Our Achievements

Training

There is currently just one consultant paediatrician in government service in all of Sierra Leone, and no postgraduate training available in-country to produce any more. We are working to change this, and have a crop of medical officers who are committed to further studies in paediatrics. Our ultimate aim is to have the capacity to train specialist children’s doctors and nurses at the Ola During Children’s Hospital, and we have taken significant steps towards making this a reality. We have now recruited a Professor of Paediatrics from Nigeria who is working full time at the Ola During Children’s Hospital, and with her help, we have supported a number of young doctors to prepare for and take the primary exams for the West African College of Physicians. Our first cohort passed these exams in October 2010.

We also recognise the vital importance of in-service training, and have provided consistent and continuous education to raise clinical standards day-by-day. For nurses in particular, many of whom learn on the ward as they cannot afford to study for further formal qualifications, demonstrating and reinforcing good practice has had a significant impact on performance. Much of this training has been delivered with input from our partner in Wales, Abertawe Bro Morgannwg University NHS Trust.

Hospital Management

A hospital requires so many things to be done right before a doctor or nurse’s work can save a child’s life. Standards and protocols, and a culture of professionalism and co-ordination, must be initiated and upheld by the hospital managers, and we have worked hard to encourage this at the Ola During Children’s Hospital. We have also helped to foster a performance-oriented culture amongst the nurses, not least by working with hospital management to design and implement a performance bonus based on ward standards.

We have made significant improvements to the organisation of care. For example, we helped introduce a triage system so that incoming patients are correctly assessed for relative urgency, and are handled accordingly. This proved vital when patient numbers skyrocketed upon the introduction of free care for children under five in 2010.

We have introduced computerised medical records, and reinforced administrative protocols so that cases can be tracked effectively. Not only does this mean patients receive better care, but that we are better able to monitor mortality and morbidity at the children’s hospital, and thereby track performance, examine trends, and inform research.

Facilities and Supplies

When we started working with the children’s hospital in 2007, the hospital had not had a reliable source of running water in several years. With less than $1,000 of funding and assistance from us, the hospital maintenance team successfully repaired the water system, and have maintained it since. (To read a case study of our work with the hospitals’ water, as an example of how we work cooperatively with the hospital, click here.)

We also improved the power supply with a back-up generator, which allows for 24-hour care even during the frequent power outages that are a feature of life in Sierra Leone. We purchased concentrators, which have been in near constant use since their arrival and have saved countless lives, as well as other essential medical equipment.

The hospital is still poorly resourced, and requires key equipment and supplies before it can operate as an accredited teaching institution. Among our most important initiatives in the comings months are to secure an x-ray machine and improve the hospital laboratory. The improvement of the laboratory, which is being led by our partner in Wales, Abertawe Bro Morgannwg University NHS Trust, includes both equipment and staff training.

Co-ordination and Planning

The healthcare system in Sierra Leone is severely under-funded. Supplies run out and are not replaced and many staff are poorly paid. By encouraging staff to propose solutions and apply through the Sierra Leone Institute of Child Health board for the funds to make them possible, we have helped break the cycle of poor resourcing and low morale. The staff on the ground are well aware of shortcomings in the hospital and often have ideas for how to improve things, but until recently, did not dare to hope that they might be able to put their ideas into practice. The hospital now produces an annual plan and quarterly project proposals to which all staff are encouraged to contribute.

The appetite for change is there at the hospital. We now need the funds to enable that change and reward the staff’s energy and faith in us.

Case Study on Water

When the Welbodi Partnership first began work at the children’s hospital, the hospital had not had reliable running water for several years.

We worked closely with the children’s hospital maintenance team to map the water system and identify the problem. Once the problem was isolated, we provided the maintenance team with funds – less than $1,000 – to buy necessary parts and repair the faulty pumps.

The entire process was time-intensive and undoubtedly much slower than if we had brought in an external plumber to address the problem. However, working with the children’s hospital’s maintenance team allowed us to develop their understanding of how the water system functions, to build local capacity, and ensure that the local know-how exists to continue with ongoing water supply maintenance.

The result is not only running water in the children’s hospital, but also a stronger and more empowered maintenance team that is better equipped to tackle future problems.