Saturday, January 5, 2008

A Source of Medical Care Located

While sitting in an Internet cafe near my house on Christmas Eve, I met an Australian doctor who had driven here in his 25-year-old Toyota Land Cruiser from India (after shipping it there from Australia). It took him a few years in which he often stopped for several months in one place to work before moving on. He said he planned to continue making his way around the perimeter of Africa over the next few years, but that he intended to stay in Sierra Leone for a while. He said he thought it was an exciting place at the moment (I imagine he was referring to the country-wide efforts to recover from the civil war) and that he wanted to work at a local hospital. He had even identified one in Goderich, not far from where the Goderich Waldorf School is. It is called Emergency Hospital and is run by an Italian NGO called Emergency that provides medical services among other things to civilians affected by war. After I told him a little about our school and the medical issues we have been facing, he suggested I go visit the hospital because he knew they were due to receive a pediatrician soon.

That was over a week ago, and I finally visited the hospital the day before yesterday. It is about a thirty-minute walk from school along dusty roads that are at the moment being prepared for paving, so I was relieved to step inside the hospital compound where the air was relatively dust-free.

Inside the compound the walls are whitewashed, with the red accents of the Emergency trademark. Lovely flower gardens are planted in between the one-storey concrete buildings that house the various wards, an operating room, a kitchen, a classroom, and offices for the staff, both international and local.

When I entered I asked at the reception booth just to see about making an appointment with an administrator, but was promptly introduced to one of the office staff, an Italian man who in turn introduced me to an Australian nurse who gave me a full tour of the hospital. Only five minutes into the tour, she told me that they provide free medical care to all patients under fourteen in addition to free surgical care for all patients. I asked if that included medication, holding my breath already because I could hardly believe it could be true, and she matter-of-factly replied, "Yes, but please do not think we can give your students any special treatment. We have many children here every day and cannot put your children ahead of the others in line...." I had already stopped listening and begun waving my hands so she would stop and I could tell her that the sheer availability of free and reliable medical care was an incredible boon for our school and that we would have no trouble behaving ourselves when bringing students there.

I went on to tell her that we had been using the local Arab clinic, and she nodded in understanding when I expressed my reservations about the quality of the care. Although the nominal charge for consultation made the clinic very appealing to the school, the consultations never lasted for more than a few minutes, and the diagnoses were always malaria and typhoid without so much as a blood test to verify. The patients were then given a prescription for about nine different medications to be filled at the pharmacy, where a charge of about fifteen dollars for a bag full of medicine was the norm with every student we took there. There were no directions or cautions printed on any of the medicine wrappers, but given that most of the parents are illiterate, that was not likely to have made much difference. It was the speed with which the medicine was handed over and the patient sent off that always left me somewhat concerned. There was no follow up by the doctor, and I myself was left in the dark by the pharmacist's rapid-fire approach to explaining in Krio how to dose the patient with each of the medicines. I have to say, however, that despite my reservations, all of the students we took there have returned to school looking and feeling better within a few days. The nurse at Emergency looked at me skeptically when I told her this last bit and said they were always treating people who had been seen at the Arab Clinic and not treated properly.

In the end, it is really a wonderful development for the school, and I cannot wait to report it to the faculty on Monday. I have also been given some leads on funding for a school feeding program through the World Food Programme and an organization that might be able to treat a boy in Class VI who has cataracts in both eyes. When things happen in this way, I feel very fortunate to be here.

A Postscript:
I have been making rather snide remarks about the reliability of the Sierra Leone Post Office while waiting for a few packages sent from the U.S. in early November to arrive here. I had made all sorts of speculations about postal workers not being paid (which is true, it turns out) and therefore giving into the temptation to open and loot packages from abroad, which in my case, at least, was not true. Yesterday I traveled alone for the first time into downtown Freetown to make a last-ditch effort to locate the packages, the contents of which I assumed were already scattered throughout the markets of Freetown.

When I arrived inside the dark hall of the Post Office, I was quickly directed by several very helpful people to the Customs Office, where three more very accommodating gentlemen located the records for the receipt of each of the packages, reissued package slips for me, found my packages in the storage room, rushed me through the customs procedure, carried my packages down to the street, hailed a taxi for me, and even helped me haggle with the driver over the fare to my compound gate. I was nearly breathless with gratitude and exhilaration at receiving the packages, but felt terrible guilty about all of the disrespectful things I had said about Sierra Leonean postal workers. I nearly apologized in the Customs Office, but I was never at any point in the whole process very clear about what was happening, and I did not want to upset anyone before the packages had arrived. After they arrived I was whisked so quickly out of the building and into a taxi that I had no time to make my confession.

It seems I am still learning that there is a great deal that is trustworthy and reliable in this country.

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