So its now December and I've been back in the UK for about a week now and it still feels very strange to me. I've missed the end of summer, autumn has passed me by completely and without the run up to Christmas I am struggling to get excited now I am back. If we had some snow I think I would be better prepared but the wet, cold, windy and miserable weather is just annoying.
I'll try and write about two things that stand out the most from my first term to give you an idea of what I have been up to over the last few months but I'm sure I will probably forget something else important so I may do another recap at a later date.
Dentist Day
My first term out in Sierra Leone was pretty eventful to be honest. The first major event has got to be the dentists day held at the Academy. This in itself would have been pretty hectic but when you add a medical emergency it becomes pretty terrifying, particularly for someone new to the country with very limited knowledge of local hospitals or medical centres!
6 Dentists and 6 Dental assistants came to the Academy from the Smiling World Foundation to treat the CBF boys and then look at as many school children from Tombo as we could possibly fit in. I'd had a busy week or so organising for 10 different schools to come for time slots and then the afternoon was for for the adults.
It was very difficult to organise but worthwhile as the majority of children seen by the dentists had some form of dental problem and the dentists were very busy fixing peoples teeth. The staff had to 'man up' a bit when it came to the CBF boys being treated as we knew that most of the younger second generation had not ever seen a dentist before and would definitely need treatment. As they have only been with the Academy for one term they weren't around when the dentist came to visit last time. Some of our boys had as many as 6 teeth removed as the damage was too extensive to fix!
The school children from Tombo were pretty vocal about their treatment but we had to keep reminding ourselves that they had all received numbing injections so it wasn't pain they were crying about, the dentists said the kids tend to confuse the pressure feeling with pain and panic thinking its about to hurt.
All was going swimmingly and our older boys in particular were doing a fantastic job of helping the dentists and making sure everything ran well and then a 15 year old girl decided to have a appendicitis on me! She had been treated by the dentist and had mentioned some small abdominal pain. We had already confirmed that we were unable to provide any medical help other than the dentistry that day else we would have been overrun with people needing assistance that I'm just not qualified to give, or able to cope with in such high numbers. Whilst the girl was waiting outside for the rest of her classmates to be finished she collapsed on the ground. After some questioning I guessed we were looking at something like appendicitis or pregnancy complications so sent for her mother stressing that she was in an extremely bad way and needed transport to the hospital and that it couldn't wait.
Waiting for someone to arrive seemed to take forever. We had managed to move her into one of the classrooms to keep her away from the others, for her privacy and so that she didn't terrify any of the other children that were waiting outside. The last thing we needed was for the smaller children to think it was seeing the dentist that had caused her so much pain. I tried to keep her calm but her deteriorating level of consciousness was a huge concern for me. We gave her as much pain relief as we had access to but I must confess that was extremely limited. A few of our boys stayed with me fetching me things and making sure no one else came into the room and I cannot thank them enough for that.
Eventually I was told someone had come for her and I went to speak with them away from Fatima but was met by an Ocada driver - her mother wasn't around and her aunt had sent a bike taxi to collect her! I was furious! There was absolutely no way this poor girl could get on a bike as she was literally writhing in agony in my lap at this point screaming that she was going to die so the Dentist allowed us the use of her vehicle and we collected her auntie and headed to the nearest hospital - an hour away!
Throughout the beginning of the drive Fatima cried and pleaded saying she was going to die and there was no one to save her. I managed to find out from her auntie that she had been to see a doctor several times over the last few years suffering from abdominal pain and her family had been told she required an operation to remove her appendix. The issue with this is that there is no public healthcare in Sierra Leone like there is in the UK and with her father and brothers and sisters dead and an elderly mother, Fatima does not have the money needed for the operation. Whilst she was making a lot of noise I wasn't too concerned, anyone will tell you that if someone is shouting and writhing around they are usually fairly ok but its when they start to go quiet and stop moving around that you start to panic. Unfortunately this is exactly what she did, most likely passing out from the pain but it was getting harder to rouse her which was definitely worrying.
Upon arrival at the hospital we were seen right away by one of the doctors who confirmed that he suspected I was correct and her appendix had likely burst or was beginning to burst, meaning she required an operation right away to remove the appendix and clear out any infection in the area (I won't go into all the gory details) She was given fluids and strong painkillers and had started to come to before I left, which was a bit reassuring. As I left the doctors were starting to stabilise her to get her ready for the operation that we all thought was coming.
Knowing her family did not have the money needed for the operation it was extremely difficult for me to leave her and her auntie at the hospital. At least I knew they had given her some drugs for free that were improving her condition. As I left Fatima was crying out 'please don't leave me, if you leave me, I will surely die, I just won't make it' Unfortunately there was nothing else I could do at that stage. I could not personally pay for her operation, despite what I may have wanted to do. It would not be right for me to associate the Academy with that kind of medical help and assistance as its not something they would be able to provide on a regular basis and I could not afford to pay for it personally unless I intended on paying for medical help for every one that heard about the incident and decided to come up to the Academy gates, or be prepared to turn everyone away.
That night was heartbreaking. The hospital phoned on a regular basis to let me know that the family had not yet come up with the money for the operation but that they were managing to keep her fairly stable, I think they were hoping I would offer to pay, so at least I knew she had made it so far but I really had prepared myself to hear that she had passed away. Luckily I have since found out that her family managed to travel to Freetown and collect enough from estranged family members and friends to pay for the operation and she has now returned to school, minus her appendix! I hope to visit with her next term and find out how she is doing.
Malaria
Several of the boys have been treated by me for malaria this term but I didn't expect to need treatment myself. When the boys are sick with malaria they don't seem to be too poorly but I guess this is because they are a lot more used to it than I am.
It started with a headache on a Wednesday night but I wasn't too concerned as I had no other symptoms and generally felt pretty well. Even when I woke up feeling poorly on thursday morning I didn't think much of it and spent the morning in bed relaxing. I attempted to go to the beach in the afternoon for a change of scenery but ended up sleeping under a towel on a sun lounger in the shade so it was a bit of a wasted journey! By the evening I was feeling better so spent Friday taking it easy but I managed to eat normally all day and could control my slight temperature easily with paracetamol.
I must mention that I take Doxycycline daily as a preventative measure for malaria so I would never have thought it could possibly be serious at all. I had taken several malaria tests over the last few days just to be on the safe side and each was negative so I was fully expecting to wake up on Saturday morning feeling fresh as a daisy and ready to watch the boys play the game.
What actually happened was me waking up at about 6am with an excruciating headache that literally made me burst into tears! I managed to take some paracetamol and get back to sleep but I have never felt pain like it and unfortunately it was still there when I woke back up. Everyone was down at the pitch watching the match so I felt particularly miserable lying in my apartment by myself sobbing at the pain and panicking thinking about what could be wrong. I still didn't suspect malaria and was wondering if I had picked up some sort of virus and unsure what to do. I finally made the decision that something clearly wasn't right and I needed to go to hospital. We had to wait for the vehicle to return from Freetown where it was dropping the opposition team back home so we didn't get to leave until late afternoon/early evening. By this point I was completely beside myself. Being in pain all day like that is exhausting.
I don't remember too much about the drive in to Freetown other than me screaming because it hurt so much and feeling like I was going to throw up at every turn. The headache had gone beyond a headache by this point and it felt like my head was about to explode or that someone had stuck a knife between my eyes. I'm sure anyone that suffers from migraines will say thats how they feel on a regular basis and if thats the case then you have my sincerest sympathy as it was a complete nightmare for me, I genuinely thought something really bad was going to happen to me.
What I do remember was the arrival at the hospital (at about 9.30pm!) and being rushed through into an emergency room and the nurses attempting to put a canula in. I say attempting because thats what it was, several attempts in fact. Luckily with new needles each time as they also repeatedly dropped the needle or placed in on the bed. Thank god for Tom arguing over cleanliness and insisting on new needles!
The difficulty may have been because the nurses weren't very good at the procedure but more likely to do with the fact that I have tiny veins, always have, made even tinier by the severe dehydration I was suffering from as I was later informed. Having had IV painkillers before and knowing how much more effective they really are, I was, perhaps understandably, increasingly frustrated with the attempts to place a canula and they eventually called for an Intensive Care nurse or doctor to come and do it. I can only assume this was because the Intensive Care staff will be a lot more used to putting canulas in in difficult situations and more likely to actually be able to get it in a vein.
By now the word Malaria was popping up several times and I think they even started treating me for malaria despite us telling them I had tested negative several times. It was pretty lucky they did though as the following day my blood tests results came back in and it was confirmed to be Malaria. The doctor stated the levels were so high that I must have had it for about 3 weeks before I had been admitted (which made me feel slightly better about making such a fuss the day before) so had been very poorly when I had been brought in. The malaria treatment itself is pretty quick and I was discharged three days later with a further course antimalarials and some antibiotics for the kidney damage the malaria had inflicted. Language barriers can be an issue here, particularly with the medical side of things I am rapidly learning so my discharge notes confirm I have malaria and peptic ulcer disease.. you learn something new every day! I suspect this is on there either because of the kidney pain and damage or maybe even to do with the fact that when asked I stated my stomach was very painful from wrenching all the time! Never mind!
The IV malaria's worked a treat and my headache disappeared but I was left with what felt like those Chinese relaxation balls in my lower back - swollen kidneys most likely and a fair amount of pain. Not much fun to be honest and I was pretty much cursing Africa at this point!
For the duration of my hospital stay I spent most of the time asleep but the times I were awake I was kept highly entertained by the antics of Tom and the nursing staff. The nurses decided they didn't need to bother coming back in to check on my IV as they knew as soon as it was finished Tom would be straight at the nurses desk asking her to take it off. He also caused great amusement by moving the room around so I could watch TV on the one afternoon I actually felt well enough to. When I left the nurses said they would miss me but I think they actually meant they were sorry to see Tom leave!
Frustratingly enough two weeks later the headache returned and I started to feel very unwell again so I had another course of anti malarial tablets which seemed to do the trick - anything to tide me over until I got home was a bonus!
Even now I still don't feel right at all, I am constantly tired and need to lie down regularly. Headaches are a common occurrence for me at the minute, as are dizzy spells. I've been checked over and a malaria test was negative so its a case of wait and see what happens really. Hopefully it will just take me some time to recover and then I will get back to normal but we will see!
A lot of people have asked if it has put me off living in Africa at all and my answer is no. Whilst I was very scared at the time it was a fear of the unknown that bothered me more than anything. I know now what it can feel like to have malaria so it wouldn't scare me in the future. Likewise I was always terrified of needing hospital treatment over there and now I know its not as bad as I imagined - after all I'm still here so they obviously did something right.Things can happen anywhere and yes I am exposed to a lot more dangerous things in Sierra Leone I am also around a lot more things that make me happy there and surely that far outweighs the risks of anything bad.
I'll try and write about two things that stand out the most from my first term to give you an idea of what I have been up to over the last few months but I'm sure I will probably forget something else important so I may do another recap at a later date.
Dentist Day
My first term out in Sierra Leone was pretty eventful to be honest. The first major event has got to be the dentists day held at the Academy. This in itself would have been pretty hectic but when you add a medical emergency it becomes pretty terrifying, particularly for someone new to the country with very limited knowledge of local hospitals or medical centres!
6 Dentists and 6 Dental assistants came to the Academy from the Smiling World Foundation to treat the CBF boys and then look at as many school children from Tombo as we could possibly fit in. I'd had a busy week or so organising for 10 different schools to come for time slots and then the afternoon was for for the adults.
It was very difficult to organise but worthwhile as the majority of children seen by the dentists had some form of dental problem and the dentists were very busy fixing peoples teeth. The staff had to 'man up' a bit when it came to the CBF boys being treated as we knew that most of the younger second generation had not ever seen a dentist before and would definitely need treatment. As they have only been with the Academy for one term they weren't around when the dentist came to visit last time. Some of our boys had as many as 6 teeth removed as the damage was too extensive to fix!
The school children from Tombo were pretty vocal about their treatment but we had to keep reminding ourselves that they had all received numbing injections so it wasn't pain they were crying about, the dentists said the kids tend to confuse the pressure feeling with pain and panic thinking its about to hurt.
All was going swimmingly and our older boys in particular were doing a fantastic job of helping the dentists and making sure everything ran well and then a 15 year old girl decided to have a appendicitis on me! She had been treated by the dentist and had mentioned some small abdominal pain. We had already confirmed that we were unable to provide any medical help other than the dentistry that day else we would have been overrun with people needing assistance that I'm just not qualified to give, or able to cope with in such high numbers. Whilst the girl was waiting outside for the rest of her classmates to be finished she collapsed on the ground. After some questioning I guessed we were looking at something like appendicitis or pregnancy complications so sent for her mother stressing that she was in an extremely bad way and needed transport to the hospital and that it couldn't wait.
Waiting for someone to arrive seemed to take forever. We had managed to move her into one of the classrooms to keep her away from the others, for her privacy and so that she didn't terrify any of the other children that were waiting outside. The last thing we needed was for the smaller children to think it was seeing the dentist that had caused her so much pain. I tried to keep her calm but her deteriorating level of consciousness was a huge concern for me. We gave her as much pain relief as we had access to but I must confess that was extremely limited. A few of our boys stayed with me fetching me things and making sure no one else came into the room and I cannot thank them enough for that.
Eventually I was told someone had come for her and I went to speak with them away from Fatima but was met by an Ocada driver - her mother wasn't around and her aunt had sent a bike taxi to collect her! I was furious! There was absolutely no way this poor girl could get on a bike as she was literally writhing in agony in my lap at this point screaming that she was going to die so the Dentist allowed us the use of her vehicle and we collected her auntie and headed to the nearest hospital - an hour away!
Throughout the beginning of the drive Fatima cried and pleaded saying she was going to die and there was no one to save her. I managed to find out from her auntie that she had been to see a doctor several times over the last few years suffering from abdominal pain and her family had been told she required an operation to remove her appendix. The issue with this is that there is no public healthcare in Sierra Leone like there is in the UK and with her father and brothers and sisters dead and an elderly mother, Fatima does not have the money needed for the operation. Whilst she was making a lot of noise I wasn't too concerned, anyone will tell you that if someone is shouting and writhing around they are usually fairly ok but its when they start to go quiet and stop moving around that you start to panic. Unfortunately this is exactly what she did, most likely passing out from the pain but it was getting harder to rouse her which was definitely worrying.
Upon arrival at the hospital we were seen right away by one of the doctors who confirmed that he suspected I was correct and her appendix had likely burst or was beginning to burst, meaning she required an operation right away to remove the appendix and clear out any infection in the area (I won't go into all the gory details) She was given fluids and strong painkillers and had started to come to before I left, which was a bit reassuring. As I left the doctors were starting to stabilise her to get her ready for the operation that we all thought was coming.
Knowing her family did not have the money needed for the operation it was extremely difficult for me to leave her and her auntie at the hospital. At least I knew they had given her some drugs for free that were improving her condition. As I left Fatima was crying out 'please don't leave me, if you leave me, I will surely die, I just won't make it' Unfortunately there was nothing else I could do at that stage. I could not personally pay for her operation, despite what I may have wanted to do. It would not be right for me to associate the Academy with that kind of medical help and assistance as its not something they would be able to provide on a regular basis and I could not afford to pay for it personally unless I intended on paying for medical help for every one that heard about the incident and decided to come up to the Academy gates, or be prepared to turn everyone away.
That night was heartbreaking. The hospital phoned on a regular basis to let me know that the family had not yet come up with the money for the operation but that they were managing to keep her fairly stable, I think they were hoping I would offer to pay, so at least I knew she had made it so far but I really had prepared myself to hear that she had passed away. Luckily I have since found out that her family managed to travel to Freetown and collect enough from estranged family members and friends to pay for the operation and she has now returned to school, minus her appendix! I hope to visit with her next term and find out how she is doing.
Malaria
Several of the boys have been treated by me for malaria this term but I didn't expect to need treatment myself. When the boys are sick with malaria they don't seem to be too poorly but I guess this is because they are a lot more used to it than I am.
It started with a headache on a Wednesday night but I wasn't too concerned as I had no other symptoms and generally felt pretty well. Even when I woke up feeling poorly on thursday morning I didn't think much of it and spent the morning in bed relaxing. I attempted to go to the beach in the afternoon for a change of scenery but ended up sleeping under a towel on a sun lounger in the shade so it was a bit of a wasted journey! By the evening I was feeling better so spent Friday taking it easy but I managed to eat normally all day and could control my slight temperature easily with paracetamol.
I must mention that I take Doxycycline daily as a preventative measure for malaria so I would never have thought it could possibly be serious at all. I had taken several malaria tests over the last few days just to be on the safe side and each was negative so I was fully expecting to wake up on Saturday morning feeling fresh as a daisy and ready to watch the boys play the game.
What actually happened was me waking up at about 6am with an excruciating headache that literally made me burst into tears! I managed to take some paracetamol and get back to sleep but I have never felt pain like it and unfortunately it was still there when I woke back up. Everyone was down at the pitch watching the match so I felt particularly miserable lying in my apartment by myself sobbing at the pain and panicking thinking about what could be wrong. I still didn't suspect malaria and was wondering if I had picked up some sort of virus and unsure what to do. I finally made the decision that something clearly wasn't right and I needed to go to hospital. We had to wait for the vehicle to return from Freetown where it was dropping the opposition team back home so we didn't get to leave until late afternoon/early evening. By this point I was completely beside myself. Being in pain all day like that is exhausting.
I don't remember too much about the drive in to Freetown other than me screaming because it hurt so much and feeling like I was going to throw up at every turn. The headache had gone beyond a headache by this point and it felt like my head was about to explode or that someone had stuck a knife between my eyes. I'm sure anyone that suffers from migraines will say thats how they feel on a regular basis and if thats the case then you have my sincerest sympathy as it was a complete nightmare for me, I genuinely thought something really bad was going to happen to me.
What I do remember was the arrival at the hospital (at about 9.30pm!) and being rushed through into an emergency room and the nurses attempting to put a canula in. I say attempting because thats what it was, several attempts in fact. Luckily with new needles each time as they also repeatedly dropped the needle or placed in on the bed. Thank god for Tom arguing over cleanliness and insisting on new needles!
The difficulty may have been because the nurses weren't very good at the procedure but more likely to do with the fact that I have tiny veins, always have, made even tinier by the severe dehydration I was suffering from as I was later informed. Having had IV painkillers before and knowing how much more effective they really are, I was, perhaps understandably, increasingly frustrated with the attempts to place a canula and they eventually called for an Intensive Care nurse or doctor to come and do it. I can only assume this was because the Intensive Care staff will be a lot more used to putting canulas in in difficult situations and more likely to actually be able to get it in a vein.
By now the word Malaria was popping up several times and I think they even started treating me for malaria despite us telling them I had tested negative several times. It was pretty lucky they did though as the following day my blood tests results came back in and it was confirmed to be Malaria. The doctor stated the levels were so high that I must have had it for about 3 weeks before I had been admitted (which made me feel slightly better about making such a fuss the day before) so had been very poorly when I had been brought in. The malaria treatment itself is pretty quick and I was discharged three days later with a further course antimalarials and some antibiotics for the kidney damage the malaria had inflicted. Language barriers can be an issue here, particularly with the medical side of things I am rapidly learning so my discharge notes confirm I have malaria and peptic ulcer disease.. you learn something new every day! I suspect this is on there either because of the kidney pain and damage or maybe even to do with the fact that when asked I stated my stomach was very painful from wrenching all the time! Never mind!
The IV malaria's worked a treat and my headache disappeared but I was left with what felt like those Chinese relaxation balls in my lower back - swollen kidneys most likely and a fair amount of pain. Not much fun to be honest and I was pretty much cursing Africa at this point!
For the duration of my hospital stay I spent most of the time asleep but the times I were awake I was kept highly entertained by the antics of Tom and the nursing staff. The nurses decided they didn't need to bother coming back in to check on my IV as they knew as soon as it was finished Tom would be straight at the nurses desk asking her to take it off. He also caused great amusement by moving the room around so I could watch TV on the one afternoon I actually felt well enough to. When I left the nurses said they would miss me but I think they actually meant they were sorry to see Tom leave!
Frustratingly enough two weeks later the headache returned and I started to feel very unwell again so I had another course of anti malarial tablets which seemed to do the trick - anything to tide me over until I got home was a bonus!
Even now I still don't feel right at all, I am constantly tired and need to lie down regularly. Headaches are a common occurrence for me at the minute, as are dizzy spells. I've been checked over and a malaria test was negative so its a case of wait and see what happens really. Hopefully it will just take me some time to recover and then I will get back to normal but we will see!
A lot of people have asked if it has put me off living in Africa at all and my answer is no. Whilst I was very scared at the time it was a fear of the unknown that bothered me more than anything. I know now what it can feel like to have malaria so it wouldn't scare me in the future. Likewise I was always terrified of needing hospital treatment over there and now I know its not as bad as I imagined - after all I'm still here so they obviously did something right.Things can happen anywhere and yes I am exposed to a lot more dangerous things in Sierra Leone I am also around a lot more things that make me happy there and surely that far outweighs the risks of anything bad.
