After Sierra Leone explosion, a well being system is strained

When a gas tanker exploded in Sierra Leone earlier this month, killing 98 on the scene, the numerous survivors included a motorcycle-taxi driver who, whereas caught in visitors, was engulfed by the fireplace.
The driver, Yusuf Kamara, sustained burns to 80% of his physique. But for a time, he might stroll and speak — and fear in regards to the $27 he’d misplaced within the hearth, three days’ wages.
“This was not child’s money, not small money, and it all burned,” he stated in an audio word, 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 dying toll has climbed from 98 to 144, as of Saturday, and extra survivors had been nonetheless being admitted to hospitals Friday.

In a rustic with out a single burn unit, and with important drugs unavailable or operating low, medical doctors and nurses try 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 generally 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 damage 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 circumstances and 121 deaths throughout all the pandemic, the nation is not any stranger to well being crises. An Ebola epidemic that started in 2014 killed nearly 4,000. Floods and mudslides killed many a whole bunch in 2017.

But the severity of the accidents from this explosion shocked even medical doctors seasoned by earlier crises. “The scale and magnitude, I’ve never seen anything like this,” stated 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 once they noticed the tanker leaking gas simply earlier than the explosion, fairly than fleeing, they rushed to collect some. Many of these killed had been the breadwinners for his or her households, so the tragedy plunges a number of the neediest on this West African nation additional into desperation.
From the second sufferers began flooding hospitals, medical doctors, nurses, directors and authorities officers have labored across the clock to cobble collectively provides and handle a patchwork response. An emergency coordination workforce 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 employees 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 medical doctors fear that it will solely worsen.
The well being sector in Sierra Leone is fragmented, a messy constellation of public, non-public and nonprofit applications. Although the federal government is nominally in cost, it depends closely on overseas donors’ funding and provides.
Patients surviving on meager earnings recurrently have to purchase important medicines from non-public pharmacies. But Lawrence Sandi, managing director for the National Medical Supplies Agency, stated the federal government was selecting up the tab for the burn victims.
When he heard in regards to the explosion, Sandi stated, he went straight to Connaught Hospital’s medical retailer, gathered provides there and gave them to medical doctors. With key provides like IV fluid operating out simply after the accident, he went to the non-public pharmacy subsequent door to purchase extra, he stated.
“I just said whatever you have, we’ll pay for it,” Sandi stated.
But at hospitals throughout the town, a number of sufferers’ households stated 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 line 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 yr.
“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 stated. “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 quick difficulty.
“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,” Sandi stated.
Those who’ve survived are usually not solely nervous about their very own restoration but in addition in regards to the impact their absence can have on their households.
“I take care of my brothers and sisters and my children,” Ibrahim Sorie, a 25-year-old driver, stated 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 stated 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 Thursday. She nonetheless doesn’t understand how precisely Ibrahim, a visitors police officer, caught hearth.
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 scrub Ibrahim’s physique, and $23 for an ambulance — in whole, greater than she made in a month. On prime of that, she needed to spend $165 to feed the mourners, an crucial in a rustic the place funerals are extraordinarily necessary. 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 stated, tears in her eyes, wearing pink and purple lace for the funeral. Her mom is sick, she stated, 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, Kamara made a video message for his mom final Saturday, two days after the fireplace. “Tell my mom I won’t die,” he stated. “Give her courage.”
On Sunday night time, he referred to 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, Yusuf Kamara’s 7-year-old son noticed a motorbike rider.
“Look, Daddy is coming!” the little boy stated to his grandmother, not understanding what had occurred.
“Everyone started crying,” Memunatu Kamara stated. “There was not a dry eye in that car.”