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Inside Sierra Leone's Connaught Hospital

By Allieu Sahid Tunkara

Connaught hospital is Sierra Leone’s central and oldest medical facility, and it occupies a large surface area at Percival   Street in the heartland of Freetown. The back of the hospital faces the famous Atlantic Ocean near King Jimmy wharf. The hospital by its facial looks is one of the few monumental edifices the state can take pride in. It was established in 1911 during the colonial period to provide medical services to the people in the then colony. Some buildings have been erected to add to the old building owing to the   health demands of the growing population. At the time of my visit, a new building is being constructed to give the hospital a facelift. The new building is the permanent isolation centre where victims of future outbreaks of infectious diseases would be taken care of. This is one of the few lessons Ebola outbreak has taught the country’s health officials.

Inside the hospital, one can sense that the wounds the Ebola outbreak has inflicted on the people are still fresh. This is evidenced by the low number of patients in the hospital wards as compared to the number of patients in the pre-Ebola days. Nurses in green, blue, pink white uniforms move hurriedly from one ward to another to provide the much needed medical service. Others are in their wards to perform their routine duties of taking care of their patients. On the corridors of the hospital, some patients who are tired of lying on their hospital beds could be seen with sad faces while their visitors sit by and chat with them as a way of expressing sympathy for the patients.

The matron in the  Connaught hospital, Isatu Kamara spoke lengthily about the current status of the hospital which she has served in her present capacity for six years. From her account, the   staff strength stands at 1,200 and 40 out of this figure are medical doctors. The hospital has 26 different units with different specialisations. Some of the prominent units within the hospital are the surgical, radiological, physiotherapy, cancer, epilepsy, mental health and psycho-social counselling and the accident and emergency units to name but a few. Various medical officers in the appropriate areas of specialisation man the units assisted by trained and qualified medical doctors. The accident and emergency units is run by Chinese expatriate medical officers who have come to aid their Sierra Leonean counterparts. The nurse population as outlined by the matron is somehow encouraging. However, the Staff nurses commonly referred to as the State Registered Nurse (SRN) is in acute shortage. As if to confirm the statement of the matron, the head of the Physiotherapy unit, during my interview with the matron, entered the office and complained about the shortage of trained and qualified nurses in his unit. The matron assured the unit head that whenever nurses are posted to the hospital she would ensure that five nurses are posted to the physiotherapy unit immediately. Not too long, another nurse came in and requested for Personal Protective Equipment (PPE) as she was about to deliver treatment to one of her patients in the ward. His request was dishonoured as no PPE was available at the time of the request. This was the situation the hospitals in the country were operating when the Ebola virus struck. It was also a situation that led to the death of many doctors and nurses in the country as the Ebola virus is highly contagious so much that it requires PPE for the safety of   health staff.

The Connaught hospital matron, Isatu Kamara was bold enough to state that when the Ebola virus broke out, Connaught hospital had only seven beds for Ebola patients. Currently, the hospital has about 300 beds for potential Ebola victims. However, the matron still expressed her discomfort with the low number of beds when compared to the growing number of residents in the city. The three hundred bed capacity cannot cater for the 2, 5000,000 population. The situation is worsening as rural –urban migration has taken an upward trend since the people believe firmly that one can access only sound medical facilities when he comes to the city. The growing number of slums in the city (Susan’s Bay and Kroo Bay) is an apparent recipe for future outbreaks of contagious and deadly disease like the Ebola Virus. This underscores the need for the Connaught to be highly sophisticated so that it can meet the current challenges of a society with a growing population. Despite all the odds, Miss Kamara  builds an unyielding hope in the Permanent isolation centre that is being constructed at the frontage of Connaught hospital, which she said, if completed will help greatly in tackling very serious infectious diseases.

Handicap International, one of the most vibrant international non-governmental organisations is sponsoring medical students who are pursuing various medical courses to beef up the staff strength at the hospital. As it stands, the organisation has started showing low interest Owing to the Ministry of Health and Sanitation’s failure to take ownership of the training of the medical officers in terms of providing the required resources to fast track the learning process. Again, the new graduates from the medical college cannot take care of secondary health problems. All these factors combined to plunge Connaught Hospital into the very state in which it has found itself.

One of the crucial facts that came out during my interview with the matron is the attention government pays to public health education while neglecting the curative sector. It could be hard to achieve the desired objective if government erects the public health education on a weak curative foundation. By their very looks, the serving nurses at the hospital are not well paid let alone motivated. Capacity building of these nurses is at a low key as no refresher training is provided for them when they pass out from the various medical colleges to serve at the Connaught hospital. This reflects on their service delivery. Although the hospital has no volunteers trying to carve an envious personality for itself, the situation there is fast relegating to the status of an advanced health centre.

Even the sanitary situation in the hospital premises is to some extent unsatisfactory. This is a poignant irony as a hospital is expected to citadel of environmental hygiene. The odour that emanate from the wards is pungent.

The hospital’s current sad status requires huge investment by both government and the relevant development partners so that a positive turn around can be created. The giant nature of the building matters, but it is the quality of its human resource that matters more. If it fails in this direction, the hospital would fit into the old saying that not all that glitters is gold.

(C) Politico 09/07/15


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