Glimpses of Salone’s medical crisis

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I covered the story of a nine-year-old girl who injured her spine after she fell down a flight of stairs when a classmate pushed her. For the past six months, she’s been languishing at the 34 Military Hospital in Freetown, being treated only with pain and inflammation medication. Properly diagnosing and treating her would require an expensive trip abroad to Ghana or India. But her condition isn’t especially extreme — the real problem is Freetown’s healthcare system. If Freetown had the proper scanning machine, it would be a different story.

I read about the lack of medical infrastructure in Sierra Leone before I left, but that was no preparation for actually getting a glimpse of what this means for people’s lives.

I wrote a brief news story on Isha, the nine-year-old girl, which you can read here. I also wrote a column in which I talked about what it was like to visit the hospital and cover the story, and offered some of my thoughts.

The girl’s mother was subdued and sad. She didn’t have much to say when I interviewed her (understandably). She took out a tablet to show me photos of her daughter’s back soon after the accident.

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I don’t know what exactly counts as a health “crisis” for a country. There’s no doubt Sierra Leone was in one while Ebola tore through it. Luckily things are basically functioning now — depending on your definition of that word. As a whole, Sierra Leone is not in a truly dire state like, say, Syria or Liberia, as I saw in a recent documentary.

But I kept thinking, and wrote in that column, that the shortage of staff, medications and basic medical equipment is really a serious, if low-level crisis of its own, though one that doesn’t get much international attention. It’s not a TV-ready African humanitarian disaster — instead it’s a slow-burning one.

After I covered that story, I asked one of my editors if I could do more reporting on exactly what the hospital’s shortages are, and how this is affecting people’s lives. My colleague suggested I talk to the staff of Connaught Hospital, the main hospital in Freetown. So the next day I set out alone to interview the head matron at Connaught.

It was pretty bureaucratic.

Connaught Hospital was built by British colonists in 1911, and it’s a complex of white buildings with an open space in the center filled with staircases, palm trees and soil. The entrance to the hospital is through a metal gate designed for cars and people. When I got there, a constant stream of people was trying to get through it. There was a hospital worker stopping people so that the stream leaving and entering could alternate, and thereby control the traffic. Before I could proceed into the rest of the hospital, a worker sprayed my hands with what I assume was some kind of hand sanitizer.

Right at the entrance was a small booth for payments, and throughout the hospital there were signs pointing to different areas of specialization. I was directed to the matron’s office up some stairs leading from the central area of the complex.

The whole hospital reminded me a bit of a motel or apartment complex in the United States. Though it was bigger than most apartment complexes, it hardly seemed fitting for a city with a population as large as Freetown’s. The needs of a hospital in 1911 and 2016 are clearly different.

On the way to the matron’s office I passed boxes stacked to the ceiling with the Red Cross logo on them. Outside her office was a bookshelf full of medical textbooks, and posters explaining how to properly put on personal protective equipment.

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Matron Isau Kamara, who was accommodating and a bit world-weary, said I would need to get permission for an interview from the public relations officer from the Ministry of Health. I would need to provide a letter stating my purpose for the interview, signed by my editor, and physically bring it to that office across town to get clearance before coming back for the interview.

I went back to the Awoko office, figuring my colleagues would have an easier solution than this headache in the making. They did. I returned to the hospital with my colleague Ade Campbell, who covers the medical beat for Awoko and has cultivated many sources in the field. While we were waiting for the matron, Ade pointed out a recently created ebola quarantine unit in the hospital. He said Connaught is mostly a teaching hospital. One of its biggest problems is staff morale: the workers aren’t being paid enough.

We found the head matron out on her rounds for the day. After seeing me with Ade and exchanging a few words with him, she immediately agreed to an interview the next day. Apparently, she hadn’t believed I was with Awoko newspaper at first, thinking I was with the international media and pretending to be with Awoko to get access, or something — hence the stifling bureaucracy. This goes to show that my colleague Ade is a great beat reporter.

But I also have to say, for a hospital with serious shortages that needs more funding, I found it kind of infuriating that the policy toward international reporters is to basically make things hard for them by drowning them in bureaucracy. How would this help anything? Ade said people working somewhere like Connaught don’t want bad media coverage. But whether this is because they’re afraid of losing their jobs over bad coverage, or don’t want inconvenient facts to get out, either way something is clearly broken. 

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Isatu Kamara, head matron of Connaught Hospital in Freetown

The next day I went back to the hospital for the interview. To be honest it wasn’t an especially informative or clarifying interview, as the matron wasn’t very forthcoming. But I learned that the hospital doesn’t have the money for many basic necessities, and has a serious lack of specialized staff. You can read the piece I wrote based on the interview here.

The problem of brain drain might be behind this lack of specialist doctors in Sierra Leone that the matron alluded to. Apparently, there are more Sierra Leonean doctors working in Chicago than in the entire country of Sierra Leone! There is no way for doctors to earn specialist degrees within Sierra Leone, so they have to be trained abroad. The matron said it’s about five times cheaper to send doctors to be trained in Ghana than the UK or the US. It was strange to hear her talk about it like a financial investment in this way, but it also makes total sense.

My colleagues at Awoko are awesome because, among other reasons, they’re always willing to help me go after stories I’m interested in. That same week, wanting to do more interviews, I went with a colleague to another hospital complex, this one in east Freetown. There were two hospitals next to each other, one for children and one for pregnant women. As my colleague expected would happen, we didn’t get any interviews; at the children’s hospital we were told to make an appointment next time, and at the other we were instructed to go to another part of town and give a letter to the public relations officer from the Ministry of Health. More bureaucracy.

I haven’t gotten any more hospital interviews yet, but I wrote a column about the walk to the hospitals which refused to give us an interview, and what they were like inside. You can read it here.

Links to pieces:

Wheelchair-bound girl needs treatment abroad

Column: Witnessing Salone’s medical crisis

Connaught Hospital needs staff, beds and funds, according to matron

Column: A walk to the hospital

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