26th November 2004

We drove from Freetown to Kambia on Monday with MSF; 5 hot, sweaty hours in the back of a 4WD with boxes of provisions and a boy with his leg in plaster. He was getting a lift back to Makeni after being treated at the Italian Emergency hospital in Freetown. At first the road north was in good condition, on a par with European roads, but after about an hour's driving it turned into dirt track, full of potholes and clouds of orange dust.

We arrived here in Kambia town in the early evening and were warmly greeted by Alice Battye, Mary and Francis, three of the Sierra Leonean nurses working at the hospital.  We are staying in the last of a row of small, neat houses built for the staff.  We have running water and electricity for two hours a night, both of which are luxuries in a town where many houses are piles of blackened bricks, burnt down by rebel soldiers four years ago.

The hospital staff are doing their utmost to help us out and sometimes it is even a little overwhelming. Alice Battye often appears on the doorstep bearing small bowls of rice, ground nut soup and plantain fritters to help us on our way.  Anthony, the hospital administrator, has been on overdrive since we got here and no sooner do we utter a request than he is organising people to carry it out.

There is a constant hum coming from the hospital, where patients lie in the spanking new building attended 24 hours by medical staff. Their families sit around on benches outside.  Women with thin plaits braided tightly to their heads and sarongs in all the colours of the rainbow tied around their waists chat to each other or to men with football shirts and bright yellow plastic sandals.  A couple of goats are to be seen wandering around aimlessly.

The hospital itself seems to be functioning well, there is an energy and drive about it and people here are very proud of their new hospital. There isn't enough water, their only electricity is from a generator and their cool room is often warm.  Yet there are competent staff here and whilst there might not be enough and they might lack certain skills, people are working hard and trying to improve things. Whilst all is by no means perfect, there definitely is a feeling of moving forward.

What is more disturbing is what is going on outside Kambia town in the remote villages in the district. On Wednesday we went to visit the village of Tombo Wallah, on an island in the south-west of Kambia District. It is the most incredible place with the feeling of being far, far removed from the real world. There is something magical about the boat journey to get there, down a narrow river estuary leading out to the Atlantic Ocean, passing small wooden fishing  boats and settlements on the bank.  We reached the island in the middle of the day when the sun was bright like the colours of the houses and people's clothes.  We visited a Peripheral Health Unit (PHU) there, which Minette Walters wrote about recently a Sunday Times article promoting MSF's work.  The people there were amazingly open and friendly, but speaking to staff there, they do face a lot of health problems because of their remoteness. On the way back the boat was crowded with patients that needed to go to the hospital.  Among them was a girl paralysed from the waist down, eight months pregnant and being taken to the hospital along with her caretaker, her husband's younger brother. She had never been in Kambia town before and worried about when she was going to see her blind mother again.

In the next few days we hope to visit more of these PHUs.  There are 34 in the district, 5 of which are supported by MSF.  We particularly want to see those that MSF do not support as these have less resources and we feel that it would be more appropriate for us to work there with our film project and to see how KHA might be able to support them in the future. 

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