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.

First posted @ http://blogs.bmj.com/bmj/2011/03/30/sandra-lako-oxygen-for-the-feeding-centre/

#2 Photo of the week

"Five children with Burkitt's Lymphoma receive treatment on the ward"

The Burkitt's Program is a partnership between Ola During Children's Hospital and Mercy Ships.

© 2011 Sandra Lako

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.

24,600 km across Africa on a bicycle to support Welbodi

People have gone to great lengths to support our work, but this may well be the lengthiest length yet.

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.

#1 Photo of the week

© 2011 Sandra Lako

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/