![\"Pikin](\"http:\/\/www.bmj.com\/columns\/icons\/pikin_hospital.jpg\")
Most of my job here in Freetown requires skills not covered at Medical school or my GP training thus far.\u00a0 For a start, most of my role here is about management, coordination, and training.\u00a0 But, trying to get things done on behalf of a small charity in a poor country, there are many unusual demands, which are hard to prepare for.<\/p>\n
Many of these demands come about because the Welbodi Partnership, the charity for which I volunteer, supports the Children\u2019s Hospital in a rather unusual way.<\/p>\n
The Directors of the charity, mindful of others\u2019 failed attempts, tried to find a more efficient and sustainable way to transform the Hospital.\u00a0 The first step was to build relationships within the Hospital and with the Ministry of Health and to spend a lot of time trying to understand in detail the problems and the barriers that keep things from changing for the better.<\/p>\n
After some time, they formed a Board which brings together the Chief Medical and Nursing Officers from the Ministry, the Management of the Children\u2019s Hospital and representatives of the Welbodi Partnership.\u00a0 This Board meets every three months to consider proposals put forward by the Hospital for how Welbodi funds should be spent.\u00a0 It also reviews progress on previously-approved proposals.<\/p>\n
We had our quarterly meeting last Saturday and around 30,000 USD worth of funding was approved, for projects ranging from improving the water supply, to furniture in the Outpatient Department, to pulse oximeters and suction for the Special Care Baby Unit, to making more basic tests available in the Emergency Room.<\/p>\n
It was all immensely cheering.\u00a0 Until I remembered that I now have to help the Hospital implement these projects.<\/p>\n
I know from experience that this involves things well beyond my ken.\u00a0 How often in your UK practice have you designed an Emergency patient trolley from scratch and given your drawings to the welder?\u00a0 Only to find that caster wheels with brakes cannot be sourced in Freetown.<\/p>\n
Luckily, I only had a single prototype made before committing more money.\u00a0 The nurses politely but firmly stuck the brake-less trolley in the corridor and reverted to the hip-height beds with no sides.\u00a0 Don\u2019t worry, they said, the mothers make sure they don\u2019t fall off.<\/p>\n
Fortunately for me, I persuaded my partner to accompany me to Freetown this year.\u00a0 Alex has been volunteering as a small business advisor, helping Sierra Leonean entrepreneurs to get their businesses going.\u00a0 But, knowing his many practical skills and problem-solving nature, little by little, I have inveigled him into the Hospital and its problems.\u00a0 As a result, he spent the whole of this Saturday at the top of the 5-storey high water tower, working with the Hospital maintenance team to fix the water pump.\u00a0 I think it\u2019s a key new skill for me, this inveigling.<\/p>\n