Sierra Leone hospital brings needed relief

Twenty-two years after the facility was closed down because of the civil war in Sierra Leone, Hatfield Archer Memorial Hospital in Rotifunk has started doing surgeries again.

Hernia and hydrocele surgical operations were performed on nine men in July, the first of 300 patients diagnosed for those surgical needs.

The United Methodist hospital was the main health service provider in Moyamba District in pre-war years but shuttered in 1995 when rebels of the Revolutionary United Front invaded the district. It re-opened in 2014.

Hydrocele and hernia infections are high in Moyamba District and many of the patients have lived with the devastating conditions for decades because they could not afford the cost of the operations in other hospitals elsewhere in the country. Hydrocele is an accumulation of serous fluid in the scrotum leading to enlargement of the scrotum.

Hatfield Archer’s chief medical doctor, Dr. Braima Lansana, said each operation was done on cost recovery basis of Le400, 000 (an equivalence of $53), and that the real cost elsewhere was around Le2,000,000 – an equivalence of $300.

“You are the first nine lucky ones,” Lansana told the patients as they were about to be discharged on July 12. “Help us spread the message that the hospital is now fully operational...”

The facility had a pre-war reputation of offering free treatment and surgeries. To pay at cost recovery is a new phenomenon that the overwhelmingly poor community is grappling with.

The cost recover fee of Le400, 000 for these operations covers cost of medicines, not surgery, Lansana said. “So, the key problem we are facing now is to change that psyche — get them to pay for services.”

This part of the country — Moyamba District — is one of its poorest districts and the Bumpe Chiefdom where the hospital is located is the poorest in the district with very little economic activity going, he explained.

Raising even 400,000 Leones was difficult for a good number of the patients interviewed. Musa Koroma, who has lived with hydrocele for 10 years, had to get family support to supplement the meager income he earned from farming.

Koroma said he was highly relieved just a few days after the operation. The disease had affected his mobility, along with his mental health and social interaction. In his community where all the men bathe in one stream, he did not have the courage to do so, owing to the shame and laughter the disease was associated with. “I do not have words to express how happy I am,” he said.

Allieu Sesay, 80, a farmer from Masella, does not clearly remember how long he had lived with hydrocele but it has been more than 20 years. He believed the frequent pain from hydrocele was responsible for his poor performance in the farm and his subsequent poverty.

He would have to be carried by others when he suffered an attack from the disease and that would mark the end of his workday. In Sesay’s case, his two sons had to contribute funds so he could take advantage of the almost free operation opportunity at the newly rehabilitated United Methodist hospital. The children were aware that the cost for the operation elsewhere would be out of their earning power and loaned money to make it happen for their father.

Osman Sankoh, a 20-year old hernia patient from Saima Wharf, is at the upper high school level at Bumpeh Academy. He said severe stomach pain used to affect his studies and resulted in his poor performance in school. Though his father and mother are separated, they pooled resources to pay for his operation.

Foday Sankoh, 25, has lived with hydrocele since birth. Sankoh’s scrotum had become so large that normal walking was impossible. His wife, with whom he had a child, abandoned him because of his condition, which he described as shameful in his community. He hopes to find a new wife when he completely recovers from the surgery.

Emmanuel Caulker had a painful hernia for 11 years. He got the news of the operation opportunity at Hatfield Archer Hospital through the hospital’s public address system —  mounted on a vehicle that moved around the community — which asked patients to report and register. He grabbed the opportunity and, after one week into his recovery, he said he was feeling very relieved. 

The hospital needs resources to sustain the surgery department, which is slowly picking up. But the funds are slow in coming. The facility admits over 300 non-surgical cases a month and the number is expected to rise as news of good services continue to reach the people.

With plans to handle over 200 outstanding hernia and hydrocele cases, Lansana says the hospital needs their own resident anesthetist, cardiac monitor, oxygen concentrator and sutures.

Hatfield Archer had to call for support from the United Methodist hospital in Kissy, Freetown, to do surgery because they did not have all the equipment and personnel needed to do the operation. Hatfield Archer Hospital does not generate enough funds to buy such equipment because the money patients pay is not enough to cover operational cost, Lansana explained. 

Jusu is director of communications for The United Methodist Church in Sierra Leone. News media contact: Vicki Brown at (615) 742-5470 or [email protected].