Eight Million Patients: One Doctor
Sierra Leone’s Only ENT
It’s a known fact.
In all of Sierra Leone, there’s only one Ear, Nose, and Throat (ENT) doctor.
My father, who turned 80 on Monday, has been trying to see the ENT since last week.
He has a ringing in his ear and, as a result, can’t keep his balance. He also had a bout of vomiting in the middle of the night.
He was admitted to Choithrams, but even before that, he was trying to see the ENT.
Posin say di doctor day make lek im na God.
They say that sometimes he just turns his phone off.
In my naïveté, I asked why they don’t just call another one.
Na e wan day.
Wetin you mean?
Na wan ENT day. Na bin Dr. Songo Williams e wan traday, but e don retire.
The new one-man ENT is now Dr. Kabineh. I’m told he’s young.
There are over 8 million people in Sierra Leone, and this one doctor has to serve them all.
I begin to imagine what life must be like for Dr. Kabineh. E wan grain, getting calls all the time from everywhere. When will he have time for himself?
In the last two weeks, two doctors have died in Freetown. One, Dr. Adrian Hanciles, was first reported missing before they found his body at the morgue.
On August 27, Dr. Aruna Maada Jabbi died. He was only 36.
I don’t know the circumstances of either of their deaths, but when the physician-to-population ratio is roughly 1:24,000—compared to the WHO’s recommended baseline of 1:1,000—you have to wonder whether there’s a direct link between these premature deaths and the staggering physical toll on our doctors.
My dad will be discharged this morning. He’s stable, but he still hasn’t seen the ENT. I’m not sure if he will.
We’ve decided that perhaps the best thing for him to do is to go back to the US for treatment.
Too much of Sierra Leonean life is left to chance. One ENT for a whole country?
Every young professional I speak to who is going back to school tells me they’re going to study law.
Each time, I wonder: do we really need more lawyers right now? If the law school paused admissions for a decade, society would keep functioning—yet a shortage of doctors costs lives every single day. This isn't a knock on the profession of the ‘dangerously educated’, but rather a reflection on the stark mismatch between what our country urgently needs and what our workforce continues to produce.
I know conditions of service for doctors still need improving. I also know that specializing costs money, and doctors need to leave Sierra Leone to do so—at great personal expense.
But change is needed.
If for no other reason, than for lone specialists like Dr. Kabineh. I haven’t met him, but I can’t imagine the pressure and workload he faces.
I wrote this simply to remind everyone to have a little more empathy for healthcare workers.
Next time you can’t see the doctor you need, just remember that for some, you’re patient 1 of 24,000. For others, like Dr. Kabineh, you’re 1 of eight million.
Give a little grace.
