Serving the People of Sierra Leone

Sandra Lako was born in The Netherlands but grew up on board the Anastasis where she spent much time playing with patients in the hospital. What might be uncomfortable for some was normal for Sandra and she was not bothered by the sights and sounds of a hospital.

Sandra later became Dr. Sandra Lako and has been practicing medicine now for over 17 years in Sierra Leone. In this beautiful country, she’s seen the need for safe surgery and medical care. But, she has also seen the resilience and determination of the people she works alongside. Dr. Sandra is excited to have the Global Mercy in Sierra Leone as she works with Mercy Ships to bring hope and healing to the Sierra Leoneans.

In this episode, Dr. Sandra Lako shares some fun childhood memories on the Anastasis. She tells about the moment she knew she wanted to go into medicine and the gift of living and working in Sierra Leone. Dr. Sandra is sure to fill you with hope that God is moving and doing great things amongst those in need in West Africa. Looking for a way to join our mission of bringing hope and healing? Partner with us through a gift, volunteering with us, or by joining us in prayer.

New Mercies Podcast Transcript

Welcome to the New Mercies, a podcast by Mercy Ships, where we’ll take you behind the scenes and on board our incredible hospital ships that are transforming lives all over the world. We invite you to join us each week as we sit down with our crew, patients, volunteers, and partners to hear their stories of life-changing hope and healing.

Sandra Lako was born in The Netherlands but grew up on board the Anastasis, where she spent much time playing with patients in the hospital. As a teenager, she decided she wanted to become a doctor and pursued that dream to become Dr. Sandra Lako. She has now been practicing medicine for over 17 years in Sierra Leone. And she is thrilled that the Global Mercy has arrived where she gets to serve with Mercy Ships once again. She is an extraordinary woman that will bless you. Here is my interview with Dr. Sandra Lako.

Raeanne Newquist:

Dr. Sandra Lako, thank you so much for taking the time to speak with us today on New Mercies, welcome you to the podcast.

Dr. Sandra Lako:

Thank you very much. It’s a pleasure to be here today.

Raeanne:

Well, you’re coming to us from Sierra Leone, which is very exciting, because currently, our Global Mercy is in Sierra Leone beginning of brand-new field service there. And it’s not brand new to you, though you have been in Sierra Leone for quite a few years living there. And so I’m thrilled to get to hear from you firsthand about the country, your knowledge of the need there and what is so special about this place that’s caused you to live there for so many years. But before we get into that, we need to kind of hear about your connection to Mercy Ships, which I understand goes way back to your childhood. So why don’t you tell us how your Mercy Ships journey began.

I was actually very young, I was two years old when my parents decided to join Mercy Ships. I was born in the Netherlands. And that’s where I lived with my parents, my older sister and my parents had wanted to do missions for quite some time and heard about Mercy Ships and decided to join the ship in Greece at the time, they took myself and my sister along. And yeah, I spent my childhood on the Anastasis, which was the first mercy ship that was my home. And I think having arrived to the ship as a two year old, meant that, to me living on a ship and growing up in that community setting was really normal, even though it’s very unnormal. And I don’t think I realized how unique My childhood was until I left the ship at the age of 16. After I finished high school on board and moved back to the Netherlands to continue my education, I realized how different my upbringing was, and actually how special it was as well.

Raeanne:

What are some of your favorite childhood memories of growing up on a ship?

Sandra:

A lot of what I loved about the ship was the community. There were always people around and it was very easy to get to school, it was a very quick commute of two minutes, down the hallway down the stairs, it was very convenient. I usually would have friends around and it would be very easy to meet up with friends after school. And that was always nice. There were also challenges in that although there were around 50 children on board, there wasn’t always someone my age. And so then you don’t have someone in your grade or your age to hang out with. That was challenging at times. But generally, there were a lot of people around to hang out with which is great. We spent a lot of time outside on the deck. When I grew up on the Anastasis, we did not have AC. It was very hot. And we spent a lot of our time outdoors. And so we would play a lot of games out on the deck like foursquare, sometimes field hockey, when I was really young, I would get on my roller skates and be roller skating on the deck. So there was a lot of outside activity. The ship was also a great place for hide-n-seek, there were a lot of different places that you could hide in. So we would often have very long games of hide and seek. So there was a lot to do.

Of course, the other part of what I really loved was traveling. And especially when I was growing up on the ship, we would spend shorter amounts of time in countries, it was before there was internet. And we actually spent half of the year doing more of a public relations tour either in North America or Europe to raise awareness about the organization and raise funds to ensure that the work that Mercy Ships does could continue because all of those surgeries we provide for people are free of charge. And so a lot of the year would be spent traveling from country to country, maybe three to four weeks in one place at a time. We would have hundreds if not 1000s of People touring the ship to learn about the work that we were doing. And then the rest of the year was spent doing the field service work, where we actually delivered the surgical care. And at that time, we also had quite a few off-ship projects, both in agriculture, as well as construction projects, building schools or clinics. And so there was quite a lot going on. But it enabled us to travel around quite a bit. And of course, I was a child, I was going to school on the ship, but the school and my home traveled with me. It did provide the opportunity to meet people of different cultures. And yeah, see different places, hear different languages. So it was quite a rich upbringing, I would say.

Raeanne:

And very unique, because it’s much different than I think the experience that a lot of children have on board today. They don’t sail as much as you did, spending half of the year sailing all over North America and Europe, and then the other half of the year in Africa. That’s just not something that that we currently do. So you really had quite a unique experience. Was there a hospital onboard the Anastasis?

Sandra:

There was actually and my mom is actually a nurse, and she worked as a nurse on the ship in the wards initially supporting the inpatient work. And then later, she started working in the post operative. So after a patient had surgery, she would be provided with nursing care, I had the opportunity as a child to actually go down to the ward and visit patients either before or right after their surgery, that was a really unusual experience as a child, but again, for me felt quite normal. We would have the opportunity to play with the children and just share God’s love with them. And it provided eye opening experiences. It was amazing to be able to do that.

Raeanne:

What was that like for you as a child to be in the hospital with people that had conditions that were so unique and so different? Was that ever shocking to you? Or scary? Or did you feel uncomfortable?

Sandra:

It was actually never shocking to me, because I think I had grown up in that environment. And I knew the types of conditions that Mercy Ships was treating, and it was a part of what I knew, and it wasn’t unusual. And I think because my mother was working in the hospital, it was just quite normal, actually. So you know, patients would be able to come out on the deck as well at times. And so there was quite a lot of interaction there.

Raeanne:

That’s awesome. Such a unique experience. Was there a patient in particular, as a child that maybe grabbed your heart or someone that you got to know while they were on board?

Sandra:

There were definitely a couple of children, especially maybe infants with a cleft lips and palates who their families really struggled because they were ostracized, because they had a baby with this condition. And so we were really able to encourage those families. And yeah, there’s a couple of infants that we would take care of regularly. And that made a big impact on me, there was also an elderly man, he must have been in his 40s or 50s. And he had a cleft lip, which in western countries like the U.S. and the Netherlands, where I’m from, you wouldn’t see an adult with a cleft lip. Those surgeries are done very shortly after birth, but for this particular person, that surgery had not been available. And so yeah, being able to meet him and just see the transformation that took place when he had the surgery was incredible.

Raeanne:

When did you know that you wanted to go into medicine? And it kind of sounds like your childhood really led you down a path of pursuing a medical career. But when was it that you really felt like this is what I want to do?

Sandra:

So it was really during the first field service that Mercy Ships did in Sierra Leone, actually, that I had an experience that led me to want to go into medicine. And so at the time, Mercy Ships was doing more off ship programs and one of the programs was an off-ship clinic, so providing primary care services to communities. And so as a teenager on board at the time, we had the opportunity to spend a week at some of these projects, to join in and have that experience. And one of the projects I went to was a school that was being built and we literally spent a week painting the school, which was fun. It got us out of school. It was interesting. But the other experience I had was actually joining one of the medical clinics and so myself and a couple of my friends went out to the community where Mercy Ships was hosting this clinic. And we were able to participate in that week. Now, of course, it was a teenager. Medically speaking, there wasn’t anything I could do.

But there was actually a measles outbreak at the time. And so there were a number of children who came with their caregivers who were quite sick. And a lot of those children hadn’t eaten for days due to their illness, and they were quite dehydrated. And so we literally sat there helping the moms kind of spoon feed their children, and a lot of that was oral rehydration solution, because they were so dehydrated, and so trying to help the moms provide basic care for the sick children. And there were a couple of children that died that week due to measles. And that made a big impact on me. And that’s when I first considered pursuing medicine as a career. Or I should say, more as a missions focus, to go and study medicine, and then one day, come back to Africa and be able to provide medical services here. So that’s how it all began.

Raeanne:

And that’s exactly what happened. So you had mentioned that you left the ship at 16 years old to go back to the Netherlands and continue your education. Why don’t you tell us a little bit about your path of medical school? And then what ultimately led you right back to Sierra Leone?

Sandra:

Yeah, when I left the ship, I went back to the Netherlands, I actually had to do two years of what’s called an International Baccalaureate program as kind of a segue between high school and the ship and going into University in the Netherlands. And so I did that. And actually, that was very helpful because it was actually in English, my classmates were all international. And it provided this opportunity to transition from this childhood on a ship, which is actually quite unusual. I learned at that time normal for most people was very unusual for me at the time, but in this setting with friends from the Netherlands and having a public school system that I became a part of. So that was all quite a big transition. And of course, the language, I really grew up speaking English. Although my parents often spoke Dutch to us as children, we often spoke English in return. And so English really is my first language. And so going back to the Netherlands, yeah, it was all a huge change for me. So that kind of two year segue was really helpful. It enabled me to continue studying in English, and having international friends while getting used to the culture and this new environment and kind of life off of the ship. And so after those two years, I went to medical school, and completed that in the Netherlands. I worked in the Netherlands, briefly.

And then I went to the UK to do a course in tropical medicine. And it was while I was in the UK during this course, that’s when I received a call from Mercy Ships, saying that they were going to start a health facility in Sierra Leone. And the purpose of this facility was actually to provide care for woman with obstetric fistula. So as a childbirth injury, which was quite common in Sierra Leone at the time, of course, I wasn’t a surgeon. But I had trained as a general doctor and had an interest in pediatrics. And I had done this tropical medicine degree. And I was asked to come and set up a clinic so that the local community would be able to benefit from this new facility that was being put on their doorstep. And so I asked a lot of people about this opportunity and prayed about it. And it really felt like it was where God was leading me to go. And I had been wanting to go back to Africa, I was looking for kind of the right place to go the right timing, the right organization, and this seemed to be a good fit. And of course, I knew Mercy Ships. And so you know, that made it easy for me to decide to do this. And so I moved to Sierra Leone at the time, I thought initially that I was coming for one year, when I got to Sierra Leone, this would have been early 2005, at the time, the child mortality rates was very high, highest in the world, with one in four children not reaching the age of five. Because of that, I decided to focus the clinic, the outpatient clinic on child health.

And so I hired staff and you know, worked with the organization and as they were setting up the obstetric fistula side of the hospital, I was setting up the pediatric side and so I hired national staff and we started this clinic, and that clinic is still running to this day and still provide care to both women and children. And so, yeah, that facility was initially run by Mercy Ships and then handed over to another organization in 2008. But it has continued since then. And so it is a bit of Mercy Ships legacy. And yeah, so I was able to work there as a clinician for the first four years of my time here. So my first year became four years quite quickly, I think it was kind of midway into that first year that I thought my contract ends in six months. But I really feel like I’m just getting started, the clinic is just now established, there’s still a lot to do, it’s too soon to go. And so that’s why I extended and ended up staying here for a lot longer than I would have imagined.

I also spent six years working at the government run Children’s Hospital in town here, and part of clinical but a big part of that was also to help strengthen the systems and the processes within the hospital to provide training for health professionals, and to help with quality improvement work. Yeah, that has given me a lot of experience also on the public health side, which has helped me to get where I am today.

Raeanne:

What an incredible journey and I just love how God has woven this story through your life bringing you to a place that has such need and has fully equipped you to be there and serve. Do you practice general medicine then?

Sandra:

In Sierra Leone, I’ve really only done pediatrics. And a lot of that is kind of general practice type work. But for children, and a lot of infectious disease, of course, is a lot of malaria here. That’s kind of what my focus has been.

Raeanne:

You’ve basically been in Sierra Leone now for about 18 years. Is that correct?

Sandra:

That’s correct.

Raeanne:

Oh, my goodness. So you’ve probably seen a lot of changes in the country, I hope. Whereas when you first started, the mortality rate for children was so high. Have you seen that number go down? Has there been improvement over the last 18 years?

Sandra:

There has been a lot of improvement over the last 18 years. And I think, you know, that’s one of the highlights of being here for so long is that you can see those changes. So yeah, the child mortality rate has dropped, which is great. And I think one of the amazing changes that has taken place is that, despite challenges in the history of Sierra Leone, people have been really determined to see things move forward. And I think one of the big changes I’ve seen is the emphasis that the ministry of health and sanitation here has had on training. And so they have in the last probably five years started residency training programs for doctors here in Sierra Leone. So instead of having to send doctors out to other countries, they can now train them here in Sierra Leone. And you know, the types of specialties are still limited, but they are kind of growing that portfolio. And it is great to see doctors who have actually been able to complete their training here, who then stay to practice here, and are providing services to their own people.

Raeanne:

Wow, that is very important. What else can you tell us about Sierra Leone, tell us about the country. And then also more of the conditions, if you will, that you’re seeing in your clinic and in the hospitals, what are a lot of the needs of the people?

Sandra:

So there are a lot of medical and surgical needs here. A lot of what I was seeing in the pediatric clinic was primarily infectious diseases. So malaria, stomach bugs, a lot of pneumonia or bronchitis, colds, ear infections, the usual things also that children in the US or in the Netherlands would have, of course, diseases like malaria are pretty unique to this part of the world, and still do lead to quite a lot of child deaths. And so that is a huge area of focus here in terms of prevention and also prompt treatment. In terms of surgery. I mean, there’s a lot of general surgery cases seen here a lot of cases like hernias, which is something that Mercy Ships addresses, and then also a lot of surgical conditions, such as the cleft lips and palates and the orthopedic conditions. Also a lot of acute surgical care, like appendicitis, is something that you would see here as you would see in other parts the world. Traffic accidents, sadly, are very common here, so there’s a lot of injury due to traffic accidents as well. So there’s a wide range of specialties or conditions that are seen here. Now, one of the challenges in Sierra Leone is that not every type of specialist is available. So for example, there’s no maxillofacial surgeon in country. And there’s only one pediatric surgeon for the whole country of 8 million people. There are only two anesthesiologists in country. So it’s a lot of nurse anesthesia providers. But that number is also limited. So there’s really a deficit in the number of specialists and health care providers in country. And that is why Mercy Ships has decided to also work in the education and training space to try to help the host country increase the number of specialist providers. So I’m really excited about that part of the work that we will be doing here in Sierra Leone.

Raeanne:

Well, you are such a huge asset to Mercy Ships as we are in this, the very beginning of this field service, because you’ve been there, you’re boots on the ground for the past 18 years, you offer so much insight. And I’m sure you have so many relationships built with the Ministry of Health and, and the government and so forth. So we’re just so grateful for your partnership and your role with Mercy Ships, especially during this field service. So thank you. This is so exciting to have someone with such extensive knowledge and a beautiful connection to Mercy Ships from the time you were two years old. As this field service begins, what will your specific role be?

Sandra:

That’s a very good question. So I’m not new to Mercy Ships, and I’m not new to Sierra Leone. But I’m new to this specific role. I am the country director for Mercy Ships here in Sierra Leone. So I represent the organization to anyone in Sierra Leone, basically. And that can be at government level, to educational institutions, to health facilities to communities. And so I bridged that kind of space between the organization and the country. Yeah, it’s a great place to be in. But of course, it means that my job is very diverse. And also means that sometimes I don’t quite know what’s happening next.

Raeanne:

It’s an adventure.

Sandra:

So before the ship came to Sierra Leone, a lot of my work was around the preparations for the ship’s arrival. And so that entailed a lot of meetings with various ministries in the government sector, to make sure that everything was in place. And that could be anything from logistics around the ports and the water supply, to working with my team to make sure processes are in place for registration and recognition of medical staff working on the ship, to making sure that we have suppliers who can deliver food to the ship. And so I have been working with a team of people to prepare for the arrival of the ship. And so that has been a lot of my work, on the other hand, is also been around setting the stage for the education and training programs. So, working closely with our international programs department, and also specifically our education team on the ship to determine what the best education and training projects would be here in Sierra Leone. And so there’s been a lot of conversation with both people in the ministry of health as well as at the hospitals and educational institutions to see what are the current gaps? What is already being done? What are the government’s plans, and how can we step in and work alongside them to achieve their goals? And so that’s been a part of what I was doing prior to the ship coming.

Now that the ship is in Sierra Leone, one of my main roles will be making sure that the ship is in good contact with the people on the ground in Sierra Leone. So really still making sure that I am a liaison between our partners on the ground and the crew on board and kind of networking and making sure that they’re in contact with the people they need to be for the operations on the ship to be successful. And then part of it is also establishing our in-country team. So Mercy Ships now has a country engagement plan with the host countries. So my team is not only here to prepare for the arrival of the ship, but also here during the ship’s phase and also after the ship leaves. So we’re not only focusing on the 10 month field service, but after the ship sails out of Freetown, some of us will be left behind. And we will continue the work that’s been started. And a lot of that will be around the education and training projects that we’ll be doing. And we’ve really shifted as an organization to looking more at long term educational opportunities for long term impact. And that’s something that I’m really passionate about, I think it enables us to really partner with people on the ground and teach them skills and expose them to maybe new procedures or different ways of doing procedures, and equipping them so that when the ship leaves, they can continue and they can carry out that work, and they can deliver safe surgical care in their own settings. So I’m really excited about the potential there to train others and to multiply the impact that we have, by working through national health professionals.

Raeanne:

Wow. Well, that is very exciting. I was going to ask you, what are your hopes for this field service, but I think you just beautifully articulated that! The education piece of Mercy Ships is growing and it’s important.

Sandra:

It’s always been important, but it’s really growing in focus.

We couldn’t ask for a better country director, Dr. Sandra, I’m so grateful for you, and all that you are offering during this field service. But especially as you mentioned, when the ship leaves in 10 months, just the lasting impact that there’s going to be there and how wonderful that you will remain in Sierra Leone to continue all the things that have begun during this field service. Now 18 years in Sierra Leone, that’s probably the longest you’ve lived anywhere and thinking about your upbringing, is it home to you?

Sandra:

It really is long to me. Yeah, definitely this is home. I think in part also, because my family kind of scattered across the globe, I have family in the Netherlands, family in the US and family in Haiti. So there’s not really another place that I would call home. And I think like you said, I’ve spent more time here than anywhere else. So this really has become home over the years. And I think that’s why it’s also just an honor to be in this role. I feel like I have a good grasp of Mercy Ships as an organization and how we work and what our vision is. And also because I’ve been in Sierra Leone, I feel very much connected to the people here who are amazing, and very energetic and hospitable, determined and resilient. And it’s yeah, it’s just great to be able to work alongside them, and just be a part of bringing about transformation in their country with them.

I really see this as a partnership. And yeah, it’s just great to see how God has orchestrated my life. And when you make decisions throughout your life, you don’t really know what’s happening years in advance. But when you look back, you can really see how God has tied things together and connected paths. And I’ve been reminded of Abraham and how God called him to go to another place without really even knowing where he was going. And he was obedient to that call. And I would never have guessed 18 years ago that I would still be in Sierra Leone. But this is clearly what God has called me to do. And looking back, it’s so easy to see how all of the different roles that I’ve had over the years, the different experiences, how that’s all kind of set me up for this role, and how that can be beneficial to Mercy Ships as an organization, but also just the impact that I can have with my colleagues and friends here in Sierra Leone. So it’s, it’s a really exciting time.

Raeanne:

Gosh, it really is. And I just love how you beautifully shared that it really touched my heart — God sent Abraham to a country that he didn’t know, and how God had purpose and intention and had equipped him for that time and how he’s really done the same with you. From the time you were little from the time you were born, He was weaving this story throughout your life and it’s such a beautiful thing to hear. Thank you. Thank you for sharing that with us. And thank you for your obedience to say Yes, Lord, I’m going to go do this. I’m going to move and I’m going to go to this other country and make it my home and have this lasting impact on the people there. It’s just it’s a beautiful, beautiful story, and I’m so grateful that you’ve shared part of that with us today. We are so excited for what God is going to do in this field service and Sierra Leone, and so thrilled that you are a part of it and offering all that God has equipped you with through your experience and your knowledge of the people in Sierra Leone and your relationships there and how that’s going to be just a beautiful thing for Mercy Ships. So thank you, Dr. Sandra for what you’re doing. And thank you for taking the time to share with us a little bit about it today.

Sandra:

Yeah, you’re so welcome. It’s really is a privilege to be able to share on the podcast and just to share my story. And, of course, the work that goes on through Mercy Ships and through what I’m doing is, is not about me, it’s really about God’s work and his plans. And I’m just constantly reminded of the verse that says that, you know, God’s ways are higher than our ways and his thoughts are higher than our thoughts. And I could never have imagined that this is where life would have taken me. But, you know, I know that this is God’s plan, and this is his story. And it’s just really exciting to see what God will do through the Global Mercy being here in Sierra Leone over the next 10 months. Thank you so much. I’m very excited that the Global Mercy is here in Sierra Leone to meet the surgical needs that the country has and the gaps that are there, as well as to provide an opportunity for local health professionals to learn alongside our crew and develop their skills and knowledge.For more information about Mercy Ships, go to mercyships.org, and to keep up with the guests on New Mercies, follow us on Instagram at NewMerciesPodcast.