ahead-onlus - Aid, Health and Development-Onlus by Fabio Riccardi

The “Raoul Follereau” hospital in Bissau


The “Raoul Follereau” hospital in Bissau, as it is today, began to operate on 20 October 2003, after 5 years of inactivity due to the civil war of 1998. The hospital was rebuilt based on the standards prescribed for any type of clinical building in Italy or other developed countries. It is the only hospital of its kind in Western Africa because of the high standards of assistance and treatment. It is a regional point of reference for the treatment of tuberculosis, malaria and malnutrition. It is also the national reference centre for the fight against tuberculosis .

The staff – made up of about 70 members including doctors, nurses, general health workers, technicians and administration staff- are all from Guinea.


Hospital Structure

Services are completely free for the patients; this is to avoid selecting patients in favour of the slightly better off ones.

The “Raoul Follereau” hospital covers an area of approximately 7500 m of which 2500 are covered. The buildings are easy to reach, located on the main road which goes from the centre of the city to the airport. The whole building is surrounded by an open area, which has been made into a park in order to reduce the circulation of dust, especially in the dry season (October-May).
The building is divided into eight sections; three of these are wards for patients, two are clinics, one for diagnosis and two for services.

The hospital has 104 beds (which can be increased to 115 if necessary) and has been organised in a way that it has all the requirements necessary for basic assistance. The functions of the sections can be outlined as follows:
-Section 1: Reception, Laboratory of clinical analyses, microbiological and molecular biology, central Pharmacy.
-Section 2: Radiology
-Section 3: Services (staff canteen, storage areas, kitchens, laundry, ironing room, refectories for patients)
-Section 4: Administration and Training
-Section 5: Area for Adult Ward
-Section 6: Area for Adult ward and mortuary
-Section 7: Area for Children Ward and paediatric malnutrition clinic.
-Section 8: Clinics and Day Hospital for the treatment of Tuberculosis and pulmonary illnesses.
The section for radiological diagnosis has two rooms equipped with modern machinery. The rooms are fitted out in such a way that operators and patients are fully protected from radiation. The radiology service is available both to patients who are staying in hospital as well as to those in the clinics. As it is the best structure in the whole city, patients from other hospitals in Bissau and the whole region are often received.
Ultrasounds and echocardiography tests can be carried out for patients staying in wards next to the radiology rooms.

The hospital offers a high level of services for staff and patients. In this section can be found the storage areas, refrigerated cells and freezers for conserving food. There is a large kitchen fitted out with professional equipment.
The wards are divided into 3 wards, two for adults and one for children. All the rooms – which have 3 or 4 beds – have a bathroom with hot water and a shower and their own exit. There are toilets fitted out for use by disabled persons. All the rooms are light and airy with ventilation systems. Each bed has its own mosquito net which is regularly changed and sprayed with mosquito repellent.
In the clinics patients who come to stay in hospital for the first time are visited, and also patients from the surrounding area who have been sent for a specialist visit. Two doctors and three nurses receive patients every morning. The hospital takes in approximately 600 people a year, and carries out more than 4000 visits at the clinics.

The building, the machinery and the organisation of the hospital are also used for the training of the staff. Over the years numerous training and professional development courses have been organised for staff, in particular for the health workers. The courses treated some of the most important aspects health assistance
Over the years, the method of working has given plenty of space to staff training through the exchange of experiences and discussing ways of finding solutions to individual cases. In fact, during the working day, there is a time for showing and discussing clinical cases.
Some of the health workers in the hospital, in particular the nurses, have been specifically trained to hold Health education courses for the patients and –in the case of children- their relatives.


Hospital Activity

In 2007, 548 sick people stayed at the Hospital Raoul Follereau and the Hospital carried out about 4,300 treatments in the clinic. Approximately 25% of the patients who stayed in hospital were under the age of 15.
In 2007, the hospital provided 30,379 day hospital services, and hospital beds were occupied for 80.02% of the time.
In 2007, 2,904 radiographies were carried out for patients at the hospital, and 4,116 for clinic patients or patients from other health structures of the capital or other parts of the country, making a total of 7,020 radiographies, with an average of 135 radiographies a week.
This is due to the improvement in the methods of diagnosis, and to the availability of more therapeutic protocols, but also to the pharmacological and environmental protocols used to prevent malaria in patients and to reduce the number of mosquitoes in the hospital.


Present Needs

For the present being the government of Guinea Bissau still does not have the financial and technical means necessary to fully manage and develop the complex activity of the “Raoul Follereau” hospital. Since the first months of 2008 up to now, the diagnostic, therapeutic and assistance activities have been drastically reduced, while all training courses for hospital staff, including staff from other hospitals, have been stopped completely. Due to this lack of funds, the number of patients who receive treatment in hospital or assistance in the clinic has fallen considerably. The variety of medicines given has also been reduced as well as the laboratory tests.
This sort of situation risks to remarkably slow down the fight against the spread of tuberculosis in the country.
Because of this situation and the difficulties the “Raoul Follereau” hospital faces, the Ministry of Health of Guinea Bissau has turned to the Association “Aid, Health and Development-AHEAD” with the aim of finding a way to get this association to manage the hospital, in order to guarantee its survival and, in the future, its development.

In reply to this request, in October 2008 AHEAD and the Ministry of Health of Guinea Bassau drew up a preliminary agreement in which AHEAD agrees to begin a campaign to make people aware of the situation and to raise funds to support the “Raoul Follereau” hospital. The ultimate objective is to settle on a definitive agreement in
which it agrees to organise and develop of the work of the “Raoul Follereau” hospital.
The cost of AHEAD’s contribution is estimated at 400,000 Euro a year. This sum – if provided along with the management and supervision of the hospital activities – would allow the hospital to maintain the quantity and quality of the services carried out in 2007, and even to improve them.

Hospital Raoul Follereau in Bissau

Women's Ward outside

One of the two Cafeterias

Pediatric Ward

Out patient Clinic

One of the two X-ray Rooms

Laboratory

Laboratory