Freetown, Sierra Leone, is pretty heavy with history in two directions, having once been a primary departure point for African slaves (via the Portuguese) and later, in 1787, being settled by 400 freed slaves and African-Americans, under the guidance of British abolitionists. After that community collapsed in violence two years later (a "misunderstanding" between Europeans and Africans? The devil you say), it was tried again in 1792, and — well, that's about all I know really, and anyway, this isn't meant to be a history lesson. Let's just say it's still there, despite the French, the British, the diamonds, and Charles Taylor.
Why am I telling you this? Because a good friend is in Sierra Leone for a spell as a doctor with a volunteer organization that shall remain nameless, and she passed along a rough story a couple of days ago that I thought I'd share. If you're squeamish you might not want to read on, though it's not all that graphic. The upshot is I won't be complaining about healthcare here for a while.
Anyway, her first couple of weeks there were uneventful (other than the Harmattan), but then...
"One of my volunteers was mowed down by a motorcycle in a remote part of the country! My worst nightmare! It was night, when we're not allowed to be on the road (for safety reasons — driving is not good during the day, but impossible at night). Fortunately, two other volunteers were in the same town as the injured volunteer, though he didn't know that at the time.
As I've told you, there's a large Lebanese community here — especially Lebanese/Sierra Leoneans, who although never having been to Lebanon retain many of their terrific qualities of hospitality and caring. The Salones (Sierra Leoneans) are naturally the same way, being very friendly and caring people. So the combination of the two peoples can be very interesting, and certainly proved helpful that day. A Leb/Salone picked up the volunteer (who was profusely bleeding) and took him to a gov't hospital, which I'll describe in a minute. Somehow the word spread like wildfire, and the two other vols showed up at the hospital — thank goodness, because they ended up sleeping with the injured one, and providing the necessary care to him...a head injury, he needed neurological check every two hours throughout the night. I was on the phone continuously between them and the doctor treating the vol. To make a long story short, the volunteer, apart from a bad head injury that required two wounds to be sutured (and that neurological checking), had multiple cuts and abrasions all over his body, and probably a broken ankle (or at least some torn ligament).
[note: italics mine. – mw]
But here we go. The wounds were sutured without any anesthesia, and by the light of the volunteers' cell phones, since there's no electricity and no generator there! And the volunteer, with his open wounds, was laid on a bed where there had been blood spilled by a previous patient! Yes, this is Africa. They do the best they can, but it ain't much. When I arrived at the "hospital" the next day I almost fainted...I've seen bad in my life, but absolutely nothing like what I saw there. The volunteer is a great kid, and really sucked it up, and did all that I told him. Got him out of there, to Freetown, cleaned him up and gave him appropriate exam and treatment, which is still ongoing.
But everything here is such an effort that all my time has been taken up by this event. I've looked into helicopter medevacs for him, etc...but nothing yet, although it's very much in the planning stages. And there are several SL doctors in Freetown that are quite good and have been trained in the U.S. It's just that there is so little in the way of equipment. Tomorrow I'm getting him two CT scans (head and ankle) — price is $500 for both! Get that! (note: I think that's cheap? Or, I dunno, expensive?! –mw) And the hospital — also a gov't facility, is absolutely the worst (even worse than the one in Bo [note: Bo is Sierra Leone's second-largest city, pop. about 215,000. –mw]) that I've ever seen in my life...bare beds with 6-7 people lying in each one...and if there are no family members around to help the patients don't eat, they lie in their own filth...I won't go on, you get the picture.
I took a brief nap today and am sure happy to be back in Freetown; took the volunteer and the driver for shawarma and felafel at a Lebanese place, where I had a terrific conversation, all in Arabic mind you, with the old man, the owner. So that's been my time...it's just very dicey when you can't do what you know you have to for injuries."