Theory to Practice – My Elective with the King’s Sierra Leone Partnership

By King’s elective student James Barnacle

I had been interested in Global Health for several years before being lucky enough to study the intercalated degree at King’s College. It expanded and developed my interests, looking at how and why countries developed and the relationship between development and health. It was on the course that I first heard about the King’s Sierra Leone Partnership, and met Oliver Johnson, who at the time was teaching and tutoring on it.

Until my elective I had never been to sub-Saharan Africa and a year of narrowly spaced exams meant that I was reluctantly losing touch with the global health world. A medical elective with the partnership was a fantastic opportunity to consolidate what I had learnt, emerge myself in global health once again and see the theory and principles from the course put into practice. With this in mind, Anna (a colleague from Cardiff who had also studied global health) and I found ourselves outside the KSLP office on the second floor of the administration building at Connaught Hospital, not really knowing what to expect but very excited to find out.

What the KSLP office lacked in space it made up for with filter coffee, wifi and an incredibly friendly atmosphere. On our first day many of the faces were already familiar after we had joined several of the team the night before in a desperately empty national stadium to watch Malian singer Salif Keita! Oliver introduced the partnership’s work in Freetown and I was surprised at how discussions and seminars from the course were flooding back to me as I heard about KSLP’s recent achievements and future plans.

We were given several projects during the six week placement including collecting timings and demographics of those presenting through the front gates before and after the introduction of a triage system aimed at prioritising sick patients. In addition, we evaluated the nursing skills lab by performing an inventory, talking to nursing staff and students and identifying areas for improvement.

The partnership works closely with the nursing school, and more effective use of the skills lab will improve nurse training. We presented recent KSLP research at the annual Health and Biomedical Sciences (HBIOMED) national conference to leading academics in Sierra Leone. Finally, we helped analyse epidemiology data from over 350 patients to identify key presenting complaints, investigations, diagnoses and drugs. This will help direct the free emergency drugs initiative being introduced at Connaught, but in the future will be a reference for lab test requirements, disease burden and drug prescribing.

As well as liaising closely with the KSLP team, working with local staff and students was an integral part of our projects. Two nursing students, Benson and Sahid, worked closely with us collecting the inventory. In A&E, we had a strong rapport with Dr Cole and the nursing team who played a crucial part in the data collection. On ward rounds, we developed friendships with the medical students, some of whom had even visited Wales on their elective. They were enormously welcoming and always willing to answer questions about their challenges and experiences.

The autonomy we were given forced me to draw from the skills I had gained on the course, notably critical reflection in the context of health system strengthening, development and policy. Our time there gave us a window into an organisation working closely with the government to put the principles I had learned about into action. I could not imagine a more engaging and enjoyable way to put the ideas I had developed on the global health course into practice. I will stay closely linked with the partnership and hope to return to Sierra Leone in the future.