St John's Hospital, or Mabesseneh, as most people call it, is an important link in the health of people here in the Lunsar and Makeni area of northern Sierra Leone. Run by the Catholic order St. John's of God, and sponsored by Spain, it was quite well known in this area for quality health care with a more loving approach than is sometimes characteristic of health care in West Africa. So, people came from far away to seek treatments here, even from the neighboring country of Guinea. Their usual census was from 60-80 patients, and they did a large maternity business and a full array of surgery. But in fact, it was this very fame which became an Achilles heel, as a patient from Guinea came there for treatment of an ill defined fever, diarrhea, and headache in September. Unfortunately, he turned out to have Ebola, and before the plague was stopped, Dr. Manuel, a Spanish priest and the beloved surgeon here for many years had died, and about 9 nurses who had treated the patient ended up dying as well. So the hospital was shut down in September, and has been closed for the past 5 months. With the help of IMC (my parent organization), St John's built a very nice triage center where every patient checking into the outpatient clinic would be screened by people in protective equipment, and if they have no suspicion for Ebola, they are referred on to the outpatient treatment center where the patient can see the doctor. It started about the 2nd week of January, and has rapidly grown to now seeing about 35 patients a day or so.
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After training the staff at St John's in donning PPE--ready to go
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So this next week, the hospital will open once again, with the triage center functioning as well for screening all the inpatients as well. If a patient does show some suspicion of Ebola, then they are referred over to our ETC for testing. Of course, we pick up many cases of malaria, acute gastroenteritis, and other issues that are not Ebola, but that is okay. So far in the 4 weeks, only 7 or 8 patients have had to be referred to the ETC, and I am happy to report that all of them have ultimately been negative for Ebola. So that reflects more the fact that Ebola incidence is falling here in West Africa than necessarily anything else, but I do think the screening process works. So that is why we feel pretty good about the process of opening one more of the cogs in the health care system here in West Africa. There are plans to assist with the opening of up to 6 or 7 other local health care facilities with the help of IMC, but that process has been a bit slower, so I suspect that many of them are a good 2 months off.
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One of the buses used for transport of staff at the hospital
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Sign over top of the entrance at St. John's
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I have spent a great deal of time there over the 6 weeks that I have been here. And, although not as exciting or risk taking as working in the ETC, it is probably the more important role here in Africa for the long term. So it is good to be part of the whole recovery of the health care system here. It is not enough just to stem the tide of the Ebola outbreak, but the future is important too. I hope that organizations can see the need for ongoing work. They have recruited doctors and staff from Nigeria to help run the hospital, and as far as I can see, it looks like we will be good to start up the week after Valentine's Day. We do have a surgeon who is here from Italy for 1 month, and after that, it looks like other volunteers will be coming as well. Perhaps in the near future, St. Johns will once again become a powerful force in the health care system of Sierra Leone.
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Dr. Manuel, the surgeon who died
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The new entrance to St. John's hospital, with triage area to the right
Doctors helping with the training from IMC head towards the main hospital
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