Here I am still alive in Freetown after 4 weeks – and at the start of my stay that seemed a bit unlikely! I have to say that living and working here is among the most challenging things I have ever done. Life is just not easy for the majority of people living here. I have to say, of course, that I am fortunate compared to most, but the conditions of life mean that you seriously have to curtail your plans for getting anything done, whether on a professional or personal level.
The first weeks at PCMH hospital where I have my placement were quite difficult. The house officers, who make up half the medical staff and do most of the practical work, had not been paid for 3 months and they decided to go on strike as their complaints were being ignored. This was understandable, but unfortunately the midwives decided that if there were no house officers to review the patients, they would not do the initial triage and assessment although they were still in the clinics and emergency rooms on duty. So they just shut the doors and the waiting areas filled with patients, including those coming in by the one hospital ambulance. The consultants are not around much after the morning review as they go to see their private patients. So in the week I should have been getting my induction and orientation, I ended up down in clinics and triage with one other doctor, trying to see 30 patients (and they do live up to their name of patient here – no complaints like we would be getting at home!) Actually the problems are similar to those at home and many of them could be helped with basic things like IV fluids or antibiotics, or admitted to the labour ward. I have seen lots of interesting cases from a medical point of view, but it is an exhausting way to work. Fortunately the situation with pay seemed to get resolved after a week so the house officers have come back to work. I still need to get my job plan sorted out, and I’m hoping that there will be some way to fit in sessions for the house officers as well as medical students and midwives, but it will take a bit of time to work that out.
The other main issue for me is transport across the city to the hospital. It is in the east end, pretty much among the slums, and public transport doesn’t go across the big market that is in the middle of the city. Plus there is terrible congestion on the roads and in the public transport at peak times. It’s been taking me about 2 hours each way to go from my house to the hospital and is not very safe. VSO don’t automatically provide any transport but hopefully they will be able to do something to help out as I don’t think I can carry on in this way.
At least I have had my weekends off and that has given me a bit of time to buy some food in the market and do some cooking, also to find a swimming pool where I can cool off from the constant sweaty heat (and have a shower) and a few walks out of town to escape the craziness. Everyone is different, but I’m not a big city person and I think I will be spending some time out of Freetown when I can.
That’s all for now, there’s no electricity tonight so will try to post this while I still have power on my computer.
Carolyn
