Humanitarian field service in Sierra Leone

Growing up on board the floating hospitals of Mercy Ships, Dr. Sandra Lako’s childhood was anything but normal. She was just a teenager when she first sailed into Sierra Leone and encountered a country that would define the course of her life.

There, Sandra left the hospital ship to accompany a medical team as they set up a clinic in a village outside of Freetown, tending to a measles outbreak. Sandra spent the week sitting with mothers who were bringing their sick children for care.

“Of course, I was a teenager, so not skilled to actually help medically, but I was able to help the moms who were giving their children fluids to rehydrate them,” remembers Sandra. “Sadly, a couple of children died that week. That really had an impact on me… Those experiences are really what determined my plans to go to medical school.”

Sandra went on to study medicine in her home country of the Netherlands. Years later, she returned to Sierra Leone to help establish a Mercy Ships health facility in Freetown, providing obstetric fistula care for women with childbirth injuries as well as child health services.

Eighteen years later, Sandra still calls Sierra Leone home.

A Nation of Resilience

“What I love most about Sierra Leone is the people,” shared Sandra. “They’re vibrant, energetic, hospitable, but also resilient. They have been through a lot of challenging times, and it is just amazing to see people rise up and continue to aspire to do more. And I think that makes it amazing to be able to work together with them and to be able to make a difference together.”

Despite undergoing painful challenges in recent history, such as a decade-long civil war and being hard hit by the Ebola outbreak in 2014, its people have refused to let these obstacles become their legacy. Instead, Sandra says Sierra Leone – a nation of more than 8 million people – is known for its tremendous positivity and strength. Set against a backdrop of mountains and white sand beaches, Sierra Leone’s striking natural beauty is also a standout feature.

The Surgical Need in Sierra Leone

When Sandra first began working as a medical professional in the country in 2005, the child mortality rate in Sierra Leone was the highest in the world. At the time, 1 in 4 children didn’t live to reach the age of 5. The opportunity to be involved in pediatric care and reduce these numbers played a large part in keeping her there.

Sierra Leone’s surgical care landscape has improved in many ways since those days. Yet the need for safe surgical care and education remains incredibly high.

“There are not very many specialist surgeons in Sierra Leone. There are currently only two anesthesiologists in public service, so there’s a real need to raise up a surgical workforce across surgery and anesthesia, nursing, biomedical engineering, and sterile processing,” explained Sandra.

“If you look at the global surgery estimates, the unmet needs for surgery in the sub-region is really, really high,” echoed Dr. Mustapha Kabba, Deputy Chief Medical Officer – Clinical Services for Sierra Leone’s Ministry of Health and Sanitation. “Certainly, Sierra Leone falls within this category because we don’t have enough specialists in country. We have primary healthcare systems that are up and running, but … we really need specialized people.”

One specific area of need is for trained maxillofacial specialists. There is not currently a single maxillofacial surgeon in Sierra Leone. This means anyone suffering from conditions like a cleft lip/palate or facial tumor, for example, have limited opportunity to receive the specialized care they need in the country. Generally, their options include paying the significant cost of travel and surgery abroad – or simply living with their condition, and its consequences, indefinitely.

Mercy Ships to Sail to Sierra Leone

Mercy Ships is grateful to be invited by the government of Sierra Leone to provide surgical care for specialties like maxillofacial, as well as offering sustainable surgical education, in the very near future. In August 2023, the largest civilian hospital vessel, the Global Mercy™, will sail into the port of Freetown, marking the sixth Mercy Ships field service over the span of 30 years to this nation.

Over the course of these decades, changes have taken root – from the national scale all the way down to the individual level. Along the way, partnerships have ignited hope and multiplied impact, with each action having a ripple effect over the years.

Looking Back: Impact Multiplied Over Decades

Someone who’s been there since the earliest days was a young man named Patrick Coker. He first received surgery on board a Mercy Ship in his home country of Sierra Leone during its first field service in 1992. Patrick then waited a decade for the ship to return for the follow-up surgery he needed. Three years later, when Mercy Ships came back again in 2004, Patrick decided it was time to give back after receiving so much. He came on board to serve as a translator, devoting his language skills to helping other patients feel seen and heard.

Now, nearly 20 years on from that time of service, Patrick has been ordained as a pastor and become a positive voice of hope in his own community.

On a larger scale, Mercy Ships’ partnerships have led to lasting impact over the years. After establishing a health facility dedicated to obstetric fistula care and child health, Mercy Ships handed over the hospital – now the Aberdeen’s Women Centre – to the Freedom from Fistula Foundation in late 2008.

“That center, to this day, continues to provide quality obstetric, pediatric, and fistula surgical care services to the people of Sierra Leone,” shared Sandra.

Looking Ahead to the Future

Now, both old and new partnerships await. Dr. Kabba will be among those from the country’s Ministry of Health and Sanitation to welcome the hospital ship to her latest port. As a key counterpart within the government, Dr. Kabba will continue to play an instrumental role in sustaining an effective partnership between Mercy Ships and Sierra Leone – the kind of partnership that will lead to lasting change in the years to come.

“The Global Mercy is looking at the most sustainable approach – not just come, treat, and go, but now they are even trying to see how best you can work with the local resources available to have some form of presence, even when they are not here, to do follow-ups, to support training programs, to support institutions like Connaught Hospital,” explained Dr. Kabba.

“When the ship comes with their maxillofacial surgeons to help in treating cases, we see this as an opportunity for our local colleagues to learn so that we can have this knowledge also transferred locally – so that in the absence of Mercy Ships, people can also continue to treat disabled patients locally.”

Surgical Care and Education Through the Global Mercy

Over the course of this field service, Mercy Ships aims to provide life-transforming surgeries for more than 1,900 patients, including specialties like maxillofacial, orthopedic, ophthalmic, plastic reconstructive, and general surgeries. In Dr. Kabba’s eyes, it’s impossible to overstate the importance of surgeries like these.

“It’s a life-saving discipline. The types of surgeries you are providing are surgeries mostly for chronic issues where people are debilitated. After such surgeries there is a huge improvement in their quality of life. Children who have bowed legs, who are ridiculed in school, who cannot perform sports… they are no longer ashamed of going out in public. People who have pain from some mass on their face – when the mass is removed, the pain is gone.”

Meanwhile, an increasing focus on education, training, and advocacy will manifest in exciting new ways in Sierra Leone. Throughout the 10-month field service, Mercy Ships will partner with a government hospital to provide hands-on training, where volunteer medical crew will work alongside national healthcare professionals to exchange knowledge and practices. This collaborative approach to training will provide parallel opportunities for growth and learning.

“There’s an African proverb that has always stood out to me, and it’s, ‘if you want to go fast, go alone. If you want to go far, go together.’ And to me, that is a picture of partnership,” shared Sandra. “And as Mercy Ships, we really want to work alongside our partners and work together to strengthen the surgical ecosystem in Sierra Leone. I’m excited that we will be able to be a part of training Sierra Leoneans and enabling them to provide surgery in Sierra Leone for their people. This is what multiplying impact looks like.”

In just a matter of weeks, the Global Mercy will sail into Sierra Leone for the very first time. Stay tuned to see hope and impact in action!