Arnua, Osman and Osman come from Gbonkolenken, the area Hon ABD Sesay is representing in parlement. As need arise representing sometimes means assisting practically. So these kids have hernia’s, but their parents can not afford to have them operated. So when their honourable is a medical doctor and he makes the promise to assit, he has to fullfil.
The three of them came to City Garden Clinic a bit shy. All had successful surgery on September 30th.
No more pain and no longer at risk of strangulation!
She was born at home on September 18th, but fortunate for baby Jawara that there was a good midwife, as she was born with spina bifida.
The same day of delivery the midwife took the family to City Garden Clinic (she was advised to come after she had done some inquiry where to take the baby).
The next day she was operated to close the spina bifida.
This operation was successful, but as often happens her head started to increase in size, a sign of hydrocephalus.
So as soon as the first operation had healed, she underwent a second operation on September 26th: placement of a VP shunt. A drain from the head to the abdomen, to drain the excess water from the head to the abdomen, where it can easily be absorbed.
Unfortunately she got fever and signs of infection of the brain on the 6th day. The drain needed to be removed immediately.
With antibiotic she was treated until there was no more fever , but the head started to increase in size again.
So she underwent a third operation to place a new VP shunt again, but now on the other side. After the operation she got fever, but no signs of infection of the brain; she was found to have malaria. As soon as she started on the malaria medicine, the fever was gone. Now she is doing well.
It is time she received her name: Adama Erdi Jawara. Adama after her grandma and Erdi after the doctor that is treating her.
As a hospital based on the Christian Faith it has been a real blessing to have been able to share food to all our in-patients this Christmas.
Many shared it together with their caretakers. All enjoyed a good meal!
For some patients it is hard to be able to have (good) food every day. Especially those that come from far and have no relative in Makeni.
When just coming there is some money, but after staying longer (as their treatment sometimes requires) it starts to be difficult.
Some other patients/caretakers do share with these patients (which always make me respect them more).
But this day all received a good meal and a drink!
On the top floor of City Garden Clinic a conference room was created. The aim of this room is to be able to hold meetings, gatherings (like a Christmas Party) and have better opportunity for teachings at the hospitals and worship service.
The room was there, but the furniture to make it functional was still lacking.
A proposal was send to the ‘Antonius Ontwikkelings Fonds’ via Nynke, our partner and great assistant in diabetes care, in the Netherlands.
The proposal was approved and the local carpenter Idrissa ’Putin’ Sesay and his boys started to work. They made 6 tables and a cupboard.
A whiteboard was bought in Freetown (from a separate donation of Anneke, nurse from the Netherlands).
With very generous discount (via Sande3r from Smarter Hospital and ForEyeT) the beamer was bought in the Netherlands and brought by mr Rudi on his return.
Dr ABD bought 42 chairs in Freetown for a good price thank to his thorough negotiations.
All was well coordinated by the facility manager of City Garden Clinic, mr Rudi.
Regular teachings have started!!
A great THANK YOU to Antonius Ontwikkelings Fonds!
As City Garden starts to treat more orthopeadic cases, more X-ray are being viewed.
An X-ray is normally printed on special X-ray film. There is need for a light from behind to see the structures/bones well.
For months/years we have been using daylight: holding the X-ray up to the sky, with sometimes clouds or trees behind.
As hospitals that are much dependent om donors for equipment and other medical stuff it is important to work together. So when the doctors from Masanga Hospital visited uis and found out we are planning to create a makeshift viewer, they offered to check their store, as they were donated more than they needed themselves, including additional X-ray viewers.
So the next visit to Masanga we came back with the viewer and got it installed in our Out Patient Department. It works very well, it also makes it easier to teach and to consult.
The board of the small NGO from the Netherlands came to visit City Garden Clinic. One of the board members is dr Erdi and since the visit mr Rudi as well. Other board members present were Gert and Sander. Also Gert’s wife Sibel joined the visit.
Previous and still ongoing projects in Yele were visited (like the primary school renovation project and the follow-up by the Teach-The-Teacher project).
But also much time was spent with dr ABD and other people brainstorming about the future of City Garden Clinic. Some great plans were discussed!
Smarter Hospital has committed themselves to support the future of City Garden Clinic on project base
Also the Child Care Center in Makinkisa was visited.
City Garden Clinic is a small private clinic trying to deliver accessible and affordable healthcare with high quality of service, in a country where there is very limited health care. The aim of City Garden Clinic is to improve the living standard of the inhabitants of Makeni and surrounding, in the Northern Province of Sierra Leone. The clinic is working on a cost recovery base, this means the income should keep the clinic running; there is no aim to make profit. Our staff and volunteers have the utmost commitment to quality services and professional health care.
The clinic has an outpatient department, basic laboratory services, ultrasound services and a pharmacy. There is an inpatient capacity of 64 beds. There are two operating theatres. The clinic is open 24/7 for emergencies and during daytime for all medical problems. This has resulted in a positive reputation in surgical care and in a growing number of clients/patients. (However the clinic doesn’t have a maternity at this moment.) The clinic has about 50 staff: 12 clinicians/laboratory staff, 21 nurses, 6 admin staff and 11 support staff (cleaners and security).
The clinic is in a positive growing cycle and is now implementing a variety of projects to further improve the quality and professionalism of the provide health care. One of the project is uniform for all staff. This is essential because of the clients/patients needs to be able to recognize the staff.
As stated the clinic tries to be accessible and affordable, so the prizes are kept as low as possible. Even in some cases clients that can not afford treatment will receive treatment, because the clinic can not send them away. Since uniforms are not directly linked to healthcare, there is no money to buy uniforms.
Therefor we received the kind assistance from Smarter Hospital to City Garden Clinic to provide its staff with new uniforms. To keep things affordable and sustainable, we bought local rolls of good quality cloths and have a local tailor make two uniforms for each staff. All uniforms are decorated with a woven logo of the clinic. More logo’s are ordered, so future new staff can be provided uniforms as well.
We thank Smarter Hospital and its donors vert much for this superb support!
Isatu, a middle aged lady, was brought in to City Garden Clinic one late afternoon. She had been involved in a severe traffic accident with an “Okada”, the typical motor bike taxi in Sierra Leone. She had a broken hip and on the other side the pelvis was broken. She also had a fracture on the right lower arm. X-rays were needed to confirm the initial diagnose and be able to judge the extend of the damage. Since City Garden does not have X-ray facilities she had to go to the Government Hospital in Makeni, some 4 miles away which involved negotiating about 2 miles of bad dirt roads full of potholes and bumps. She was put in the back of a pick-up truck since the hospital does not have an ambulance. Uncomfortable under normal circumstances, excruciatingly painful in her condition.
After her return with the X-rays she was operated on the same evening, pins placed in her legs and put on traction. After three (!) months lying on bed on traction, new X-rays were taken showing that the fractures had healed nicely. Although it was explained to her that it would take a while and lots of practicing before she could walk again properly, Isatu was a bit disappointed that she could not walk straight away after the pins were removed. However, as practicing with the aid of a walking aid progressed she became more happy and in the end she could walk normal again.
Had Isatu gone to the government hospital in Makeni she probably could not have been treated there. Although this hospital is the second line referral hospital for the whole Northern Region with over 2.5 million inhabitants, not always a doctor is available, certainly no “bone-doctor” of which there are only a very few in Sierra Leone. Even simple wrist fractures and the like go untreated or are treated in the wrong way, resulting in a life long disability. Orthopedics in City Garden Clinic certainly make a difference.
It has been a long time since I sent a newsletter. At least for my feeling too long ago. With the end of this year in sight, I thought it would be a good opportunity to hear from me again. Meanwhile the rainy season is over and the dry and dusty season starts again. Especially here in the hospital that is located in a neighborhood with only unpaved roads with a lot of traffic, especially okadas (motorcycle taxis) of which hundreds pass by every day. Within a day everything is covered in a thin layer of red brown dust and after a week the car is not used you can hardly see anything through the windshield. The dry season also means the “burning season” in which all overgrown pieces of land and verges are burned down, as well as farmland on the surrounding hills. Sometimes it gets out of hand and it is not uncommon for a few houses or a whole village to disappear into a fire. On the photo a burning Wussum Hill that we are looking forward to.
In my last newsletter I talked about the visit of a number of board members of the Smarter Hospital Foundation, I am now also a board member of SHF, where one of the goals of this visit was to develop a five year plan for SHF and City. Garden Clinic. We are convinced that we have a good plan for the future and are now fully committed to giving the plan a handle.
Looking back on the past year, I was mainly involved in “logistics”, although the first half of the year was about 60% of my time in the phasing out of Child Care Center in Yele, of which I regularly reported in newsletters during that period. The Care Center is now in full swing and twenty Ebola orphans have found a good home. Mainly logistics this year or to create order in the chaos in two 40-foot containers full of donated stuff, the processing of another forty feet that arrived in the middle of this year and a full and unordered drug warehouse that nobody knew what was in store now and what not. Now at the end of the year everything is reasonably well organized and most of the inventory has been made and a system has been set up to keep track of consumption. For the time being on paper, but now I have started guiding our store keeper, Osman Fofanah, in an Exel program to keep track of the entire stock of administration.
In such an exercise you also regularly encounter items that you think, what do we have to do with this? But there is usually always an alternative use to find which also saves a lot of money because you do not have to buy any other stuff. So I came across a large amount of sets for use in kidney dialysis. As far as I know kidney dialysis does not exist in Sierra Leone, perhaps somewhere in Freetown, and we do not have the equipment here in City Garden. But the tubes of those sets are perfectly suited to make probes for stomach feeding. Special infusion bags for food that we can not use for that purpose because we do not have the necessary pump and other materials. With some other parts of infusion sets that we have in abundance and with catheters of a size that we do not use, Dr Erdi has made rinsing bags to be able to rinse the bladder. This is done with NaCl 0.9% infusion liquid (Normal Saline) which is actually just salt water. But that is expensive and after a prostate operation you need a lot of liters. That can also be done just with boiled water with some kitchen salt in it. If a prostate operation is planned, rinse well-washed rinsing bags with boiled water and then fill with boiled salt water, let it cool down and then it can go to the nursing ward. Our kitchen is therefore regularly what I, as Erdi is doing, always call the salt water factory again.
With this kind of creativity, you can also help patients with a stoma on their way. Recently we had a patient who had to have a large bowel stoma permanently. After the operation had been successful and the patient could be discharged, the question was of course how do you get stoma? We do have a nice stock but not to provide someone lifelong for a while and just get stoma bags here in this country, apart from the costs. A cheap and practical solution: the bottom of a plastic drinking mug or cup cut away, two holes for attaching elastic band and ordinary plastic bags that you can buy anywhere on the market through the cut-open cup and then the “stoma” around your waist fastens over the stoma outlet. See the pictures.
Last year we of course had the necessary medical “ups-and-downs”. Fortunately, not too many downs and many, sometimes surprising, ups or cured patients. The child with the open back and water head of which I had it in a previous newsletter has, although it initially went well, ultimately not saved. On the other hand, for example, quite a few patients with neglected bone fractures or amputations who thought that they would never be able to walk again themselves, who could leave the hospital with or without a prosthesis.
Finally, I wish everyone a Merry Christmas and the best wishes in good health for the New Year.
Last Updated: June 22, 2020 by Andre Schmitz
Political charity hernia’s
The three of them came to City Garden Clinic a bit shy. All had successful surgery on September 30th.
No more pain and no longer at risk of strangulation!
Thank you Hon ABD Sesay!
Last Updated: June 22, 2020 by Andre Schmitz
Baby with spina bifida and hydrocephalus
The same day of delivery the midwife took the family to City Garden Clinic (she was advised to come after she had done some inquiry where to take the baby).
The next day she was operated to close the spina bifida.
So as soon as the first operation had healed, she underwent a second operation on September 26th: placement of a VP shunt. A drain from the head to the abdomen, to drain the excess water from the head to the abdomen, where it can easily be absorbed.
Unfortunately she got fever and signs of infection of the brain on the 6th day. The drain needed to be removed immediately.
With antibiotic she was treated until there was no more fever , but the head started to increase in size again.
Last Updated: June 22, 2020 by Andre Schmitz
Christmas sharing
Many shared it together with their caretakers. All enjoyed a good meal!
For some patients it is hard to be able to have (good) food every day. Especially those that come from far and have no relative in Makeni.
When just coming there is some money, but after staying longer (as their treatment sometimes requires) it starts to be difficult.
Some other patients/caretakers do share with these patients (which always make me respect them more).
But this day all received a good meal and a drink!
MERRY CHRISTMAS!
Last Updated: June 22, 2020 by Andre Schmitz
Conference room set up donated by “Antonius Ontwikkelings Fonds”
The room was there, but the furniture to make it functional was still lacking.
A proposal was send to the ‘Antonius Ontwikkelings Fonds’ via Nynke, our partner and great assistant in diabetes care, in the Netherlands.
A whiteboard was bought in Freetown (from a separate donation of Anneke, nurse from the Netherlands).
With very generous discount (via Sande3r from Smarter Hospital and ForEyeT) the beamer was bought in the Netherlands and brought by mr Rudi on his return.
Dr ABD bought 42 chairs in Freetown for a good price thank to his thorough negotiations.
Regular teachings have started!!
A great THANK YOU to Antonius Ontwikkelings Fonds!
Last Updated: June 22, 2020 by Andre Schmitz
X-ray viewer from Masanga
An X-ray is normally printed on special X-ray film. There is need for a light from behind to see the structures/bones well.
For months/years we have been using daylight: holding the X-ray up to the sky, with sometimes clouds or trees behind.
As hospitals that are much dependent om donors for equipment and other medical stuff it is important to work together. So when the doctors from Masanga Hospital visited uis and found out we are planning to create a makeshift viewer, they offered to check their store, as they were donated more than they needed themselves, including additional X-ray viewers.
So the next visit to Masanga we came back with the viewer and got it installed in our Out Patient Department. It works very well, it also makes it easier to teach and to consult.
THANK YOU VERY MUCH MASANGA!!
Last Updated: June 22, 2020 by Andre Schmitz
Visit of Smarter Hospital
Previous and still ongoing projects in Yele were visited (like the primary school renovation project and the follow-up by the Teach-The-Teacher project).
But also much time was spent with dr ABD and other people brainstorming about the future of City Garden Clinic. Some great plans were discussed!
Also the Child Care Center in Makinkisa was visited.
A new partnership has started……
Last Updated: June 22, 2020 by Andre Schmitz
Dr Abdul Sesay returns from Ukraine
Many happy and proud family members and co-workers from City Garden Clinic were awaiting him.
City Garden Clinic is proud to have him back in Sierra Leone. While awaiting to be posted he joins the work at City Garden Clinic.
We hope the houseman ship program for 2 years he has to do in Sierra Leone will go smooth and fast, so he will fully join City Garden Clinic.
Last Updated: June 22, 2020 by Andre Schmitz
New uniforms for the City Garden Clinic
City Garden Clinic is a small private clinic trying to deliver accessible and affordable healthcare with high quality of service, in a country where there is very limited health care. The aim of City Garden Clinic is to improve the living standard of the inhabitants of Makeni and surrounding, in the Northern Province of Sierra Leone. The clinic is working on a cost recovery base, this means the income should keep the clinic running; there is no aim to make profit. Our staff and volunteers have the utmost commitment to quality services and professional health care.
The clinic has an outpatient department, basic laboratory services, ultrasound services and a pharmacy. There is an inpatient capacity of 64 beds. There are two operating theatres. The clinic is open 24/7 for emergencies and during daytime for all medical problems. This has resulted in a positive reputation in surgical care and in a growing number of clients/patients. (However the clinic doesn’t have a maternity at this moment.) The clinic has about 50 staff: 12 clinicians/laboratory staff, 21 nurses, 6 admin staff and 11 support staff (cleaners and security).
The clinic is in a positive growing cycle and is now implementing a variety of projects to further improve the quality and professionalism of the provide health care. One of the project is uniform for all staff. This is essential because of the clients/patients needs to be able to recognize the staff.
As stated the clinic tries to be accessible and affordable, so the prizes are kept as low as possible. Even in some cases clients that can not afford treatment will receive treatment, because the clinic can not send them away. Since uniforms are not directly linked to healthcare, there is no money to buy uniforms.
Therefor we received the kind assistance from Smarter Hospital to City Garden Clinic to provide its staff with new uniforms. To keep things affordable and sustainable, we bought local rolls of good quality cloths and have a local tailor make two uniforms for each staff. All uniforms are decorated with a woven logo of the clinic. More logo’s are ordered, so future new staff can be provided uniforms as well.
We thank Smarter Hospital and its donors vert much for this superb support!
Last Updated: June 22, 2020 by Gert Kroon
The Story Of Isatu
THE STORY OF ISATU
Last Updated: June 22, 2020 by Gert Kroon
News Letter Ruurd December 2018
Dear people,
It has been a long time since I sent a newsletter. At least for my feeling too long ago. With the end of this year in sight, I thought it would be a good opportunity to hear from me again.
Meanwhile the rainy season is over and the dry and dusty season starts again. Especially here in the hospital that is located in a neighborhood with only unpaved roads with a lot of traffic, especially okadas (motorcycle taxis) of which hundreds pass by every day. Within a day everything is covered in a thin layer of red brown dust and after a week the car is not used you can hardly see anything through the windshield. The dry season also means the “burning season” in which all overgrown pieces of land and verges are burned down, as well as farmland on the surrounding hills. Sometimes it gets out of hand and it is not uncommon for a few houses or a whole village to disappear into a fire. On the photo a burning Wussum Hill that we are looking forward to.
In my last newsletter I talked about the visit of a number of board members of the Smarter Hospital Foundation, I am now also a board member of SHF, where one of the goals of this visit was to develop a five year plan for SHF and City. Garden Clinic. We are convinced that we have a good plan for the future and are now fully committed to giving the plan a handle.
Looking back on the past year, I was mainly involved in “logistics”, although the first half of the year was about 60% of my time in the phasing out of Child Care Center in Yele, of which I regularly reported in newsletters during that period. The Care Center is now in full swing and twenty Ebola orphans have found a good home.
Mainly logistics this year or to create order in the chaos in two 40-foot containers full of donated stuff, the processing of another forty feet that arrived in the middle of this year and a full and unordered drug warehouse that nobody knew what was in store now and what not. Now at the end of the year everything is reasonably well organized and most of the inventory has been made and a system has been set up to keep track of consumption. For the time being on paper, but now I have started guiding our store keeper, Osman Fofanah, in an Exel program to keep track of the entire stock of administration.
In such an exercise you also regularly encounter items that you think, what do we have to do with this? But there is usually always an alternative use to find which also saves a lot of money because you do not have to buy any other stuff. So I came across a large amount of sets for use in kidney dialysis. As far as I know kidney dialysis does not exist in Sierra Leone, perhaps somewhere in Freetown, and we do not have the equipment here in City Garden. But the tubes of those sets are perfectly suited to make probes for stomach feeding. Special infusion bags for food that we can not use for that purpose because we do not have the necessary pump and other materials. With some other parts of infusion sets that we have in abundance and with catheters of a size that we do not use, Dr Erdi has made rinsing bags to be able to rinse the bladder. This is done with NaCl 0.9% infusion liquid (Normal Saline) which is actually just salt water. But that is expensive and after a prostate operation you need a lot of liters. That can also be done just with boiled water with some kitchen salt in it. If a prostate operation is planned, rinse well-washed rinsing bags with boiled water and then fill with boiled salt water, let it cool down and then it can go to the nursing ward. Our kitchen is therefore regularly what I, as Erdi is doing, always call the salt water factory again.
With this kind of creativity, you can also help patients with a stoma on their way. Recently we had a patient who had to have a large bowel stoma permanently. After the operation had been successful and the patient could be discharged, the question was of course how do you get stoma? We do have a nice stock but not to provide someone lifelong for a while and just get stoma bags here in this country, apart from the costs. A cheap and practical solution: the bottom of a plastic drinking mug or cup cut away, two holes for attaching elastic band and ordinary plastic bags that you can buy anywhere on the market through the cut-open cup and then the “stoma” around your waist fastens over the stoma outlet. See the pictures.
Last year we of course had the necessary medical “ups-and-downs”. Fortunately, not too many downs and many, sometimes surprising, ups or cured patients. The child with the open back and water head of which I had it in a previous newsletter has, although it initially went well, ultimately not saved. On the other hand, for example, quite a few patients with neglected bone fractures or amputations who thought that they would never be able to walk again themselves, who could leave the hospital with or without a prosthesis.
Finally, I wish everyone a Merry Christmas and the best wishes in good health for the New Year.
Until a next newsletter
Ruurd