SPEECH DELIVERED BY HIS EXCELLENCY
ALHAJI DR AHMAD TEJAN KABBAH,
PRESIDENT OF THE REPUBLIC OF SIERRA LEONE
AT THE RE-OPENING CEREMONY OF CONNAUGHT HOSPITAL
27TH APRIL 2006
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Mr Chairman
Cabinet Ministers
Honourable Members of Parliament
Your Lordship the Chief Justice
Your Lordship the Mayor of Freetown Municipality
Your Excellencies Members of the Diplomatic and Consular Corps
Representatives of the United Nations Family
Paramount Chiefs and other Traditional Leaders
Senior Civil Servants
Staff of the Ministry of Health and Sanitation
Distinguished Ladies and Gentlemen:

By the early 1980s the health care delivery system started to experience a gradual decline that reached an appalling level of deterioration in both quality and scope by the end of the decade.

The government in power then was spending less than one percent of the Gross Domestic Product (GDP) on the health sector, the only country in the whole world with such a low level of national health expenditure. By the early nineties, not a single government hospital was effectively functional. Connaught, the main referral hospital, presented a severely overused institution with all structures and facilities in a state of disrepair and decay. Even its roof was made of asbestos material, a very dangerous health hazard. Most toilet facilities and water systems did not function, the operating theatres barely functioned and so were the Laboratories, X-ray, Dental Unit and the Blood Bank facilities. The same situation existed in all the government hospitals throughout the country.

As an interim measure, government using its own resources and funds donated by citizens and local business houses, carried out an emergency rehabilitation of the wards and the annexe, here in Connaught. This was not enough and government had to approach its development partners for assistance. The African Development Bank (ADB) responded by fielding a mission towards the end of 1987 to appraise the health services in Sierra Leone.

The mission visited hospitals and health centres in the Western Area and the districts, held several discussions with the senior staff of the then Ministry of Health and agreed that the rehabilitation of a number of referral and district hospitals would be the most appropriate priority health sector intervention for the country. In a second mission, staff training and the development of health sector human resources components were included in the project. The main objective was to rehabilitate identified existing health facilities and build staff capacity so as to strengthen the health care system to deliver quality services.

The project was appraised by the ADB in December 1994 and again in August 1996. The loan agreement was signed in August 1998 but due to the rebel war, the project only became effective in December 1999 and was formally launched in February 2000, fourteen years after the visit of the first ADB mission. In the meantime our people kept dying by the dozens, all because of lack of appropriate remedial action.

The three main referral hospitals of Connaught, Princess Christian Maternity and Children's hospitals, and health centres at Ross Road, College Road Cline Town, Jenner Wright, Kissy and Regent were selected to benefit from the project. The health centres had earlier been completed and reopened to the respective communities. Today we are poised to reopen the hospitals to the public for their use.

Connaught Hospital now has, in addition to what existed before, a three-storey administrative block, standard mortuary that can accommodate 30 corpses at a stretch, two-storey kitchen, laundry, maintenance workshop and generator house with three 250KVA generators. The entire compound has been fenced and perhaps most significant, all the asbestos roofs have been replaced with roofing tiles, thereby protecting patients from additional diseases they would have contracted by coming to the hospital. Provision has been made for emergency intensive care and dialysis units to ensure proper patient care. This is welcome because before now those kidney patients who could afford it had to be taken to neighbouring countries for treatment.

Additional facilities at the Princess Christian Maternity Hospital include amongst others, two-storey outpatient department and administrative building, and a maintenance workshop, a 30,000 gallons water tank tower and a mortuary with a capacity to hold 30 bodies. These facilities are shared with the Children's Hospital, which also has a Nutrition Unit to house severely malnourished infants and their mothers.

Government shall continue to develop these hospitals to provide post-graduate training for graduates from the College of Medicine and Allied Health Sciences (COMAHS) to acquire the much needed highly specialized skills. This will partly address the problem of the brain drain by training locally qualified doctors as specialists who can earn higher salaries. We will also complement this by trying to revise upwards the basic salaries of newly qualified doctors. We will also welcome proposals from the Ministry of Health for the early realization of these strategies. On this note, I would like to recognise the patriotic and yeoman services of those of our compatriots who have resisted the temptation of greener pastures and have remained in this country in spite of the difficulties of their working environment.

During the colonial period, good quality medical care could only be obtained from metropolitan Europe and only expatriate civil servants were eligible for that privilege. With the Africanization of the senior ranks of the civil service some of our people also gained access to this privilege but its use was controlled rigorously by screening and discretionary procedures to put a check on the resultant enormous rising foreign exchange cost to the government. With the improvement in the provision of quality medical care locally the use of taxpayers money to meet the cost of overseas medical expense since the majority of Sierra Leoneans are excluded from this entitlement will be a thing of the past. However, individuals may continue to make private arrangements for medical treatment overseas.

The example set by the Choithram business in upgrading the hospital at Hill Station in Freetown is laudable and worth emulating. I therefore appeal to all businesses, individuals, families and communities to join government in its effort to provide appropriate, widely accessible and affordable health care services to our people. I also urge those who work in this relatively modern hospital environment to develop a maintenance culture in order to maintain the quality of these facilities. They belong to all of us.

To provide autonomy for the day-to-day operations of these hospitals government has established Hospital Management Committees and Hospital Boards with well-defined terms of reference. These new organisations together with staff have the joint responsibility for the overall management including cleanliness and proper functioning of these hospitals. I appeal to the general public, the users of services provided by these hospitals, to assist the officials of the hospitals in discharging their duties. It is important, as users of these hospitals that you endeavour to obey the regulations which are put in place to allow for a smooth flow of the services being provided.

Government will continue to monitor the needs of the health care sector in order to provide the necessary financial support to achieve the standards foreseen in the Millennium Development Goals. However government will take a dim view of any abuse of medical facilities in these hospitals. Swift disciplinary measures will be taken against any officials who are found to use improperly medical facilities at the hospitals such as drugs, vehicles and equipment. Measures will also be taken to prevent the reservation of hospital beds for private patients at the expense of ordinary Sierra Leoneans who cannot afford to pay private fees. Hospital Management Committees and Hospital Boards are expected to be more vigilant to ensure that the concerns I have expressed here today are adequately addressed so that ordinary Sierra Leoneans can derive maximum benefits from these facilities.

In this regard I call on these institutions to review the available manpower in terms of experts especially the foreign medical personnel assigned here by friendly countries from Nigeria, China and Cuba as well as our own with a view to maximizing the use of their expertise in these hospitals. We cannot continue to keep them in satellite clinics and other peripheral medical facilities where their services are under utilized.

On behalf of government and the people of Sierra Leone I thank all those who in diverse ways, have contributed to the successful completion of this project.

Mr Chairman, Distinguished Ladies and Gentlemen, it now gives me the utmost pleasure to declare the Connaught Hospital re-opened to the public.

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