Emily Spry is back in Freetown

Pikin HospitalIf you blinked, you probably missed it, but I’m back in Freetown after a short Easter jaunt to the UK to see my family and a few friends. I was surprised but delighted to be snowed on in the mountains in Wales; at least I can say that I experienced the legendary winter of 2009-2010, no matter how briefly.

When I left, the Children’s Hospital was entirely empty of patients; the doctors and nurses were nearly two weeks into a strike over pay. Several of the administrative staff were beside themselves, as they milled around the empty corridors; they hated seeing the Hospital that way. The only silver lining was that the Environmental Health people got to spray the wards to their hearts’ content, hopefully banishing unwanted insects.

However, the day after I left, the president issued a statement that all those not back at work by the Monday morning would be fired. Frantic meetings followed and eventually the associations agreed; they would go back to work.

It seems that ultimately, the nurses will get around 150 USD per month, with more for very senior nurses, whilst the house officers (i.e. newly-graduated doctors) will get around 600 USD, pre tax. Paying the highest rate of tax plus national insurance, the house officers will take home around 300 USD per month.

The mood seems to be cautiously optimistic. “It’s not what we wanted, but it’s better than nothing,” several people have said to me.

The focus is now moving to the looming day (27 April) when user fees for pregnant and lactating women and children under 5 will be abolished. I would love to say that the Children’s Hospital is ready but it’s not. They are currently trying to create an appropriate store for the free drugs and a dispensary.

For me, triage is the scary part. We expect a huge influx of people coming to get whatever free stuff they can while it’s there, not yet believing that the programme is to continue. The danger is that the emergency cases will be hidden in the crowd.

The great thing about going back to work today was appreciating again the incredible warmth of the people that I work with here. I was only away for a week but everyone welcomed me with huge smiles and hugs and asked me about my holiday, my family, my journey and everything else. It’s so different from the working culture in the UK, where a brief nod would probably have done. After very mixed feelings leaving family and friends at home, today I felt really glad to be back.

Emily Spry is a doctor from London who has taken a year out of her General Practice Specialty Training Programme to live and work in Sierra Leone, West Africa. She is working for the Welbodi Partnership, a charity which supports the main government Children’s Hospital in a country where more than one quarter of children die before their fifth birthday.