Sierra Leone
Trip Report,
Sierra Leone, Tom Johnson, Jr. / Africa Surgery, Inc. (ASI),
Nov. 1, 2008-Feb. 1, 2009
I was still a bit jet lagged in my room in Mosongbo Village when Amie, a woman who I first met in 1990 during my Peace Corps days, dropped by from two houses up with her grandson, Amadu Kanu, a skeletal, lethargic ten-year-old. She rubbed his belly lightly and told me that that was where he was having pain. I told her I had to go get three children with club feet treated by a team of German orthopedic surgeons who would be working here for only one week. However, I realized that Amadu had to go to the Holy Spirit Hospital quickly. He tested positive and was medically treated for malaria and the water-borne disease, typhoid. But he continued to have severe pain making him unable to eat. An ultra-sound scanning revealed that his intestine was perforated. He had not eaten in over 15 days. His prognosis was not good. We referred Amadu to a surgeon in Freetown, the Capital city 100 miles away, who supposedly had the equipment needed to resection his intestine.
While I went to look after the club-foot patients with the German surgeons, my new counterpart, Foday Tarawalie, went to Freetown to take on the task of negotiating Amadu’s surgery. In Sierra Leone hospitals do not have room service or supply food. It is necessary for someone to be there to help care for the patient and even to purchase some of the medicines and intravenous drips and syringes from outside pharmacies. Amadu almost died on the operating table. Fortunately, Foday was able to purchase two extra pints of blood taken from suitable donors. After a week and some days Foday was able to leave Amadu at the Freetown Government Hospital in the care of Amadu’s mother and return to the village.
During my last week in Masongbo we set up a water purification system next to a well about 50 yards from Amadu’s house. Another one of my counterparts, John Thullah, and his young helper are supplying containers of treated water to Amadu’s family and to another victim of a water borne disease, dysentery, whom we had surgically treated for a prolapsed rectum during the past year . All the villagers are being encouraged to drink this safe water which we will provide for free so long as they come to the well with a cleanable container possessing a lid. We also set up a water purification system at the Fatima Tertiary Institute. This system is capable of treating 2,000 liters at a time and will be supplying safe drinking water to the junior college type institute, to many diocesan offices, and to a large secondary school on the same grounds. John and his helper, Amadu Tarawalie, will be training some of the staff of the Fatima Institute in the operation of the purifier and the distribution of the treated water.
A renowned spine surgeon from Hungary was at the St. John of God Catholic Hospital along with the German orthopedic surgeons. When I met Dr. Zsolt he was frustrated to have found the hospital’s surgical theater and equipment inadequate to safely perform complex spinal surgeries. He was especially concerned about Judith, a two and a half year old girl with a congenital spinal deformity who he felt was on the verge of becoming paralyzed. Dr. Boachie, the director and head surgeon of FOCOS, knows Dr. Zsolt and agreed to make room in the surgical schedule in Ghana for Judith. Her parents had taken my advice and had previously gotten visas for Judith and her mother at a cost which must have been a lot of money for them. Judith is now back with her parents in Sierra Leone. She is wearing her brace and recovering from her surgery nicely, and she is not paralyzed. It is expected that Judith, who is our youngest spinal surgery patient to date, will have to return to Ghana for another operation as her small body grows.
Dauda Sesay is a spunky boy about nine years old whose parents are both dead, so Dauda was staying with his grandmother in a village about 60 miles from ours. Because Dauda was not getting enough to eat and because he had been selected by the FOCOS director, Dr. Boachie, to have surgery to improve his very badly TB deformed spine, my counterpart, Foday, took him into his household to build him up for a couple of months. After returning to Sierra Leone from Ghana, Dauda, along with the other four post-ops who received surgeries by FOCOS in November, spent six weeks recovering at the Holy Spirit Hospital. Dauda has just rejoined the other eight child-spine cases who have become a part of my counterpart Foday’s extended family. He is very welcome by these children who are becoming like brothers and sisters to each other.
Two representatives from the Scottish based International Reconstructive Plastic Surgery (IRPS) made a visit to Sierra Leone to assess the situation and to determine where they might be able to perform non –cosmetic reconstructive surgery. They were very impressed with the Holy Spirit Hospital which now possesses a special microscope needed for delicate surgeries on hands and feet. I have begun to photograph and to compile a list of cases, including children born with cleft pallets or lips, adults with contracted fingers due to tendon degeneration or with various growths, and burn and trauma victims. An American based organization, Smile Train, has also expressed an interest in visiting to help the children with the clefts. Foday found an eleven year old boy who was severely scarred about a year ago by an accidental “lamp burning.” Sori Kargbo cannot straighten out his right arm. His chin is being pulled toward his chest by a mass of scar tissue. A few other Americans have been made aware of Sori’s extensive injuries and are trying to get funds and find some place to have him treated, but getting a visa to America or other developed countries is very difficult. It might fall to us to get Sori treated in Sierra Leone, or more likely and sooner, in Ghana, by a team from IRPS. The reconstructive surgery being done at the large government hospital in Accra, Ghana, is considered to now be on a par with reconstructive work being done anywhere in the world.
Two members of the FOCOS team came to visit Sierra Leone in January. Over a period of eight days, nurse practitioner Bettye Wright and research assistant Francis Senanu held five clinics at three locations examining a total of 117 spinal deformity cases. They saw 35 recovered or recovering post-op FOCOS patients. Thirty three of the 82 others were entirely new cases who are now registered in The FOCOS data base. All new patients whose symptoms suggested that their spines had been deformed due to tuberculosis infections were started on an eight-month anti-TB medical regime.
As a collateral benefit of the publicity caused by the visiting "spine doctors," a 15 year old girl showed up with a painfully protruding right shoulder blade. Although she had to be dismissed by Bettye and Francis as not being a spine case, we X-rayed her and had her examined by a young Sierra Leonean orthopedic surgeon who was recently assigned to the Makeni Government Hospital. Dr. Bundu diagnosed Memuatu Kanu’s problem as being caused by a large bone spur that, if allowed to continue growing, would guarantee her a life time of misery. In late January, operating in the theater of the Holy Spirit Hospital, Dr. Bundu removed the spur. Memunatu’s prognosis is very good. Her treatment and recovery will probably not cost ASI more than $400.
For those interested in additional numbers: Forty-one hernias were repaired for ASI patients at the Holy Spirit Hospital before they ran out of sutures in December. They since have been resupplied, and two more surgeries have taken place. Seven patients with severe hernias known as hydrociles have just been admitted. They will have been treated before you read this. Unfortunately, ASI funding for these surgeries has been exhausted, and we have scores of people, many in significant pain, still suffering with hernias and waiting for our help. The cost to ASI is $150 per surgery.
Six of the 15 persons we brought to the Lunsar Baptist Eye Hospital were admitted. Five had vision restored to one or both eyes by cataract surgery. One had his eye saved before it was destroyed by an optical ulcer. Seven are scheduled for cataract surgeries over the next two months. Two, unfortunately, had been irreversably blinded by onchosariasis, also known as river blindness. The cost to ASI for a cataract surgery is about $60 per eye. The three children who had club feet operated on by the German surgeon Dr. Fritof, have all had their incision lines healed and their corrected feet encased in plaster casts. They will eventually have the casts removed and will be able to start walking on the bottoms of their feet without the use of the crutches we supplied them with. One boy, who had two club feet, will have to have the other one corrected when Dr. Fritof returns this November.
More than 60 persons have been X-rayed for various reasons. A yet undetermined number were admitted or treated for various ailments on an out-patient basis at the Holy Spirit Hospital. Twenty-five women were surgically treated for prolapsed uteruses and other related problems by a four member gynocological surgery team from America which we helped the Holy Spirit Hospital to host. Ten of their twenty-five patients were brought to them by Foday and I. Approximately 90 persons each month are being stabilized for epilepsy or treated for other health problems at the St. Joseph of Cluny Sisters’ Loreto Clinic with funds provided by ASI. Twenty-three persons suffering with rotten teeth have had the aching molars extracted by our local tooth puller in the next village.
Donors to our education program have sponsored sixty four students for the school year of September, 2008 thru June , 2009, at the cost of $150 per student. Another 30 children have been sponsored by FOCOS because its board of directors realize that their post-op spinal surgery children will need to acquire the knowledge and skills that will allow them to survive in ways that won’t risk reinjury to their backs through hard physical labor. Both ASI and FOCOS also realize that education is vital for achieving and maintaining good health, especially in a culture where, for serious health problems, the first recourse is often to seek treatment by native or spiritual healers. This often causes more harm or amounts to doing nothing at all.
On behalf of all of the many Sierra Leoneans whom your generosity is allowing ASI to help, I want to thank you for your support and for your prayers. I wish to extend a special thanks to the Knights of Columbus George Washington Council 359, who gave ASI a total of $4,000 last year. This more than covered my personal travel and living expenses enabling all of your donations to go directly to providing medical, surgical, and health care. We at ASI are resolved to continue our work in Sierra Leone to the greatest extent that our funds will allow. If you are able to join us in this effort, Checks can be made out to Africa Surgery Inc. or to ASI, and mailed to me:
Tom Johnson, Jr.
189 Franklin St.
Morristown, NJ 07960
(You can also donate on line at our website: africasurgrey.org
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