When did you stay at Masanga?
What was your motivation for going to Masanga?
I became involved in the project after being contacted by Dr Austin Hunt, a medical consultant in Plymouth who helped to start up the new Emergency Assessment Unit at Masanga.
I have always wanted to work in Africa and the Capa Care STP project captured my imagination. I am convinced that the most efficient way to improve healthcare in Sierra Leone in the long term is by providing a good standard of medical education. There is a limited amount that you can achieve working as an individual clinician and the benefits will only be sustained whilst you are in the country.
What was your first meeting with Masanga like?
One of the first things that struck me about Masanga was how friendly everyone is. I have very fond memories of walking to work in the morning and being greeted enthusiastically by every villager as they pumped their water from the well!
What were your main duties while at the hospital?
I have an interest in critical care and so my attention naturally migrated to the paediatric and emergency assessment wards. I did a daily paediatric ward round and assisted with the management of acute admissions to the hospital.
I assisted when there were anaesthetic emergencies in the operating theatre and provided a neonatal resuscitation service when needed!
I spent a lot of time teaching basic airway skills, resuscitation skills, assessment of the critically ill patient and an approach to the trauma patient.
What have you learned from this experience?
Clinically, I gained a lot of experience in paediatric critical care and managing moribund children which is fortunately not very common in the UK. Working in Masanga often felt like opening a tropical diseases textbook! I saw lots of interesting conditions including malaria, leprosy, tuberculosis, HIV, onchocerciasis, giardiasis, cysticercosis and schistosomiasis. Even relatively common conditions, such as hernias, present in an entirely different way in Sierra Leone!
Teaching both the STP students (Mohamed, Shamie, Ishmael & Joseph) and the CHO students (Alhaji, Amin & Tairu) was really rewarding. They were enthusiastic and seemed to grasp new concepts quickly. I had to learn to adjust my teaching content to make it relevant to the resources available at the hospital.
I had the pleasure of getting to know and working with some very knowledgeable tropical doctors (Dr Alex Van Duinen, Dr Josien Westendorp & Dr Claudia Bijen), a diligent Emergency Department doctor (Dr David Potter), an intrepid obstetrician (Dr Adam Forrest) and a retired surgeon (Dr Torre Gauperaa) from whom I learnt a lot.
What is your advice to others that are thinking about going to Sierra Leone and Masanga?
Consider all the equipment that you will require for your role carefully, much of it won’t be readily available in country. Try to discuss your plans with someone who has recently been to Masanga as they may be able to suggest what supplies are running low.
I would recommend taking over teaching resources in electronic format. Multiple copies on CD or on USB sticks would be useful as the STP students have their own laptops. Internet reception is unreliable so bring copies of the programs necessary to load the resources as well (such as Adobe Reader, Microsoft Office etc).
Take a few luxury food items to liven up evening meals! Take money in US dollars, ideally in high denomination (fifty dollar bills). Change your money into Leones at the airport because it is difficult to change money around Masanga. Mobile phone reception is generally poor around the hospital and 3G data reception is unreliable, particularly with AfriCell. Buying a local SIM card (AirTel) can reduce your mobile phone bill on return!
Be prepared to see some distressing sights and be involved in some emotionally challenging cases. The limitations of the locally available treatment can be really frustrating.