Alumni Profile: Ahmed Seedat and the Importance of Building Relationships

I initially volunteered with KSLP as clinical lead from September 2013 to March 2014, having spent the previous six months volunteering with VSO (Volunteer Services Overseas) in Sierra Leone.

Amed SeedatIn those early days it was just Oliver and me, shortly joined by Suzanne, so our roles were a little more fluid and we had a bit more space in the office!

My role mainly involved supporting the Connaught Hospital Improvement Committee, particularly in strengthening the Accident & Emergency Department, supporting colleagues at COMAHS in delivering teaching and training for undergraduate medical students as well as working on postgraduate training with a focus on strengthening the internship programme.

I returned to Freetown in August – September for the Ebola outbreak.

Back in the UK I’m a Respiratory Registrar trainee based in South London but left for an OOPE (out of programme experience) in November 2015 – I managed to stay in the UK for just over a year!

Currently I’m in Yida, Unity State, South Sudan working as a medical doctor for MSF. In Yida, MSF are providing medical care for the refugee population affected by conflict in South Sudan and the disputed South Kordofan region.

Although the context is very different requiring a different approach and perspective I find that as with KSLP, relationships between national and international staff, the wider community and other key stakeholders are extremely important. This can be less than straightforward in an unstable region or area affected by conflict. Nevertheless, building relationships particularly with colleagues and the local community lays the foundations for trust, mutual learning and knowledge exchange which is not only helpful for us as individuals but hopefully translates into wider health gains for the local population.

A Passion for Nursing – Connaught Hospital Matron Isatu Kamara

Since she was a little girl she had Connaught Hospital relies on its team of dedicated nurses to keep functioning. Isatu Kamara, or as we all know her as “Matron,” has been at the helm of this team since 2014.

Since she was a little girl she had “the passion to become a nurse.” She started her career as a Registered Nurse at Connaught so she knows all the “nooks and crannies of Connaught.” She left Connaught to continue her career working in Kambia Government Hospital, Ola During Children’s Hospital, and Kabala Government Hospital. Before returning to her home at Connaught, she had been the Matron of Kenema Government Hospital for three years. She uses her extensive managerial and technical experience to ensure that the highest quality of nursinc care is available to all patients. 

When asked if she has advice for future nurses, her answer is that “you should be willing to perform, you should have the capacity to perform and have the opportunity to perform.” A strong enabling environment is particularly important to Matron who explains that “if we have the basic equipment, skills and motivation then the enabling environment is there for nurses to perform.”

Matron is very proud of the recent changes to the hospital, especially the cleanliness of the wards after the recent IPC training that has been conducted. “Connaught Hospital is such a different place, I encourage all people, partners and staff to make the most of the facilities available such as the Oxygen factory, the A&E Department and the Infectious Disease Unit.

Reflections from the Intensive Care Unit – Ruth Tighe

I graduated from Nottingham Medical School in 2004 and after many years out exploring countries and specialities, I finally decided on Anaesthetics/Intensive Care Medicine.  In the past most of my experiences working abroad have been aimed at improving my clinical skills, to ensure I have been exposed to extreme cases to hopefully make me a better registrar.

I would have always claimed global health was an interest but until January 2015, I wasn’t planning to adventure out to Africa again until I’d become a consultant.  But then the idea of Sierra Leone came up via one of my best friends, Ling – Emergency Co-ordinator for the King’s Sierra Leone Partnership and I couldn’t resist.

I chose to work with King’s because it proposed a unique way of developing intensive care in a low income country that has no post-graduate training and less than 5 anaesthetic doctors in country. The King’s approach thinks more about the system and the professionals you are working with rather than your own skill progression.  King’s encourages a gentle approach via role-modelling for staff working in the main governmental tertiary hospital, to instil comprehension and propagate behaviour patterns that will continuing after I’ve left. Essentially it is about being incredibly patient, building relationships, and working together to spot holes in the functioning of the Intensive Care Unit. Most solutions are achieved without huge changes in practice; the focus is rather on training, education, and monitoring outcomes to demonstrate efficacy.

Although we are mostly volunteers, we are trying to tackle large-scale projects to impact on the entire health system. One of my first tasks as Critical Care Co-ordinated was to support the ICU to improve the provision of oxygen in Connaught. My first four months were focused on the development of the first fully functioning oxygen factory in the country. The results have been impressive. In the three months since we got the first piped oxygen in the country, we’ve seen mortality drop by nearly 30%.  My dream is that my colleagues and I can start a program that shares our experiences with the five non-functioning factories in the districts so that all of Sierra Leone would have access to simple oxygen therapy. Our next project is to implement non-invasive ventilation and again hopefully see another fall in mortality and potentially expand this out to districts. It is incredible to work in a system where simple changes can produce such a drastic change in outcomes.

While I’m not necessarily getting awake fibre-optics or ECMO experience, I am getting more teaching, management, research, and quality improvement opportunities than I thought possible. Being passionate about this cause easily motivates me to work hard to get one project finished so I can start the next one.

Sierra Leone has been through a lot, yet there is an overwhelming sense of gratitude that they’ve come through the war and Ebola. Everyone here has such a strong faith, which is probably what holds them all together through such tough periods.

My respite is knowing I get weekends surfing at Bureh Beach – every week by the time Friday comes I’m so excited to get back in my new-old defender and bounce along the coast, hang out with friends to attempt to stand on my foamie board in the white water – it washes away any stresses from the previous week and gets me refreshed for the next.

I’d be lying if I said this wasn’t stressful.  Witnessing the poverty and the needless deaths of people who can’t afford their health care is extraordinarily draining. But any time it starts to break me, I reflect on our wonderful NHS (long may it last!),  and that I am lucky to be healthy, to have received a full education, and to be trained in a job that I love that lets me travel the world!