Sara, girl with a rare congenital abnormality

7 year-old, Sara, has been wet with urine continuously since birth, which has deeply affected her whole family. Her enterprising mother brought her 217 miles to Freetown, and attended various clinics. Twice she waited in the queue for our paediatric clinic, but because of numbers they weren’t seen, and they went back home, bitterly disappointed. On hearing on the radio about our visit to Koinadugu she came to see us. I saw her and suspected a congenital fistula of her urinary system. An IVU X-ray this morning in a private hospital confirmed my suspicion of a ureter that bipasses the bladder. I have contacted the other urologist in Sierra Leone and we plan to operate on her next week at the government hospital – paid for by our supporters. Here is Sara eating an ice cream in Freetown.

Health care in Koinadugu District

Shown is one of 12 health centres in the district, where there is a clinical health officer (known locally as a doctor), and a maternity health nurse. This centre, which serves 50 villages with a population of 10,000 is very poorly equipped. It does however have a solar powered fridge for vaccines. A 'vaccinator' tours the area

Search and bring

Last week we went on a 4-day trip with the nurse and driver who go to outlying areas to search and bring back patients suitable for fistula surgery. Our destination was Koinadugu district, the poorest, and most remote of 12 in Sierra Leone. ‘Main roads’ are dusty, steep, tracks, some with broken bridges. We stopped in 25 villages to ask if anyone had fistula symptoms. We picked up one woman but 4 other patients reported were too remote for us to access; for example “5 miles down that rough track, and then 4 miles walk. But she may be in her fields harvesting.” We went to the radio station on a nearby hilltop and asked the man to transmit a personal message (cost £1.50) to ask the women to come in during the next day or two. Sadly our efforts failed.

Joy Lyth capped for Scotland

Yes, the day before we left Scotland on our home leave we had the thrill of watching Joy in action for the national team against Sweden. They played at a high level, as you can see in the video (if you install 'flash 9' on your computer - try google) and won 32-0. Joy captains her Lismore (Edinburgh) team and trains several times a week. Well done!