LA Times Cover Story

FORGOTTEN COUNTRIES

Sierra Leone’s crises have global reach

The public health system in the West African nation is a shambles and the government teeters on the edge. Some fear it could become another Somalia.

By Scott Kraft : Reporting from Freetown, Sierra Leone

November 15, 2009

First Of Two Parts

When the power went out that night, Dr. Ibrahim Thorlie was operating on his fifth patient of the day in a maternity hospital with a shortage of antibiotics and running water. His colleague was doing an emergency caesarean in the next room. In the corridor, a bucket on the floor held a stillborn baby.

Thorlie turned wordlessly in the darkened room and lifted his gloved hands. Sweat beaded up on his forehead like dewdrops. A nurse reached into the surgeon’s pocket and pulled out his penlight, a pas de deux they had clearly performed many times before.

An aide was dispatched to start the generator and, eventually, a few low lights flickered on in the operating rooms. The rest of the hospital remained dark.

The power had failed two nights before, but no one on duty knew how to operate the generator. So Thorlie had awakened the deputy health minister, who woke the minister of energy, who contacted the electrical substation and got power restored. (The substation, it turned out, had taken a bribe to divert electricity to another neighborhood.)

It was an all-too-typical week at Princess Christian Maternity Hospital, which takes on the most difficult cases in a nation of 6 million.

Told of those events the next day, Sierra Leone’s first lady, Sia Koroma, a trained nurse, sighed. “It’s hair-raising, but it’s true,” she said. “And that’s one of the government’s best hospitals. The others are worse.”

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