They say time flies when you are enjoying yourself and I think that is definitely true for my time in Sierra Leone. Things have changed quite a bit since the outbreak of Covid-19. Later I will get to how this has impacted the work that we are doing at Enable the Children. However a lot of positive work was completed before the restrictions came in to place so I am very pleased about that. I cannot believe how far through the year we are already. It doesn’t seem that long ago that I was in the UK; but that was way back in December! As it has been a while I wanted to share with you what has been keeping me busy……
Clinic work makes up the majority of my week; spending 2 days at the children's hospital and half a day at a local health centre. In these clinics, alongside some of the Enable the Children team, I spend time treating patients who are admitted on the wards with brain injuries, assessing new patients to the programme and reviewing patients to check on exercises; particularly with families who are struggling to do the required therapy at home. In total from January to March there were 128 new children with disabilities seen in clinic and 362 review appointments. The clinic can be chaos. It is a small space but we can treat 3 patients at a time; providing an excellent environment to let discouraged families witness other children with disabilities and hear stories and testimonies from families who have been in the programme for a longer amount of time. Although it does get hot, sweaty and noisy, clinic is probably my favourite place to work; as there is space and toys to help facilitate treatment but also room to draw alongside members of the team and offer teaching and encouragement on different approaches to problems.
Covering clinic means I get out into the community on a Monday. However, community visits are happening throughout the week; a total of 326 home visits happened throughout the first 3 months of the year. The work in the community lets us check up on patients who will struggle to get to clinic and also those patients who know the exercises and have demonstrated that they will perform them regularly at home. Personally, I do find being out in the community tiring; the travelling between patients means I struggle to get into a flow of performing therapy, plus being cooped up in a car going over very bumpy roads isn't always fun! But it does let me have a better understanding of Sierra Leone culture; lets me witness the range of conditions families live in here, lets me experience the different environments that we are asking our families to perform exercises; which in turn challenges me into thinking outside the box on how best to adapt treatment plans. It provides a more private situation for families to express any areas that are making them discouraged and/or depressed. In addition, it also offers up moments where we are able to stop, take some time and pray with the families. Because of all these positives it means I am able to put my personal feelings of tiredness to one side and get stuck into the work.
Over the years, from before I was involved with Enable the Children, the programme has grown from providing therapy and exercises to children with disabilities to providing pastoral support, behavioural support, hosting support meetings, child sponsorship, paying school fees and providing specialised therapy equipment. All of which are hugely beneficial but also require a lot of resources, a lot of planning and a lot of time to do (and more importantly to do well.) Sadly, because time is always against us providing these benefits puts a lot of strain and work on to the team. It is a real challenge to balance these things while ensuring that the therapy provision is ongoing, but the team definitely rise to the challenge! I never thought I would dream of getting a pick up truck but the more I see pickups driving around Freetown the more I think how much more efficient our work at Enable the Children would be if we had one to go alongside our other vehicles. That way delivering equipment wouldn’t mean sacrificing a team treating patients in the community.
February was a very tiring month but also hugely positive. The reason it was so tiring was that it was a bit of a party month (not for me but for the patients!) Right at the start of the month there was an event called ‘A Night to Shine’. This is a global event supported by an American foundation with the vision of providing teenagers with disabilities a prom style party. Enable the Children, in collaboration with another charity and a church in Freetown, helped plan, organise, set up and facilitate the whole event. The event involved face painting, photo shoots, a red carpet, a talent show where deaf children sang, a girl who does not have the use of her hands demonstrated how she writes holding a pen in her mouth and there was a dance recital using sign language as the base of the choreography. At the end of the party there was a crowning ceremony, food and a goody bag for every attendee.
A Night to Shine was just the warm up event though. The annual enable the children beaching outing was also in February and there was only a 2 week turnaround; meaning a lot of hard work! The beach outing takes place on one of the local beaches in Freetown and we invite all 750 patients in the programme along with 2 family members. In an effort to break stigma towards disabilities we also invite village chiefs and prominent members of the local communities. This year there were around 2000 attendees, who got to enjoy games, a bouncy castle, testimonies, skits, swimming and lots of food. It is a powerful thing witnessing mothers making friends with other mothers who have the same struggles, witnessing children with a whole range of disabilities not caring about their movement struggles because there is a ball to be kicked, or a rope to skip over, or an ocean to paddle and splash in, or a bouncy castle to jump on.
This year there was a real blessing in that the Assistant Minister for Social Welfare attended and has now taken it upon himself to target fathers who are not supporting their children. Also a BBC journalist who through a radio broadcast and newspaper article has drawn further attention to the struggles of children with disabilities in Sierra Leone. Listen Here
Making the beach outing easier for the ETC team was the arrival of a team from Hoboken Grace Church and Faith Chapel Hill Church. This team were very happy and willing to help with the clean up of the beach (before and after the event), being part of the welcoming team, manning the registration desks, handing out food and water, and really just throwing themselves into the joy of the occasion. As for me, the day was a whirlwind of activity but I mainly remember getting up at 5am to begin the construction of shelters on the beach and the continuous carrying of 12 foot long wooden sticks. The church teams blessed ETC further by treating us to a couple of days away at one of the lovely beach resorts down the coast from Freetown. This short getaway really was a refresher to the body, the mind and the soul! I do enjoy doing nothing but eat, sleep and splash in the warm Atlantic Ocean!
I knew before coming to Sierra Leone that I would be spending some time teaching. The teaching is often with the ETC team but I am also one of the Functional Anatomy lecturers for the Sierra Leone Physiotherapy School. The school is based in a town called Masanga which is about three and a half hours drive from Freetown. Due to this distance, when I’m teaching, I stay there for a few days so I can actually get to know the students and don’t feel rushed. Since returning in December I have had a couple of visits to Masanga and it has been really positive to witness the progression the students are making and their eagerness to learn.
Since March the universities have all been closed which has meant teaching stopped for a period of time. However, teaching has begun again but online. As the internet is a wee bit variable in quality I have chosen to film myself in a number of short video clips talking on anatomy. Being filmed is not something I enjoy or am good at so it was a rather trying experience but with the help of Rob they are coming together and being shared with the students!
Things are changing regularly due to coronavirus. There have been two full lock-downs; both for 3 days. The honest truth is that Sierra Leone would struggle with a longer lock-down; there is a high level of food insecurity, there is a reliance on fresh produce and for the majority of the population no reliable way to store fresh food for any length of time, making starvation and malnutrition a much more likely cause of illness and death. Currently, it is too risky to perform hands on therapy; so no community work. The children’s hospital was shutdown due to an outbreak there; sadly the abandoned children there all contracted coronavirus, but have since recovered. Clinic work is continuing but in the form of advice and parent led exercise reviews. To make up for this lack of clinical and community contact the team are calling each patient to make sure they are doing okay, that they understand why we aren’t able to see them and also that they are following the coronavirus advice. We are also carrying out food distributions to families in our programme; each family is receiving around 2 weeks worth of rice, onions, tomato paste, herbs and spices, milk powder, sugar and salt.
Although this wasn’t what I expected to be going through during my time with Enable the Children safety comes first and I do feel we are still managing to have a positive impact with what we are doing.
Thinking and praying for you all during these strange days.
Thanks for reading, much love and God bless x
Thanks to Dr Sandra for the beach outing photos!