Dr Mohamed Wurie Bah, Medical Superintendant
Hospital in Bonthe

I graduated in medicine from the University of Freetown and have been in Bonthe now for only 4 months. There is a huge crisis in health care in this country. Most of my graduating class in university have left the country to study and practice abroad. However, not everyone can leave – not everyone will go. We need to stay. We need to make sacrifices for our country. 

And in fact, it is a misconception to think that doctors and nurses leave the country for purely financial reasons. Yes, it is true that doctors aren’t respected here, the pay is extremely low and the conditions are very difficult indeed. But in fact most doctors leave here due to the lack of systems – and not for greener pastures. As such, we lack specialists here. We graduate medical school andwe get stranded, stuck. How long can you be a house officer? I graduated in 1999 but look where I am today – I am still only a medical officer. But by comparison, my colleagues from my graduating class who went to the UK are well into their specialities.

I volunteered to come to Bonthe. here. I didn’t come for the money. Someone has to work for people.

When I arrived here, I practically made the hospital close, so bad was its condition. As I see it, a non-functional hospital is worse than no hospital at all. Now we are trying to get the people to use the hospital. It is grossly underused. I am not sure why this is the case, but it is and we are trying to reverse it.

In maternity for example, they see the hospital as a dump. Four days ago we lost a mother and baby. The TBAs (Traditional Birth Attendants) hold onto the women far too long. In this instance, it was a case of Placenta Preavia and breech. This is a situation which should never be attempted as a normal delivery. There is no way it can be delivered without surgery. But at 8 or 9pm a huge crowd brought her into the hospital. I was called and came immediately. She was bleeding profusely – the baby’s foot was presenting, and – we have a huge problem here with light, you’d think the first priority for the hospital would be light but this is not the case – we were operating under candlelight. I immediately examined the woman. It was terrible. The baby was half-way out, with its head and neck stuck up, literally stuck – with half the body out. She, the woman, was bleeding profusely. She needed blood urgently – she had lost a huge amount already. I tried to, under black-out lamp, deliver the child manually but it was just not possible because the cervix had already clamped around the child’s neck. And there is a big problem here with blood – people are shy about giving blood – no one wants to – the relatives just disappeared – and we were left with no blood to give her. We could only give her plasma. There are simply no volunteers to give blood.

It will never go off your mind. After this, I was so despondant, so demoralised, I didn’t feel like coming to work. Because here too was a case of poor ante-natal care. And here people believe it is god’s will. They don’t fight against it. There are a lot of quacks here too – there is no control – and they get away with a lot of what I consider criminal activity. And for that they take a lot of money from people. No one cares. No one seems to care.

The hospital is practically being strangulated. Before, there was no capable doctor, no surgeon. Now there is a capable matron, and I do it all, I do surgery too. But there is no administration. I have been here four months. There was never a proper handover from the previous doctor – and I have no idea about hospital business.

People don’t want to come work here. If they are posted here they are considered finished, punished – it is considered an “overseas” posting – but yet there are the same conditions, the same problems throughout the country.

And a gross injustice has been done to hospital staff. There is absolutely no comparison between the treatment of judicial graduates – lawyers, ministers – and doctors. The hospital has been deliberately savaged. We are not working for ourselves, we are working for the people of SL. But while we are employees of the government, the government doesn’t see it like that.

Hospitals are the end-point. They have been sidelined.