Dr. Bobson Brima Sesay, Medical Superintendent of the Bonthe Government Hospital in Bonthe City, Sherbro Island, Bonthe District, was interviewed by Oswald Hanciles on December 28, 2019. The interview would be for print and electronic media use; and for social media.
In just five months in his new position, Dr. Bobson Sesay has succeeded in turning things around dramatically in the hard-to-reach hospital; the main referral medical station on the island.
One of the most important things that would make a hospital to be called a hospital – since Islamic-induced scholars started the concept of a hospital about a thousand years ago in Baghdad (where modern Iraq is) – is the keeping of accurate records on patients, and their treatments. Dr. Sesay said he met this recording keeping “haphazard”; done on ordinary exercise books. He has changed that. Record keeping is now being done systematically, in standardized formats as is done at the Connaught Hospital in Freetown.
There is now a single revenue collection site in the hospital, where there were multiple revenue collection sites before.
Nurses used to move around the hospital without uniforms; now, he has ensured they are in uniforms, with ID cards displayed.
Some of the wards in the hospital had lacked beds and linens, Dr. Bobson Sesay said. The bearded doctor recollected a scenario when he had just arrived in the hospital: “I met a nurse talking harshly to a mother who had brought her convulsing child with severe anemia; the nurse saying the mother should take the lappa she was wearing to be used as a bed linen; the mother protesting that there was vomit of her child on the lappa”.
Dr. Bobson Sesay said he had to “knock on doors” to ensure the hospital has adequate beds and linens. It appears as if there is now a surplus of these, as he opened a tarpaulin-like store room with still unopened beds and linens that had just arrived in the hospital. During his visit to Sherbro Island for the 2019 Christmas Season, the President, Retired Brigadier Maada Bio, commissioned the new materials. The President was given a guided tour of the hospital, and shown the desperate needs of the hospital in his home district.
There is no regular electricity supply, even in the surgical ward. Dr. Bobson Sesay said that the huge circular overhead lights in the ward are just “for show”, as during surgery what would be used would be ordinary bulbs, and “headlamps” tied to the foreheads of doctor and surgical assistants.
This lack of adequate electricity has meant that the store room of the hospital is mostly dark, and drugs which must be kept in refrigerated environments to keep them potent are being kept in a hot and dark room, whittling their efficacy.
There are two 10KVA and 27KVA generators functional in the generator house which Dr. Bobson Sesay showed me and my three video professionals, but they are of little use, since the electrical wiring in the hospital had been done in colonial times, and are dangerously inefficient in transmitting electricity in the hospital. The air-conditioning in the surgical ward is just another “piece of furniture”, non-functional; even in the doctor’s office, there is no air-conditioning, and he sweated profusely as we conducted the video interview with him. There are no “remote allowances” for medical personnel working in one of the most remote places in the country. Medical staff have to struggle every month to get their salaries. Housing is a huge problem which Dr. Bobson Sesay has only started denting by having the matron’s quarters repaired. He met a situation in which four nursed would sleep in a single bedroom. There is no petty cash for miscellaneous expenses, or, emergencies. The absence of proper medical equipment is scandalous – it could be about the worst such situation for a main hospital in a district headquarter station.
“We have urgent need for an ultra sound scanning equipment”, the soft-spoken Dr. Bobson Sesay raised his voice to accentuate his need. “The form of medical practice here is what is known in our profession as ‘Tropical Medicine’ or ‘Crude Medicine'”, Dr. Bobson Sesay said, trying a bit of humour to a very disturbing situation in which even during surgery wrong instruments are used, risking contamination. The overworked doctor is both the clinical head, and head of administration. It’s hardly a wonder that the perception among medical professionals in the country is that if you are posted to the Bonthe Government Hospital you have “been sent on punishment”.
The most prevalent diseases reported in the hospital are: hypertension; anaemia; Hepatitis B; and common Malaria. There is a huge supply of medicines in the medical store, but without regular electricity and air-conditioning, their potency would be questioned. There is a clear case of what Dr. Bobson Sesay called “dumping” – the supply to the hospital of medicines which they have little use of. In what used to be a staff quarters inside the hospital compound, there were unsightly cartoons of personal protection materials in cartoons rotting on the verabdah facing the street.
Dr. Bobson Sesay said proudly that since he took over there have been “very reduced infant mortality”; and no maternal deaths. Dr. Bobson Sesay said he has ensured that patients admitted would have three meals a day, unlike before – though the kitchen where the meals are being prepared is crammed; using fire wood emitting thick smoke; and the exposed bowls where water from an untreated well would be collected looked frightfully unhygienic. Also, patients would have to leave their wards and walk ten meters away to bright-yellow- painted flush toilets – a problem during the rainy season.
The peeled painting on the walls of the hospital; the bare cement floors on the corridors, give the impression of a slum dwelling. It’s an understatement to say the main hospital in the home district of the President needs urgent life-saving attention; including the need for image whitewashing.
Oswald Hanciles reporting from Bonthe City.