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Kambia
Hospital
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I arrived in Kambia with very little idea what to
expect. Off the plane and straight into an MSF vehicle,
whisking me to their Freetown headquarters, before I was
sent off on the bumpy ride to Kambia, I wondered quite
how I’d ended up where I was, and really, whether I
was going to survive the next month.
I am currently taking a year out from my medical
degree to undertake a BSc in International Health, one
of the bonuses of which is a research study on a topic
of your choice, with the opportunity to conduct your 4
weeks fieldwork abroad. As a sixth-former, my school
charity had been the Fistula Hospital in Addis Ababa,
Ethiopia, which treats women suffering from a condition
called Vesico-Vaginal Fistula (VVF). This is a
devastating condition which occurs mainly in African
countries, as a result of their high rates of obstructed
labour, and poor emergency obstetric care. It leaves the
women who suffer from it with a hole between their
bladder and vagina, so leaking urine continuously. As a
16 year old girl the thought of both the physical and
social consequences of this problem left such a mark on
me, that given this opportunity for research aged 21, I
couldn’t help but want to look further into this
problem.
Through a strange series of circumstances (mainly
involving a Cheltenham-based godmother!) I came to hear
of the Kambia Hospital Appeal, and their involvement
with VVF. Indeed, the chairman, Dr. Richard Kerr-Wilson,
has himself conducted VVF surgery on many women in Kambia.
Sadly VVF is a problem that is very prevalent in Sierra
Leone, and particularly a rural area such as Kambia, so
it seemed an ideal destination for my research, which
was to involve in-depth interviews of VVF sufferers and
their partners.
I had left England with anticipation, eager to get
‘stuck in’ to some on-the-ground research, which I
felt reassured would be not to problematic, as the MSF-Holland
team currently running the Kambia temporary hospital had
agreed to help facilitate it. I was determined not to be
unsettled by my parents’ and friends’ assertions
that I was entering ‘a war zone’, and was likely to
return minus a limb.
To be fair, I was proved right in the end. Although
Kambia shows sad remnants of the past destruction by
rebels, such as the many dilapidated buildings and the
remains of the burnt-down prison, the only bombardments
to be found are those of the mangoes crashing down on
the tin rooves, as May is peak mango season (an
unexpected bonus of visiting at that time of year…).
Despite their sad past and difficult circumstances, the
people are overwhelmingly happy, and mostly to be seen
laughing or dancing in the street, calling out ‘opoto’
(white man) tirelessly as any of the 6 (or 7 with me!)
white residents of the town walks past.
MSF had done a sterling job of finding me VVF cases,
and I ended up being able to interview 12 women and 4 of
their partners, rather than the anticipated 5 or 6. It
was fascinating to finally speak (via an interpreter of
course) to these women, whose condition and
circumstances I had spent the past 6 months reading so
much about, if a little depressing to hear the facts
spoken aloud and feel their full implication. The women
told a sad story of an uncomfortable and humiliating
condition, which left them ashamed and socially
isolated. Indeed in a third of the cases I saw, they had
been abandoned by their husbands altogether and were
left to fend for themselves and any remaining children,
supported only if a relative was kind enough to take
them in. Fortunately, however, two of the women I saw
had been lucky enough to get repaired. They were as if
reborn as a result: eternally happy and grateful, as
their lives had effectively been given back to them. One
can only hope that in the future, such an opportunity
will arise for more of these long-suffering women, and
furthermore, that healthcare provision in Sierra Leone
will eventually improve, in order to prevent the
occurrence of conditions such as VVF.
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Kambia
Hospital
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One small step that is being made in that direction
at least, is the construction of the brand new Kambia
Hospital. Indeed, since my departure, the patients of
the ‘temporary’ (but now in place for 2 years!)
In-Patient Department, run by MSF-Holland jointly with
the Ministry of Health, have been moved to brand new
premises rebuilt on the old hospital site. I can’t
imagine their faces when they see the rows of sturdy
steel beds rather than the wooden ones, and definitely
feel more reassured at the prospect of surgery going on
in these new well-lit surroundings, rather than in the
dark IPD with its resident chickens!
Julia Fortes, May 2004
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Kambia
Hospital ward (May 2004)
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