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Rebuilding health services after Ebola

Sierra Leone has finally come out of devastating Ebola pandemic that killed over 10,000 people in the country and left thousands more affected.

The country has been given the all clear, opening the doors for volunteers to safely come back and work with local partners to rebuild the country after such a huge trauma.

It’s a tough job; many people no longer trust that hospitals are a safe place despite the country being Ebola-free since early 2016. Pregnant women particularly stopped coming for their antenatal checks, choosing to deliver in the presumed safety of their homes.  

Now Sierra Leone is looking to the future, and desperately needs volunteers to come back and mentor, coach and support health staff to improve their services – making hospitals and health centres a fully functional, well-resourced and trusted port of call for everyone.

GP Alex Burns was a VSO volunteer in a government hospital in the north of Sierra Leone before the outbreak - he shares his experience working in Makeni hospital.

How is it working as a doctor in Sierra Leone?

At the front of my building the word ‘hospital’ was displayed on a sign. It’s the same word on the entrance to hospitals in the UK- but what happens inside was very different. I saw a lot of mothers die. I had never seen or heard about stillbirth in the UK but there were huge number of cases here. In Sierra Leone, there were very few pieces of equipment - I was always stunned at how bare the room was. In the UK there would be electrical devices, various lines, cannulas and lots of medical gadgetry.

Dr Alex Burns, vso volunteer GP at Makeni Government Hospital, teaches colleagues and students the importance of using partographs.. VSO / Georgie Scott

Dr Alex teaches colleagues, nursing and midwifery students the importance of using partographs.

What have you been doing?

Most mothers in Sierra Leone die of several simple causes, bleeding, eclampsia, obstructed labour – these all can be prevented, and complications barely encountered in the UK anymore. The way to handle them is normally very cheap and accessible, so I was implementing simple and effective methods to try and save mothers’ lives in maternal health wards. Sometimes it was trying to get nurses, midwives and untrained health assistants to recognise a sick woman and help with delivery.

Best and worst bits of working in Sierra Leone?

I enjoyed tropical medicine- I find all the worms and parasites that the human body here fascinating. It was a good experience to refresh skills in areas you don’t get the opportunity to develop in the UK.

Any memorable moments?

I did a fair amount of paediatrics and obstetrics in the hospital too. I was teaching a trainee midwife how to induce labour because the patient had eclampsia. In the UK, every pregnant woman has their blood pressure checked for this, but it’s a real killer in Sierra Leone. Mothers with eclampsia might have an epileptic fit – that’s why you need to get the baby out soon. I taught this Sierra Leonean midwife (who used to be a traditional birth attendant) how to do this, and she did it on her own the next day. The end result was a healthy mother and baby boy.

There are other VSO volunteers at the hospital where you are placed – how does that work?

My fiancée Natasha, a paediatrician,  also worked at the hospital. Our skills were complimentary at times. We worked together quite a lot, especially in obstetrics, as a paediatrician she specialised in resuscitating new born children so often a delivery I orchestrated produced a child that she resuscitated. One of the most constructive and nicest things about working in Makeni government hospital, was working alongside a VSO volunteer midwife trainer in the midwifery school; she taught students herself and it was nice to see that theory put into practice in the hospital.

Volunteer GP, Dr Alex Burns, Sierra-Leone

Dr Alex and VSO paediatrician Natasha Sauven discuss a patients notes with Medical Superintendent Dr Ibrahim Bundu on ward rounds.

Is there a need to continue the work you have started?

There are undoubtedly hospitals across Sierra Leone that would benefit from having more doctors, midwives and nurses for one year or longer, to implement simple and effective ways of treating patients, and saving lives. I saw a lot of change in Makeni government hospital whilst I was there - but that was just me and my fiancé in a country of six million people.​

What would you say to someone considering volunteering with VSO?

VSO’s work here is important. It’s about training professionals and that’s an effective way of making change. It lasts a long time.

If you would like to make a difference training, coaching and mentoring health staff please take a look at our vacancies for medical and healthcare professionals.

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