Fieldset
Sierra Leone: My return to the MSF Academy

In Sierra Leone, MSF teams are working with a new generation of medics. Dr Daan Van Brusselen shares an update from a programme that's helping staff develop their skills and save lives...

It has been a very long time since I’ve written something on the blog. But recently I was on my way back from Sierra Leone, and airports and long flights always grant you the opportunity to reflect on life.

Since I last wrote, I’ve been doing my usual job as a paediatric infectious disease specialist in Antwerp, Belgium, but I still regularly work for Médecins Sans Frontières / Doctors Without Borders (MSF).

Big questions

One of the big questions I have been asking myself for a long time is about what happens when MSF leaves a region. I’ve worked for MSF in multiple crises, in places as diverse as Haiti and Pakistan, and some years after an earthquake, a conflict, an epidemic… it inevitably happens: the situation stabilizes, and elsewhere there are emergencies where the medical needs are greater and more urgent. As an emergency humanitarian organization, this is where MSF has to focus our resources and expertise.

At this point it might be that we hand over a medical project that was started by MSF to be run by local partners – for example the country’s Ministry of Health, or an NGO.

But although the acute crisis may have passed, often the places we are leaving still face health problems: for example very high maternal and child mortality rates. And often they don’t have a lot of resources to address this.

So, how can we ensure a smooth transition so that when MSF withdraws, local healthcare workers can continue to provide medical care? How can we make sure that what has been achieved is sustainable?

For a few years, MSF has been trying to offer a concrete answer to that question through the ‘MSF Academy for Healthcare’. I’m part of the team working on the Academy, and I’d like to introduce you to the project.

The MSF Academy

The MSF Academy for Healthcare was founded in 2017 and it provides professional training programmes for local healthcare personnel like nurses and midwives in low-resource settings like South Sudan, Sierra Leone, Guinea, Mali and CAR among others. Besides theoretical lessons, we focus strongly on bedside teaching: the strong point of our courses.

I was once again able to observe for myself how well this approach works on a recent assignment in Kenema, Sierra Leone.

Kenema is a small town close to the border with Liberia, where MSF is running a paediatric hospital. I’ve worked in Kenema before and have seen how the dedicated team treat children with all kinds of conditions, notably severe malaria, all kinds of infections and malnutrition. In the very near future, the team will be opening a maternity unit too.

The Kenema team is providing vital hospital care for the sickest children, but that’s not its only goal. We are also doing our very best to make Kenema a teaching hospital for nurses and community health officers in the region.

Tailor-made

Community health officers were originally trained to diagnose and treat patients for a specific range of medical conditions in the community, but – because of the lack of medical professionals in Sierra Leone – they now often take care of very sick mothers and children in hospital settings.

In 2019 I wrote a two-year paediatric curriculum to train the hospital’s Community Health Officers (CHOs). The course was tailored to the needs of MSF’s hospital in Kenema, with a strong focus on infections and tropical pathology like sickle cell disease. So this year I returned to Kenema again to evaluate the curriculum and make a few modifications to help our learners achieve their potential.

New leaders

As part of my time at the hospital, I was also able to do a lot of one-to-one bedside mentoring myself, and even to meet again some of the community health officers I worked with last time I was in Sierra Leone.

Working with our students so closely really showed me how hard they work to get the most out of their training. Talking to them it was clear that, more than anyone else, they realize that the ‘tailor made’ paediatric curriculum is an opportunity to improve the quality of care in their country and to pass the knowledge on to other colleagues afterwards.

Coming back to Kenema was an opportunity to see the impact that the Academy is already having. One of the mentees I worked with again this year was very new to the job when I first met him. But this year I was impressed to see that he is already one of the leaders in the ward, teaching other clinical health officers skills and building their confidence.

Sustainable impact

I’ve worked in many different hospitals and clinics with MSF, and while providing on the job training to colleagues is almost always part of the work, it can be somewhat ad hoc. The continuous professional development that the Academy team is providing in countries like the Central African Republic, South Sudan and Sierra Leone gives local health workers the opportunity to access more professional and comprehensive training, which benefits both the staff member and the patients.

While the Academy’ and its training of health professionals is still very new, my time with the team in Kenema has only reinforced my belief that the approach offers a major and sustainable impact on the quality of care available to patients, not only for as long as MSF is in the areas where it operates, but also for the longer term.

Top image shows a clinical mentoring session at the MSF Academy for Healthcare in Kenema.

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Read more: Stories from Kenema

The first little lady in Kenema Hospital

“They named him after me”: Saving lives in Sierra Leone