While significant developments have been made in the past year, there is still room for overwhelming improvement in the Pujehun Government Hospital, according to Dr. Tom Sesay, the medical superintendent of the hospital’s secondary healthcare unit.
“I don’t want to say great improvements have been made, but there have been some significant changes here,” Dr. Sesay said. “But there’s still quite a lot of room for improvement – in both quantity and quality.”
The hospital is broken up into two components: Primary and secondary health. The primary unit deals with preventive medicine, health education, immunizations, nutrition, sensitization of certain diseases, and operation of peripheral health units.
The secondary healthcare handles basic healthcare services such as a patient clinic, medical and surgical needs, counseling and treatment of HIV, and emergency operations.
Among the constraints, Dr. Sesay listed staffing, infrastructure and funding as the primary areas of concern.
“The infrastructure is the main thing – it’s not adequate,” he said. “With a large influx of patients, many times we have a shortage of medical supplies or even beds. When one ward is overloaded with patients, we have to bring in beds from the adjacent ward and sort of overlap the two.”
The hospital was provided with one ambulance in 2007, which was a necessary addition – although Dr. Sesay did note that a single ambulance is hardly anything to write home about, especially considering the vulnerability of the Pujehun district. But the ambulance has turned out to be a double-edged sword, as Dr. Sesay explained.
“There hasn’t been a situation where we’ve had all of the wards loaded with patients, but it’s coming close to that,” he said. “The health service is improving, but with more referrals due to the ambulance bringing in more patients, there’s not enough equipment to go around.”
From the outside looking in, the general facility and conditions of the hospital are nothing to write home about. With many patients suffering from malaria, all beds are accompanied by a mosquito net but blankets are used in the place of nonexistent bed sheets.
The wards are easily crowded and there is little or no privacy for patients, as 10-20 patients occupy rooms which are separated only by a curtain. There is only one stethoscope – one of the most vital and common tools in the medical field – to go around the entire secondary healthcare unit. The hospital is also without an autoclave – a machine used for sterilizing surgical tools – which can cause sanitation problems. For now, the staff members improvise and use a stove to sterilize their tools.
“We just still have a lot of problems,” Dr. Sesay said. “There aren’t enough qualified staff members – I’m the only qualified doctor in the secondary health center and many of our staff members are volunteers. The water and toilet facilities need to be improved; it’s important for a hospital to have good toilet systems. And we have just one water pump.
“We had an electrical pump, but that broke down. If this single hand pump for water happens to break down, that will cause big problems.”
The problematic issues don’t stop there. Even though Dr. Sesay believes that the primary and secondary health units should be separated, in Pujehun they are located in the same building complex. Therefore, with most of the focus going to primary healthcare, secondary healthcare relies on and shares the power supply with the primary. If the secondary healthcare center is for some reason cut off from the primary healthcare’s power supply, they have just a single, small generator with which to work.
“The primary and secondary health units should be divided,” Dr. Sesay reiterated. “All of the money goes to primary health. No NGOs or organizations have come to support us because accessibility is where they concentrate. Without the proper funding, we end up having to buy our own medicine and as a result, costs for patients go up as more and more of them come in. It’s not an ideal situation.”
Dr. Sesay said that the hospital made an appeal to UNICEF for more support – specifically for a better feeding center for the patients – but they haven’t received any.
“Pujehun is a vulnerable community and it needs support,” he said.
By Yu Nakayama and Solomon Rogers