The Province of Freedom

Sierra Leone (Lion Mountains) was named by the Portuguese back in the 1400s on seeing the range of wooded hills that sit back from the coastal beaches lining the length of the Freetown peninsula. The city is situated on the northern tip of the peninsula, Atlantic Ocean to one side and Africa’s largest natural harbour opening from the mouth of the Sierra Leone River, on the other.

The site was chosen in 1787 by the British as a settlement for freed slaves that had become destitute in England as a consequence of the abolition movement.  This tropical idyll was touted as a haven for the new settlers but the reality was somewhat different; conditions were harsh throughout the rainy season and many died as a result of disease and starvation.  This first settlement was actually burnt down by a local ruler but a second attempt to form a colony was made 5 years later in 1792.

This time, the settlers originated from Nova Scotia, freed slaves who had fought for the British during the American Revolution.  The original settlement had been reclaimed by the jungle but the new colonists cleared the forest as far as a giant cotton tree which still stands at what is now one of the busiest junctions in the city, next to the colonial era Courts of Justice building. The conditions were tough for the first inhabitants of the Freetown Colony but through hard work and determination, they began to prosper.  The Sierra Leone Creole people (Krio) went on to establish and populate what is now the capital of the country and shape what was to become a centre for culture and education. 

 

The Cotton Tree

British influence remained, initially in order to shield the town from the demands and taxes of indigenous leaders, but subsequently to intervene in the ongoing trading of slaves whilst also protecting its own trading interests in the region and expanding the protectorate into the hinterland.   The settlement became a Crown Colony in 1808 and went on to become the capital of British West Africa.  Independence arrived in 1961 but transition was far from a smooth process.

During the next 20 years, corruption became commonplace as society and the economy began to break down.  The country endured a series of coups and attempted coups, becoming a republic in 1971 and was a one-party state by 1978.  With a divided society established as a legacy of colonial rule, an unstable government and a marginalised youth, the country was a powder keg ready to ignite.  In 1991, civil war broke out when the Revolutionary United Front (RUF) crossed the border from Liberia and within a year the president had been deposed.  In 1999, Freetown itself was taken for a brief time by rebel forces.  A ceasefire was finally declared in 2002, by which time it was estimated that 50,000 people had been killed in a decade of terrible violence and civilian suffering.

The country slowly started the re-building process; in 2005, the last UN peacekeeping force left the country and a new president was democratically elected in 2007.  The country has a vast array of natural resources; diamonds, titanium and iron ore, bauxite and gold can be found in abundance and foreign investment in these industries, as well as fisheries and agriculture was helping to expand the economy.  Money was being invested in desperately needed infrastructure projects and GDP began to grow.  All this progress came to a dramatic halt, however, in May 2014 when the first case of ebola virus disease was detected.  By September, Freetown was in lock-down and under-siege from a very different type of threat.

Fast forward 12 months, the threat is diminishing, and the city is once again trying to re-build.  People go about their daily business, the streets are crowded with stalls, there is laughing and shouting in equal measure and car horns sound relentlessly in the impatient queues of traffic.  This is a noisy and lively city, from the call to prayer before sunrise to the sound of music well after sunset into the early hours, activity never stops.  Young men play football on the beach, the bars are open and music is playing.  Freetown is a chaotic city but it possesses a welcoming charm and even a certain beauty when viewed from the quiet of the surrounding hills. 

There are many challenges ahead for the government and people of Sierra Leone but I feel privileged to witness the start of what I hope will be a positive new chapter in the turbulent history of this remarkable country.  

Sunrise over Freetown

The city viewed from Leicester Peak

Football on Bureh Beach

Welcome to Freetown

Day 1:  September 16th 2015

The screech of wheels on tarmac and a round of applause from surrounding passengers signals my arrival in Freetown, the capital of Sierra Leone.  Situated in the west of the country on the Atlantic coast, it has a population of around 1 million people and it is where I will be calling home for the next 12 months.

“Welcome to Freetown, the local time is 5:30 in the evening and the current temperature is 25 degrees,” announces the pilot as we taxi to a stop at Lungi Airport.  The humidity makes it feel much warmer and with the country approaching the end of the rainy season, it will only get hotter.  The runway and surrounding vegetation are still damp and it is clear that it has rained heavily today.  On the approach to landing, the coastal rivers appeared swollen and the descent had been turbulent through dense cloud.  I was yet to become aware of the significance of this, however, as I made my way through passport control.

I am relieved to find that my temperature is normal at the screening check point and can proceed to collect my luggage unimpeded.  The quickest route to the city involves a forty-minute journey across the harbour by water taxi and I disembark to find my luggage and Victor, the organisation’s driver, waiting on the jetty holding a sign with my name and a big ‘Welcome’.  So far, so good! 

The rest of the evening passes in a blur as I am introduced to the rest of the King’s team and battle fatigue to remember all the new names and faces of the people that I will be working closely with over the coming months.  I head to bed, oblivious to the terrible tragedy that has taken place in the city during the day.

  

The rain had been persistent and torrential during the day and had wreaked havoc throughout the city causing widespread flooding.  Several deaths had been reported by the following morning and thousands of people have been displaced, having lost their homes and possessions.  The National Stadium is being used as a temporary settlement and the government has advised people to stay at home and not to travel unless on essential business. 

I will be working at Connaught Hospital, the main government referral hospital situated to the east of the city next to Kroo Bay which was one of the areas worse affected by the flooding.  The hospital did not escape from the disaster and its theatre complex was flooded meaning that no surgery could take place.  Despite this, a procession of patients attended the emergency department throughout the morning with a variety of wounds and injuries from minor lacerations to open fractures and more significant trauma, many sent over from the stadium.

Doctors, nurses and ancillary staff throughout the hospital mobilised to provide care to the patients and the Emergency Department became the focal point for triage, assessment and treatment of the wounded.  The hospital matron, emergency team and trauma ward played a vital role in ensuring that all the patients were managed in a timely and efficient fashion.  Pain relief, antibiotics and tetanus injections formed the bulk of treatment and the emergency dressings store for the hospital was exhausted by the end of the day.

Having only arrived in country 12 hours previously, I remained a frustrated spectator to most of the day’s events.  My desire to help and get stuck in was tempered by the fact that I had no knowledge of how the hospital was organised and where equipment was kept.  In fact, by the time I arrived in the early afternoon, most patients had been seen and managed which is a huge testament to the work of the hospital staff that pitched in to help out. 

As the crowds dissipated and the afternoon heat began to settle, thoughts turned to short term problems and longer term solutions, many of which are beyond the remit of the healthcare sector.  The possibility remained of further rain and ongoing casualties over the next few days, cases of malaria were likely to increase and cholera remains a significant concern.  Despite the fact that everyone pulled together to provide fantastic care, it will be important for the hospital to devise a formal major incident plan that can coordinate staff in the future.

I am reassured that this is not a normal day in Freetown but I remain to be convinced that such a phenomenon exists.   If positives can be taken from such an awful day, it is that staff worked hard together to provide vital care and made a significant impact on the outcomes of the people that attended the hospital.  I am humbled by the resilience of the people of Sierra Leone and their ability to remain positive despite all the knocks that the country has taken.  It has been an eventful first 24 hours!