Back to the Connaught and the tour courtesy of Jane Gibson in December, after the detour into Why the Connaught? and a hike. Before entering the main compound we took a short stroll around an historic part of Freetown stopping first at the entrance to King’s yard.
The plaque reads “Royal Hospital and Asylum for Africans, rescued from slavery by British valour and philanthropy. Erected AD MDCCCXVII  His Excellency Lieut Col MacCarthy Gov”. King’s Yard was where returned freed slaves were kept in quarantine when they first arrived in the colony. It later became part of the Colonial Hospital which burnt down in 1920 and is now used by the international charity Sightsavers and is the main eye clinic.
Further along Wallace Johnson Street (formerly Water Street) we looked down on this dirt slope, which was where a branch line of the railway used to wind down to the dockside, allowing goods to be loaded from ships on to the train. We passed St George’s Cathedral  and the statue in front of it of Tom Peters, an escaped slave, who was evacuated from the United States to Nova Scotia by the British and subsequently was instrumental in persuading the British Government to establish Freetown.
At the end of the street is the former Water Street Station. It was here that the Hill Railway, the dockside branch and the mainline, going up country, all connected. During the war the station building became a refuge for displaced people and part of it now serves as the bus station.
Water Street Station in former times [above] and today [below]
The last stop on our tour of historic sights was the so-called Portuguese steps – which have nothing to do with any Portuguese, but were built by Governor MacCarthy around 1818 to allow access from the town to the dockside. For film buffs, they feature in the 1954 ‘Heart of the Matter’ starring Trevor Howard.
We returned along Wallace Johnson Street to the Conaught Hospital, where ebola prevention measures, such as hand washing before entering, were still in place. Beyond the security post is the triage area where patients receive their initial assessment. This is one of the innovations introduced by the King’s Sierra Leone Partnership [KSLP] which has been working with the Connaught since 2012. The team were on the ground when the ebola outbreak hit Sierra Leone. One of these was Terry Gibson, a retired consultant, who remained, as a volunteer, throughout the crisis and kept the hospital functioning largely without the support of other doctors, some of whom had died of ebola, others were absent. Read his blog about the experience here with a plea for others to step up and follow his example.
Once through the entrance the large central courtyard is revealed. It is criss crossed by paths covered with corrugated roofs to protect from rain and sun. The ward blocks are set apart so the shady verandahs and large windows on all sides allow the breezes to ventilate the building – the colonial architects knew how to build for the climate in a time before air-conditioning. This is still an advantage in a country with very little electric power.
The small building pictured is the new oxygen bottling plant built by KSLP which is an important contribution to improved patient care.
We finished our tour in the physiotherapy department where patients were exercising on two donated ex-gym cycling machines, one of which no longer has any resistance. A step-trainer blocked one wall – donated, but not working. A few patients raised and lowered arms with strings on the wall, but the staff struggle to rehabilitate patients. On one side were a pile of donated, high specification wheelchairs destined for children with cerebral palsy, but I had to wonder how long they would last out in the community where pavements are lacking, obstacles abound and the most usual use for any wheeled gadget (baby strollers in particular, but I have seen a wheelchair used) is to carry an icebox from which to sell drinks.
Basic equipment is scarce and patients have to pay for consultations and any additional diagnostic tests and medicines. The exceptions are pregnant women and children under five. Dialysis equipment was installed some time ago, but is yet to be commissioned.
Medical staff coming from Europe struggle to reconcile their training with such a resource constrained environment, where even simple equipment such as walking frames could benefit patients so much. Items such as crutches, which the NHS don’t bother to recall because it costs too much to sterilise them, could be used here to great effect. It is not that patients here don’t deserve sterilised equipment, but as an alternative to nothing, second hand is acceptable.
Complaints about British hospitals pale into insignificance when you realise this is the main hospital in Freetown. In the UK we have a lot to be grateful for and the NHS, with all its problems, is definitely high up on that list. Another is that we don’t have slums like the one in Kroo Town immediately behind the Connaught. Looking over the seaward wall there are pigs and people scavenging in the mud washing down from the main rubbish dump,which smoulders day and night.
Kroo Town was once a bucolic bay as illustrated in an old album of pictures discussed in this blog. Sierra Leone has come a long way since those days, but has much further to go before its people have access to adequate shelter, education and healthcare.