Monday, February 7, 2011

The Government Hospital Makeni, Northern Sierra Leone



Images from a ramshackle hospital in the northern half of the country, three hours from the capital Freetown. Young teenage girls join in a mother and baby group and others nurse their sick infants.

Thursday, February 3, 2011

City of Rest



IT is grimly ironic that the most damaged and broken people in the small
west African nation of Sierra Leone are housed in a falling-down old
building no longer fit for purpose.
Though the organisation itself — City of Rest — is a longstanding and
reputable refuge for men and women with addiction and mental health
problems, those who run it are only too willing to admit its obvious flaws.
Rats scurry, space is limited, there is no adequate running water or
toilet facilities. The “kitchen” is a stone shed where meals are cooked
over an open fire.
City of Rest is only rehabilitation centre in a country recovering from a savage civil war, and which is now rife with alcohol and drugs abuse.
This is a place for the misfits nobody wants, the people who have nowhere else, or
whose families’ simply cannot manage them.
Set up by Pastor Morie Ngobeh, who has worked with street boys since the 1980s, the 70-something-year-old still manages the facility and is assisted in the day to day
running of things by Dutch woman Heleen van den Brink, who joined in 2007.
The charity is also supported by a local board made up of seven local professional Sierra Leonean men and women committed to developing and overseeing its work.
Referrals to the centre come from the courts, the police – but mainly from families who have no where else to turn.
Many are here involuntarily and some of the men are chained up for
security reasons. Although they don’t like it, staff say there is no
other option.
Walking around City of Rest, it is clear that it is highly unsuitable.
But the best is made of what they have. A faith-based programme — though
it is open to anyone who accepts the Christian character — there is
counselling, basic classes in life skills, as well as a spiritual
programme.
According to Ms van den Brink, if the residents only have an addiction problem
they can be out in six months, but for those with a mental disorder and depending
on family situation, they can end up staying for years.
“We don’t want to keep them that long, but for some it can’t be helped.
We don’t have the right medication because it is not available in the
country and some are very violent and hard to manage and cope with them.”
Although it is a tough working environment, according to Ms van den Brink, the appeal of City of Rest is that it is a local sustainable charity.
But the place is literally falling apart, she says.
“We are very grateful the building is given to us with very little rent,
but during the day there are more than 50 people and no working toilet.
Water is a big issue. We don’t have water. We try to store in a tank but often doesn’t work.”
Although this the case for many Freetown residents, when you are dealing with a large number of people in a small space, it becomes all the more acute.
Talking to the residents, however, the importance of the work quickly transcends the surroundings.
One man, 31-year old Mohamed (pictured below bottom left) says both of his parents were
killed in the war, when he was just two years old.
He is excitable and talks about adventures in Holland and across Europe.
It is difficult to tell what is real and what’s not in his jumlbled tale, but he has ended up here at City of Rest where he has been on and off for five years.


Other residents are former “child soldiers” — but not all were involved in fighting, and as Ms van den Brink points out, life since the war ended has been so horrendous that it can overwhelm people as badly as the war did.
Many inhabitants seem too disturbed or incoherent to speak too. One boy in handcuffs has just been brought in, no-one knows why. Is he mentally disturbed or on drugs? It is impossible for staff to make a diagnosis, and even if they can, they have little access to medication which might help.
“The whole frustration and trauma of poverty and lack of perspective damages people. There are no jobs, a bad healthcare system — so many
children and mothers are dying,” Ms van den Brink explains.
“People have trauma all the time, they hardly have a chance to process
what happened during the war because if they did really think about it
they would fall apart and not be able to function.
“I hear horrendous stories from people and I think how do you function
but they just carry on because they have too,” she says.
“Some of them are ex-combatants who fought during the war. Many youths
were introduced to drugs during the war, the most common being
marijuana which causes a lot of psychosis. We are seeing more cocaine and heroin now too.”
But for all the good work that goes on at the facility, its lack of
funding and space — about 40 residents live in cramped and dingy
conditions — are serious barriers to progress.
There is hope however, as City of Rest was awarded three acres of land
by the government and a building project for 70 residents — men, women
and youths — about three miles outside Freetown is underway.
“We have started building, it’s what we call a faith project. There is
no funding for it, we have just started and trust it will come together.
It’s for 70 people, 30 youths, 20 men and 20 women.
The purpose built facility when completed will provide much better facilities enabling them to include vocational training, life skills, and communication classes, and opens up the possibility of an income generating scheme.
There will be a lot more security, and it’s a lot more attractive. We will have our own gardens and space for people. All we need now is the funding to get it built.”

For more information or to make a donation log onto:
www.cityofrest-sl.org

Wednesday, January 19, 2011

Maternity and children's hospital, Freetown



From the outside, Freetown's Ola During Children’s Hospital and Princess Christian Maternity Hospital looks like any regular hospital.
And certainly the lick of paint makes it appear as though progress is afoot. But once inside, it is clear that despite a promise to provide free healthcare to children under five and breast-feeding mothers, everything is in short supply - including those all important free medicines.
Not only that, the hospital is clearly under resourced and has no proper water supply.
The children’s ward is particularly chaotic. Many have TB and have to stay for about a month or more. Their mothers often stay with them and have to bring food as what the hospital supplies is not enough.
Malaria is a huge issue, as is malnutrition.
In the mainly deserted and desolate labour wards, mothers in distress, often unattended. In Sierra Leone most women give birth in the community clinics or at home. Only those who are ill make it to hospital, which is what gives the wards such a depressing air.
One girl has been there a week she tells us. Just waiting. Clearly petrified. She might not be well educated but she no doubt knows the statistics and lost friends or family members.

Another very young couple – the girl says she is 16 but it’s not likely – are in the special care unit with their tiny baby, waiting to be admitted. Wrapped in a single blanket the father holds him carefully but doesn’t really know what to do with sickly creature he is now responsible for. Although it’s a quiet day there is no rush to tend to the very sick infant.
Perhaps there is a feeling it is too late. And that is often the case. By the time they get to hospital it really is as a last resort. And it is by taxi probably crammed in with countless others, along dusty beaten up unpaved roads.
That’s the reality. So while the statistics for the hospital show that eight women died in child birth here last November, you can be sure in every community around the country that is being replicated and on a even greater scale.

Tuesday, January 18, 2011

Update from Freetown - Friday with Goal

It has not been as easy to access the internet as we first hoped! Freetown though more developed than you might think for an African city is still a sprawling mess with limited electricity, running water and Internet access. (pictured below Internet access is usually received via satellite)


After arriving at Lunghi airport at 3.30am we finally got a water taxi – another 45 minutes and with the help of a lovely American woman – thanks Paige – found our lodgings.
The manager of our place – Derrycombe lodge – had been waiting at the helipad to collect us but the only way over at that time was by water.
We made it back there eventually, after dropping a random soul at the lobby of a hotel where he was going to try and find a taxi into the city when it got bright. Finally, at 5am, we got to bed.
There was no time for rest though as Goal were scheduled to pick us up at 8am and we headed for the George Brook health clinic in central Freetown.



Although we were wrecked after only a couple of hours sleep it was a great day and it is clear just from one day on the ground the impact the government's free mother and baby scheme is having on impoverished woman.
Under the scheme all woman who are breast feeding and children under 5 can access free healthcare.
However there are still many challenges to overcome such as lack of resources and supplies. The small clinic we visited is for a population of 20,000 or more probably.
After a tour and talks with the young mothers and expectant mothers - who more often than not are alone - we travelled to the slums of Mabella in the eastern part of Freetown. It was here we saw the full horror of how people in the city are forced to live.
Here the communities are living almost in the sea.

Space is at a premium and health and sanitation is a battle being hard fought. There are fresh water taps in the area, and two public toilets but still the people live in utter squalor. In Susan’s Bay which is right at the water edge the people only have running water twice a week. In the rainy season they are living ankle deep in water all the time.
Young children and women spend their days trekking up the hill to Mabella to bring fresh water down.
There is dirt and rubbish everywhere. There is no security and children run riot, babies crawl in the mud and dust.
The strength of the women in these communities is inspiring and you would have to wonder what keeps them going.



Goal staff have built up great networks within the communities which really helps the women to have a voice and no doubt empowers them.
Next we paid a visit to a drop in centre for vulnerable and abused children.This was truly a magnificent place and the difference made to the lives of these damaged children was captivating. ( A boys class room pictured below)
The head of the centre told me that they have been used by pimps, thrown out by their families, abused emotionally physically and sexually and yet there they were singing and laughing and learning.
The resilience of children is amazing but nevertheless they are in real danger.
Once the centre closes for the day they are back out into the big bad world of adults who are waiting to prey on them.


All in all an amazing day. So thanks to Marion and all the Goal staff – driver, support workers, community volunteers and of course all the people who spoke to us and allowed them to photograph them.

Thursday, January 13, 2011

Getting there

It's 430pm and myself and Clare are waiting to board a flight which gets us going onthe first leg of our trip.
We will arrive in Freetown tonight at about 330am via Casablanca.

For a bit of background to the trip, while you'd be forgiven for thinking Ireland and a small west African nation called Sierra Leone have absolutely nothing in common, just like the inferior health system mothers and babies once experienced in Ireland -  as late as 1949 more than 50 of every 1,000 babies died before the age of one - women in Sierra Leone face an uphill struggle to access any kind of healthcare.
The country, which is trying to find its feet after a brutal civil war which ended in 2002,  has one of the highest maternal mortality rates in the world.
 For every 100,000 live births in the west African nation, as many as 1,800 women die. And every year another half a million pregnant women die each year because they can't access healthcare.
According to a 2008 Unicef health survey, out of every 1,000 children, 140 die before they reach their fifth birthday.
Although it may be more than a half a century ago in Ireland, it is still difficult to comprehend that in 1949 one child in 16 born in that year did not live to see her or his fifth  birthday. Diarrhoea and enteritis were the biggest killers of babies.  Tuberculosis and other preventable and treatable diseases swept through the nation, killing older children. It was only in 1951 that the Catholic Church backed the medical  profession in strongly opposing a proposal for free medical care for  mothers and children.
It was only last year in Sierra Leone that something like that scheme has become possible for women and children. From April 27 2010, all treatment and medicines for pregnant women,  lactating mothers and children under five in Sierra Leone are being provided free of charge in all government health facilities. Around 1.2 million mothers and children will benefit from the abolition of fees which acted as a barrier to treatment for most people and which contributed to the many maternal and child deaths in Sierra Leone.
How the scheme is being rolled out on the ground and what impact it will have remains to be seen but it seems as though the will is there. Sierra Leone is a country desperately trying to drag itself out of poverty, to rehabilitate and care for its citizens who firmly believe in its future.
The health of its woman and children are paramount to this recovery and during this trip myself and Clare hope to find out how the policy is being implemented on the ground.

So that's it folks. Tune in for more who knows when - hopefully tomorrow. We are not yet sure what kind of access we'll have to the Internet but should be pretty steady. (This turned out not to be the case so unfortunately a live blog was not possible but we have since updated the blog with more to follow).