Masanga- Sometimes there aren't words.

What an adventure I have had these past two weeks!

Back in 2011, I heard about a hospital in a small village called Masanga in Sierra Leone and since then I have wanted to visit and see how it would be to work there. This past two weeks I was able to go with my friend and fellow nurse Steph to experience life at a hospital in the jungle.

Taking public transport means having two bodies squashed into one seat, sweating all over the person/people you are sitting next to, having random men tell you they love you because you have white skin, letting a stranger find a taxi for you in the right direction, receiving cokes from said stranger, making friends and having a laugh about the most random things seen on the way.

The journey to Masanga took 8 hours, 4 different taxis (six passengers and a driver in each 5 seater car) and an okada ride (motorbike taxi) over a very bumpy dirt road, Steph squashed in the middle and me with a big 15kg backpack strapped to my back. We arrived safely, without a scratch and in good time. We met the family who we’d contacted to come to Masanga hospital and a group of Danish volunteers who we’d be working alongside in the next two weeks and eventually collapsed into bed after a long day of travelling.

The hostel where we stayed

My bed

Day 1 began by Steph and I joining a group of people for a morning meeting which is a report of the on-call doctors work over the previous night. The group of people we’d be working with who also attended the meeting consisted of two Dutch doctors, two UK doctors, several Surgical Training Program (STP) students from Sierra Leone, several Community Health Officer (CHO) students from Sierra Leone, a surgeon and theatre nurse from Norway, two physios one from the UK, one from Denmark and several other volunteers from Denmark, two nurses, one pharmacist and one medical student.

First thing after the meeting I was shown around the hospital by one of the Danish nurses, Ditte. We walked through the new Emergency ward, with 8 beds on one side and 3 beds in a resuscitation room that had one oxygen converter that worked with a small generator or when the power was on. We also walked through the rest of the hospital, which has an outpatients department, maternity ward, paediatric ward, surgical ward, labour room, dressing room and two operating rooms.
During the tour we stopped in on the surgical ward rounds with one of the STPs (they act as doctors) and I asked Ditte plenty of questions about how things were run. It was strange suddenly being the one who didn’t know how the hospital ran when I was so used to knowing the ins and outs of the ship hospital and I would be the one showing the new nurses. Now I was the new nurse.

The patients can come to Masanga for a hernia repair and pay a small fee, or if they are admitted for an emergency then it’s free. They pay a couple of dollars fee for a bed and then they can stay in it until they are ready to discharge. The hospital doesn’t provide any food, so the patient needs to find or organise their own. The patients without caregivers can certainly struggle to care for themselves. Also if the patient needs a blood transfusion it has to come from a family member.
I met a couple of patients who have been in the hospital for two years with chronic wounds. One girl is about 7 years old and the other about 16. When Ditte first arrived at the beginning of the year the 16yo girl hadn’t been out of bed and outside in all that time. Now they have a routine in place for her to have her wounds dressed and her up and outside in her chair for a couple of hours of sunshine. Ditte said she has watched her personality break forth through some love and attention. She is a bright girl with a very sweet smile.

After lunch we opened the play room and the children from the paediatrics ward came down for some play time. It was nice to get to know these kids during playing and we even sung some songs in English and Krio.

After closing the play room I headed up to emergency and found the two Dr Davids and Steph, along with the staff in emergency working to stabilise a 7yo boy. I joined in by helping where I could and we worked on keeping him alive for what only seemed like an hour but was actually more like 3. Every now and then I would look at the scene around me and choke back tears. Despite our best efforts and doing CPR on two separate occasions his death was called. It was an undiagnosed illness.

One of the nurse aids tied the boy’s big toes together and thumbs together with pieces of old IV tubing, then put cotton wool in his nose and mouth and then wrapped him in his mama’s lapa ready for the okada ride back to their village for burial. Meanwhile his mama rolled around in the grass outside the emergency, wailing and throwing grass in the air. The boy’s body lay on the bed and we stood there, shocked at what had just taken place, defeated by an unknown illness. With a numbness spreading over my heart, we dragged our feet home, to wash off the sweat and process how it felt to see a little life slip through our fingers.