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!