managing a pediatric outpatient clinic with an organisation called Mercy Ships. After a year at home, she returned to Sierra Leone to volunteer as medical coordinator with the Welbodi Partnership, a UK based charity supporting the only government-run children’s hospital in a country where 1 in 5 children do not reach the age of five.
First posted @ http://blogs.bmj.com/bmj/2011/02/11/sandra-lako-life-saving-blood/
Friday, January 7, 2011
Volunteers wanted! Healthcare managers
Location: Freetown, Sierra Leone
Assignment Length: 1 year
Application Deadline: 31st January 2011
Starting: July 2011 (starting date may be flexible)
Job Description
The Programme Manager will provide technical leadership and contribute to the development and implementation of ongoing and new programme activities aimed at improving the quality of paediatric health care in Sierra Leone, starting at the country’s only specialist paediatric facility, Ola During Children’s Hospital (ODCH).
Responsibilities
The Programme Manager will be responsible for the design and implementation of hospital management programme work. You will be one of two volunteer Programme Managers working under a Medical Coordinator who is already in place. The role includes:
1. Needs assessment and planning: Work closely with the management at ODCH and where appropriate the Ministry of Health and Sanitation, to analyse barriers to the delivery of timely and effective healthcare for children and develop ongoing plans to address these barriers.
2. Implementation, monitoring and evaluation: Take joint responsibility with ODCH management and staff for implementing, monitoring and evaluating work to address management issues in the hospital. This may include coordinating and delivering in-service training for hospital management and other staff.
3. Teamwork: Work closely with the national and international staff and volunteers who comprise the Welbodi Partnership team, including contributing to planning, monitoring and evaluation, fundraising and reporting processes.
Qualifications
1. At least two years’ experience working in hospital management is highly desirable, although candidates with other relevant experience in delivering or managing healthcare will also be considered. Additional postgraduate qualification in international development, public health or public policy is highly desirable.
2. Professional experience of healthcare in Africa.
3. In-depth, substantive knowledge of healthcare policy in developing countries.
4. Excellent people skills and a demonstrated ability to work collaboratively with people from diverse backgrounds in a dynamic and constantly-shifting environment.
5. Excellent written and oral English communication skills.
6. Flexibility, focus, and the presence of mind to work in sometimes difficult and chaotic circumstances.
7. Commitment to the goals and principles of the Welbodi Partnership.
Applications
The Welbodi Partnership (WP) is a UK-registered charity established to support the provision of paediatric health care in Sierra Leone and in particular to support the Sierra Leone Institute for Child Health (SLICH). SLICH is a joint project between the Sierra Leone Ministry of Health and Sanitation, the Ola During Children’s Hospital, and the Welbodi Partnership to create a centre of excellence in paediatric care. It forms part of the Government of Sierra Leone’s Strategic Plan for Reproductive and Child Health.
Ola During is Sierra Leone’s only specialist children’s hospital, located in the poor and densely-populated eastern part of Freetown. More than 15,000 patients are treated at the hospital each year, spread across three inpatient wards, an outpatient department, emergency room, ICU and a therapeutic feeding centre. The hospital is under-resourced and providing adequate care is still a challenge.
To learn more about us, please visit our website at www.welbodipartnership.org.
We are seeking individuals to fill the role of Programme Manager described above. You will work as part of a team of three international volunteers at ODCH. You will also be part of the wider Welbodi team, including the charity’s Directors in the UK, USA and Freetown, our Fundraisers and a network of local and international partners.
Interested candidates should please send a CV and cover letter by 31st January 2011 for the attention of: Dr Emily Spry.
emily@welbodipartnership.org
Further important information for applicants
The Welbodi Partnership is a small organisation with limited financial resources. To keep our overheads low, this position has been filled on a voluntary basis over the past 3 years.
We will provide you with an apartment shared with other Welbodi Partnership international volunteers and transport to and from the Hospital on a daily basis. We can also contribute towards cost of travel to Sierra Leone, visas, and medical insurance. However, all other living costs will be your responsibility.
Although Sierra Leone is a very poor country, it is surprisingly expensive to live an expatriate lifestyle. It is possible to by a local meal of rice and sauce for just a few dollars, but an individual pizza in one of the Western-style restaurants costs $12. The minimum that you will need in living costs is around $300 per month, with many spending around $500 per month.
As Programme Manager of the Welbodi Partnership, you would have a direct and significant impact on the quality of care provided to children both at ODCH and throughout the paediatric healthcare system. You would be part of building a relatively new organization from the ground up, of identifying and implementing high-impact interventions -- including quality training for Sierra Leone's young doctors and nurses -- and of building a foundation for lasting change. You would join a committed core team and would be responsible for leveraging the contributions of a wider network of volunteers and partners to bring significant and lasting change to ODCH and the public healthcare system.