While two weeks in Sierra Leone is not nearly enough time to make a spiritual analysis of the region, there are a few things that I did observe.
First some facts:
Sierra Leone is approximately 60% Muslim, 30% Animists, and 10% Christian.
Since animism is largely entrenched in society there is often some crossover into the Muslim and Christian populations. Despite what we often read in the news about sectarian violence around the world, there is a significant absence of that in Sierra Leone. One can often find Christians and Muslims intermarrying, working together and living side by side. They still observe many of the customs of Islam (praying 5 times a day, fasting for Ramadan, dietary restrictions) but cannot be described as fundamentalist in any negative sense of the word. Even during the decade long war religion was rarely pulled into either side of the conflict. Another common misconception involves the role of religion in female genital mutilation/cutting (FGM/C) (AKA female circumcision). While FGM/C has been associated with Islam it is not a requirement of the religion and many women who do not practice Islam have had FGM/C. It is more of a cultural ritual, not a religious one.
While this amity between religions is fantastic when it comes to daily life it can make things a little more difficult to a Christian sharing their faith and trying to effectively convey the Gospel message to others. Many will say that Allah is the same as our God. This is a delicate issue that needs to be approached in a culturally sensitive manner with a lot of truth in love.
Now if you want to witness some great prayer and worship, visit a West African church! I have now gone to church in Benin and Sierra Leone and nothing matches it.The worship is lively with singing, drums and dancing all to the glory of the Lord. Listening to the prayers of the people puts my meager prayer life to shame. It is nothing for pastors to have all night prayer sessions.
And their faith is evident in their prayers for they have nothing else to fall back on. They cannot afford medications (no social agencies to help here) or to buy food so they pray. I will never forget a prayer session during my first trip to Benin. One of the members of our team is a type 1 diabetic well controlled using an insulin pump. Here in the US we would often pray for the doctors to have wisdom and for the medications to work effectively. These pastors in Benin prayed for the diabetes to 'pack its bags and leave'. How often do we pray for healing like this in the US? Probably not very often. Probably only when we have exhausted the knowledge of the doctors and tried many medications to no avail. Prayer takes on a different tone when you are in a situation where the only thing that will make the situation any better is an intervention from God.
I have a feeling that my prayer life will become more intense and focused when we get to Sierra Leone. My goal is to start that intensity and focus now because we need just as much God intervention now as we prepare for the trip as we will need once our feet hit African soil.
Wednesday, October 26, 2011
Tuesday, October 25, 2011
After thoughts
As can be imagined witnessing the birthing experience brought me quickly back to the realities that Jeneson and I would be facing as medical personnel in Sierra Leone.
This is country of almost 6 million people.
The average life expectancy is 47 years.
Out of 1000 live births, more than 123 of those children will die before their first birthday
There are 0.016 physicians for every 1000 people
These are the stark facts about life in Sierra Leone.
Many people have a romanticized view of missionaries and of the adventures that they are having. It doesn't take but one of these experiences to realize that the reality is anything but.
Reality, like Satan, comes to steal, kill, and destroy.
But I will not let Satan squash the burden that God has placed on my heart for the people of Sierra Leone; to tell them of God's love for them and to show them through caring for them physically, emotionally, and spiritually. I will continue to pray in earnest that God will prepare me as a follower of Jesus Christ, as a Wife, as a Mother, as a Nurse Practitioner to go to Sierra Leone and minister to them. While I know there are many things that I want to show and teach them, I know from experience that they will teach and show me many things also. I need to be open to how God will work in me and through me.
Will you pray with me?
This is country of almost 6 million people.
The average life expectancy is 47 years.
Out of 1000 live births, more than 123 of those children will die before their first birthday
There are 0.016 physicians for every 1000 people
These are the stark facts about life in Sierra Leone.
Many people have a romanticized view of missionaries and of the adventures that they are having. It doesn't take but one of these experiences to realize that the reality is anything but.
Reality, like Satan, comes to steal, kill, and destroy.
But I will not let Satan squash the burden that God has placed on my heart for the people of Sierra Leone; to tell them of God's love for them and to show them through caring for them physically, emotionally, and spiritually. I will continue to pray in earnest that God will prepare me as a follower of Jesus Christ, as a Wife, as a Mother, as a Nurse Practitioner to go to Sierra Leone and minister to them. While I know there are many things that I want to show and teach them, I know from experience that they will teach and show me many things also. I need to be open to how God will work in me and through me.
Will you pray with me?
Monday, October 24, 2011
An African Birth
I have struggled and prayed often over the past several weeks about this post:
How should I frame my experience?
How much should I go into detail?
How much did I want to relive those moments?
Would people even want to read about it?
What is the significance of my experience?
Suffice it to say that I don't know all the answers to those questions, but know that what I saw did cause me to pause and reflect on what it is that Jeneson and I are doing in going to Sierra Leone. What is our purpose and how will God use us there.
It started out as a typical evening after dinner relaxing on the porch talking when we were summoned by a nervous father wanting us to go with him to his daughter who was in labor with her first child. After some miscommunication we realized that, as previously requested, one of the traditional birth attendants in Mokanji was letting us observe a birth.
We entered the dark stick and mud, thatched roof hut as dusk was falling over Mokanji and met the mother-to-be who was uncomfortable and in labor. As we comforted her and tried as best we could to demonstrate how to effectively push there were a number of things that were unsettling.
You could see the scar from the female genital mutilation (i.e. female circumcision).
You could sense her hesitation to push because of the pain.
The traditional birth attendant was encouraging other women to assist in the birth by pushing on the pregnant belly and pinching her belly and inside of her thighs (they thought this pinching would stimulate contractions!).
I saw her puffy feet and asked about her blood pressure (she did not have a blood pressure cuff to take one with).
This was not the supportive, empowering experience I had with all three of my children!
Then the worst happened. After about an hour and a half of pushing, the mother's body suddenly shook with a seizure. She was eclamptic!! This is not a good situation to be in here in the US and certainly not out in the middle of Sierra Leone!
After about 2 minutes the shaking stopped and pushing resumed on her abdomen in attempts to get the baby out. Fifteen minutes later the mother again regained consciousness and after another 15 minutes the beautiful baby boy was born. But things were not good. The cord was wrapped around his neck and when he emerged you could see meconium (the baby had pooped while still in the uterus, a sign of distress and not a good situation for the baby). He was limp and lifeless......
I have never felt so utterly helpless or prayed so much in all my years.
After rubbing his back, slapping the bottom of his feet and trying to wipe out his mouth with gauze, attention turned back to the mom to deliver the placenta. The cord was tied off with string and cut with a razor blade. There was no bulb suction to even try to clear the baby's nose and mouth (probably would not have helped in this case though).
He was gently wrapped up and put off to the side while they they continued to attend to the mother.
She continued to deteriorate during the night and have seizures (she needed medication to get her blood pressure down and medication to stop her seizures, none of which are available right now in Mokanji) until the next morning when we drove her, the birth attendant, and the woman's sister in the back of a pick up truck to the nearest hospital 2 hours away.
I did hear that she seemed to recover physically with no long-term problems.
Sierra Leone has one of the highest maternal and child mortality rates in the world.
More on my thought from this experience tomorrow.
How should I frame my experience?
How much should I go into detail?
How much did I want to relive those moments?
Would people even want to read about it?
What is the significance of my experience?
Suffice it to say that I don't know all the answers to those questions, but know that what I saw did cause me to pause and reflect on what it is that Jeneson and I are doing in going to Sierra Leone. What is our purpose and how will God use us there.
It started out as a typical evening after dinner relaxing on the porch talking when we were summoned by a nervous father wanting us to go with him to his daughter who was in labor with her first child. After some miscommunication we realized that, as previously requested, one of the traditional birth attendants in Mokanji was letting us observe a birth.
We entered the dark stick and mud, thatched roof hut as dusk was falling over Mokanji and met the mother-to-be who was uncomfortable and in labor. As we comforted her and tried as best we could to demonstrate how to effectively push there were a number of things that were unsettling.
You could see the scar from the female genital mutilation (i.e. female circumcision).
You could sense her hesitation to push because of the pain.
The traditional birth attendant was encouraging other women to assist in the birth by pushing on the pregnant belly and pinching her belly and inside of her thighs (they thought this pinching would stimulate contractions!).
I saw her puffy feet and asked about her blood pressure (she did not have a blood pressure cuff to take one with).
This was not the supportive, empowering experience I had with all three of my children!
Then the worst happened. After about an hour and a half of pushing, the mother's body suddenly shook with a seizure. She was eclamptic!! This is not a good situation to be in here in the US and certainly not out in the middle of Sierra Leone!
After about 2 minutes the shaking stopped and pushing resumed on her abdomen in attempts to get the baby out. Fifteen minutes later the mother again regained consciousness and after another 15 minutes the beautiful baby boy was born. But things were not good. The cord was wrapped around his neck and when he emerged you could see meconium (the baby had pooped while still in the uterus, a sign of distress and not a good situation for the baby). He was limp and lifeless......
I have never felt so utterly helpless or prayed so much in all my years.
After rubbing his back, slapping the bottom of his feet and trying to wipe out his mouth with gauze, attention turned back to the mom to deliver the placenta. The cord was tied off with string and cut with a razor blade. There was no bulb suction to even try to clear the baby's nose and mouth (probably would not have helped in this case though).
He was gently wrapped up and put off to the side while they they continued to attend to the mother.
She continued to deteriorate during the night and have seizures (she needed medication to get her blood pressure down and medication to stop her seizures, none of which are available right now in Mokanji) until the next morning when we drove her, the birth attendant, and the woman's sister in the back of a pick up truck to the nearest hospital 2 hours away.
I did hear that she seemed to recover physically with no long-term problems.
Sierra Leone has one of the highest maternal and child mortality rates in the world.
More on my thought from this experience tomorrow.
Wednesday, October 19, 2011
Village life
So what is life like in Mokanji? Slower pace. Community living. Laid back. Rustic. Peaceful. These are all words to describe village life.
The only running water is from the hand pumped well.
The only electricity is from the rare generator.
Food is cooked in a coal pot or over a 3 stone fire, either way the fuel is coal.
Laundry is done by hand and hung in the hot African sun to dry.
Chickens are truly free range and goats are tethered so that they don't eat up every piece of vegetation or relieve themselves too close to the well.
There are no latrines.
At night there are more stars than the human eye can comprehend and the only lights you see are the little flashlights as people walk by and lightening flashing in the distance.
The spiders are big, but my shoe is bigger.
You are grateful for the bats that glide under the porch rafters because you know that means a few less mosquitos.
There are a plethora of misconceptions about health and wellness and disease.
Death is common place.
There are some really cool lizards.
Even in the middle of Africa you can dance your troubles away a couple of nights a week at Mokanji's Old Skol Nite Klub (thanks to a generator).
The only running water is from the hand pumped well.
The only electricity is from the rare generator.
Food is cooked in a coal pot or over a 3 stone fire, either way the fuel is coal.
Laundry is done by hand and hung in the hot African sun to dry.
Chickens are truly free range and goats are tethered so that they don't eat up every piece of vegetation or relieve themselves too close to the well.
There are no latrines.
At night there are more stars than the human eye can comprehend and the only lights you see are the little flashlights as people walk by and lightening flashing in the distance.
The spiders are big, but my shoe is bigger.
You are grateful for the bats that glide under the porch rafters because you know that means a few less mosquitos.
There are a plethora of misconceptions about health and wellness and disease.
Death is common place.
There are some really cool lizards.
Even in the middle of Africa you can dance your troubles away a couple of nights a week at Mokanji's Old Skol Nite Klub (thanks to a generator).
Tuesday, October 18, 2011
Josiah in Sierra Leone
Josiah had a blast in Mokanji. He made so many new friends that are looking forward to him coming back. He would literally play all day with occasional breaks, coming back up on the porch saying that he just wanted to rest and he was 'tired of playing'. 'Tired of playing!!!' I don' think I have ever heard such words come out of my child's mouth before! I love how play transcends language and that to truly play you don't need all these expensive gadgets and gizmos. The majority of the time Josiah and his friends just ran around and played with sticks and the occasional ball.
It was so funny, when we would look through these pictures or show other people, Josiah would point and say 'That's me in the blue shirt' or 'That's me in the red shirt'. REALLY?!?!
Just like here in the States, Josiah loves to hang out with the 'big kids'. One of his new friends was Junior, a general laborer helping with the construction of the houses. At one point, they decided to change names so now Josiah is referred to as the 'white Junior' and Junior is known as the 'black Josiah'. I loved watching Josiah (or the 'white Junior') just completely integrate himself into the village. He played and danced with the kids, hung out with the big guys, and even helped Mommy do some dressing changes on some wounds.
It almost seems like he grew in stature and maturity overnight while we were there. Josiah makes friends so easily and is completely uninhibited when it comes to going up to people, especially kids, and introducing himself and starting a conversation. Here he is with Alfred, his self-pronounced best friend in Freetown who he knew all of 10 minutes before we left for the airport. 
And he played with the African car that 14 year old Francis made him for his birthday. It is assembled from two sardine cans, two sets of wheels and a strip of fabric to pull it around with. Josiah would find roly polys and pull them around in his car. Not exactly the safest toy, so because of the tetanus hazard and not wanting his sisters to get cut on it or break it, we opted to leave it in Mokanji.
Josiah was so exhausted from all his fun at Mokanji that he could barely stay awake in the airport and he basically slept while I walked him out to the plane, up the steps, to the bathroom to change and into his seat. This is how he spent the entire plane trip to London. He woke up about an hour before landing, just enough time to go to the bathroom and have breakfast before our next layover and last flight.Josiah would say often during our trip that he missed Daddy and Sofia (Lydia only a little bit) and was glad to see them. He is looking forward to going back to Mokanji to play with all his new friends.
Sunday, October 16, 2011
Medical situation in Sierra Leone
Currently there are two nurses who work at the government run Community Health Clinic in Mokanji. They use one of the old hospital buildings for their clinic. I was able to talk with them for a few minutes to see what they are able to do for the people of the Mokanji region. One morning a week they have a prenatal clinic where they use a Pinard horn, not a doppler like we are used to using to hear the baby's heartbeat. 
The nurses also take the woman's blood pressure, weight and give tetanus shots (when they have them). They don't have any urine test strips to check for protein or glucose or any medications to give for any problems or issues and have run out of the government supplied prenatal records to record the mother's information.
They have a few antibiotics that they have available to them when the goverment supplies actually get to them (not as often as they are supposed to).
The nurses also take the woman's blood pressure, weight and give tetanus shots (when they have them). They don't have any urine test strips to check for protein or glucose or any medications to give for any problems or issues and have run out of the government supplied prenatal records to record the mother's information.On Friday mornings the nurses hold an 'under 5 clinic' for children under 5 years old. They weigh children and measure mid-upper arm circumference to help determine nutritional status. It takes a month for a child to be able to receive Plumpy Nut (a nutritionally dense ready-to-use-food). However some of these children cannot wait a month. I saw one girl who was 13 months old and only weighed 13 pounds! I think that she has developmental issues because she would push out the mashed up banana with her tongue that we tried to feed her and would choke on the Plumpy Nut.
They have a few antibiotics that they have available to them when the goverment supplies actually get to them (not as often as they are supposed to).I saw so many things that can be done to improve the quality of life and decrease the incidence and severity of illness with simple teaching and basic medications and supplies.
Sierra Leone Diary 2nd installment
Thursday & Friday September 22 & 23
After finally falling asleep, Josiah and I slept through our alarm and had to rush to get dressed and grab a few bananas and biscuits from the hotel breakfast area so that we could leave and get to the ferry on time.
Side note about Freetown geography - If you look at a map of Freetown you will see that it is situated on the coast of the Atlantic ocean as an offshoot of land, the middle of which is a hill. The airport is on another offshoot of land and therefore the quickest and best way to get from the airport to Freetown proper is either by water or air. Now a helicopter ride would be pretty cool, but expensive, so instead we spent about $2 US to ride in the first class section on the ferry for the 45 minute ride to the main section of Freetown.
We met up with Charles and Petra (They are the Canadian couple who have been there since the beginning of the year. Charles is managing all the construction of the houses and hospital) who were gathering construction supplies in Freetown and loaded our suitcases into the back of the pickup truck. It is a 6-7 hour drive to Mokanji; the first 2/3 of the driving is adequately maintained paved roads, but then we turned and the road turned into a packed dirt road riddled with road engulfing, waterfilled pot holes!
We arrived in Mokanji in time to unload the truck and get back in for an hour drive to a local mining camp for dinner. Mokanji is situated about one hour away from Sierra Rutile Mine. An interesting fact about the mine is that the only reason that they were able to survive the war without major damage is because they hired mercinary soldiers to protect the mine property. In fact, some of those soldiers are still on staff with the mine as security! The mine is a nice escape to get a good meal and some uninterrupted time. Since our houses in Mokanji are literally steps from the community well, there are often visitors and requests for help that come throughout the day. After such a long day Josiah and I slept well.
After a good night sleep, Josiah barely wanted to stay on the porch long enough to eat breakfast before going out to play. The kids (and everybody else) thought him quite the novelty. Because of the mine (they employ quite a few Caucasian Europeans and Africans) and short-term mission teams they have seen Caucasian adults before, but most have never seen a little Caucasian boy. Josiah had such a great time playing with all the kids. I love how play is universal and language barriers do not inhibit friendships with children.
After finally falling asleep, Josiah and I slept through our alarm and had to rush to get dressed and grab a few bananas and biscuits from the hotel breakfast area so that we could leave and get to the ferry on time.
Side note about Freetown geography - If you look at a map of Freetown you will see that it is situated on the coast of the Atlantic ocean as an offshoot of land, the middle of which is a hill. The airport is on another offshoot of land and therefore the quickest and best way to get from the airport to Freetown proper is either by water or air. Now a helicopter ride would be pretty cool, but expensive, so instead we spent about $2 US to ride in the first class section on the ferry for the 45 minute ride to the main section of Freetown.
We met up with Charles and Petra (They are the Canadian couple who have been there since the beginning of the year. Charles is managing all the construction of the houses and hospital) who were gathering construction supplies in Freetown and loaded our suitcases into the back of the pickup truck. It is a 6-7 hour drive to Mokanji; the first 2/3 of the driving is adequately maintained paved roads, but then we turned and the road turned into a packed dirt road riddled with road engulfing, waterfilled pot holes!
We arrived in Mokanji in time to unload the truck and get back in for an hour drive to a local mining camp for dinner. Mokanji is situated about one hour away from Sierra Rutile Mine. An interesting fact about the mine is that the only reason that they were able to survive the war without major damage is because they hired mercinary soldiers to protect the mine property. In fact, some of those soldiers are still on staff with the mine as security! The mine is a nice escape to get a good meal and some uninterrupted time. Since our houses in Mokanji are literally steps from the community well, there are often visitors and requests for help that come throughout the day. After such a long day Josiah and I slept well.
After a good night sleep, Josiah barely wanted to stay on the porch long enough to eat breakfast before going out to play. The kids (and everybody else) thought him quite the novelty. Because of the mine (they employ quite a few Caucasian Europeans and Africans) and short-term mission teams they have seen Caucasian adults before, but most have never seen a little Caucasian boy. Josiah had such a great time playing with all the kids. I love how play is universal and language barriers do not inhibit friendships with children.
Friday, October 14, 2011
Sierra Leone Diary 1st installment
Tuesday and Wednesday, September 20th and 21st
Josiah and I arrived at the airport with a mix of emotions. While we were excited to be leaving for Sierra Leone, I wish that it were all of us going and not just Josiah and I. Josiah was happy that he was able to get a window seat on the plane (it was what he talked about for the two weeks prior to the trip) and we gave lots of hugs and kisses to Jeneson, Lydia, and Sofia before heading toward security.
Let me just say now that travelling with a 5 year old by yourself is a breeze compared to travelling as a family of 5 with 3 small children! We sauntered through security and wandered around our terminal while waiting for boarding. The Virgin Atlantic flight to London was a breeze. Josiah and I watched a movie, ate our dinner then Josiah changed into his pjs so that he could sleep the rest of the flight.
We arrived at Heathrow International Airport in London for our loooong 6 hour layover (about twice as long as I like my layovers to be). Josiah had the most unusual birthday experience of celebrating his 5th birthday in the London airport, flying in airplanes and landing in Freetown. Josiah donned his birthday hat, I pinned his birthday ribbon to his shirt and we stretched our legs walking around terminal one. After a waffle and fruit smoothie breakfast, we colored a bit, played with the toys in one of the stores, played the card game War and went in search for lunch. Josiah chose a birthday lunch of a chocolate chip muffin with milk, topped off by 3 scoops of chocolate ice cream. (I DO let my kids indulge every once in a while!).
I was surprised on the flight down to Freetown how many Caucasian faces I saw on the plane. I suspect that many of them were miners returning to work in one of the numerous mines in Sierra Leone. I was a bit worried toward the end of the flight. Since we were travelling internationally we were required to fill out an immigration card for the government of Sierra Lone, stuff that I have done many times before. However, this time I had an anxiety provoking revelation that I did not have all the information required by the form. I knew that Rev. Joseph would be picking me up at the airport; I knew that I would be staying out in Mokanji with Charles and Petra, but I did not have any way to contact them! There there we stood in the line for the immigration booth, a very pale woman with her 5 year old son. Suddenly a face peaks out from around the other side of the booth asking me if I am Sandra and handing me a cell phone! It was Joseph!! He was calling me from the waiting area to let me know that he was there to pick me up and that the man who handed me the phone was a 'brother' there to help us with our bags.
We collected our baggage with no difficulty and prepared to leave the airport in the middle of our first African thunderstorm. We drove 10 minutes to a small hotel near the airport to spend the night. While it was not a Holiday Inn, it was clean, had electricity, and running water. After a much needed shower Josiah and I went to bed.
More to come in the days to come chronicling our trip to Sierra Leone.
Josiah and I arrived at the airport with a mix of emotions. While we were excited to be leaving for Sierra Leone, I wish that it were all of us going and not just Josiah and I. Josiah was happy that he was able to get a window seat on the plane (it was what he talked about for the two weeks prior to the trip) and we gave lots of hugs and kisses to Jeneson, Lydia, and Sofia before heading toward security.
Let me just say now that travelling with a 5 year old by yourself is a breeze compared to travelling as a family of 5 with 3 small children! We sauntered through security and wandered around our terminal while waiting for boarding. The Virgin Atlantic flight to London was a breeze. Josiah and I watched a movie, ate our dinner then Josiah changed into his pjs so that he could sleep the rest of the flight.
We arrived at Heathrow International Airport in London for our loooong 6 hour layover (about twice as long as I like my layovers to be). Josiah had the most unusual birthday experience of celebrating his 5th birthday in the London airport, flying in airplanes and landing in Freetown. Josiah donned his birthday hat, I pinned his birthday ribbon to his shirt and we stretched our legs walking around terminal one. After a waffle and fruit smoothie breakfast, we colored a bit, played with the toys in one of the stores, played the card game War and went in search for lunch. Josiah chose a birthday lunch of a chocolate chip muffin with milk, topped off by 3 scoops of chocolate ice cream. (I DO let my kids indulge every once in a while!).
I was surprised on the flight down to Freetown how many Caucasian faces I saw on the plane. I suspect that many of them were miners returning to work in one of the numerous mines in Sierra Leone. I was a bit worried toward the end of the flight. Since we were travelling internationally we were required to fill out an immigration card for the government of Sierra Lone, stuff that I have done many times before. However, this time I had an anxiety provoking revelation that I did not have all the information required by the form. I knew that Rev. Joseph would be picking me up at the airport; I knew that I would be staying out in Mokanji with Charles and Petra, but I did not have any way to contact them! There there we stood in the line for the immigration booth, a very pale woman with her 5 year old son. Suddenly a face peaks out from around the other side of the booth asking me if I am Sandra and handing me a cell phone! It was Joseph!! He was calling me from the waiting area to let me know that he was there to pick me up and that the man who handed me the phone was a 'brother' there to help us with our bags.
We collected our baggage with no difficulty and prepared to leave the airport in the middle of our first African thunderstorm. We drove 10 minutes to a small hotel near the airport to spend the night. While it was not a Holiday Inn, it was clean, had electricity, and running water. After a much needed shower Josiah and I went to bed.
More to come in the days to come chronicling our trip to Sierra Leone.
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