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Friday 16 May 2014

Connaught Fashpack

As a part time communications consultant working with the King's Sierra Leone Partnership I have very little to offer in the way of innovative management ideas, clinical skills and curriculum advice. However as someone who has a preoccupation with Sierra Leonean fashion (I have turned it into a serious hobby through my blog Freetown Fashpack I do feel qualified to comment on the uniforms of Connaught Hospital.

The Hospital is in many ways like stepping back in time.The uniforms remind me of the old photos my mother occasionally pulls out from her early nursing days in the 1960s. At Connaught, uniforms are worn with a deep pride and carefully reflect the hierachy within the hospital. According to Matron Kamara "There is a lot of dignity in our uniforms, they help with staff morale and self esteem. When I put on my uniform I look cute, and I feel very proud". 

I  recently developed a chart which displays the many uniforms worn by Connaught staff so that staff can be identified by visitors.  In doing this I learned about the rank and file of Sierra Leone's hospital workforce and was able to photograph several willing models who all looked perfectly groomed and were more than happy to pose for the camera.

Nursing aide Susan Sandy looks smart in her distinct green uniform.

Fatmata is a first year state enrolled community health nursing student (SCHN). Each year she will add an extra blue stripe to her nursing hat but will remain in the blue and white until she becomes a trained nurse. The 2.5 year SCHN course at COMAHS requires three O Levels to take the entry exam. 


Benson is also a SCHN student studying at COMAHS. The three blue stripes on his white shirt show that he is a third year nursing pupil.

State registered nursing students (which requires a higher entry qualification than the community nursing students) wear this pink uniform every day of class. Their year of study is identified by the stripes on their nursing hat. You can see Mariatu has three stripes on her hat showing that she is a third year student.

Ignatius models the crisp white male version of the state registered nursing student uniform. The single stripe across his pocket shows that he is a first year student.


Mac Joe graduated from the blue and whites many years ago ('don't ask it was a long time ago) and is now a state enrolled community health nurse. Trained male nurses always wear these light brown pants teamed with a white shirt.


 
As a fully trained state enrolled community health nurse Adiatu has also broken free of the blue and white and now wears a grey uniform with lace edged and white hat to work each day.


Agatha is a fully qualified state registered nurse and required five 0 Levels to be accepted into the three year nursing course at COMAHS . State registered nurses wear all white uniforms with a red belt. There are no hard rules about the type of belt, I've noticed the elasticized variety with a jeweled clasp is quite popular. Agatha picked hers up from PZ market in town, Freetown's shopping epicenter.


Dura Kamara shows us the male version of the staff nurse uniform - crisp, white and simple. As is the custom in Sierra Leone, he likes to keep his shoes spotlessly clean, "I try and clean them every day after work".

 
Sister Fatmata Kargbo, head of the pediatrics ward holds a Bachelor of Science degree and is known as a BSc ward sister. These senior nurses who deputize the matron wear an off-white uniform with blue detail. They don't have to wear a cap.

The boss lady Matron Kamara is identified by her white hat and blue belt. The four stripes on her epaulette indicate that she is the most senior nurse in the hospital.

Wednesday 7 May 2014

Theory to Practice - My Elective with the King’s Sierra Leone Partnership


by King's elective student James Barnacle
I had been interested in Global Health for several years before being lucky enough to study the intercalated degree at King’s College. It expanded and developed my interests, looking at how and why countries developed and the relationship between development and health. It was on the course that I first heard about the King’s Sierra Leone Partnership, and met Oliver Johnson, who at the time was teaching and tutoring on it.
Until my elective I had never been to sub-Saharan Africa and a year of narrowly spaced exams meant that I was reluctantly losing touch with the global health world. A medical elective with the partnership was a fantastic opportunity to consolidate what I had learnt, emerge myself in global health once again and see the theory and principles from the course put into practice. With this in mind, Anna (a colleague from Cardiff who had also studied global health) and I found ourselves outside the KSLP office on the second floor of the administration building at Connaught Hospital, not really knowing what to expect but very excited to find out. 
    Myself and partner in crime Anna Davies at Connaught Hospital

What the KSLP office lacked in space it made up for with filter coffee, wifi and an incredibly friendly atmosphere. On our first day many of the faces were already familiar after we had joined several of the team the night before in a desperately empty national stadium to watch Malian singer Salif Keita! Oliver introduced the partnership’s work in Freetown and I was surprised at how discussions and seminars from the course were flooding back to me as I heard about KSLP’s recent achievements and future plans.

    The new triage pilot at Connaught in action.

We were given several projects during the six week placement including collecting timings and demographics of those presenting through the front gates before and after the introduction of a triage system aimed at prioritising sick patients. In addition, we evaluated the nursing skills lab by performing an inventory, talking to nursing staff and students and identifying areas for improvement. The partnership works closely with the nursing school, and more effective use of the skills lab will improve nurse training. We presented recent KSLP research at the annual Health and Biomedical Sciences (HBIOMED) national conference to leading academics in Sierra Leone. Finally, we helped analyse epidemiology data from over 350 patients to identify key presenting complaints, investigations, diagnoses and drugs. This will help direct the free emergency drugs initiative being introduced at Connaught, but in the future will be a reference for lab test requirements, disease burden and drug prescribing.

As well as liaising closely with the KSLP team, working with local staff and students was an integral part of our projects. Two nursing students, Benson and Sahid, worked closely with us collecting the inventory. In A&E, we had a strong rapport with Dr Cole and the nursing team who played a crucial part in the data collection. On ward rounds, we developed friendships with the medical students, some of whom had even visited Wales on their elective. They were enormously welcoming and always willing to answer questions about their challenges and experiences.

    The entry of the triage at Connaught.

The autonomy we were given forced me to draw from the skills I had gained on the course, notably critical reflection in the context of health system strengthening, development and policy. Our time there gave us a window into an organisation working closely with the government to put the principles I had learned about into action. I could not imagine a more engaging and enjoyable way to put the ideas I had developed on the global health course into practice. I will stay closely linked with the partnership and hope to return to Sierra Leone in the future.