From the Field: Health Facilities in Sierra Leone Work to Restore Services

A team from Direct Relief is traveling through West Africa to better understand the needs of health care partners and formulate long-term strategies for strengthening health systems devastated by the Ebola outbreak. Our Emergency Response Manager, Jenny Hutain, shares her observations from Sierra Leone.

Restoring Capacity as Ebola Wanes

Today, Andrew (Director of International Programs and Emergency Response) and I visited the Holy Spirit Catholic Hospital in Makeni, a beautiful 85-bed capacity hospital in the third largest city in Sierra Leone.  The facility was clean, spacious, and well-kept.

Infection control procedures prevented us from visiting patient care areas of the hospital without properly donning protective clothing, which we were not prepared to do.

Dr. Patrick Turi told us that the hospital was closed during the height of the Ebola crisis and is now running at about half capacity because of the sharp decrease in patients seeking care at medical facilities. He believed that the hospital would run at full capacity again as the surrounding communities regain trust in the health care system.

In the pharmacy, we took turns identifying items that we recognized as having been donated by Direct Relief through local partner Medical Research Centre.  Noticeably, several Teva drugs were being distributed to patients, such as the antibiotic azithromycin.  Dr. Turi was excited about the prospect of receiving more specialized drugs for cardiovascular disease, diabetes, and hypertension, which could help offset costs, such as rehiring of staff.

Support Continues for Successful Ebola Treatment Unit

Next, we visited the Ebola treatment unit dubbed Hastings II, which still boasts the highest survival rate in the country at about 70 percent.  The unit is operated by the Sierra Leonean military but the hygienic tasks and nursing duties are carried out mostly by volunteers. These individuals choose to work in a dangerous environment in hopes of getting priority for paid work.

When we arrived, there were no less than a dozen men and women in matching blue scrubs cooling in the shade outside the treatment ward.  In the compound that houses the Ebola treatment unit (a converted police training facility), there is an administrative building, a storage unit, and the Ebola ward itself, which is divided into several sections.  The Ebola ward is partially visible from the common area.

Recovering patients watched us as the doctor pointed to the notes stuck on the inside of the plexiglass and explained that this was a form of communication, as no items are physically transferred in and out of the ward.  Direct Relief, through Medical Research Centre (MRC), shipped significant amounts of pharmaceuticals and supplies to Hastings.

Supplies Stocked in Country

Down the street from the Hasting Treatment facility, MRC Director Abdul Jalloh showed us the warehouse rented by MRC to store donated drugs and supplies.  Direct Relief provided a grant to MRC to rent and operate this warehouse as well as purchase a truck to transport the supplies to more than 50 facilities in three districts.

The warehouse was beautifully clean and organized, and stocked entirely with supplies sent by Direct Relief: Ansell gloves, Baxter fluids, We Care Solar panels, and much, much more.  A small team was loading up the truck to take to Bo – the second largest city in Sierra Leone.  Andrew and I were very impressed.

Abdul recalled how Hastings II once ran out of ceftriaxone, which was essential to treat patients with certain types of bacterial infections, and MRC was able to provide the drug immediately because of the donation. He said the Central Stores would have taken two weeks.

Reinstating Maternal & Child Health Services

To end our day, we visited Aberdeen Women’s Centre in Freetown, a facility which we have supported through the Obstetric Fistula Repair Program.  Aberdeen is the only permanent facility providing obstetric fistula repair in Sierra Leone.

Through funding from the United Nations Population Fund (UNFPA) and others, and supplies from Direct Relief, Aberdeen strives to provide at least 200 fistula repair surgeries per year (an incredible number).

Because of reallocation of resources to fighting Ebola, they have not been able to provide fistula repair services since April, but they plan to restart soon and continue to provide birthing services. The facility delivered 1,228 babies in 2014, several by caesarian section.  Painted on the wall toward the entrance is “YU NOR DEY PAY NO MONEY” – all services are free of charge.

Looking Toward Life After Ebola

After only a few days, but endless discussions about Ebola with health authorities, politicians, local leaders, and medical practitioners, it is apparent that the complexity of the issue is staggering—the disease, the politics, the unintended consequences, the international response, the messaging, the historical implications, and on.  Sierra Leone’s history will forever be divided into “before Ebola” and “after Ebola” just as it is colloquially divided by the civil war.