It was April 16, 1953, in the third year of
my first term in Sierra Leone. I was at that time a Medical
Technologist, working in the laboratory of our "bush"
hospital at Rotifunk. Dr. Mabel Silver was the doctor. The only
nurse/midwife had left not long before for furlough. I was
concerned about Dr. Silver, for the load of work was too much for
her, made doubly difficult because of the lack of a nurse. While
we had African staff, who were very loyal, at that time the
nurses had little training (more like nurses’ aides). Ernest
Kroma, our dispenser, was indispensable.I knew that Dr. Silver had had a heart attack some years earlier. One evening at supper, I said to her, "Dr. Silver, I think you should tell me what I should do if you should have another heart attack." She laughed, and said she would tell me if it came to that. I reminded her that she might not be able to tell me. So she told me what injection she should have.
It was only the next day that she came home very tired late in the afternoon, after seeing four hundred patients. I was in charge of housekeeping, and gave direction to meal preparation. When supper was ready, I went to her room where she was lying down, and called her. She said, "I think it is time for that injection." She was having severe pain from an angina attack. I ran to the hospital to see our head nurse, "Mama Abby," and told her I needed her to bring the injection. I asked her not to tell anyone else what had happened. She gave the injection, and after a little while the doctor asked me to have the nurses bring over the charts for the patients in the hospital, as she wouldn’t be able to go over! One did so, and she got up to write orders. A little later, a Lebanese woman came to the door, saying that a young woman patient we had seen that afternoon was coughing up blood. I had not had time to report the lab findings to the doctor, so I told her then that the sputum was full of tubercle bacilli. Since the Lebanese were financially able, she told me to tell Mama Abby to go give an injection of morphine to the patient, and then tell them to take her to Freetown (the capital city) as soon as possible.
I was very concerned, because I knew that Dr. Silver could have another attack and die at any time. So I went down the hill to the railroad station, and asked the Station Master if there was a goods (freight) coming through that night (I knew there were no passenger trains until the next day), and at that time there were no roads. I explained that I must get Dr. Silver to a doctor in Freetown, and asked if it would be possible for me to take her on the train. He was very willing to make arrangements, and I went back to see Ernest Kroma. I asked him not to tell anyone else because I knew a lot of people would be upset if they heard that Dr. Silver was so ill, but told him I would need him to come with some men at about 2:00 a.m. to carry her down on a lawn chair we had. I then went back and told the doctor of the arrangements I had made, and said, "You will go, won’t you, Dr. Silver?" She gave an answer so typical of her--that she would, because if she didn’t she knew it would be an extra worry for me!
It happened that an English woman, who was teaching at our Harford School for Girls, about 20 miles away, was with us in order to have a physical exam. I asked her to help me by packing a suitcase for Dr. Silver. When she finished, she said, "I have put in a pair of white gloves, too." I said, "Why would she need white gloves?" Her answer, "Well, you know that in Freetown she may need to go to some official event, where she would need the gloves!" It wasn’t until later that I laughed about this. I am sure she had no idea how ill the doctor was.
I was able to get into a box car with the doctor as
planned, and went on the trip of 55 miles--a very slow trip. I
found that the Station Master had phoned the hospital in Freetown
and talked to the head nurse (who was from Rotifunk, and had
known Dr. Silver since she was a girl). At about 8:00 a.m. we
reached the point where the road from Freetown ended, and she
herself was there with an ambulance. I of course went with them
to the hospital, and then went to the Mission House in the town.
I had had no sleep all night, and of course had been under great
stress. I was glad to eat a little breakfast, have a bath, and go
to bed!Later in the day I went to see Dr. Silver, and wrote down a list of instructions. I would not be able to treat any patients (legally), and would have to send them away. We had T.B. patients in the hospital which were being treated with a new medicine, and she told me the symptoms that might occur, in which case I should stop the medication. Some outpatients were taking a series of injections, and the dispenser and I could treat them. I returned the next day to the hospital, where I was in charge! For the next two weeks I worked to close down the hospital. It was very difficult to send away people who had come from miles around, many of whom had no other place to go for medical treatment. To them, all white women in white uniforms were "doctors," and they could not understand why I could not treat them.
Time does not allow me to tell about the child who was brought in with cerebral malaria (I confirmed that in the lab), and who died later, in spite of the treatment which we gave her (we couldn’t turn her away!). I felt very bad about that. Later, Dr. Silver recovered, and persuaded the doctor who took care of her to allow her to stay in Sierra Leone instead of returning to the States. Eventually, she came back to Rotifunk, supposedly to work part time. By then we had a new nurse from the States, and a midwife from England. Then both of them became ill with a mysterious viral disease which was never diagnosed--but that, too, is another story!