By Kimberly Nabieu, HCW Medical Programs Liaison
Mercy Hospital is making a concerted effort to strengthen connections among decision-makers at area health facilities. Since his arrival in the fall of 2016, Mercy’s Hospital Administrator, Jinnah Lahai, has held a series of meetings with other health professionals, and Dr. Amara has joined in these efforts since his arrival in early 2018. Sierra Leone is a small country with fewer than 200 doctors, and so most of them know each other. Mercy’s Dr. Amara already had strong ties to the health system in Bo through personal and professional connections, and he is utilizing those connections to increase collaboration. Mr. Lahai and Dr. Amara are dispelling the stereotypical view of some that ‘other’ hospitals are “competition” by deliberately reaching out and seeking connection. The new Bo District Medical Officer, Dr. Carson-Marsh, shares Dr. Amara’s views that working together makes more sense than working alone.
Recently, Dr. Amara visited Bo Government Hospital to meet with Dr. Minnah. He found both Dr. Minnah and Dr. Kabba (from Gila’s Hospital) in surgery working on an acute abdominal case involving pain on the right side. Dr. Minnah was in the process of locating the appendix when Dr. Amara remembered a similar case he had recently done at Mercy with Matron Augusta where the appendix was wrapped in the omentum - a thin layer of tissue that holds the intestines in place - and pulled deep into the abdominal cavity behind a number of other structures. This made it extremely difficult to locate. Dr. Amara checked to see if this was also happening in Dr. Minnah’s patient and was able to locate the inflamed and infected appendix. They were able to successfully remove it, and the patient made a full recovery.
After assisting Dr. Minnah, Dr. Amara was able to observe Dr. Kabba’s case. A more unique surgery, Dr. Kabba was working on an infant with a kind of spina bifida. This patient’s spinal column had not formed properly, leaving a section of the spinal cord and spinal nerves protruding through an opening in the column into a sac on the outside of the baby’s back. This happens when the child is developing and leaves a lump on the back. Dr. Kabba was able to repair the defect, returning the exposed nerves back into the spinal column and closing the opening. These types of defects are typically caused by nutritional defects that can be addressed through prenatal care early in pregnancy. Dr. Amara’s ability to observe this surgery not only broadens his knowledge of complex surgical cases, but also highlights the needs Mercy is addressing through its prenatal program.
Mercy is also collaborating with Rural Health Care Initiative (RHCI), an NGO that works on community health projects, including a birth waiting home in Tikonko (one of Mercy’s outreach catchment areas). RHCI is piloting a Positive Deviance Hearth project that could potentially uncover some local solutions to malnutrition affecting infants and children under five. Those results will be shared with Mercy to improve Mercy’s own outreach nutrition program. Mercy is also working to assist the birth waiting home with occasional use of the portable ultrasound so the staff can know when mothers are expected to deliver.