After Sierra Leone Explosion, a Health System Is Strained

After Sierra Leone Explosion, a Health System Is Strained

FREETOWN, Sierra Leone — When a gasoline tanker exploded in Sierra Leone final week, killing 98 on the scene, the numerous survivors included a motorcycle-taxi driver who, whereas caught in site visitors, was engulfed by the fireplace.

The driver, Yusuf Kamara, sustained burns to 80 % of his physique. But for a time, he may stroll and speak — and fear concerning the $27 he’d misplaced within the fireplace, three days’ wages.

“This was not child’s money, not small money, and it all burned,” he mentioned in an audio observe, the final recording of his voice, earlier than he perished.

Several days after the explosion in Freetown, the nation’s capital and largest metropolis, the tragedy has claimed extra lives and put the nation’s already precarious well being care system to the take a look at. The loss of life toll has climbed from 98 to 144, as of Saturday, and extra survivors had been nonetheless being admitted to hospitals on Friday.

In a rustic and not using a single burn unit, and with very important drugs unavailable or operating low, docs and nurses are attempting to stave off infections within the sufferers who’ve survived this far.

It is a herculean job. Most of the sufferers nonetheless being admitted suffered burns over 25 % of their our bodies. At a hospital in Freetown often known as 34 Military, the mortality price has been round 60 %. As sufferers die at one other, Emergency Hospital, their beds are going to victims who’re harm much less badly, and who couldn’t initially be admitted for a scarcity of area.

While Covid-19 has not overwhelmed Sierra Leone, which has reported simply 6,400 instances and 121 deaths throughout the whole pandemic, the nation isn’t any stranger to well being crises. An Ebola epidemic that started in 2014 killed virtually 4,000. Floods and mudslides killed many lots of in 2017.

But the severity of the accidents from this explosion shocked even docs seasoned by earlier crises. “The scale and magnitude, I’ve never seen anything like this,” mentioned Dr. Songor Koedeyama, a hospital medical superintendent who, within the blast’s aftermath, volunteered at Connaught Hospital, the nation’s foremost hospital, the place many of the victims had been taken.

Dozens of drivers and bike riders had been killed and injured within the accident. Some had been so poor that after they noticed the tanker leaking gasoline simply earlier than the explosion, somewhat than fleeing, they rushed to collect some. Many of these killed had been the breadwinners for his or her households, so the tragedy plunges among the neediest on this West African nation additional into desperation.

From the second sufferers began flooding hospitals, docs, nurses, directors and authorities officers have labored across the clock to cobble collectively provides and handle a patchwork response. An emergency coordination group was up and operating by the morning after the explosion.

But from the beginning, the weaknesses of Sierra Leone’s well being system have proven. Hospital workers members are quickly burning out, and there are few clinicians to switch them. Government pharmacies have been unable to supply important medicines, together with these for managing acute ache and antibiotics. And docs fear that it will solely worsen.

The well being sector in Sierra Leone is fragmented, a messy constellation of public, personal and nonprofit packages. Although the federal government is nominally in cost, it depends closely on overseas donors’ funding and provides.

Patients surviving on meager earnings usually have to purchase important medicines from personal pharmacies. But Lawrence Sandi, the managing director for the National Medical Supplies Agency, mentioned the federal government was selecting up the tab for the burn victims.

When he heard concerning the explosion, Mr. Sandi mentioned, he went straight to Connaught Hospital’s medical retailer, gathered provides there and gave them to docs. With key provides like IV fluid operating out simply after the accident, he went to the personal pharmacy subsequent door to purchase extra, he mentioned.


“I just said whatever you have, we’ll pay for it,” Mr. Sandi mentioned.

But at hospitals throughout town, a number of sufferers’ households mentioned they had been nonetheless instructed to pay for medicines and different provides.

For the survivors who’ve made it this far, care will grow to be an increasing number of troublesome, in accordance with Dr. Kilongo Papy Mulailwa, a surgeon who helped with the response to the fireplace. Patients who’re discharged might want to return to specialist hospitals for weekly remedy, for so long as a 12 months.

“Plastic surgery, dealing with mobility, you’ll need a lot of physical therapy. All of which are very difficult to get in Sierra Leone,” he mentioned. “You can anticipate that the next three months, for the ones who survive, will be very difficult.”

But a scarcity of antibiotics is a extra speedy concern.

“My fear is we don’t want to start a patient on it and then we don’t have enough for their entire treatment, because they might develop resistance,” Mr. Sandi mentioned.

Those who’ve survived should not solely apprehensive about their very own restoration, however concerning the affect their absence may have on their households.

“I take care of my brothers and sisters and my children,” Ibrahim Sorie, a 25-year-old driver, mentioned on Wednesday from his mattress on the 34 Military hospital. His legs, arms, and far of his head had been burned, and in a whisper, he mentioned he was in excessive ache. “I take care of all of them, I pay for school fees. So now, with the accident, I just don’t know what I’ll do. We really need support from the government.”

The households of those that have died, already bereaved and traumatized, now additionally face monetary destroy.

Mariatu Mansaray, the sister of 1 sufferer, was panicking about making ends meet as she waited for a mortuary to launch her youthful brother Ibrahim’s physique on Thursday. She nonetheless doesn’t understand how precisely Ibrahim, a site visitors police officer, caught fireplace.

Not lengthy earlier than he died, Ibrahim instructed her from his hospital mattress, “I didn’t see fire, I just saw smoke.”

The mortuary charged her $23 to clean Ibrahim’s physique, and $23 for an ambulance — in whole, greater than she made in a month. On high of that, she needed to spend $165 to feed the mourners, an crucial in a rustic the place funerals are extraordinarily essential. And then there can be the seven-day mourning ceremony within the household’s dwelling village.

“I have to take care of his child now, and I have two children, I have to take care of all of them,” she mentioned, tears in her eyes, wearing pink and purple lace for the funeral. Her mom is sick, she mentioned, and relied on Ibrahim’s wage every month to get by. “It was already too much on all of us, and now that he’s gone, it’s worse.”

From his hospital mattress, the motorbike taxi driver, Yusuf Kamara, made a video message for his mom final Saturday, two days after the fireplace. “Tell my mom I won’t die,” he mentioned. “Give her courage.”

On Sunday night time, he known as his cousin, Memunatu Kamara, asking her to cook dinner him some soup. But by the point she arrived with it the subsequent morning, she was instructed he had died.

On the best way to the funeral, Mr. Kamara’s 7-year-old son noticed a motorbike rider.

“Look, Daddy is coming!” the little boy mentioned to his grandmother, not understanding what had occurred.

“Everyone started crying,” Ms. Kamara mentioned. “There was not a dry eye in that car.”

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