Commonwealth Nurses Federation – West Africa, 1981

Freetown & Sierra Leone – Written by Helen Mussallem.  

Until 1981, Sierra Leone was, to me, just a name on the map of West Africa. I had met the

country’s senior nursing officer and her assistant in nursing education many times at ICN

Congresses. The latter person was afflicted with sickle cell anaemia –the first case I had ever

encountered. I soon learned that this hereditary condition was common in many families in West


My hotel at Manny Lo was luxurious but far out of Freetown. I should note here that Freetown is

reached by a ferry which runs on an erratic schedule from the airport. While travelling on the

ferry and enjoying the warm sea breeze, I was delighted to note that the matron and the two

accompanying nurses were in full uniform. Despite the winds and surf, they somehow managed

to stay starchily stiff.

The hospital and the school of nursing were unlike those of other developing countries. The

school was rather bare, with a minimum of teaching tools. Likewise, the hospital was barely

furnished –but clean. Wards consisted of rows of beds in a large, open room and the “utility

rooms” and equipment was in rather poor shape. I could sense from conversations with the

Matron and her assistant, however, that the “caring” for patients was paramount even though

the curriculum was disease oriented. In essence, it followed the U.K. pattern for the preparation

of nurses.

As planned, I delivered three speeches on “primary health care” to the nursing staff, to the

entire hospital staff and one which was open to the “general public”. Everyone listened politely,

laughed at the appropriate times and applauded enthusiastically. I shall never know if my

enthusiasm for the WHO goal of “Health for all by the year 2000” was understood by any

member of the audience. I often heard those words repeated but I was never sure if they really

understood the concept and how it might be implemented in their own country. Would the

students see the vision of this new approach to health care and internalize it? Not likely if the

rigid curriculum, as I viewed it, was followed.

The chief nurse recognized my enthusiasm for primary health care and arranged for me to see

a primary health setting several kilometres inland. We set out on a hot, hot day. I was in the

front of the car with the driver and the matron and her assistant –again in full uniform –sat in the

back. About one hour out of Freetown, we heard and saw a loud explosion of steam from the

radiator. The car stopped suddenly. For a while, the driver just sat but eventually, he opened the

hood –still spurting steam. Having driven a car since the age of 10 and having been loaned a

second hand car during my student days, I had some, scant knowledge of auto mechanics. I

had even had a similar experience with a burst radiator hose in a huge Essex. This seemed

similar but, unwilling to interfere, I sat quietly with my companions until the driver announced we

were stuck as he had absolutely no equipment for repairs. Ready for action, I got out of the car

and asked to see the problem –a broken radiator hose alright and all the water was gone.

Looking around, I spotted a small stream way down in a gully and asked the driver to fetch

some water. He refused saying he had no container. We did have our water rations for the day

but how was I to fix the burst hose with no tape of any kind. I had an idea. While the matron

kept the driver from following me, I went to the back of the car and removed my pantyhose.

Triumphantly, I returned to the front where the hood stood open and instructed the driver on

how he was to repair the burst hose. His eyes got bigger and bigger. He simply could not

understand what I was talking about but, together, we wrapped the burst hose with the

pantyhose. I then used all our precious water –about three to four litres –for the radiator.

Thankfully, the car started and we managed to drive the five or six miles to the next village.

There, a temporary patch was applied and my handiwork discussed to the amusement of the


Prior to reaching our destination, we stopped to pick up the public health nurse for the region.

When we finally arrived, I emerged from the car to the sound of many women singing around

large pots. The pots, to my amusement, reminded me of the ones in Sunday school books that

showed the natives boiling the missionaries. The public health nurse explained that these

women were midwives whom she was teaching to sterilize the blades, knives and cord, etc.

used for deliveries. I asked what they were singing and was told that it was a song of thanks “to

my mother for having brought this wonderful woman into the world” (me). I was especially

touched as it was 14 March (1981) –my mother’s birthday.

Glancing to one corner of the clearing, I saw the elders seated around a rustic table discussing

plans for health care. Nearby a group of young men was being taught by a “trained health

teacher”. He was teaching them how to carry vaccines, packed in dry ice, and administer them

to villagers in the remote areas of the country. The teacher asked me to address the group and

he would translate. I started off by telling them about the WHO goal of health for all and noted

that my home was far away and that it was covered with snow and ice. The translator stopped

and, when I asked if there was a problem, answered, “Yes, we don’t have words for ice and

snow”. Ever inventive, I suggested he tell them that the temperature in my country was cold like

the dry ice in their vaccination kits. They all laughed hysterically. I was then asked to come and

see their new project — a compost heap with boards on four sides! This was a new and exciting

venture in this part of Sierra Leone.

“Could I go out to the little huts I could see from the compound,” I asked. They discouraged me

as there were “biting snakes” in the area and I would have to wear high leather boots. I went!

Along the path, mothers held their children out in front of them. When they saw me, they

pinched their children’s cheeks and said something — always the same-sounding phrase.

Curious, I asked for a translation but my guides were reluctant to interpret saying it was a bad

word. “What bad word,” I asked. “White woman, white woman”. That was a bad word! That was



Arrival at the airport in Ghana was almost as spectacular as arriving in Nigeria.

After the strenuous lectureship in Nigeria, covering cities and villages, I returned to the

Government House residence for VIPs with a serious flu-like condition with fever and a hacking

cough. The “government nurse”, who came at my request, confirmed that I was ill and should

not travel the next day. I had to travel, however, so tight was the schedule for visits to the seven

countries –Nigeria, Ghana, Liberia (not Commonwealth but squeezed in by the Secretariat),

Sierra Leone, The Gambia, Malta and Cyprus.

I was transported to the airport in great style but the trip took hours through the city’s congested

traffic –possibly the world’s worst. Peddlers approached our car continuously hawking all types

of wares. The most amusing were young girls with radio/stereo/recorders on their heads –the

music going full blast. I coughed continuously.

At the airport, I left the first class lounge and boarded the Royal Dutch Airlines jet, again first

class. I leaned back ready to soak in the calm of this luxurious style of travel. The aircraft was

cool and clean and special gifts of Dutch chocolates and mementos were offered. En route, we

stopped only at Abuja(?). It was an all too short hour of luxury.

When we landed I peered from the plane and saw dozens of immaculately dressed nurses in

starched aprons, bibs and frill caps. The other first class passengers were asking the hostess

what was going on but I said nothing. As I disembarked, the 30-nurse guard of honour stood

with military precision. What a thrill! Then I was presented with the customary bouquet. I felt like

royalty! Unfortunately, my beautiful bouquet was full of ants which crawled all over my front as I

posed for pictures.

The route to my lodgings was interesting. We passed through many guarded gates and finally

reached my luxurious quarters –built for use by President Nkrumah. He was a large man so the

bed was double, double size. At night when I coughed constantly the whole, massive bed


After completing my lectures on “Continuing Education, An Essential to Nursing Strategy and

Networks in Primary Health Care” in Lagon, I was scheduled for appearances in various cities

and villages in Ghana. To my delight, I found I was to travel by private, government plane with

Capt. Reynolds as pilot and accompanied by the chief nursing officer.

For each trip, my companion and I boarded the plane and were settled into our special seats.

Only then were the other Ghanaian passengers allowed on with all their goods and chattels.

Before takeoff, Capt. Reynolds would come back to ensure that we were comfortable and to

give us instructions about seat belts, etc. I was very impressed with his decorum and his

concern for us.

At one stop in Northern Ghana, I gave my lecture in a large school packed with students,

villagers, etc. I had difficulty being heard as the large yard was filled with innumerable guinea

hens, which made such a loud racket that I had to shout to be heard. I was told the hens came

only once a year and brought good luck. After shouting for about 30 minutes, I thought I would

lose my voice. I did take time out for coughing.

When we returned to the airport, we could see that here was a problem. A young man had

taken photos with his camera and immediately the military police pounced on him and seized

his camera. Neither the young man, nor we two, had realized that we were in a restricted zone.

The young man pleaded for his camera –without success. We boarded the plane and I asked

my companion to seek Captain Reynolds’ help. When she refused, I boldly walked up to

Captain Reynolds when he boarded the plane and relayed the whole story. He sprinted from the

plane, talked with the military police and returned with the camera, giving it to the young man.

Only the film was removed. My reward was the boy’s most appreciative ear-to-ear grin.

The day after our return to Lagon was a national holiday and we, and other dignitaries, had

special seats for the festivities. I was fascinated by the huge umbrellas carried by aides and

used to shield the tribal chiefs from the hot sun. The parade started and who was the smart,

slim, air force officer leading the entire parade? Our Captain Reynolds.

Later, after my return to Canada, I heard that he had been elected President, an office which

he has held to the present day.

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