Tying things up at work
on Freetown Blog (Sierra Leone), 01/Dec/2009 11:36, 34 days ago
It's my last few days at work now, and I'm trying to finish things off and spend time talking to others about their plans for next year. One of the things that keeps surprising me is when I find people with great skills who just need a bit of support to help focus their efforts. There is one man, Dennis, in the department who is Rwandan and initially came to Sierra Leone to help with monitoring elections. He later had to leave SL because of the war, but subsequently had to leave Rwanda for the same reason and returned here. He has been working in the Ministry for a while, though without a salaried contract.Dennis is fantastic on Microsoft Access and Excel. By sitting down with him and talking about the sort of questions we need the staff headcount database to answer, he is well able (far more able than me) to generate the reports required.Some of the answers are shocking, but they really help the Ministry to state its case to the Government and to donors.One of the issues we have picked up is that around 50% of the newly qualified Enrolled nurses appointed this year did not take up their posts. It is not difficult to see why when you understand that transport to get to their base could easily be $10, and basic accommodation could be $50 per month,and compare that with the salary scales:GradeMonthly salary14 $  359«Consultant13 $  27612 $  195«Medical Specialist11 $  15110 $  909 $  69«Medical Officer8 $  527$ 40«Nursing Sister6$ 285$ 22«SRN4$ 18«SEN3 $  162 $  141 $  12«Nursing AideThe only way anyone is able to keep functioning at work at all is through making informal charges for basic services. But with general poverty rates as high as they are, that means that many people simply cannot afford to access basic health services at all.So you see what I mean about the scale of the challenges here.When you work with people who have seen services decline through the years of conflict, and are still struggling to get things moving back in the right direction, you can only admire the tenacity that keeps them going.I'm starting to wonder how all this might make me view the problems and constraints of the Health Service in Wales on my return...