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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. 

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 


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