Visit to Sierra Leone ’19

In November 2019, I was fortunate to be able to return to Sierra Leone. The purpose was to visit The Shepherd’s Hospice as well as meeting up with Dr Mary Bunn and her team of nurses at Connaught Hospital in Freetown.

Since my last visit in 2016, at the end of the Ebola epidemic, much has changed at The Shepherd’s Hospice. The hospice has moved from its original site in Allen Town to MacDonald village, about an hours drive outside of Freetown. The site is beautifully situated below a range of hills and provides a much more peaceful environment set back from the main road.

hospice with hills
Hospice with surrounding hills

The hospice in-patient building is built around an open courtyard, with the capacity for  12 in-patient beds. Each in-patient unit contains 3 beds, with its own shower-room attached. The laboratory, out-patient clinic and staff canteen are also located here. During my visit I met four patients who had been admitted, one for the management of her pain and wounds related to advanced breast cancer. The team demonstrated a good knowledge of basic palliative care and it was good to see this lady smiling and planning her discharge back home.

The Shepherd’s Hospice continues to function primarily as a health care provider for the local community, treating minor ailments as well as testing for TB and HIV infection. If tested positive, the team ensures that the person is given treatment and is provided with ongoing support and monitoring.

It was very encouraging to meet up with Dr Kelfa Koromba-Kpallu, the Medical Officer, and Magdalene King, Senior Nursing officer. Thanks to the generosity of our supporters, the UK Friends of The Shepherd’s Hospice (UKFTSH) fund their salaries. They were both enthusiastic about the work they do in providing palliative care.

Hospice team
Dr Kelfa Koromba-Kpallu (2nd from right) and team

Having changed our charitable objectives, the UKFTSH can now also support any development of palliative care in Sierra Leone. I therefore took the opportunity to meet up with Dr Mary Bunn and her new team at The Connaught Hospital, the main government hospital in Freetown. She is a palliative care Doctor from the UK, with experience of working in Africa. She is working as a volunteer to establish this new palliative care team. Three nurses, Hawa, Patience and Grace work alongside her.

Connaught Hospital team
Dr Mary Bunn and her team of nurses at The Connaught Hospital

She has made great progress since commencing her work in Sept 2018. In the first year, 133 patients were referred. Most referrals (95%) are for cancer patients, although the team are happy to see any patient with progressive, life threatening conditions requiring palliative care. Sadly, knowledge about cancer is very limited in Sierra Leone and so many patients present with very advanced disease. Sierra Leone has no radiotherapy services and very limited chemotherapy. For the majority of people diagnosed, palliative care is the only realistic option for care and relief of their suffering.

Dr Mary Bunn and her team of nurses also visit the main children’s hospital in Freetown – Ola During and give advice and support to ease the suffering of the children referred. They also conduct community visits, following up on patients too ill to attend the hospitals.

Mary has a vision for palliative care to be introduced throughout Sierra Leone. She wants to train Community Health Officers and nurses working in the government health centres/hospitals. By training a number of staff, she hopes to create a network of small palliative care teams across Sierra Leone. The UKFTSH has committed to fundraise to enable this education and training commencing in 2020.

I was delighted to see that all the nurses in her team were able to do an initial palliative care assessment and make recommendations on care and medications required to manage symptoms. They demonstrated a compassionate and empathetic approach to the patients they interacted with, something I haven’t always seen over the years of nursing in Sierra Leone. This team is helping to educate others in the hospital and they now receive referrals from every ward, as the importance of this service is now being recognised.

I left Sierra Leone encouraged by what I had witnessed and enthused to fundraise to help sustain these services.

Esther with TSH team
Esther with TSH team

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