“Let me show you… So you take this cartridge, be very careful not to touch or damage the barcode when you put the sample in, otherwise it won’t scan. Then, we put 1ml from this vial in the cartridge and then place it in chlorine for 20 minutes. This kills anything from the sample that’s on the outside of the cartridge so when we put it in the machine it’s the deactivated virus being scanned.” We are in the laboratory department at Connaught Hospital and our colleague Mohamed is demonstrating how he uses the newly installed GenExpert machine donated by WHO to screen surgery patients for Ebola. This test, which takes only 90 minutes to process, can have a dramatic impact on the safety of both the surgeon and patients.
The laboratory department is a perfect representation of Connaught’s history and change in progress. In one room sits the original Microtome machine from when the hospital was opened in 1912; it is still processing histopathology samples (sectioning) to test for conditions like cancerous or malignant cells. In another room, Mohamed is running the fully modern GenExpert machine to screen patients for Ebola and HIV, as well as other infectious diseases.
Through Sierra Leone’s post Ebola recovery plan, we expect that the way labs operate will continue to undergo substantial changes. Billy, KSLP’s lab co-ordinator, will be working with the Labs team to drive improvements to help navigate this process.
While surveying the alley between the pharmacy and storerooms for a potential new main entrance, I pause to chase some unwelcomed guests from of the hospital grounds. Three pigs had wandered into the patches of grass and rubbish lying between the fence on Percival Street and the weathered wall of Ward 10. The rusting gates that enclose the colonial era compound could not deter the four-legged vagabonds, seasoned by years of navigating between the tin-roofed Kroo Bay slum dwellings below the cliffs our hospital occupies. After watching them scurry down the road for a while, I return to my work on this misty Freetown morning.
The afternoon’s responsibilities fluctuate at a moment’s notice. At times, I round the wards to recruit discharged patients for our daily focus groups. The next minute, I am either mapping out a new construction site or attempting to repair a CT scanner printer with only a ruler and German user manual to my aid. At the end of the day, I climb on the back of a motorbike, preparing to weave through gridlocked cars and potholes on the streets leading to my home in the hills. I playing a nightly game of “is this chicken or fish” at the dinner table and then walk to my balcony to watch the rays from the setting sun as they hit the exhausted-fueled evening haze enveloping the city below. Such is a day in the life of an intern with the King’s Sierra Leone Partnership at Connaught Hospital. For five weeks over Summer I worked at Sierra Leone’s main tertiary referral hospital between my first and second year of medical school at the University of Pennsylvania. Born the son of Sierra Leonean immigrants in the United States, my first journey to my ancestral home had been 23 years in the making. From the time I stepped off the plane at Lungi Airport to catch the aged ferry that steams across the bay toward city on the horizon, I knew I was in for a journey I would not soon forget.
Sierra Leone has been a country of fascinating contradictions and juxtapositions. Lively shantytowns lie in the shadows of sterile, towering mansions purchased during the recent mining boom. Traffic lights unused for decades dot the city among ruins of construction sites abandoned in the 1980s, haunting reminders of an era of prosperity cut short by eleven years of civil war. The bustling cities rapidly work to catch up with the modern world and just hours away lie timeless, untouched villages carved out of the jungle. My time in Freetown was more than I could ask both personally and professionally. King’s Sierra Leone Partnership’s unique relationship with the Connaught Hospital leadership and Ministry of Health and Sanitation offered a look into hospital management one could not experience in other settings. The group’s work ranged from clinical responsibilities, to researching staff/patient satisfaction, to strategizing for improved hospital operations and much more. The weeks of work culminated with a meeting with the Minister of Health herself to present our task force’s findings. Beyond the efforts at the hospital, I immersed myself in the energetic culture of Sierra Leone. I connected with family whom had only been faceless names and stories weeks before. The emerging expat community brought me together with like-minded innovators from around the world who are lending their expertise to Sierra Leone’s development. Afternoons of basking in the sun on miles of empty, untouched beach, wandering crowded markets, and chatting over a Star beer at a local bar gave glimpses into a way and pace of life I have not found elsewhere. All in all, my time in Freetown was the perfect way to spend the summer. I am already looking forward to my next trip to my new home. Swit Salone, a de kam!