Submitted by: James Fernando
James Fernando first dreamed of being a medical missionary in high school. At the age of 16, he set himself on this path, and God deliberately kept him there. When he met Rachel O’Hare, who was on track to join the physician assistant program at Union College, he was smitten. The two married and wondered where God wanted them to serve.
At the end of his residency program, Fernando had not heard God speak to him for 11 years, since high school. Within 12 hours of approaching Richard Hart, M.D., Dr.P.H., president of Loma Linda University, with the question, “Where are we needed?” Hart responded, “Guyana and Sierra Leone.”
With faith reaffirmed, they choose Sierra Leone. Later they learned it has a greater than 50% Muslim population and the worst maternal perinatal mortality rate in the world. A civil war 30 years ago, and Ebola 10 years ago damaged the country that is one of the world’s poorest.
They arrived in Sierra Leone with eight suitcases. Their 40-bed hospital is situated on the only paved road in the city. Necessity had the Fernando’s learn quickly how to shop using a different language in a crowded pedestrian market where they were the obvious oddity of the day.
At the hospital, they quickly learned the available medicines at the pharmacy because there are so few. The struggles of working with the perpetually impoverished population and staff were immediately obvious. Less than half of their staff had electricity in their homes. Other hurdles include poorly trained nurses, no medical records, and the side effects and persistent presence of witch doctors. They often treat the complications from witch doctors, including superinfections that result from an open fracture treated with leaves and dirt. The belief in witch doctors is so strong, that they have been recognized and condoned by the government and their own hospital staff seeking treatments.
One man brought in a child who had been seizing continually for two days. They tried to obtain a history but the man didn’t know anything because the child had been dumped into his bag at the market. The mother was nowhere to be found.
When a child presents with any kind of developmental delay or seizures, they are classified as a “demon baby” in Sierra Leone. The belief in spirits is so real that, if a woman goes into a body of water in the dark, they believe she is impregnated by the water spirits and gives birth to a “demon baby.” Traditional treatment is to take the child far into the jungle, lay it on a big white sheet, and surround it with a ring of flour sprinkled on the sheet. A large stick is then placed over the abdomen of the baby, and everyone goes into the jungle out of visual range. “Healing” doesn’t happen while you watch. It is said that the child turns into a snake, which eats all the flour, and goes back into the jungle in its original demon form.
The hospital, like the country for which it provides care, is perpetually in a precarious financial position. Committed to care for all who cross their threshold, payment often never comes. There are basically two types of people who seek care. The first are the majority, with malaria, hypertension, diabetes, burns, and broken bones. These occur every day, and each case is complicated by abject poverty.
The second are the prominent people. They have means, are politically connected, often claim “ownership,” believing themselves entitled, and often don’t pay.
As the new coronavirus came to Sierra Leone, the government took it seriously. They closed the borders. The embassy sent the Fernandos an email saying there was one more charter flight to the U.S. from Sierra Leone. If they didn’t take it, they should be prepared to stay for an “indefinite period,” even up to a year.
After an emotional struggle, they decided to take annual leave early and went home to be with family in Tennessee.
The government is now using their hospital as a COVID-19 treatment center. There is much more to the story of James and Rachel Fernando. Read their blog at farflungfernandos.blogspot.com. See where their long call will take them.
Georgia-Cumberland | August 2020