By: Betty B. Long, Clinical Nurse Specialist and
Adjunt Professor at Pace and Long Island Universities
The Sa Leone Health Pride, consisting of a high powerful team of medical specialists from the prestigious Columbia Presbyterian Hospital in New York City, returned from Sierra Leone on May 26, 2006, from a two week tour after participating in their Second Annual Educational Conference and work-shop. The Sa Leone Health Pride, Inc., is a Non Profit Organization founded by Sierra Leonean born Nurse Practitioner & Adjunct Professor, Florence M. Dorwie. Apart from teaching in two Universities in New York City, Ms. Dorwie also works at Columbia Presbyterian Hospital where she successfully solicited the help of Physician Specialists, Specialized Nurses and Counselors for this trip. Once this was achieved, she immediately began preparations for the trip to Sierra Leone in September, 2005.
The team left New York on May 12, 2006, and conducted successful conferences and workshops in Freetown and Bo. The opening ceremony was on May 15, 2006 at the Miata conference Hall at the Youyi Building, Brookfields, Freetown. The conference was organized in conjunction with the Ministry of Health and Sanitation, and the Reproductive Health Services in Freetown. Ms. Dowie introduced each member of the team and explained the goals of the organization. Noticeably absent was the Minister of Health and Sanitation, Mrs. Abator Thomas, who had previously consented to deliver the opening remarks; however, a letter of excuse from her was read by Dr. Daoh the Chairman of Reproductive Health Services. Present were: Dr. Peter Silcana of UNFPA, Dr. Yvonne Harding of Marie Stokes Hospital, Dr. Smart, Vice Chairman of RPHS at Cottage Hospital, Dr. Kargbo of SLPMMA, and representatives from UNICEF and WHO. Sixty registered participants and other unregistered participants attended the Freetown conference. The primary goal of the Sa Leone Health Pride, Inc is to assist in reducing infant and maternal mortality rate in Sierra Leone, which is one of the highest in the world and is ranked 177 on the UNDP’s Human Development index scale.
Several doctors and nurses from local hospitals and clinics attended the workshops. Participants from the Northern Province and the Western Area and the surrounding areas attended the workshop in Freetown. The Bo Workshop attracted a far large audience from the Eastern and Southern provinces, including Bonthe. Participants in Bo appeared more spontaneous, updated and were noticeably knowledgeable in answer to questions. Equipments were freely distributed to Matrons of Government Hospitals and Heads of local clinics.
Dr. Laxmi Baxi, Obstetric and a Gynecologist for more than 30 years, also former Chair of Maternal Fetal Medicine at Columbia Presbyterian Medical Center lectured and presented two papers to a group of physicians at Connaught Hospital on Diabetes in pregnancy and other complications in pregnancy. At an earlier conference at Miatta Conference Hall at Yuyu Building, Dr. Baxi lectured on Obstetric Emergencies, Postpartum Hemorrhage, Shoulder Dystocia and Cord Prolapse. Dr. Baxi has published more than 100 articles and papers; she is a trustee of Sa. Leone Health Pride, Inc., and is strongly committed to assist in reducing infant and maternal mortality in the country. Dr. Baxi believes that conferences and workshops such as these are necessary to upgrade the experience of doctors and nurses.
Dr. Nancy Jasper is an Obstetric and Gynecologist, an Attending and Assisting Clinical Professor at Columbia University College of Medicine in New York. Dr. Jasper lectured about Sepsis and Management of Labor on a broader comprehensive approach. She is strongly committed to help reduce infant and maternal mortality in Sierra Leone.
It is noted that New York Presbyterian Hospital was the only hospital to be named to the 2005 Honor Roll by the US News and World Report. It is the hospital of choice to many dignitaries, ordinary people and world leaders. About two years ago, President Clinton (USA) had a successful major heart surgery performed at this hospital.
Other members of the team:
Ms. Dawn Kilts is Dean of School of Nursing, Long Island University, Brooklyn Campus, New York. She is also a Nurse Practitioner. She made strong presentation on Hypertension in Pregnancy and is very strongly committed to the aim of the Sa Leone Health Pride, Inc…
Ms. Betty B. Long, Adjunct Professor at both Long Island and Pace Universities and is a Clinical Nurse Specialist at Columbia Medical Center and Midwife. She expressed in serious terms the dire consequences of poor medical facilities, the high mortality rate and feels obligated to render as much help as she can possibly afford. She lectured on Sickle Cell Anemia in Pregnancy and was the Guest Speaker at the School of Midwifery. This was Ms. Long’s second visit to Sierra Leone. She is Trinidadian and has adopted Sierra Leone as her second home. She is the Vice Chair of Sa Leone Health Pride, Inc.
Mr. Douglas Kilts was a Nurse Practitioner and HIV Counselor at Beth Israel Hospital, New York. He is now retired. His presentations in Freetown and Bo were based on HIV in Pregnancy and enlightened on more recent developments. He is also committed to help address the rising problem of HIV in pregnancies.
Ms. Caitlin Kilts is a young and vibrant student pursuing a Masters in Public Health (MPH) degree at the Columbia University School of Public Health. She made compelling presentations in Freetown and Bo on Malaria in Pregnancy. Amazingly, Caitlin has expressed her focus in helping to alleviate some of the medical problems she saw during her premier trip to Sierra Leone.
Given the chance to be home with a powerful team of medical professionals was indeed an exciting feeling for Ms. Florence M. Dorwie, who is the Founder and Director of Sa Leone Health Pride, Inc. During the conference in Freetown Ms. Dowie lectured on preterm labor. At the School of Midwifery, Ms. Dowie demonstrated on a tool on how to perform speculum exams and cervical assessment. Ms. Dorwie is Adjunct Professor at both Long Island University and Pace University in New York City. She is also a Nurse Practitioner in Labor and Delivery Triage at Columbia Presbyterian Medical Center and, she is also a Sexual Assault Examiner in the City of New York. Despite her very busy schedule, Ms. Dorwie has an exceptional desire and compulsion to help her beloved country, Sierra Leone. Her aim is to assist to reduce the high infant and maternal mortality in the country. “I have committed myself to my people and country, and a large percent of my earnings is spent on Sierra Leone” she said recently. Florence explained that “a woman is more likely to die giving birth in Sierra Leone than in any other country in the world, mainly due to a shortage of medical staff and medical equipments, poor training, and compounded in some cases by greed and selfishness by some practitioners. The consequences are alarmingly endemetic, damaging and potentially disastrous; that the staff is not properly equipped to deal with complications that occur during labor, delivery and postpartum.” One way of helping is through education, she said, “the each one teach one model” and by providing the most essential health care materials. According to Ms. Dorwie, several of the doctors she spoke to do not own a computer, those who do, do not have ongoing electricity to access mail and obtain information on line; as a result, they are separated from this ocean of knowledge, the research and processing of data that the computer readily provides.
WHY FLORENCE WAS TEARFUL
The team visited and interviewed patients, staff and ancillary workers at Caunought Hospital, Cottage Hospital and Marie Stokes Hospital, all in Freetown. At one hospital, four patients with full term gestations who had reportedly started laboring at home with either a nurse or a traditional birth attendant, and encountered problems were transferred at last minute to a hospital only to have Caesarean Sections performed; but it was too late, all ended with stillbirths. Three of these patients developed sepses and one an ileuses, all complications of prolonged labor and Caesarean Section. All were at risk. One of them was a 15 year old girl from a suburban region of Freetown was reportedly in labor for two days. She was fully dilated but could not deliver. She was transferred to a hospital in Freetown where a Caesarean Section was performed. She apparently lost her first child. At the same hospital, a woman was transferred from the provinces to Freetown with obstructed labor. She had a fistula-an opening between the vagina and rectum caused by prolonged and obstructed labor. She had pungent odor similar to that of a decomposed flesh. The team was informed that she had no family member or resource to purchase the urgently needed antibiotics to treat her sepses. Death seemed imminent. The attending physician confirmed her problems and inability to purchase antibiotics. At this point, it was too much for Florence to hold, and she cried. The team immediately volunteered to provide the drugs to treat the patients, and requested a guarantee from the physician that the medications will not be withheld or sold to the identified patients, a common practice we are told demonstrated by some physicians, nurses and matrons in the country. But the Physician turned to the team with a smile and said he could not guarantee any thing; however, he later promised to dispense a 24 hour dose to the identified patients and to provide us with their prognosis. Florence immediately left the group and went home to get the required medications for the patients: Cipro and Amoxicillin which she handed to the physician. Six days later, on the eve of the group’s departure to New York, they visited the patients at the hospital and were elated to note that all the patients described were alive and progressing well. One of them was sitting up smiling and eating; the 15 year old was strong and active and was due to be discharged soon. Another patient had significantly improved in health but was still receiving antibiotics for slight infection. We were all happy. Our effort paid off. We saved lives. We believe that if health care providers could transfer high risk patients to tertiary care center on time, medications are available, proper training administered, proper structure, attitude and supervision implemented, a passionate approach to life is maintained, funds are available then more lives would be saved. We noticed that during our rounds simple things like thermometers were not available to take temperature. This does not auger well. No doubt, if these areas are corrected, far more lives would be saved.
SCHOLARSHIP AND FREE SURGICAL PROCEDURES PROMISED
We visited the Medical School, a subsidiary of Fourah Bay College, and spoke with the Vice Chancellor Dr. Aiah Gbakima, and the director/chair of the Medical School to discuss about an exchange program involving Doctors and Nurses. Ms. Dawn Kilts, the Dean of Long Island University School of Nursing in New York, discussed a plan to provide scholarship to young, talented and interested Sierra Leonean doctors and nurses to attend identified institutions in the US, but with stipulation that they be bonded by the Sierra Leone government to return to Sierra Leone and provide a minimum of 2 to 3 years service as payback for their training. In retrospect, Interns/Resident doctors and Nursing students from the US would have access to go to Sierra Leone to do electives which may help to ease scarcity of caregivers in Sierra Leone.
Dr. Baxi and her husband who is a cosmetic surgeon have expressed interest to visit Sierra Leone and provide free services to at-risk patients with Cleft Lip, and Palate.
Dr. Jasper has also expressed a desire to go to Sierra Leone with a team including anesthesiologists to repair fistulas sustained during obstructive labor or gynaecological problems.
Please note that Stethoscopes, Fetal Scopes, Laceration and Circumcision Trays were donated by Ms. Susan Sheppard, a Representative from Kendall Health Care.
Sa Leone Health Pride gave out one hundred Blood Glucose Monitors donated by Ryan Walker of Bayer Healthcare.
Sa Leone Health Pride purchased the Strips for the Blood Glucose Monitors and bought medications: Cipro, Bactim, Amoxicillin Flucanizole, Tylenol, Cytotec and Methagine.
Sierra Leone Health Pride, Inc also donated Educational Materials (Videos, CDs, Books, Pens and Manuals) to doctors and nurses, and Thermometers, Gloves, Pregnancy wheels, Disposable Panties for patients with Post Partum Hemorrhage.
Our team stayed at the elegant Kimbima Hotel. We extend a special thanks to owner Mr.: Sam King, who was wonderful and professional. Mr. Ernest Ndomahina for his generosity and other staff members at Kimbima for the appropriate and wonderful treatment the team received.
Thanks to Mrs. Mamie Caulker for her time and valuable work in coordinating the workshops, and as Liaison between the Ministry of Health, the Reproductive Health Services and with the Founder of Sa Leone Health Pride, Inc.
Thanks also to Bayer and Kendal Health Care for donating materials and equipments.
Thanks to Dr. Yvonne Harding for providing her vehicle to pick the team us up from the Heliport to the hotel and to Miata Conference Center.
A special thanks to Mr. Rashid Sesay for providing his lap top and projector for our PowerPoint presentations.
The Sa Leone Health Pride gives thanks to all the patients and staff at Connaught, Cottage and Marie Stokes Hospitals for sharing their stories with us. We also thank all those who rendered their time to help us work collectively as a team and to assist the team in their effort to reduce infant and maternal mortality in Sierra Leone. So many people helped but all the names can not be listed herewith, so we thank you all very much.
The members of the team were each responsible for their travel and other expenses from the United States to Sierra Leone and back. Our sincere thanks and appreciation to all of them, donors and other professionals for their immense support, dedication, humanity and selflessness. .