{"id":875,"date":"2009-11-09T11:22:51","date_gmt":"2009-11-09T10:22:51","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=875"},"modified":"2010-04-22T16:24:50","modified_gmt":"2010-04-22T15:24:50","slug":"emily-spry-on-nursing-in-sierra-leone","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2009\/11\/09\/emily-spry-on-nursing-in-sierra-leone\/","title":{"rendered":"Emily Spry on nursing in Sierra Leone"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.bmj.com\/columns\/icons\/pikin_hospital.jpg\" alt=\"Pikin Hospital\" width=\"160\" height=\"110\" align=\"left\" \/>The nurse steps forward into the circle, putting her hands together.\u00a0 She prays aloud, \u201cin Jesus\u2019 name,\u201d asking that our four day workshop at the Children\u2019s Hospital be blessed, \u201cso that we might put everything that we have learnt into practice.\u201d\u00a0 After a rousing Christian song, we proceed directly to the Muslim prayer.\u00a0 Nearly every nurse who clapped, sang and loudly proclaimed \u201cAmen\u201d now turns her palms to the ceiling and intones in Arabic.\u00a0 Quietly atheist, I vaguely join in with the gestures; luckily no one expects me to know the words.<!--more--><\/p>\n<p>Such religious tolerance is the norm in Sierra Leone, though I do wonder if my faithlessness would be as well accepted, if I were more open about it.\u00a0 Either way, I\u2019m sure that this society has much to teach, as well as to learn.\u00a0 Someone told me that life is so hard here that the wise hedge their bets; mosque on Friday and church on Sunday.\u00a0 A nurse whose birthday it was told me that she would spend her special day praying that she will see another one next year.\u00a0 With average life expectancy in the 40s, it is perhaps unsurprising that people in their 30s are nervous.<\/p>\n<p>The last day of our Emergency Assessment and Treatment workshop for the nurses this week coincided with pay day.\u00a0 The junior nurses receive 120,000 Leones (around 20 GBP) per month from the government for working a six day week.\u00a0 It\u2019s not enough even to buy rice for an average family for the month, though many nurses are the only breadwinner.\u00a0 At the Children\u2019s hospital, a charity provides a monthly top-up of a further 50,000 Leones (around 8 GBP), still little more than the average monthly spend on getting public transport to work.<\/p>\n<p>Nurses\u2019 neglecting to come to work at all is a major problem at the Children\u2019s Hospital, particularly at night.\u00a0 To make ends meet, staff often take part- or even full-time jobs in private healthcare facilities, on top of their government jobs.\u00a0 The Ministry of Health and Sanitation has central control of staffing, making it hard for the Children\u2019s Hospital to replace those who do not attend.<\/p>\n<p>But, as I consider the small pile of tatty bank notes that the nurses are taking home for the month, I wonder about things the other way around.\u00a0 While some do not attend, most are there, many working longer than their hours rostered.\u00a0 Why do they come to work at all?\u00a0 The Children\u2019s Hospital is trying hard but is chronically under-resourced and treating a poor and sick population; around 1 in 10 children who are admitted die.<\/p>\n<p>As I see it, these nurses are no different to healthcare professionals elsewhere.\u00a0 Yes, they want to be paid; they need to eat and they have families to support.\u00a0 But that\u2019s not the only reason they work here.\u00a0 They are here because of the respect that they get from their community for their skills, even if that means being woken in the night by a neighbour with a sick child.\u00a0 They are here because of the gratitude of parents when a child recovers.\u00a0 They are here because they enjoy the camaraderie with colleagues who have also seen life and death and everything in between.\u00a0<\/p>\n<p><em><strong>Emily Spry<\/strong> 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&#8217;s Hospital in a country where more than one quarter of children die before their fifth birthday.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The nurse steps forward into the circle, putting her hands together.\u00a0 She prays aloud, \u201cin Jesus\u2019 name,\u201d asking that our four day workshop at the Children\u2019s Hospital be blessed, \u201cso [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2009\/11\/09\/emily-spry-on-nursing-in-sierra-leone\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":125,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223],"tags":[1493,1492],"class_list":["post-875","post","type-post","status-publish","format-standard","hentry","category-guest-bloggers","tag-nurses","tag-sierra-leone"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - 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