By Kemo Cham
The Ebola outbreak and its effect on the healthcare work force in Sierra Leone exposed the weakness of the system and emphasized the need to place premium on training, medical students and officials have said.
When the epidemic erupted, healthcare workers were at the forefront as expected. And even after months into the ‘battle’ there was very little knowledge about the disease, leaving a vast proportion of the population, many of them medical personnel themselves, highly vulnerable.
Sierra Leone eventually lost 11 doctors to the viral disease and nearly 300 healthcare workers were said to have fallen ill while trying to provide support for the sick. And about 200 of them lost their lives.
“It shows how much we lack in human resources and infrastructure and that`s why so many people died,” said Haja Safiatu Sovula, Vice President of the Sierra Leone Medical Students Association (SLEMSA). She blamed the much reported corruption and mismanagement for the apparent dysfunction within the health system, whose effect had filtered down to them.
“Whatever affects the people affects us,” the 5th year student at the College of Medicine and Allied Health Sciences (COMAHS) of the University of Sierra Leone told Politico on the fringes of the recently concluded SLEMSA General Assembly.
It was the first gathering of its kind since the association was reactivated two years ago. The theme of the two-day session hosted at the Bintumani Hotel in Aberdeen, Freetown: ‘Human Resources for Health’, was informed by a huge shortage of man power in the health sector, a situation worsened by the epidemic, the association said.
One concern of SLEMSA is access to scholarship and opportunities for specialized training.
Meeting the requirements for entry into the COMAHS is an uphill task, and understandably so. And on entry the workload to remain afloat takes a major psychological toll on students, especially for those on scholarship who require good grades to keep their funding coming.
This has given cause for many students to fail repeatedly some crucial modules, forcing them to repeat or even fail to live their dreams, said Ms Sovula.
SLEMSA wants the authorities to consider providing adequate funding opportunities for students.
Presently students are only considered for scholarship after getting a place in the college. But the association wants automatic qualification for funding.
COMAHS is the only institution training medical doctors in Sierra Leone. According to sources, only about half of the students there are on scholarship. SLEMSA has between 300 and 400 registered members, and the association says membership is automatic once you have been enrolled.
Professor Baila Leigh, senior lecturer at COMAHS, as keynote speaker, discussed the state of practicing medicine in Sierra Leone, the need for training of more personnel, and cited the crucial role of public health doctors.
Must doctors in Sierra Leone are clinicians and this has left a huge vacuum in the public health sector, he noted.
This is may also be partly responsible for the country`s seeming inability to control infectious diseases, with the 2014 Ebola outbreak and two prior outbreaks of cholera being typical illustrations of this point.
“Not everybody can be a clinician. If you don’t have the public health doctors things are going to be difficult [for the country],” said the professor of Obstetrics and Gynecology.
As part of the opening session a short video skit was played, illustrating the effect of medical brain drain, a phenomenon seriously affecting developing countries like Sierra Leone which are already struggling to produce trained medical doctors.
Experts say Sierra Leone needs to produce at least 150 doctors yearly if it`s to meet its demand. But amidst complaints of lack of resources and infrastructure, this is proving complicated.
And with the little that is currently produced under the prevailing circumstances, poor wages and working conditions are pushing more to seek ‘greener pastures’ in the developed world.
“It is very heart-rending after spending six or seven years struggling and you continue to suffer again,” remarked a student from the floor during a brainstorming session that followed the video screening.
Dr Eva Hancilles, President of the Medical and Dental Association of Sierra Leone, said one of the good things to have come out of the Ebola epidemic was that it forced authorities to revisit the health system. She said the priority is not just about increasing the number of doctors but also providing opportunities for more specialized studies.
Dr Hancilles, who also lecturers at the COMAHS, said currently there were only four popular options of specialization for doctors in Sierra Leone - gynecology, obstetrics, internal medicine, and surgery.
“We do not have doctors going for anesthetic, ophthalmology, intensive care medicine, or accident and emergency medicine,” she lamented.
SLEMSA VP Ms Sovula said besides shortage in lecturers, most of whom are already occupied by realities on the ground as policy makers and practitioners in theatres, they also face challenges of equipment in the classrooms.
Consequently, Sierra Leone has one of the lowest doctor-patient ratio in the world with three doctors per 100, 000 people. That compares sharply with the situation in the Indian Ocean archipelago of Seycheles, also in Africa, which boasts of a doctor-patient ratio of 151 per 100, 000, said to be the highest on the continent.
But according to Foday Sawi, deputy minister of Health and Sanitation II, who represented the substantive Minister at the SLEMSA General Assembly, all these concerns could soon be addressed. He disclosed plans, among others, to introduce to parliament a Post-graduate Hospital Bill and the establishment of teaching hospitals the country.
The post-graduate hospital bill, he said, would pave the way for the provision of post graduate courses in the country.
“There are challenges of course. But in the midst of that we are doing our best to ensure that healthcare in Sierra Leone regains its past glory,” said Mr Sawi.
Emil Koroma, Manager at the Human Resource Department of the MoHS, said as part of its strategic plan the ministry was poised to prioritise training in terms of needs and in line with the plan.
(C) Politico Online 05/10/15
