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'Sometimes there would be two or three patients in one bed'


Catrin Boyle has contended with corruption, shared beds and very scarce resources in Sierra Leone.

Fresh from the fields of the Glastonbury festival, children’s nurse Catrin Boyle received a call that was to change her life.

It was VSO asking her to teach nursing in Sierra Leone. “I had to say yes. I thought: ‘Well, if I can manage five days at Glastonbury, I can manage anything’. “

Ms Boyle had wanted to work with children all her life, as both her parents worked in nursing. But, after five years spent working on a children’s ward at a hospital in Aberystwyth, opportunities abroad appeared tempting, with VSO topping the list.

“They were so good in preparing and supporting you,” she says.

So, Ms Boyle began her adventure as a volunteer nurse in one of the world’s most poverty-stricken countries.

On arrival at her two-year placement at Olaturing Hospital in Freetown, Sierra Leone, she found that even the small things she did could make a huge difference.

“They’re so shortstaffed, just an extra pair of hands helps. And when you’re able to suggest a different way of doing things, the nurses appreciate it.”

Low staff numbers is a huge problem. “We complain a lot about workload in the UK, but there you would have maybe two nurses and a couple of auxiliary nurses to about 60 patients. Sometimes there would be two or three patients in one bed.”

As well as the lack of equipment, training and resources, large-scale corruption affects healthcare provision, and she found this one of the biggest challenges.

Although the government has made healthcare free for under-fives, staff would still often charge parents for treatment. Initially, Ms Boyle was shocked but gradually learnt to look at things from local people’s point of view.

“The local nurses are not paid much and it’s a source of income. You can’t really be too upset when their wages barely cover the cost of transport to get to work and back,” she says.

On seeing cannulas being used repeatedly, Ms Boyle again had to remember the different priorities. “They didn’t have any more and were just working with what they had,” she says.

She began by working on the wards with a paediatric doctor. She soon saw that the time sick children were waiting to be seen needed to be reduced and decided to work with staff to educate them about emergency triage and treatment (ETAT).

Ms Boyle realised immediately how keen local staff were to improve care. She says: “It was really good to see what we’d taught being taken on board and used. When we went back, the ward sister was using ETAT, they’d put the posters up and were teaching it to other ward staff.

“Here we treat everything as an emergency but over there they are so relaxed. They need to react fast. But after a while I could understand why they were so laid back - with so many patients and so few staff you wouldn’t be able to function as a person if you weren’t.”

Ms Boyle has now spent 11 months in Sierra Leone. Seeing the difference she was able to make through teaching, she had no regrets: “Sometimes it was really hard but then I just thought, ‘I’m so lucky to have the option to do this’.

“It made me appreciate how much we have - having all the equipment we do and having just one patient to a bed is a luxury. Over there, just giving medication to that many patients is a challenge.”


Readers' comments (2)

  • Fantastic job Catrin and I am sure you can see the difference you are making to the lives of both patients and staff. I have been teaching operating theatre nurses all over africa for the last fifteen years and can completely understand the need to alter your standards to fit the available resources. I am always filled with admiration by the way the nurses cope with very little in the way of consumables and equipment. I am sure that Catrins teaching will go a long way to improving patient care and outcomes and wish her a very successful further year . This sort of work totally alters your perception of the NHS and its largesse . It is also very good to remove yourself from your comfort zone and face new challenges.

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  • Thanks Catrin for the marvelous job you are doing for my country. I am also a Nurse and I was trained in the UK. When I came back home it took me a while to come to terms with working in hospitals with minimal resources and with little hand washing techniques. But I was able to teach the nurses I worked with effective hand washing techniques and a lot of other things to improve patient care. Well done.
    And don't forget to have a little bit of leisure time. there are nices places to see and a beautiful beach. let it not be all work only.

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