Visit to Sierra Leone ’23

In November 2023 Trustee nurse, Esther Wigmore, and her friend and former colleague, Sara Stevenson-Baker, visited Sierra Leone, to see first hand the work of the two services we support; The Shepherd’s Hospice (TSH) and The Connaught Hospital Palliative Care Team. (See also Visit in 2019)

These are two very different services. The Shepherd’s Hospice, whose main site is in MacDonald Village, is a private health care facility, which provides primary care services to the local community. Most people who come to TSH, have never heard of palliative or hospice care. They come because there is a local health care facility. The team, therefore, provide health care services that meet the immediate needs of patients, such as treatment for malaria, hypertension, arthritis and infections. They are also caring for many patients who have an underlying infection of HIV and/or TB. Some of these patients require palliative care and pain relief. The majority of patients pay for the services provided, those who cannot afford the fees are helped by donations from Palliative Care Sierra Leone.

Following the peninsular road expansion, the old site in Allen Town was partially demolished. However, one building is still useable and after some refurbishment was reopened in August 2023. This is welcomed by the local community, who can visit this clinic to be assessed and treated by a Community Health Officer. The clinic in Allen Town also has some laboratory facilities, so continues the important work of identifying people with HIV/TB infections and getting them onto treatment.

The Shepherd’s Hospice at Allen Town
Esther Wigmore and Sara Stevenson-Baker at the main hospice site in MacDonald Village
Teaching at The Shepherd’s Hospice main site in MacDonald Village

The Connaught Hospital Palliative Care Team, is a team led by Dr Mary Bunn, and includes nurses Patience and Grace who work full-time as palliative care nurses. Other health care professionals, including Dr Melvina Thompson, Dr Greg Foday and pharmacist Ivan, all support the work of this team.

They are part of the government-run healthcare services and only palliative care patients are seen by this small team. As we accompanied the team to the wards, they were warmly welcomed by patients, families and staff. All appreciative of their expertise and care.

In October 2023 they celebrated their 5th Anniversary, with over 800 patients referred to this service. Most of their patients have advanced cancer. Although there are some treatments available for cancer, many people come too late for treatment or cannot afford the surgery and chemotherapy offered. Palliative Care is their only option and crucial to ensure they get the pain relief, help and support they need. The team have developed an expertise in pain control and in ‘breaking bad news’, helping the patient and their families to understand their situation. The team teach family members how to care for the person as they become less well. The support this teams provides is crucial.

During our visit, we heard about the many challenges this team faces but also the commitment and passion with which they care for those referred. We discussed resilience and self-care during our teaching session, important to ensuing the team can continue this essential work.

The Connaught Hospital Palliative Care team with Esther and Sara
Dr Mary Bunn and Grace on the ward round
Patience assessing a patient’s pain control