Masanga Hospital: From a Ruin to a Leading Community Hospital

Sierra Leone Masanga Hospital
Masanga Hospital: From a Ruin to a Leading Community Hospital
Dr Edward Cole | 2020 - January to March | Africa
Dr Edward Cole on the vital work currently being carried out at Masanga Hospital in Sierra Leone

The beautiful West African state of Sierra Leone is a land of paradox. The country is blessed with miles of stunning unspoilt beaches, but it is not yet known as a place that attracts tourism. It is the world’s tenth largest producer of diamonds; it is blessed with gold, it is in the top twenty of world’s largest iron ore deposit and is the third largest producer of Titanuim rich rutile, which is turned into the white pigment used around the world in paint, paper, toothpaste and white road-markings. So how then can Sierra Leone be so poor as to be consistently ranked towards the bottom of the UN human development index at 181 out of 189 countries in 2018, with 53% of the population living below poverty line?

Child bearing is one of the most natural experience all women in the world should have right to enjoy safely, but this is not so in Sierra Leone. According to data and reports published in 2017 by the Government of Sierra Leone and UN Partners UNFPA and UNICEF, an estimated 1,165 women die per 100,000 live births, the equivalent to eight maternal deaths every day. Survival rates are not dramatically different for babies who survive birth, even if mortality rates are improving - 108.31 deaths per thousand live births occurred in 2018, compared with 339.67 deaths per thousand in 1969. 

With the amount of wealth generated in the world today, it is an outrage to see such a needless loss of lives.  The disparity between the rich and poor is ever-widening. Half of the world's net wealth belongs to the top 1%; the 26 richest people on earth in 2018 had the same net worth as the poorest half of the world’s population - some 3.8 billion people.

Masanga Hospital is a volunteer-led hospital making a difference to the lives of mothers, children and people from all over Sierra Leone without discrimination. The hospital has a long and proud history of caring for poor and marginalized people. Founded in the 1960’s to support lepers in Sierra Leone when the disease was rampant, it championed their interests, providing healthcare, education and skills training to develop employment in leper communities.  

People everywhere in the world are the same - even among the poor the concept of NIMBY (Not In My Back Yard) was strong. No-one wanted a leper in sight, let alone a leprosarium in their neighbourhood. The hospital was therefore built in a remote location in Masanga, a rural Tonkolili district 140 miles from Sierra Leone's capital, Freetown. After helping to eradicate the leprosy epidemic, the hospital was transformed into a 150-bed general hospital serving people across the whole of the country by providing free treatment to those suffering from TB, polio and other communicable diseases.

Tragically, in 1991 the work of the Masanga Leprosy Hospital was halted by a brutal civil war initiated by the Revolutionary United Front, a rebel organisation trying to overthrow the Government of Sierra Leone with the aid of the Liberian President, Charles Taylor. The Civil War devastated Sierra Leone: infrastructure was destroyed, tens of thousands of people killed, others mutilated. It ruined an already weak economy and deployed thousands of child soldiers. The hospital was seriously damaged but not completely destroyed in the process, thanks to some brave locals who risked their lives to guard it against armed rebels and looters. Nonetheless, the ruined shell of the hospital became a home to wild animals up until 2006.

Then a group of close friends that had founded the UK Charity Sierra Leonean Adventists Abroad (SLAA) came together to discuss the hospital. By rehabilitating the hospital, they hoped to give back something to home communities that had survived the war and were struggling to rebuild their lives. The estimated price tag of some £2m to restore the hospital to a fully functioning health service was way beyond anything SLAA could manage, but by chance, luck, or divine intervention, a Danish Surgeon and philanthropist, Dr. Peter Bo Jorgensen, was looking for a project in Africa. Despite advice not to go to Sierra Leone - sadly perception trumps reality every time - Peter made his way to the Hospital ruins, still unaware of the existence of SLAA.  He formed the Association of Friends of Masanga (AFOM) in Denmark, which then joined forces with SLAA to create a Euro-Sierra Leonean Diaspora partnership to rehabilitate the hospital. The Masanga Hospital Rehabilitation Project (MHRP) was born, and in 2006 the partnership signed an MOU with the Government of Sierra Leone, which was still battling to reestablish civil systems, and rebuild infrastructure and a healthcare service with less than 100 doctors to a population of over 6 million. 

AFOM eventually secured the backing of Lions Club in Denmark, which enabled MHRP to slowly and gradually re-open the hospital, first providing therapeutic feeding to children with malnutrition, then  opening an outpatient and under-five children’s ward, followed by a maternity ward, which were all priority needs at the time. To quote the Chinese proverb 'a journey of a thousand miles begins with a single step' and Masanga Hospital illustrates the importance of taking the first step and not be deterred by challenges. Still faced with a severe shortage of medical doctors, the Hospital reopened in 2006 with Peter closing his surgical clinic in Denmark and embarking on 3-month trips to Sierra Leone as a volunteer doctor.

Today Masanga Hospital is a rural hospital with 120 beds. Tonkolili itself has a population of about 450,000 people - more than double the size of the population of Sutton, and larger than Croydon with its population of 403,000. It provides emergency surgical, obstetrical and paediatric care, as well as general health care, for about 12,000 patients per year.  

MHRP focuses on capacity building and created Tonkolili College of Heath Sciences to provide medical education and establish a research unit to promote opportunities for in-country health professionals with an aptitude for research to develop their talents; we believe this contributes to sustainable and high-quality health care in a country which still only has 200 medical doctors.

The cases we see range from acute surgical problems to medical emergencies like acute heart failure and infectious diseases like HIV. On our isolation ward we treat patients with tuberculosis or suspected viral haemorrhagic fever. Five hundred babies are safely delivered in our labour ward every year and we conduct about 1000 surgical procedures annually, ranging from emergency laparotomies to skin grafts for chronic wound patients. With 600 admissions a year, paediatrics is one of our busiest wards. Most children admitted here suffer from malaria, acute watery diarrhoea or pneumonia.

Caring for those in need and helping them to develop the confidence and skills needed to look after themselves are core values in all Masanga Hospital does. Valuing people - whether staff, patients or the local community it serves - is the single most important asset that has helped the hospital to survive.

Our operating costs are escalating as we try to help an ever-increasing number of people. The Government of Sierra Leone is gradually stepping up do all it can to support our work, but it will be a long time before it can take full responsibility for the service. We are looking for support, donations and qualified medical volunteers to join us in the battle to reduce the appalling child and maternal mortality rates suffered by the people of Sierra Leone, and ensure good quality healthcare for everyone.

If you think you can help, or you would like to find out further information about Masanga Hospital, drop us a line at kaleidoscopemagazinesacco@gmail.com so that we can put you in contact with Dr Cole.