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
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.
View all posts in this series
- Autobiography Introduction - December 12, 2011
- Pilot Project for Evaluation of Schools of Nursing
- Appointment as Director of Special Studies – CNA
- Survey of 25 Schools of Nursing
- Executive Director – Canadian Nurses Association
- Canadian Nurses Foundation
- 1965 – 1966 CNA activities and CNA House - January 2, 2012
- PAHO/WHO Project in Commonwealth Caribbean - December 12, 2011
- 1965 International work
- 1969-1975 International Work - January 3, 2012
- Commonwealth Nurses Federation – West Africa, 1981 - December 12, 2011
- Encounters with Fidel Castro - December 22, 2011
- Autobiography Outline - December 12, 2011