“People go to the hospital not expecting to make it out alive”

The health care system here is riddled with problems. I don’t think I have ever encountered such a limited setting and so much poverty. We each came with a role, some to perform surgeries, some to see patients in primary care, and some, like myself, who came to train local physicians. We each felt the frustrations of working in such an impoverished country where the supplies we bring are coveted like diamonds. To be clear this country does not lack the human resource nor the ingenuity and sheer intelligence it is the physical and financial resources that are missing. We cannot swoop in with just money or physicians for such a short time without a plan. The plan is we come, we work, we scout and collect data so that we can make this a successful site in future visits. The first visit is always a bit rocky and we have had our share of hiccups but each hiccup was a lesson learned. 

While so many cases were devastating, such as the children dying of treatable diseases like malaria with complications such as cerebral malaria, or a patient with meningitis who didn’t survive the night or the case of a woman with cervical cancer who has no options for chemo or radiation—our docs saw some incredibly painful cases. Yet there were some incredible saves like the young patient with appendicitis who had her appendix taken out by one of our surgeons or the diagnoses of acute HIV before significant complications. Then there was the unbelievable gratitude and appreciation from the local physicians and community health officers who sat through four days of lectures and practical skill building sessions, hanging on to every word and asking for more—there were successes and there were learning opportunities but never any failures.

In the end we realized that the poverty here is at a level that feels insurmountable, presenting challenges in the delivery of our care and educational interventions, however that has just made us all want to work harder to figure out how to come back and do more, create more impact and hopefully help the Sierra Leoneans slowly chip away at health care inequities. 

Pictured here: the crowd of patients waiting to be seen.