A year in the life of Dr Genevieve

During 2017 SSLDF and Magbenteh Community Hospital were blessed with the arrival of volunteer Doctor, Genevieve Haddock from the UK. She shares her experience:

“Magbenteh Community Hospital is a very unique place. Last January when I arrived, I never dreamt that I would be staying in the country for a whole year- but the charm of the place and the people meant that I found I could not possibly leave after 6 months.

When I arrived, despite being a foreign doctor, I was made to feel completely at home by the staff. My days consisted of a morning handover meeting, the perfect start to the day with a song ‘Tell God Tenki’ followed by prayer and a sermon to instil some self-reflection, followed by an update of the severely ill patients. Ward rounds then followed, often interrupted by the arrival of a severely sick adult or child. The afternoons wold be spent seeing new patients, teaching healthcare staff and also assisting in the Outpatient Department

The cases I saw ranged by infectious diseases such as malaria, which is endemic in the region, tuberculosis and HIV. To cases similar to that one would encounter in the UK such as raised blood pressure, diabetes and stroke. Occasionally you would encounter a more rarely seen condition, for example snake bits, pointing, tetanus and even leprosy.

It was a dynamic learning experience, not only would I spent afternoons teaching the staff but they would also teach me. I learnt about illnesses I had never encountered, about the health systems in place and how to speak Krio (the local language). Needless to say my initial attempts to do so brought much hilarity to the wards!

I also learnt about the Sierra Leonean culture. One day I was doing a ward round when I look down at the bedside of one patient to see a chicken looking back at me! Apparently, the family believed the patient to be possessed by the devil (he had a diagnosis of meningitis) and the chicken was to be sacrificed to cure him. Needless to say, the education of patients and their families regarding these beliefs is a large part of daily life.

The attitude of people in Sierra Leone is truly refreshing. No-one here takes healthcare for granted and they are so thankful for the time you invest in them, which is deeply humbling. In a country where the average life expectancy is 47, you can understand why. Almost every person I treated had lost a first degree relative. Mental health is not something that is widely recognised or treated here and if I expressed feelings of grief regarding patients it seemed to always surprise the medical staff.

The legacy of war, along with the catastrophic effects of Ebola and the instability of the economy, have rendered the healthcare system here one of the poorest I have ever experienced. Some days you would end up truly frustrated at the lack of diagnostic tests available. This meant you had to rely on clinical examination to formulate a diagnosis and come up with a treatment plan, a skill which is not used so much in the West as you are able to rely on test results.

The Under-Five mortality rate in Sierra Leone is one of the highest in the world and mothers would often present to hospital with severely ill children who may have been convulsing for a few days before they thought to seek medical attention. The loss of these children sat heavily with myself and the team. However, I learnt to focus on the success stories. I always remember an 8-month-old boy we admitted, unconscious with cerebral malaria and anaemia. The nursing staff acted quickly and I myself donated blood for the child as there is no blood bank and no donor. It was touch and go for 4 days but at the end the child came out of the coma and a week later was sent home with a very relieved and happy mother. Without the quick actions of the nursing staff, the outcome may have been very different.

Despite the challenges, I immensely enjoyed my time at Magbenteh Community Hospital. I don’t think I have ever laughed so much as I did some of the days I spent with the nursing staff. In the face of adversity, one learns that it’s the little things that bring delight. I have no doubt that some of the friendships I formed here will last a lifetime. I was made to feel a part of the family and for that I am eternally grateful.”

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