“It is only after successfully going through this that I have realized the essence of delivering at a health centre or hospital rather than to traditional birth attendants at home”. These are the word of Zainab Conteh, a house wife who lives at 4 Iscandri Street, Old Port Loko full of praises for medical staff at the Port Loko Government Hospital.

“Guess what could have happened if I had chosen to deliver at home”, she challenged.

Zainab, 28, was admitted at the Female Ward at the Port Loko Government Hospital on June 7, 2006 where she went through a successful caesarian operation performed by the only medical doctor at the Hospital Dr Ibrahim J. Kargbo-Labour. She is now nursing a bouncing baby boy, while blessing her star. 

“It was my third pregnancy. The first child died few hours after delivery at home to traditional birth attendants…I am really grateful to these people [the medical doctor and staff of the Port Loko Government Hospital] for this wonderful service because I overheard them saying that due to my height and the size of the baby I would never have delivered the child alive normally and that my life was at risk”, the 28-year old reaffirmed.    

This, among other incidents and events, illustrates the current trend in health care delivery in Port Loko, Sierra Leone’s second most populated district, which also experienced a fair share of the gruesome rebel carnage that disrupted the small scale mining and food crop production activities of the people, in addition to massive displacement and the random destruction of lives and property. Therefore, it goes without saying that the decade long civil conflict left it toll on the health sector in the district, located in the north west of the country.

While the District Medical Store was looted, most PHUs were destroyed, some beyond repairs. Although a reasonable number of them have been reconstructed or rehabilitated, there are still others which are yearning for attention.

According to the Chairman of the Port Loko District Council, Councilor Joseph Bob Amara, the health sector is doing fairly well in their district considering the fact that most infrastructures associated with health care delivery as highlighted above, were destroyed during the war.

“Apart from rehabilitation work by Government and other stakeholders to health care delivery structures, there is also reasonable drug supply”, he reaffirmed.

Councilor Amara, a member of the Hospital Board, is delighted that the health sector is relating well with Council, within the spirit of the current decentralization exercise.

“They have long presented their Work Programme and Budget for 2006 to us for review and funding, but unfortunately, Government is yet to disburse the funds to us”,   he intimated, suggesting that as district stakeholders, there is clear need for local councils to be empowered to get more and more involved at national levels in decision-making processes that relate to the health sector.

“We want everyone to know that the Port Loko District Council in particular is ready to work with the Ministry of Health and Sanitation. So they should feel free to devolve the functions that are to be devolved to us” he concluded.

According to the District Medical Officer, Dr Ibrahim J. Kargbo-Labour, until recently, the health sector was doing fairly well in the district “especially during the immediate post war period” when they were being assisted by the International Medical Corps (IMC), who rehabilitated the Hospital, including the Medical Stores in 2002.

He disclosed that when he took over there were sufficient and well motivated crops of nurses who were receiving incentives from the IMC, which encouraged them to work even harder. But as soon as IMC ceased operations in March 2003, two months after he had assumed office as Medical Officer-in-Charge, the nurses too started pulling out as the working conditions became unbearable. “This led to an acute staff shortage.”

Hence, acute staff shortage is among the immediate challenges facing the hospital in addition to the complete absence of quarters for its staff and the delay in drug deliveries.  However, Dr Kargbo-Labour is optimistic that the situation in not insurmountable as long as stakeholders are prepared to demonstrate renewed commitment to rescuing it.

“When I took over there was no pipe borne water in the hospital, but as I speak to you, engineering work for pipe borne water supply within the Hospital is at its concluding stages”, he assured.

Adding her voice to the status of health care delivery in the district, the Acting Matron at the Port Loko Government Hospital Mrs. Hawa Janneh, who has served the health sector for 30 years and the Port Loko communities for five years, described health care delivery in the district as good.

“We admit cases and treat rape victims and the vulnerable members of society free, while others are handled on cost-recovery basis. In addition, our patients though poor and find it difficult to meet with the cost-recovery system, receive total care and satisfactory services, which are administered without any form of discrimination”.

She added that one of the most gratifying things that have happened to the Hospital is the fact that most of the community people who used to bypass them for the Mabeseneh Hospital or traditional healers in the past are now willingly patronizing them “mainly due to our welcoming atmosphere, the cost-effectiveness and quality of the services we now offer despite the serious problems that we are going through”.

Mrs. Janneh disclosed that the Hospital which currently has 78 admission beds comprises four wards, namely Male, Female, Maternity and Children’s. It also has a functioning mortuary and theatre.

She is grateful for support from NGO interventions including The International Medical Corps (IMC) which, years back, provided them with drugs, medical care and also incentive for the hospital staff; Action De La Faim (Action Against Hunger) which was replaced by MSF Holland who also left the district in 2002; and the UN agency WHO provided therapeutic feeding for malnourished children.

In the areas of water supply to the Hospital she counts upon the support of ACF and TERRA TECH who each dug a well for them within the Hospital compound, one of which is currently being repaired in addition to two new ones which are being constructed by CAN Construction Old Makeni Road, funded by MEDICOS.

She is however discouraged that the Hospital which they always strive to maintain clean, has grown out of age and size, and deserves complete overhauling, including the putting up of additional structures and the availability of other services.

“This is in view of the fact that the current buildings are Colonial structures and can no longer adequately serve their purpose”.

It is worth noting that there are only two professionally trained and qualified Ministry of Health employed doctors in the district at present in the persons of Dr Kargbo-Labour, who doubles as the Medical Officer-in-Charge of the Port Loko Government Hospital and Dr Parker who is based at Lungi, Kaffu Bullom Chiefdom.

Moreover, the district, with 11 chiefdoms, which had an average level of service provision in both primary and secondary health care in the recent past, currently has 92 functioning PHUs compared to a pre-war figure of 72 and immediate post war figure of 66.

Port Loko district is indeed yearning and striving to regain glory in health care delivery.