When I came over to Sierra Leone I came armed with lots of First Aid supplies to use to train the Foundation volunteers and league members. What I didn’t expect was to be heading down to the school a couple of days after my arrival armed with a box of gloves, some plasters, some dressings and some of my own antiseptic cream!
It’s here at the school that I learnt my first lesson about the differences in the way of life in Africa.
When we arrived we were greeted by one of the teachers ‘Uncle Sammy’ He’s a friendly smiley man who seemed very pleased to see us. We introduced ourselves to the children and then I sat down to enjoy the lesson. I was astonished to be completely honest. These kids are smart and eager to learn. There is a genuine willingness in class to participate and answer questions - something you don’t see very often in lessons back home.
After the science lesson (plant reproduction - I even learnt a thing or two!) the physio from the academy read the kids a story. Every opportunity is taken to ensure these kids are learning so throughout the story key words were highlighted and written on the board. At the end of the story the meaning of the words were discussed and the kids were given some time to familiarise themselves with the new words. The words were then wiped from the board and the kids were given the words again verbally and asked to write them down as a spelling test.
Next up was my turn.. the kids were asked to come and show me if they had any cuts or scrapes to see if there was anything I could do. There was a stampede and within seconds I was surrounded by the majority of the class! I was expecting minor grazes and bruises, normal kid stuff. What I didn’t expect was the injuries the kids were to show me.
Before I go into any more detail its worthwhile mentioning the landscape over there. The ground is mainly brown dirt with chunks of gravel littered around. May is the end of the dry season so there is very little greenery, certainly no grass for the children to play on.
So whilst I got cuts and scrapes these were cuts and scrapes like I’ve never seen before. Rocks tear chunks out the childrens limbs as they play footbal and run around on the rough ground, shoes far too big or too small form blisters that turn into sores, the slightest cut turns nasty over here. Infection was common and the wounds do not seem to heal easily. The humidity is stupidly high at this time of year so unattended wounds stay open and sore, oozing and open to the flies. In an area of the world where infection control is minimal at best I probably shouldn’t have been so shocked.
Luckily most of the kids required a bit of cleaning up and a plaster to keep the worst of the dirt off. Over several visits though there were a few that required a bit more intervention.
I must stress that back home neither myself or the physio would ever treat any of these injuries. A referral to a GP or hospital would be made but you just don’t have those options out there, you have to make the best of what you have and for these kids the best we had to offer was us and our limited supplies.
One girl had an extremely large boil on her elbow. Although only a tiny head could be seen her arm was hot to the touch and swollen. Luckily the physio had some disposable scapels so he got to work. The trick with a boil is to ensure none of the infection remains behind. If you don’t completely clear the pus the boil will reform. Now I didn’t think I was particularly squeamish, I love horror films and have to see a lot of gruesome videos etc for my training but this was definitely different. My stomach was churning but I managed to hold it together whilst we drained the infection. Over here a local anaesthetic is given, out there we had nothing to offer so the poor girl had to grin and bear it.
The second girl had been running around and tripped and stubbed her toe on a rock. She’d managed to take her big toe nail clean off. Not necessarily a big deal, until I mention that this had happened several days ago and the toe was completely filthy! Back at the academy we were able to clean it off properly and apply an iodine dressing to get rid of any bugs!
The third girl was definitely the worst I’ve seen over there. Her ill-fitting hand me down shoes had given her a blister on the back of her foot. Not too bad you say, well she has no other shoes and has to wear these shoes to school every day. Without a plaster to protect it the blister had turned into a raging sore. We dressed it as best we could with some antiseptic cream but not convinced we asked her to come up to the academy for us to check the wound in two days time. When she arrived and I took the bandage off the smell was horrific, I mean really bad! Hot humid climates are terrible for wounds, whether covered or not. Usually the best option is to keep the wound uncovered or regularly change the dressings, clearly thats not really practical out there. The only thing we could try and do was cut away the dead tissue and give the area a thorough clean. The poor girl was petrified but we managed to calm her down and get it cleaned up. She left with some antibiotics to get rid of any residual infection and a big smile on her face.
Following my return to the UK I’ve had some updates about these girls. The boil never returned, the toe is completely fine with the nail looking like it may return and the girl with the sore has made a complete recovery, although she still wears the same ill fitting shoes.
When I think about it it makes me very angry that the very basics of first aid care is unavailable to these kids and their families. Clinics are far away and unaffordable. For the sake of plasters and antiseptic cream most infections could be avoided.
