More than one hundred mothers die here at birth
Sierra Leone is one of the countries in the world with the highest maternal mortality. Child mortality is also high.
Doctor Lars Seligman warns that it may rise with the war in Ukraine.
– The rising fuel prices mean that children die just because there is a lack of diesel for the oxygen generators.
For six years, the Swedish doctor Lars Seligman, 78, has worked as a volunteer in a hospital in Sierra Leone. He describes the situation as increasingly challenging since the war in Ukraine broke out and fuel prices rose. Sometimes it is impossible to get diesel. At the hospital in Moyamba where he works, there is electricity for lighting, but for other medical equipment, such as oxygen, they are dependent on diesel generators.
– At one point we had a child who died just because we did not get fuel for our generators for oxygen. A child who would certainly have survived if it had received oxygen, says Lars Seligman.
He also describes several other devastating consequences of the war in Ukraine.
– In recent months, the price of rice has risen by more than 50 percent in Sierra Leone and here there are many who already live on extremely small margins.
After several years of pandemics, the situation has become tougher for people who have become increasingly poorer. And the ones hardest hit are the kids.
– They have not been able to go to school and several girls have been more or less forced into relationships with men. And when they then become pregnant, they can not afford to go to clinics for check-ups and it can be extremely dangerous.
The most common causes of high maternal mortality in Sierra Leone are pregnancy poisoning, bleeding and infections. For younger children who become pregnant, there is another major risk.
– I have seen pregnant children as young as 10 years old. And it is very dangerous because the pelvis has not fully grown at that age. Then a caesarean section is needed to save lives.
At Moyamba Government Hospital, where Lars works, they have a maternity ward, but Lars works in the three pediatric wards at the hospital.
– Recently we had a mother who came in who had had back pain for two days before she came to the hospital. There we managed to save the mother’s life thankfully but the child was so difficult to carry that we could not save it.
Pays with his pension
Getting acutely ill people to the hospital is another problem that the war in Ukraine brought with it, as there is often a lack of diesel to be able to refuel the ambulances.
– Instead, life-threatening sick people and pregnant women are being driven in crisis on motorcycles to hospitals. It can take several hours on bad roads. So the war in Ukraine has definitely meant an increase in mortality among pregnant women is my opinion.
Lars tells of a father who rode a motorcycle to the hospital for several hours with his seriously ill daughter. Once they arrived, they discovered she was dead. For Lars, it is still difficult to tell about the incident without crying. It was in 2017 that Lars Seligman started the non-profit organization Bombali Health Development to be able to buy, among other things, medicines, equipment and food for the patients at Moyamba Government Hospital. All work he does himself is completely non-profit and he pays with his own pension all expenses such as air travel, accommodation and food during the stays.
– We have a 90-account and usually have a turnover of about one million a year and with that we can save a lot of lives. We can save a life-threatening sick child with medication for about SEK 200. And with a less ill child, SEK 20 may be enough to save a life. It is extremely cheap if you compare with the costs in Sweden. Between 94 and 97 percent of gifts go directly to children in Sierra Leone.
Works 16 hours straight
Lars works at the hospital three to four periods a year, six weeks at a time. He has also recruited more than 15 nurses and doctors from Sweden who also traveled down to work voluntarily – either on their holiday or on call from care jobs in Sweden.
– Everyone bears their own expenses and it is not a further comfortable job but it is very rewarding. To see the parents’ smile when you have saved the lives of their children, there is no money in the world to compare with.
The working days in the hospital are often long, especially during the rainy season when there is a lot of malaria.
– I usually work for 14 to 16 hours seven days a week. For a while I tried to work only six days a week but it was always a little sicker patients that I wanted to look at and therefore it turned out that I worked anyway.
In practical terms, the work at the hospital in Moyamba is very different from the work at the hospital in Sweden.
– Squeezing, feeling and examining plays a big role and you can get very far with your eyes, ears and fingers. We can take blood values and tests for malaria, but otherwise we have virtually no blood samples and analyzes. We have an old ultrasound system as well, but it is quite bad, and a simple X-ray equipment.
The work still works extremely well, says Lars Seligman, who describes his colleagues at Moyamba Government Hospital as enormously competent and committed.
– Many are medical assistants, ie staff who have a practical training focused on how to treat known symptoms. They are absolutely huge at directly discovering what disease a patient has and what treatment is needed.
Theater in the villages
Malaria, pneumonia, diarrhea and vomiting are the diseases that kill most children.
– We try to get the patients in as early as possible because then there is a greater chance of being able to save lives. So I have worked preventively with an information campaign where we visited about 190 villages and ran a play where I explain how to protect yourself from, for example, malaria and why it is important to seek medical attention early.
And the project has yielded results. The influx of patients has increased.
At one point, a life-threatening sick child came from the village the day after we were there that we could help. It survived thanks to the information and it’s cool.
Many of the residents of Sierra Leone are completely dependent on aid organizations and non-profit forces for healthcare. Despite the fact that Lars Seligman will soon turn 79, he has no plans to stop working at the hospital.
– It’s starting to get tiring in the heat so I’m going to start pulling down and only working four weeks at a time. But I will not stop. My hope is that more doctors and nurses from Sweden will be interested in going down and working so that we become more. Because if we do not do this, then the children will die.
Facts
Bombali Health Development
Through the non-profit association Bombali Health Development, Lars Seligman and other colleagues in the healthcare sector can buy medicine and medical equipment with them when they volunteer at Moyamba Government Hospital. For between SEK 20 and SEK 200, they can save the life of a sick child. Read more about how you can support them here.
Read more