Lion Mountain

Lion Mountain is the name the Portuguese gave to Sierra Leone in 1460, inspired by the ferocious weather they encountered here. Five months of thunder and lightening and tropical
downpours have started, and are wilder than anything we’ve experienced. The photos taken above in our street on last Sunday were on our way to church. Paradoxically when we reached there, just a mile away as the crow flies the streets were bone dry!

One of our Christian ward nurses, Annemarie in the same storm was in her house with her husband and four children when they heard a lot of branches falling on their roof. They rushed outside, just as a tree fell and crushed their house, so thakfully no lives were lost, only the building. As they haven't the money for repairs we have asked for the builder’s estimate so we can help them restore their home. (Two other nurses lost the roofs of their houses recently!)

(david.lyth@mercyships.org, or Helen.lyth@mercyships.org)

Repair of an obstetric VVF fistula.

Imagine you are faced with the task of repairing a hole in someone’s skin that connects with an inner cavity, the whole of which is within another deep cavity.

You first cut a circle around the hole with a very sharp small knife and extend it out on either side to give you access to the inner hole. You then carefully separate the outer skin and soft inner one, without damaging the latter. They are usually stuck together with very hard scar tissue.

You then close watertight the inner hole, with stitches at the correct tension placed at 3 millimetre intervals, and at last you stitch the outer layer.

Additional challenges:
If your inner line of sutures is at all unsatisfactory you have to reinforce it with a second line that inverts the first.

The ureters (urinary pipes from the kidney) are often involved in the hole and have to be identified and preserved at all costs, and the uterine opening (cervix) has also to be preserved.

There is usually mild to severe narrowing of the front passage

Scars of bone-like consistency that require special shears to cut through

Non existence of the water outlet pipe which has to be repaired, using nearby paper thin tissues

A hole into the back passage that has to be repaired separately.

Dave has been watching and taking notes of a world class expert this week doing extreme cases. I have also done a simpler case myself each day, growing slowly in confidence in the basic handling skills that will hopefully enable me to do the difficult cases later.

‘A fistula surgeon must never be hurried’

PS Gory photo was removed by request.

Please write : dave.lyth@mercyships.org, or helen.lyth@mercyships.org

10th June Rural Industries

In our recent trip to Bo we crossed a wide river that transects the country. On the bank we came across 20 women panning for gold from the black sand they brought up from the bottom of the river! There were also 20 men in a gang in midstream who were searching for diamonds!

In villages we saw coffee, and rubber being grown, and we were introduced into the hundreds of uses of the oil palm tree. These include cooking oil and making soap.

VVF surgeon, Judith Goh came from Australia for two-three weeks to train Dave. She is brilliant! After several previous weeks of frustration I feel greatly relieved to be shown ways to tackle the extremely challenging surgical problems that I may face on a daily basis. Thank you Lord!

Village life

We spent three fascinating days in the Bo area (see Google maps) on a trip to find and pick up ladies suitable for surgery, who are suffering from fistulas.

The dozen villages (up to 2,000 people) that we visited were so remote that none had a phone. Only government or charity vehicles ever visited. This is where a lady can be in labour for five days with no help. She may die, or survive with damage to her pelvic organs, and lower limbs.

We have a draft strategy to provide a mobile phone to selected patients going back to this environment, which has initial approval. Please pray as we study and do a pilot project.

Also pray for Dave in the next two weeks when he undergoes intensive training by an experienced VVF surgeon from Australia. In fact the next 5 weeks will be very busy with another surgeon also.