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Thursday 22 October 2015

Strengthening A&E at Connaught

On 21 October, the Minister for Health and Sanitation, Dr Abu Bakr Fofanah, visited Connaught Hospital to discuss plans for the refurbishment of the Accident and Emergency (A&E) Department.



A&E is an emerging area of specialist practice in Sierra Leone with potential to transform how health care is delivered in the country. Connaught staff have been working with King’s Sierra Leone Partnership to reform how A&E care is provided. Recently the hospital has successfully implemented a new triage system to prioritise the urgency of patient treatment. 

Sister Cecilia and KSLP A&E Nurse Mentor Hedda
The refurbishment includes the construction of a dedicated minor procedure room so that staff can conduct urgent surgeries within the A&E department.  There will also be new water and sanitation facilities for hand washing, improved waste disposal provision, and drainage to support improved infection prevention & control processes.



The A&E Team: Sister Cecilia, A&E Consultant Surgeon Dr Seisey, KSLP A&E Co-ordinator Dr Ling and Matron

Through the improved capacity of the A&E department, Connaught Hospital will be better able to respond and prevent future health crises such as ebola, as well as manage casualties from other health emergencies.  

Tuesday 13 October 2015

Technicians at Connaught

We would like to introduce Ibrahim, one of Connaught Hospital’s highly skilled technicians behind the functioning of the hospital’s new oxygen factory.



Since the rejuvenation of the oxygen factory he says, “I feel more secure in my job and that my team are needed and will continue to be supporting the hospital in the future”

The Technician Team- (l-r) Abu, Amadu, Ibrahim and Desmond

Ibrahim first started working at Connaught Hospital 5 years ago. Since then he has become a specialist in handling medical equipment like ECGs, monitors, anaesthetic machines and, of course, oxygen concentrators. Ibrahim enjoys his job and is always looking to improve his skills. He and all the technicians are hoping that in the future they will continue their training so they can maintain the full range of specialised medical equipment needed at Connaught.

Ibrahim and his fellow technicians demonstrating Connaught's new oxygen factory

Ibrahim is very positive about Sierra Leone’s future. “So many sad things have happened but we are strong people. Ebola exposed weaknesses in health care so we are improving from now.”

Friday 15 May 2015

An Engineer in Freetown

My name is Gerard Dalziel and my title here is Volunteer Site Engineer for Connaught Hospital, Freetown Sierra Leone.  I came to volunteer with KSLP through Engineers Without Borders in February for a six month period. On any give day the duties can range from repairing a centrifuge to consulting with the Sierra Leone Fire Brigade for a fire safety assessment of the hospital wards. 

The Site Engineer's major function is to assist in the planning and in preparation of contract documents to refurbish and or re-purpose portions of the hospital campus for the post-Ebola rebound of the Freetown health care system.  The international community has realized that the weakness of the health care system was one of the causes of the severity of this particular epidemic, and is therefore determined to put the resources here to bring the health care facilities up to a minimum standard of infectious disease prevention and care (IPC) so that the system is better prepared for the next epidemic.


Planning the stations of the new chest clinic



The medication station shown left as finished



We are currently in the process of building a new chest clinic where patients with a range of illnesses, particularly TB, can access care, along with HIV counselling as this is a frequent co-morbidity. The building had been abandoned for some time so was not in a good condition, but we've recently completed it and it now looks very smart. 

Before...
and after!

We have also just completed a new safer structure to house the hospital oxygen generation factory, which was previously unusable because the structure it was in was too small to prevent overheating.  We are also upgrading the oxygen delivery system with portable tanks and oxygen concentrators to support a CDC trial of a new Ebola vaccine.  


The previous structure housing the oxygen factory (right) 


The completed extension and new oxygen filling system arriving

Next week we will be putting the construction of a new infections disease (ID) holding unit out to bid, so that what is now being used as the Ebola holding centre can go back to its previous purpose.  After that we will be planning a possible campus expansion to add additional ID capacity to the hospital


Part of the reality of the work here is the on-going struggle to eradicate Ebola from Freetown and from Sierra Leone in general.  You wash your hands in chlorinated water every time you enter the hospital grounds in addition to rinsing them off with alcohol gel several times a day.  The Ebola holding unit is near the front entrance of the hospital and is occupying what used to be the emergency area of the hospital.  Post-Ebola, the old holding centre will be upgraded to a new Accident and Emergency Department (A & E) with the addition of new patient treatment capabilities.  My work is therefore linked closely to King's other projects, in this case providing ongoing mentoring and support for staff on Emergency Medicine, through expert volunteer medics from the UK. 

In order to plan for the future A & E Department, we had to measure the dimensions of the existing holding unit.  I was able to measure the outside of the building in partial personal protective equipment (PPE) but trained medical staff had to take the inside dimensions in full PPE.  The tape used to measure the inside was incinerated with other medical waste as possibly being contaminated.  This is one small example of of how Ebola has affected how we do our work here. 


The current ETU which will be changed back into an A&E department soon

The volunteer medical staff from Kings Hospital in London and the in-country Sierra Leonean staff are extraordinarily determined to eradicate Ebola and to come out of this crisis stronger and better prepared to to meet the future health care needs of the city.  I hope to continue to share in that work by lending my engineering skills wherever needed. 




Gerard and Abdul, connaught's Biomedical Mechanic