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Have you considered an elective placement abroad? How about Sierra Leone?

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Sneha and Alexandra found their capacity building elective in Sierra Leone opened their eyes to new learning opportunities

Global health is an emerging issue, but by no means a new one. The world we live in is constantly evolving and the boundaries between populations continue to change. As a result, we have become increasingly aware of not only the inequalities in healthcare, but what the response to these inequalities should be.

This awareness inspired us to take action on these issues in an attempt to bring about change.

Traditionally, opportunities in global health and international electives are associated with medicine rather than nursing. Nevertheless, this September, we travelled to Freetown, Sierra Leone for a four week nursing elective.


Alex Malet2_SNT


During this time, we rotated to four different clinical areas, including A&E and ICU. We quickly realised how difficult it is to provide even basic nursing care when you are unable to rely on the facilities and equipment that we are fortunate to have in constant supply in the UK.

We shared the frustrations of our Sierra Leonean colleagues of not always being able to change a dirty sheet or a dressing when it needs doing.

International development in Sierra Leone has traditionally taken the form of aid delivered primarily by Western organisations. While this was invaluable and necessary during and immediately after the Civil War, there is now a shift towards supporting more sustainable development. This is known as capacity building, where local communities work in partnership with organisations to strengthen their own systems and infrastructure.

This shift gave us the opportunity to undertake project work in the hospital with a capacity-building organisation linked with our university - the King’s Sierra Leone Partnership (KSLP).  

Combining capacity-building projects with clinical work meant we gained specific and often rare insights, and the partnership made us realise the value of change from within.

Working alongside hospital staff helped us appreciated the level of tolerance and innovation shown by nurses who are not given even the basic tools to do their job, to give a patient the care they deserve, or to save a life.

This is why, as students in the UK, it can be upsetting to witness failings in patient care, because we are privileged enough to have the knowledge, skills and equipment to provide patients with safe and dignified treatment.

Observing a struggling healthcare system can be difficult and upsetting. However, the active role Sierra Leonean families play in everything from attending to patients’ personal care, to hoping for a bright outcome against all the odds, at times made us feel hopeful too.

Capacity building is a productive outlet for these feelings. It can be comforting to feel part of the change that everyone is striving for, even though this process can be slow, and the results often appear un-dramatic.


Alex Malet3_SNT


Previous experiences abroad and those gained through our nursing programme have helped us prioritise the components of a safe and operational healthcare system. Having this knowledge meant we were able to make valuable contributions to the projects we were involved in, despite the fact that we are still students and very new to nursing.

Nursing, at its core, is about teaching and sharing skills, which is also at the very heart of capacity building.

Often, it is the little things in nursing practice that make the difference to a patient’s time in hospital, and the same can be said of capacity building. While the projects are part of a much longer process, small changes can greatly impact on a patient in a positive way.

We’re continuing to be involved with KSLP and hoping to see the results of these changes over time. As students, we are encouraged to believe that we can be future leaders, and to inspire each other to believe the same. Ultimately, there are a great many things we can learn from our global colleagues and the patients they look after – and it’s never too early to start.


Sneha Baljekar and Alexandra Malet are in their final year studying postgraduate diploma in Adult Nursing at King’sCollege London


Find out more about the King’s Sierra Leone Partnership


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