The Surgical Assistant CHO

Alieu F. Mansaray graduated from the Surgical Training Program in 2015 and is currently posted at the Serabu Mission Hospital in Southern Province. The past two weeks he has been [...]

Alieu F. Mansaray graduated from the Surgical Training Program in 2015 and is currently posted at the Serabu Mission Hospital in Southern Province. The past two weeks he has been attending a strategic planning conference in Bonn and Cologne regarding the future developments of the hospital. The Serabu Mission Hospital is run by the NGO “German Doctors for Developing Countries” and  is one of CapaCare´s partner hospitals in Sierra Leone. This week Alieu is visiting Norway to attend CapaCare´s annual meeting before heading to Holland to speak at the Royal Tropical Institute in Amsterdam.

Alieu F. Mansaray with the staff of Serabu Mission Hospital in Southern Province(2016)

Alieu hails from the remote town of Yiffin close to Sierra Leone´s highest mountain, Bintamanu, in Northern Province. Like so many others in Sierra Leone his personal story is one of struggle. In 1994, when Alieu was eighteen years old, his father passed away, leaving behind three wives and twelve children of which he was the oldest. As often customary in Sierra Leone his fathers two brothers assumed responsibility for and married two of the widows, the thirds was wed to a man in the immediate family. In 1997 his stepmother passed away due to obstructive labor, while giving birth to what would have been her fifth child. This left Alieu as the sole caretaker of her four remaining children, at the time the youngest was five and the oldest was ten years old. These personal experiences lead Alieu to begin a carrier in the health professions. After the civil war in 2002 he enrolled at the nursing school in Freetown. He graduated, but came to realize that as a nurse he had very little decision-making power, so he decided to go for Community Health Officer Training in Bo. As a CHO he was posted to the Community Health Center in his home town of Yiffin. The challenge in rural areas in Sierra Leone is that referrals to higher level of care can be extremely difficult especially during rainy season. The standard of roads are poor and transport is not readily available. After a loosing a fellow member of the clinic staff to a surgical condition while being transported to a district hospital, Alieu decided to seek further training to better enable him self to better deal with similiar situations.

 The road from Bo to Serabu

In 2012 Alieu enrolled in CapaCare´s Surgical Training Program. He passed basic training in Masanga and went on to placements at Aberdeen Women´s Center in Freetown and St.John of Goods Hospital in Lunsar. After completing his final exams, he underwent a year of Housmanship in Freetown, before being posted by the goverment to Serabu Hospital. In 2016 he was the most productive Surgical Assistant CHO in the country with 627 procedures preformed. Alieu would some day like to go home to his community in Yiffin to practise, but admits it will require substantial investments in infrastructure, equipment and human resources before his skills can be put to use there. He also fears for the future prospects of his profession and its recognition. Since the founding of the Community Health Officer education program in 1983, the cadre has not been governed by a regulatory body and a scheme of service. In September 2017 this led to a nationwide strike where all the CHOs refused to work. The issue is still unresolved, but promises has been made by the current government. The Surgical Assistant CHOs are also struggling for recognition. Despite their extensive training and added responsibilities, they do not yet receive additional compensation. For the moment the conditions of service and salary of a SACHO are the same as for a CHO without postgraduate training.

Alieu F. Mansary with wife Esther M. at his graduation in Masanga