Death trap in a dead zone – the state of service delivery in Kailahun government hospital

ING. Dr. Juana P. Moiwo: Sierra Leone Telegraph: 02 August 2021:

It was Thursday, the 22nd of July 2021, and I was to make a five-day dash to Kailahun to attend a workshop and to also use that space to see my people. My family and I had agreed days before the trip that we will set out at 1:00 pm local time on that day. This was so because as Dean of a School in Njala University, we often have meetings.

Indeed, on that very fateful day, I attended a couple of meetings but still managed to return home just before 1:00 pm so that we can trek as scheduled. Disappointingly though, I met my family still not quite ready to take off. After pushing all to hasten up, all was set to leave by 2:30 pm.

We set out from the quarter that for now I call my home and headed first for the filling station where I filled the tank of my 4Runner LTD to capacity. It was already 3:00 pm when we finally left the Njala Campus of Njala University. In the vehicle were my wife, two of my children and one of my grandchildren. We were in Bo after a 45-minute drive. My eldest daughter was on the wheel that day.

In Bo, we stopped to buy some few things for the relatives in the village. That took us about an hour to finish. This meant that the second leg of our journey (that is from Bo to Kenema) started at 4:45 pm. My daughter was still on the wheel for this leg of the journey and after another one hour, we were in Kenema.

In Kenema, we went straight to our car mechanic to point out a few issues with the servicing he had done a few weeks before. It was a major servicing, during which even the gearbox was replaced. While the servicing work was near-excellent, he had set the brakes too sharp and the accelerator too stiff. This meant that one needed to push the accelerator pad strong enough to realize any output in terms of speed. Also, once the vehicle picked up speed, stepping on the brakes meant a sudden stop. This was a major challenge and I made it very clear to the mechanic. As time was not on our side, we agreed to fix these issues on our way back to Njala.

For the time we were in the garage, my better-half had gone to town to buy a few bags of rice for the relatives in the village. As our own vehicle was almost full, we spoke to another colleague to help us take the bags of rice to Kailahun. So, we left Kenema after another hour (at about 6:45 pm) for yet the third leg of our journey. My eldest daughter was still on the wheel down to Segbwema, where her own journey was to end. It was already 7:00 pm, but it was a fine sunny day. So, it did not quite look like it was that late.

In Segbwema, I took over the wheel for the fourth and final leg of our journey. Only four of us had remained in the vehicle then. As it was getting dark and with the state of curfew at the back of my mind, I decided to risk a bit more to make up for the lost time. I was going at a speed of about 60‒70 m/hr. Two villages from Segbwema going to the third village towards Daru, I had a gruesome accident. A goat had suddenly appeared in my lane, and I decided to avoid it.

The name of that village is Daabu. Here, you climb a very gentle hill across the village before disappearing into a curve heading to Daru. I had just finished the hill and suddenly saw an object in my lane. At first sight, I thought it was a wheelbarrow that maybe someone had abandoned on the road. It occurred to me at once to avoid the object since I was not sure what it actually was. I manoeuvred the vehicle into the other lane since there was no traffic heading towards us.

But I soon realized that the 60‒70 m/hr speed was a bit too high and I was almost going off the road completely. So, I decided to apply the brakes a bit to have the space to get the vehicle back on the road. Under that pressure, I had totally forgotten that those brakes were not correctly set. So, upon stepping on the brake, the vehicle came to an abrupt halt, summersaulted from the back and fell over on its roof. It was a total flip-over, followed by several folds of roll-over before it finally came to a stop. This was right in the Daabu village, on the highway from Segbwema to Daru.

It was an accident! In the course of the roll-over, one of the doors had opened. My wife, youngest daughter and granddaughter were seated in the back where the door had opened. By the wonders of His grace, all three of them were flung out of the vehicle in different directions. But it all happened such that the vehicle never rolled over anyone of them. I was the only one who remained in the vehicle at the point it came to a halt. In the back seat with two kids, we normally do not wear seatbelt. But with the divine mercy of the Almighty, there was no fatality. Only that my youngest daughter was in coma for over half an hour and my wife sustained a severe wound on her knee.

I came out safe, sound and hardly with any bruise in fact. My granddaughter also came out almost unhurt, except for a small wound on one of her soles. This was the Magic in the Power of God and His Grace for all four of us to have survived. Thank You God for the blessed mercy!

I called my cousin, my eldest daughter, mother-in-law and my employer to tell them about my accident. In the village where the accident occurred, there is a clinic. The residents came to our aid, took my daughter, granddaughter, and wife to the clinic. They also helped gather our scattered belongings and put them back into the vehicle. They also started arrangements for an ambulance to take us to Segbwema, the nearest hospital. As the arrangements were going on, my cousin had already alerted our brother-in-law who happened to have been in Segbwema that evening. So, within minutes, there was vehicle from Segbwema to take us to the Nixon Hospital. Meanwhile, my cousin had dispatched a Toyota Landcruiser from Kenema to pick us up for either Kenema or Kailahun.

The news of my accident had made rounds among my acquittances around the country and my phone was inundated with calls. Then came the hard dilemma of deciding where to go with the injured. The option was there to even go straight to the Emergency Hospital in Freetown. After putting everything into perspective, I decided on heading for the Kailahun Government Hospital. My decision to do so was driven by the following reasons: I was heading to Kailahun when I had the accident; I hail from Kailahun end; our parents and relatives are all in Kailahun. I thought I was not only patriotic, but also wise enough. My understanding was that I will get the best treatments (medical and psychological) in the region, given that I hail from there.

So we headed for the Kailahun Government Hospital. The accident occurred at some minutes after 7:00 pm and within an hour or two, we were in the Kailahun Government Hospital. Once in the hospital, the ordeal started in earnest. By the time we arrived, the hospital was already full of our relatives from the village, which was a strong psychological cushion for a people so traumatized by a brutal accident. In the hospital, however, the doctor was nowhere around.

Given the severity of the injuries and the urgency of attention, the nurses on night duty tried to call the doctor but no response. My youngest daughter who was in coma was rushed to the children’s ward, resuscitated and somehow stabilized. Thanks to that female nurse who I later understand was not even attached to that ward. Did the nurse know me personally or did she just do that out of her own good nature, I am still to find out. Irrespective, I was so moved by her professionalism that I will have to return to the hospital, even if it’s just for a handshake in appreciation of her voluntarism.

For my wife, a mattress was put on the hospital floor in the women’s ward where she was put for the night and almost the whole day the next day. We asked for a VIP room and were told nothing of the sort existed in the hospital. Although the hospital building is a magnificent infrastructure, the medical service is a nightmare compared to all other hospitals I have visited in this country. There was no doctor on call and the nurses on duty were clearly reluctant to touch her, even though she was in a deep pain. Not even the wounds were visually observed, let alone treated. All we were told was to buy drugs to relieve the pain for my daughters and wife. This we did every couple of hours throughout the night and the next day.

What bothered me most was not the exorbitant cost of the drugs, but the lack of proper documentation about the patients and treatments. It was like when your patient is in pain, you can call on any nurse to prescribe a drug without any need for the patient’s medical history. I found this truly scary! In standard hospitals, I think a file is always opened for every patient and all treatments administered are recorded for any in coming medical personnel to see and use as a guide for the next treatment. So, medical history guides medical personnel in delivering medical treatments to the sick. But this is never the case in the Kailahun Government Hospital. We did this quack treatment all night and well into the next day.

At about 9:00 am the next day, a doctor appeared in the hospital. The case was reported and the fruitless effort to reach out to him that night also told. To my greatest dismay, the doctor said without regard to any risk of loss of life that he had left his phone in the hospital that night and never bothered to return for it. That is how professional things are in the Kailahun Government Hospital currently. After a short visual inspection of my wife who was in severe pain (of course without even touching her), he decided to wait for his boss to hold their morning briefing. This lasted till 11:00 am that morning and the patient was there all that while in deep pain without any attention or regard for life for over twelve hours.

As if that ordeal was not enough, no arrangements were made for a referral to an emergency hospital elsewhere till the medical doctor arrived from Njala University. Doctor Koker had left Njala Campus in Mokonde the next morning of the accident and even arrived in the Kailahun Government Hospital before the doctors who work in the hospital. But as a doctor in a different terrain, he was nearly even asked out when he decided to observe the meeting for the morning briefing. After the briefing, the doctors decided to take rounds in their wards while my wife and daughters were groaning in agony from the injuries sustained in the accident.

At about 1:00 pm that day, I totally ran out of patience, went in forcefully and threatened to cause chaos before we were attended. I asked for referral to an emergency hospital anywhere and the medical guy in charge of that sector started to remind me that emergencies were only possible within 24 hours. I forcefully responded by asking him to tell me whose fault it was if that time frame had expired. I reminded him that we were in the hospital within two hours of the accident and there we were still to be treated.

After some harassment and hard exchanges, my wife was taken to the theater and given some limited blind treatments. I call it blind treatment because not even an x-ray was done. We were told that the door to the x-ray machine is so small that a stretcher cannot go through, meaning that patients on stretcher cannot have x-ray in the hospital. That is how excellent the Kailahun Government Hospital is today. For nearly twenty-four hours (one night and one day), hardly did I see anyone saying good words about the medical services delivered in the hospital.

At 6:00 pm that day, we were eventually referred to the Freetown Emergency Hospital. We arrived in Freetown at about 11:00 pm that night, only to be told that the Kailahun Government Hospital never placed a call to request for a referral. In that case, no bed was available for us, although all of us were fully treated, including thorough x-raying, scanning, etc., etc.

We were done in the emergency hospital at about 1:00 am and again referred to the Connaught Hospital. We expressed our desire to return to the Njala Campus in Mokonde and to do our checkups in Bo and granted to do so. With that, we slept over in our home in Freetown and travelled to Njala Campus the next morning, which was Saturday the 24th of July 2021.

I have told my story not because I hate anyone, but because I want the authorities to act and proactively monitor what goes on in our government hospitals around the country. If there is a hike in death rate today in the country, we must not hastily blame it on Covid-19. We must pause and investigate so that we are guided by credible data in our claims.

Accidents and sickness are a formidable stress in our lives. The first port of call for such stress is the hospital. If the hospitals, are by their administration adding to this stress, then the government should expect nothing but more deaths in the country. A nation with a high death rate can never see growth, regardless of whatever anyone does! I am therefore calling on the government to do just a little more to ensure that standard medical services are delivered in our Government Hospital across the country.

I hope I have not wasted my precious time and that this little piece will be used to prevent unnecessary deaths in our beloved country, Sierra Leone.

10 Comments

  1. I wish you and your family a speedy recovery. Our country needs help but above all we need attitudinal change. If doctors can abandon the hospital and they are almost impossible to reach in times of emergency, what chance have our sick people in crisis.

  2. Dr Moiwo – Wishing you and your loved ones a full and speedy recovery from the horrific road accident you were involved in recently. And many thanks for your very detailed and moving account of that very unfortunate occurrence. Indeed, the harrowing narrative allows readers to relive vacariously, certainly but no less powerfully – the trauma you and your family are experiencing in all its psychosomatic dimensions. And the lamentable and criminally inadequate quality of services available at our so-called government hospitals gives the trauma as clearly evident from your words and the feelings they convey, a decidedly bitter, intolerable edge.

    In fact, your experience at the Kailahun Government Hospital goes to confirm further the disgraceful state of our country’s health system. reminding readers of an article published here a little over a month ago by Dr Marcella Ryan-Coker. Dr Ryan-Coker was beside herself with grief and despair at the passing of a fellow doctor called Wale, a dedicated anaesthetist. Dr Wale had sustained a head injury in a road accident but the health system to which he had given his all failed him tragically; failed to reciprocate in his hour of need. The reason being our Connaught Hospital for all its long history and centrality in our national health system lacks basic equipment any self-respecting government hospital located in a country’s capital city, should have for handling patients needing intensive, specialist care.

    The reason you have given for telling your story echoes uncannily what Dr Ryan-Coker felt when she said she had no political agenda to push in writing her piece. Clearly there is nothing political about your story: it is a lament by a very intelligent and articulate Sierra Leonean patriot whose love of family and country leads him to call out and courageously so what is grievously wrong with the country’s health system. Your are right to feel disappointed and betrayed as the country whose academic life you are helping to enhance owes you and your loved ones the very minimum of public services – adequate, appropriate and timely health care in an emergency. Those whom we have mandated over the years to run our country and provide that care should hang their heads in shame for failing us so calamitously. I hope and pray that the story you have told will make a difference.

  3. Thanks to Dr Moiwo, and thanks to the almighty no one in his family lost their lives, or had life changing injuries. The physical injuries will heal faster, but the psychological experience will take longer. In recounting your story with out pulling any punches, in such a vivid and candid way, one can’t help but think every Sierra Leonean that read this horrific story that visited your family, can relate or see themselves in it. Even though we didn’t witness the accident that your family went through, one can’t help but sympathise with you, and take comfort that at the end of the day, thanks to God, you and your family members were okay at the end. Now there are lot of moving parts in your story that paints a bleak picture about the state of our medical facilities, or hospitals in Sierra Leone.

    Apart from lack of government funding, even the professional medical doctors that are in the front line dealing, or in your family case been fobbed off by the medical doctor attached to Kaliahun Government hospital, clearly shows the ministry of health should take the necessary action to remind this doctor, or doctors like him around the country, they need to uphold their medical oath.Maybe reading them the riot act is a step too far, but necessary. Maybe the minister of Health should take this opportunity, and write to all our top medical officials about their responsibilities to the citizens of Sierra Leone.least we forget there is nothing political about health issues. They should all act selfishly like the nurse that came to your aid, without expecting anything in return. If she was asked why she did what she did? Her reply one will hazard a guess will go like this “Iam just doing what Iam train to do” We need more of this public workers that thinks and act like her.

    Apart from everything eles, she restore some sense of hope, in todays Bio’s corrupt Sierra Leone, there are still good professionals working in our underfunded health service, sometimes denied their Salaries on time that just want to get on with their job with out looking for pat on their backs. That their work as health professionals is to save lives in whatever circumstances. And that is what this unknown nurse is all about. Suffice to say the behaviour of the medical doctor in Kaliahun government hospital has brought the medical profession to disrupt. The genesis of your accident, and your experience didn’t starts in the accident site or your decision to visit your village. It began few weeks back when you took your family vehicle for maintenance to the garage. And the reason why you have to do that, like many fellow Sierra-leoneans vehicles owners, is a story all too familiar with every one in taking a pilgrimage to a vehicle maintenance garage.

  4. Emotionally touching and eye opener story. Bravo to you sir for sharing this traumatic and life changing event that befalls your family. Such ordeals are a common occurrence in nations where professionalism and standards are only defined in the book. The same experience can be faced virtually in all government operated medical facilities along with administrative ones around the nation. Tell tale signs of failed state.

  5. Dear Dr Moiwo,
    I hope you are recovering well.
    You are really very brave to write about your experience. My last article that exposed illegal Chinese mining in Eastern Sierra Leone highlighted the devastating medical challenges people are facing in the Kailahun District. There are only two hospitals in the district – Kailahun Government and Nixon’s, and both are woefully underfunded and mismanaged. This is a combination of political neglect and corruption, especially where medical items are stolen by medical practitioners who set up quack private clinics in Kailahun. This is the story nationally.

  6. Thanks, and may the Almighty comfort you and your family. On a serious note, nothing, nothing going to change. Worst of it, the medics are going to hate you for simply highlighting this horror in our hospitals. In Sierra Leone, there’s corruption everywhere. The hospitals are like the judiciary, both are corrupt to the core, and both affect the public more than any institution, yet very limited discuss their service. Most of these drug sales point dubbed hospitals are mere death traps. I can never imagine anti-biotics being sold or dispensed without prescription, but that’s quite normal in salone

  7. Thanks for your brilliant expression and I wish you a speedy recovery. May The Almighty Allah guide you in all of your endeavors.

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