we've come a long, long way together!

It’s amazing to be back.

Things have changed so much that it’s hard to even know where to begin. The last time I walked through Ola During Children’s Hospital, a year and a half ago, all I could see were broken systems, missing equipment, disenfranchised healthcare workers, and dying children. I left Sierra Leone feeling frustrated and somewhat defeated after a year of battling what felt like insurmountable challenges.

Now, the seeds we planted have finally taken root, sprouted, and begun to blossom. All of the pieces are coming together. Government, donors, hospital staff, other NGOs – everyone seems to be working with a level of energy that I’ve never seen before. It’s truly breathtaking.

You enter the newly paved hospital compound, and first are struck by the construction activity which surrounds the entire campus. The feeding center for severely malnourished children has been de-roofed and will soon acquire a second story. VIP latrines are being built around the back of the hospital. Bricks are being laid for the new staff canteen. The main hospital facade gleams with a fresh coat of white paint.

Inside, the changes are even more dramatic. Women and children fill the benches in the registration and triage area. Gone are the days when mothers carrying sick babies would enter a deserted hospital, desperately find their way up to the wards and be forced to beg and bribe for medical attention. Back then, untold numbers of children died without being seen by a doctor, without so much as an IV in place. No record existed of them ever having entered the hospital, having suffered, died. Today, every single child who enters the hospital is registered with a unique patient number, is measured, weighed and has vital signs taken by specially-trained nursing staff.

Triage

The sickest kids go directly to the emergency room, where children lie two to a bed receiving timely care of a quality that is rarely found elsewhere in Sierra Leone. We now have oxygen concentrators, enough for many (although by no means all) who require it; a back-up generator so that power outages don’t cost lives; doctors on call in the hospital 24-7 (with comfortable sleeping quarters and recent government salary increases that allow them to devote their time to government service); a free supply of most essential drugs (for which we have the Ministry of Health and the German Emergency NGO, Cap Anamur, to thank); and a more motivated staff to provide much-needed care. Since the removal of user fees for children under the age of 5 in April, hospital numbers have skyrocketed. The place hums with the energy that is being devoted to the business of saving lives.

The Emergency Room in Action

And we do, indeed, save lives.

I remember the days when the hospital mortality rate was upwards of 20%. We will soon publish data which shows that mortality has almost halved, which represents hundreds of lives saved over the past year alone. It’s a compelling argument in favour of free healthcare, targeted interventions to improve the quality of clinical care, collaboration between government and NGOs, and, crucially, the slowly-slowly locally owned approach that we have tried to demonstrate.

Much to celebrate! And, as always, lots more to be done.

Dr. Toyin Ajayi is a Director of the Welbodi Partnership and spent a year in 2008-2009 working as the Medical Coordinator in Freetown. She will spend the next few weeks at Ola During Children’s Hospital and in the surrounding communities, and will be blogging frequently about her experiences.