Makeni project 2008 report
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This is a summary description of a medical mission sponsored by WWSL. WWSL is an NGO that is committed to providing free medical care, elementary school education, and
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Editor's Notes
- These individuals were civilians traumatized by the rebel forces that moved through the country from the border of Liberia to ultimately enter the Freetown and assumed power in a shared arrangement after peace negotiations. The arrangement failed after the people demonstrated against continued atrosites committed by the then security forces. The were fired upon and 18 people were killed during a peaceful demonstration. The UN Peacekeepers intervened and the fomer rebel leader went into hiding to escape arrest and charges of human rights violation. He was captured inprisoned and died after going insane in prison.
- The Truth and Reconciliation effort has provided victims the opportunity to confront those guilty of these atrosites. This is a national effort to promote healing. Many people speak of forgiving these abuses. However there is still ambivalent feeling as one would expect.
- One man who had been a driver all his life having been taught to drive by his father, was now unable to pursue his trade because he has only a stump on his left upper limb. He was fitted with a prosthesis by an NGO in Freetown and given two weeks of functional assessment but no transitional work placement. He is now in the resettlement camp without gainful employment. His vocational rehabilitation is a necessary aspect of his overall medical and psychiatric treatment plan. The ideal rehabilitation effort would be to arrange for robotic prosthesis combine with micro-loans to restore functional and economic productivity.
- The restoration of pre-morbid functioning is the ideal and ultimate goal. This would require complete reintegration of the war wounded , especially the amputees , into the general community. Currently they reside in camps that were established to mitigate against the psychological stress of marginalization and stigmatization by providing a group support system.
- The pictures above reflect the current and historical resilience and hardiness of the people of Sierra Leone. The picture on the right is of the symbolic Cotton Tree in Freetown planted by the early settlers to reflect their freedom. The opposite picture reflects the basic tenacity and diligence of the people in the village of Yele.
- The demographics of the victims reflected the plurality of the general population. The psychosocial stressors in the ambient environment derived from the poverty traps in the rural and urban areas was confounded by the functional disability resulting from the amputations. The need or vocational rehabilitation in the context of a micro-credits economic structure is critical to restore the health and reduce morbidity and mortality. For example people are unable to afford medicine under the cost recovery system.
- The above represent a cross section of the clinical experience during the very limited 10 day medical mission. The need for systematic screening in both the Yele Village and the Makenie Camp for hypertension. Obesity , hypercholesterolemia, hyperlipidemia, elevated blood sugar is apparent from the high prevalence of hypertension and the high starch content of the diet.Immunization efforts for the young and old were reflected in the presence of preventable conditions like tetany.Smoking cessation interventions are indicated. The provision of cataract removal and hernia repair is an extremely important and needed service.
- The co-morbid psychiatric disorders and sub-clinical symptoms are masked by the cultural and socioeconomic priorities, Anxiety manifests as gastro-esophageal reflux.Pain is the most common chief complaint and one has to determine if it is psychic pain or physical. In most cases it is both.