Sierra Leone explosion kills more, strains health system

FREETOWN, Sierra Leone – When an oil tanker exploded in Sierra Leone last week , killing 98 people at the scene, among the many survivor...


FREETOWN, Sierra Leone – When an oil tanker exploded in Sierra Leone last week, killing 98 people at the scene, among the many survivors was a motorcycle taxi driver who, while stuck in traffic, was engulfed by the fire.

The driver, Yusuf Kamara, suffered burns to 80 percent of his body. But for a while he could walk and talk – and worry about the $ 27 he had lost in the fire, three days of pay.

“It wasn’t kid’s money, not loose change, and everything burned down,” he said in an audio note, the last recording of his voice, before he died.

Days after the explosion in Freetown, the country’s capital and largest city, the tragedy claimed more lives and strained the country’s already precarious health system. The death toll rose from 98 to 144 on Saturday, and more survivors were still admitted to hospitals on Friday.

In a country without a single burn unit and with lifesaving drugs unavailable or nearly exhausted, doctors and nurses are trying to avoid infections in patients who have survived so far.

It is a Herculean task. Most of the patients still admitted suffered burns to more than 25 percent of their bodies. In a Freetown hospital known as 34 Military, the death rate was around 60%. While patients are dying in another emergency hospital, their beds go to victims who are less injured and who could not be admitted initially due to lack of space.

While Covid-19 has not overwhelmed Sierra Leone, which has reported just 6,400 cases and 121 deaths throughout the pandemic, the country is no stranger to health crises. An Ebola epidemic that began in 2014 has killed nearly 4,000 people. Floods and mudslides claimed hundreds of lives in 2017.

But the severity of the injuries from this explosion shocked even doctors seasoned with previous crises. “The scale and scale, I’ve never seen anything like it,” said Dr Songor Koedeyama, a hospital medical superintendent who, following the blast, volunteered to Connaught Hospital, the country’s main hospital, where most of the victims were taken. .

Dozens of drivers and cyclists were killed and injured in the crash. Some were so poor that when they saw the tanker leaking fuel just before the explosion, rather than running away, they rushed to pick it up. Many of those killed were the breadwinners of their families, so the tragedy has brought even more despair to some of the most needy in this West African country.

From the moment patients started flooding hospitals, doctors, nurses, administrators and government officials worked tirelessly to tinker with supplies and manage a patchwork response. An emergency coordination team was operational the morning after the explosion.

But from the start, the weaknesses of Sierra Leone’s health system were evident. Hospital staff are quickly becoming exhausted and there are few clinicians to replace them. Government pharmacies have not been able to supply essential drugs, including those for the management of acute pain and antibiotics. And doctors fear it will only get worse.

The the health sector in Sierra Leone is fragmented, a messy constellation of public, private and nonprofit programs. Although the government is nominally responsible, it relies heavily on funding and supplies from foreign donors.

Patients who survive on a meager income must regularly purchase essential drugs from private pharmacies. But Lawrence Sandi, director general of the National Medical Supplies Agency, said the government was footing the bill for the burns.

When he heard of the explosion, Mr Sandi said, he went straight to the medical store at Connaught Hospital, gathered supplies there and gave them to medics. With essential supplies like intravenous fluid running out just after the accident, he went to the private pharmacy next door to buy more, he said.

“I just said that whatever you have, we will pay for it,” Mr. Sandi said.

But in city hospitals, families of several patients said they were always told to pay for drugs and other supplies.

For the survivors who have made it this far, care will become increasingly difficult, according to Dr Kilongo Papy Mulailwa, a surgeon who assisted in the response to the fire. Patients who are discharged will have to return to specialist hospitals for weekly treatment, for one year.

“Plastic surgery, mobility, you’ll need a lot of physiotherapy. All of this is very difficult to achieve in Sierra Leone, ”he said. “You can predict that the next three months, for those who survive, will be very difficult.”

But a shortage of antibiotics is a more immediate problem.

“I am concerned that we do not want to introduce a patient to this treatment and that we do not have enough for their entire treatment because they may develop resistance,” Sandi said.

Those who have survived worry not only about their own recovery, but also about the impact their absence will have on their families.

“I take care of my siblings and my children,” Ibrahim Sorie, a 25-year-old driver, said on Wednesday from his bed in military hospital 34. His legs, arms and a large part of his head were burned, and in a whisper he said he was in tremendous pain. “I take care of them all, I pay the school fees. So now with the accident, I don’t know what I’m going to do. We really need the support of the government.

The families of the deceased, already bereaved and traumatized, are now also facing financial ruin.

Mariatu Mansaray, the sister of a victim, panicked about making ends meet as she waited for a mortuary to release the body of her younger brother Ibrahim on Thursday. She still doesn’t know exactly how Ibrahim, a traffic police officer, caught fire.

Shortly before his death, Ibrahim told him from his hospital bed: “I didn’t see any fire, I just saw smoke.

The morgue charged her $ 23 to wash Ibrahim’s body and $ 23 for an ambulance, in total more than she earned in a month. On top of that, she had to spend $ 165 to feed the bereaved, a must in a country where funerals are extremely important. And then there would be the seven-day mourning ceremony in the family’s hometown.

“I have to take care of her child now, and I have two children, I have to take care of them all,” she said, tears in her eyes, dressed in pink and purple lace for the funeral. . Her mother is sick, she says, and relies on Ibrahim’s salary each month to get by. “It was already too much for all of us, and now that he’s gone it’s worse.”

From his hospital bed, motorcycle taxi driver Yusuf Kamara made a video message to his mother last Saturday, two days after the fire. “Tell my mother I won’t die,” he said. “Give him courage.”

On Sunday evening, he called his cousin, Memunatu Kamara, to ask her to cook him some soup. But by the time she arrived with her the next morning, she was told he was dead.

On the way to the funeral, Mr. Kamara’s 7-year-old son saw a biker.

“Look, dad is coming! The little boy said to his grandmother, not understanding what had happened.

“Everyone started to cry,” Ms. Kamara said. “There wasn’t a dry eye in that car.”

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Newsrust - US Top News: Sierra Leone explosion kills more, strains health system
Sierra Leone explosion kills more, strains health system
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