Pharmacist assists in African hospital

Story By: Diana Mathews, staff writer
dianamatthews@nrcolumbus.com

The West African nation of Sierra Leone has more than 7,000,000 inhabitants and only 120 doctors. Between 1991 and 2002, civil war destroyed much of the country’s infrastructure, including hospitals.

More than 50,000 Sierra Leoneans died from the fighting, and two million became refugees.

Although the small, mountainous country is blessed with diamond and gold mines and other natural resources in abundance, a majority of the citizens live in poverty. The country’s health care system has been called the worst in the world. In 2015, the Ebola outbreak killed 3,955 people.

The capital, Freetown, was hit a month ago by massive mudslides that killed hundreds of people and displaced tens of thousands.

Amy Sessions, a pharmacist at Baldwin Woods Pharmacy, was part of a mission group sent to Sierra Leone by the North Carolina Conference of the United Methodist Church.

Amy Sessions loved meeting Sierra Leonean children.

Leaving Aug. 28, Sessions traveled via Paris to Freetown, then to the town of Rotifunk to assist at a hospital rebuilt in 2004 by a Norwegian Methodist group.

The N.C. Conference of the UMC has committed to upgrading the struggling facility to make it “the premier hospital in western Africa,” according to the denomination’s pamphlet, “Mission of Hope: Rotifunk.”

Methodists from Norway, Sierra Leone and North Carolina “in conjunction keep the hospital rolling,” said Sessions.

 

Into the interior

Rotafunk is a four-hour dirt-road trip from Freetown, which lies on the Atlantic coast. Said Sessions, “It was the rainy season, and the roads were like rivers.”

At one point, they drove their Land Cruiser onto a tiny ferry to cross an actual river. The ferryboat was only large enough to accommodate two vehicles, and the car boarding behind them rear-ended their vehicle, pushing it almost off the deck. “I was sure we were going into the river,” she said.

Sessions and her companions carried with them medical equipment sent by individual and corporate donors.

“We took a cardiac monitor. They had been borrowing one from another hospital four hours away,” she said. The group took four computers for record keeping and a CPAP machine so hospital staff would have a better chance to keep vulnerable babies alive. One baby of 10 in Sierra Leone dies before its first birthday, and two of 10 will not reach their fifth birthday.

“We provided education on how to use the equipment,” said Sessions. “They’re used to doing everything manually and were scared they were going to break it.” The visitors also carried in consumable supplies, for which the local doctors were “very appreciative.”

People washing in and traveling on a river in Sierra Leone.

Doing what they can

Sessions saw sweet potatoes, ground nuts, cucumbers, pineapple, coconuts, okra and corn growing in Sierra Leone’s tropical climate.

“The people are very frugal,” said Sessions. She was impressed with how well “they make the most they can of what they have.”

Sessions reflected on her observations in a blog post after her return: “On a daily basis, I was overtaken emotionally by what the doctors, nurses and lab technicians were doing with the limited resources available to them… I loved listening to the patients’ stories and observing the staff in action while watching the expressions on the patients’ faces.

“I can truly say how incredibly thankful I am for the country in which I live and the incredible God that I serve,” she wrote.

Sierra Leonean physicians “treat patients with the very best care they know how and do the best they can” with limited resources, she said. She and retired medical doctor Sam Spicer of Wilmington attended patients with malaria, stomach infections and snakebite. She saw doctors remove a stick that had been impaled through a girl’s jaw, and diagnose diabetes in one woman who was there for acute gastroenteritis.

The woman might have had untreated diabetes for a long time, Sessions thought, and she was going to have to keep returning to the hospital to get thorough follow-up care.

Unfortunately, “it’s hard to get people to go to the hospital,” said Sessions. “People are still scared of the hospital setting because of Ebola.”

Even if people are willing to go to the hospital, transportation is scarce, so few rural people can make the trip into town. Sessions said that the lack of access to care was one of the most alarming things she observed on her trip.

“I am thankful for the healthcare advances and the pharmaceutical care offered in America,” Sessions wrote in her blog. “I am thankful for the patients that rely on me and depend on me to serve their healthcare needs. As Americans, we should not take for granted what we have in our everyday lives, and especially in the healthcare arena.”

Meeting needs

Colonized by the British, Sierra Leone has been independent since 1961. The population includes several different ethnic groups, some of whom are descendants of emancipated slaves. English is the official language. “It’s a creole English,” said Sessions. “You could pretty much gather the gist of what people said, especially with the kids,” who had gone to school and spoke more standard English. “There was no really language barrier.”

While 60 percent of Sierra Leoneans are Muslim, 30 percent are Methodist; other Christian denominations make up the remaining 10 percent.

At this time, Muslims and Christians are living “in harmony,” Sessions said. The president is a Muslim man married to a Methodist woman. His term of office will be up soon, and Sessions hopes his successor will continue to foster religious tolerance.

“Our team didn’t go to work in the hospital,” Sessions said. She was chosen “not to be a pharmacist” but to evaluate the needs of the local professionals and “educate them to run things efficiently.”

For example, surgeons were available to carry out routine hernia surgery with the goal of moving on to do Caesarian sections and other operations. Sessions realized, however, that a medicine shortage might derail the doctors’ plans.

Once back home, she arranged for the anesthetic Bupivicaine to be taken to Rotifunk by the next United Methodist group, which departed Monday and is in Rotifunk now. The shipment will be enough to allow 250 hernia operations.

While in Rotafunk, Sessions accompanied Dr. Spicer on rounds and helped “the pharmacy guy,” who is not a licensed pharmacist or pharmacy technician, with his duties.

Helping in the hospital lab, she carried out “malaria smears,” examining color-stained blood specimens under a microscope to detect the parasite that causes the disease. Sessions took anti-malarial medicine throughout the trip and slept under a mosquito net because the window frame in her room didn’t close completely.

Before her trip she underwent vaccinations against yellow fever, typhoid and tetanus.

“The thing that surprised me most,” she said, “was that I didn’t see a single live mosquito the whole time.” She speculated that the constant pouring rain kept the breeding areas “completely washed out, and they couldn’t fly, either. Rainy season turned out to be the best time to go there” as far as malaria risk. Teams arriving after the rain has sat for a while might find a bumper crop of mosquitoes, however.

She was shocked and saddened to see the area devastated by the mid-August mudslide. Nurses from a Catholic aid group and from the United Kingdom were administering cholera tests to the victims in Freetown as water supplies were still unsafe.

Impressions

Sessions felt afraid only twice during her trip: once during her arrival at the capital city’s airport and then again when re-crossing the swollen river on the return trip. “The ferry was closed, but we bribed the operator to get us across.” The roads didn’t faze her as she is used to going hunting with her husband, Scott Sessions.

“I had not one bad experience,” she said.

She was back home in Lake Waccamaw on Wednesday, Sept. 6, and she “would love to go back” if a future team has room for her.

The “most overwhelming” impression Sessions carried home from her visit to Sierra Leone was the people’s “attitude of gratitude” she said, as well as their welcoming and friendly behavior toward strangers. “They accepted four very different people from a very different county.”

“I went with an open mind, not really knowing what to expect,” Sessions said. She enjoyed the contact she had with Sierra Leonean children, who were engaging and friendly and followed her around as she went places.

“What made the trip life-changing for me was that, by American standards, they have so little. But they love each other, they have really close families and they love their neighbors.

“By God’s standards, they not only survive but have a good life. They don’t complain. They smile all the time. They have everything as far as being what God wants us to be.”

Tabor City gets Little Free Library, looking for more

By: Clara Cartrette, claracartrette@nrcolumbus.com

Take a book, return a book

Little Free Library for children has been installed at the Tabor City Visitor Center, thanks to the generous donation of Bell Appliance and Supply Company.

The company, owned and operated by Terry Bell and his son Bradley, purchased the weatherproof Little Free Library, but the idea came from Linda Bell, Terry’s wife and Bradley’s mother. She got the idea from a friend, Susan Deans, who had Little Free Libraries installed in Whiteville as a project while working on her Master’s degree.

The Little Free Library officially opened and was dedicated last Thursday when Lydia, Hannah and Elijah Deal, young children of Tabor City Baptist Church Pastor Jeremy Deal and wife Deanna were the first to get books from the Little Free Library.
Tabor City Promotions Director Dianne Ward, who manages the Visitor Center, said children are welcome to use the outdoor benches or come into the Visitor Center if they want to read on site. The main purpose of the Little Free Library is for customers to take a book and return a book in an effort to encourage children to enjoy reading. Books are expensive but with a lend and return project in effect, children now have access to lots of books without cost.

Clara Cartrette photo
Pastor Jeremy Deal, his son Elijah, Bradley Bell, Susan Deans, Deanna Deal and daughters Hannah and Lydia, left to right, gather around Tabor City’s first Little Free Library, located at the Tabor City Visitor Center.

Ward said she appreciates the generosity of the Bell family in providing the Little Free Library to promote literacy.

The public is encouraged to donate new or slightly used books for the “take a book, return a book” free book exchange. Drop new or slightly used children’s books off at the Visitor Center Monday-Friday from 8:30 a.m.-4:30 p.m. or Saturdays from 10 a.m.- 2 p.m. The Visitor Center is located at the corner of Fifth Street and Stake Road across from Inman-Ward Funeral Home.
The Little Free Library at the Visitor Center is for children, but everyone involved in that project hopes others in the community will step up to provide Little Free Libraries for all age groups.

Little Free Library is a nonprofit organization that inspires a love of reading, builds community and sparks creativity by fostering neighborhood exchanges around the world. Through Little Free Library, millions of books are exchanged each year, profoundly increasing access to books for readers of all ages and backgrounds.

On the recycle mornings I view
All the trash cans lined up two by two
Side by side in each yard
They’re two forms standing guard
Like old soldiers in grey and in blue

Be on guard for the fierce fire ant bite,

With the swellings and pain they ignite

Poison the sandy dome

That they build as their home

And they shift to a new, nearby site

Harvey recorded three feet of rain.
That was impossible to contain.
After the huge downpour
Locals say they’ll restore
The large count of swamped homes that remain

Patients travel to Columbus Regional from across the country to relieve foot pain

HyProCure implant can relieve a host of symptoms caused by misaligned feet

A minimally invasive, outpatient procedure called Extra-Osseous Talo-Tarsal Stabilization (EOTTS) by HyProCure® provides relief for children and adults suffering from pain caused by misaligned feet. The procedure has been performed tens of thousands of times in adults and pediatric patients,” said Don Peacock, DPM – and the technique has been vastly improved by HyProCure which is a Type II version.

What’s made Columbus County a destination for people who want the procedure is that Dr. Peacock, a national innovator in minimally invasive foot and ankle surgery, has pioneered combination surgeries that combine the HyProCure procedure with minimally invasive procedures – tendon rebalancing, for instance. These techniques allow the patient to spend less time in the OR and in recovery. “It’s just one surgery and one recovery,” he said. “And you can walk the day of the procedure.”

Dr. Peacock is on the medical staff and has surgical privileges at the hospital.

“I’ve just taken what I’ve learned about several procedures and combined them,” said Peacock. “The HyProCure procedure is by itself innovative and combining it with minimally invasive techniques that treat foot deformities and pain appeals to patients.”

HyProCure is intended for patients – children and adults – with misaligned feet. The condition may not seem severe, but it can lead to almost constant pain in the back, hip, knee and heel. HyProCure is also used to treat children with flat feet, a condition that can cause foot deformities such as bunions and hammertoe later in life.

HyProCure implant can relieve a host of symptoms caused by misaligned feet

A number of symptoms – such as heel pain (plantar fasciitis), hip pain, knee pain, hammertoe and more – can indicate misaligned feet.

The condition usually is congenital. For others, it develops over time. In those cases, overpronation is the main cause. Overpronation happens when the inward motion of the foot and ankle isn’t performing properly. People who overpronate can see their ankles roll inward when they walk.

A misaligned foot (or feet) almost always causes pain – although the pain may not necessarily present in the foot. Pain may be in the knee, hip or leg. The condition can be treated with HyProCure even before it causes pain. Doctors typically recommend treating it soon after the condition has been diagnosed.

“Patients who have the HyProCure procedure often see side benefits,” Peacock said. “Their feet stop hurting, but they can get relief from knee and back pain, too.”

And there’s no drilling or screwing involved. The surgeon makes a small incision in the skin above the outside of the foot and slides the HyProCure stent into the natural space inside the foot. Threads on the stent allow for the scar tissue to form around the grooves and lock the device in place during the healing process, which typically takes three to six weeks.