Janine Karoly of Tinton Falls is blogging from Sierra Leone where she has accompanied her husband, an ob-gyn, as part of a medical mission to the West African country where the life expectancy is about 40 and women have a one-in-eight chance of not surviving a pregnancy.
(This is the fourth in a series of five blog posts from Africa.)
The surgical team has operated on 20 patients and screened many, many, others. By the end of this mission, 22 women will have had their lives changed for the better. Word is getting out and women are showing up like crazy. One week is not going to be enough, one year would probably not be enough. Michael, Nina, and Danielle are bone tired aside from all three of them now have URI's (Inger, also). Their energy, focus, and drive make me feel so very inadequate and small.
Four surgeries are scheduled for Friday and the hospital staff is willing to work for a short time on Saturday, so two more are scheduled. They're seeing and repairing uterine and bladder prolapses (literally bladders/uteruses hanging out between their legs), ovarian tumors (dermoids), fibroid uteruses, and recto vaginal fistulas.
Some are not candidates for surgery, some need a pessary (a ring that supports the vaginal wall to hold back prolapse), some need to know, "We cannot help you now." This is called triage, but so difficult for the docs to turn them away. Tissues please.
Meet two of the most remarkable human beings on the planet:
Mr. Tom Johnson
Tom first came to Sierra Leone with the Peace Corp in 1989-91. Tom returned to SL in 2001, just after the brutal civil war and he says, "Before the armistice was signed." He spends three to four months here and the balance of the year in Morristown, NJ. "I love NJ." When in the US, Tom spends 100 percent of his time with the goal of raising money for his non-profit, Africa Surgery (africasurgery.org). He works along with F.O.C.O.S. (Foundation of Orthopedics and Complex Spine, orthofocos.org). His focus is getting help for children with spinal deformities or injuries. These surgeries are performed in Ghana (a big part of his funds going to transport) by a world-renowned spinal surgeon, Dr. Oheneba Boachie-Adgie.
He no longer needs to seek out patients, they find him. But Tom is also, truly, a jack of all trades. He'll help to repair bikes, get medicine for people with TB, give money and a note giving people entree for treatment at Holy Spirit … the list and categories endless. He resides in the village, Masongbo. Currently he has three children living with him that need spinal surgery and 70 in the country waiting for attention. One hundred percent American … 100 percent friend to the Sierra Leones. He's been a lifeline for Nina in her quest and their connection one of mutual admiration. He recommends reading, Mountains Beyond Mountains and This is a Soul. Tom states, " We are grateful for every small miracle we get. I'm going to do this till I die."
Dr. Patrick Turay
In my opinion, the word hero is overused and it's true meaning, diluted. In Sierra Leone, look no further than Dr. Patrick Turay to redefine hero … Dr. Turay defies description.
Born and raised in Sierra Leone, his parents made sure that he attended elementary and secondary school. Not able to afford to send him to college, Patrick eventually won scholarships for university studies then medical school in Russia. He speaks (and writes) Russian, having to learn the language to study medicine. He also speaks excellent English along with numerous dialects spoken in Sierra Leone. He is a very smart person.
Dr. Turay completed a fellowship in Italy for treating traumatized children and a fellowship in New Orleans for tropical and infectious disease. He has seen how others live. Many educated and professionally trained Sierra Leones leave the country, aka, brain-drain. Patrick stays. He leaves for education, for breaks … he returns. Asked what separates him from others, what makes him come back? A long silence, he becomes emotional, he composes himself before being able to respond, "I look at my people … they are lost."
After the civil war, Turay worked in Freetown treating the war wounded before coming to Makeni to do the same. (This experience, the motivation to seek out training for treating traumatized children.) He started out with a two-room clinic and one nurse, continuing to treat war victims. Then moved on to create, in a house, a 10-bed clinic.
From 2002 to the present (that's 10 years, folks), he's surpassed the obstacles facing a war-torn county, extreme deprivation and poverty, getting a clean water supply and stablizing sporadic electricity to build and financially sustain the Holy Spirit Hospital (about 65 beds), all the while creating the necessary and inherent operating systems. The hospital is owned by the local Catholic diocese but Patrick is constantly maneuvering to seek additional funds. It is never enough, the need so great.
Clearly financing is the greatest need, another huge obstacle for him, to bridge the cultural gap from what is good about the culture AND what should change, hundreds of years of basic "stone-age mentality" (Tom's words). For instance, Turay relays the problem that many SL's coming to the hospital having never been in a vehicle, having never been in a city, never stepped foot in a building, and they don't know how to use a bathroom. Hygiene, a huge problem to control in the hospital environment. Another instance, patients using native concoctions for cures, then coming to the hospital with end-stage problems that are difficult or impossible to treat. With all patients, Turay must rely heavily on clinical judgement and diagnosis and then only use tests sparingly as diagnostic tests/equipment severely limited.
He wears all the hats of administrator and physician. Between seeing a multitude of patients, he has two phones that interrupt him constantly. His difficulty in delegating responsibilities stems from the complexity of commitment. His dilemma, how much time do you invest in an individual after you tell them that they will never be compensated enough for the work ahead.
Turay is calm, eloquent and soft-spoken, he embodies the soul and spirit of loyalty to his country, loyalty to his patients, loyalty to the practice of medicine. I spent many hours watching him in action. I watch his connection to each and every person that walks in his office, patients and/or staff, calm, thoughtful, patient.
I cannot say enough.
Back to Tom: Asked if there are many cases for cleft lip repairs, Tom Johnson as he speaks to the stone-age mentality: Children born with this deformity are placed in the bush to die. If a mother refuses, the people in the village blame village problems on these cleft lip children. Should that child be lucky enough to get a surgical repair, the village problems are then shifted to witches.
Two of the most remarkable human beings on the planet … am I right or am I right?
I know that when I return to America, this experience will slowly fade. That being said, there is no question that it changes you. You are super duper grateful for all that you have but then I think I need "Africa glasses." That would be super duper helpful to remind me of the intense experience. We ALL need "Africa glasses" to keep perspective every f*&^%$g day for our WPP.
Things to know about Africa
- Expect to have grimy hands all the time
- Bury your body parts as well as hair trimmings so someone else can't perform witchcraft against you
- Every night is party night, not just Friday
- There are secret societies (????? … !!!!!)
Things Sierra Leones don't worry about
- Washing their hands after elimination
This is the fourth in a series of blog posts documenting the medical mission to Sierra Leone and the effort to bring a maternity ward to its northern region that is home to 1.7 million people and no ob-gyns. To make a donation to help One World Women's Health build a maternity ward in Sierra Leone, click here.
To read more from, and about, the Tinton Falls team in Sierra Leone: