Medics running a clinic in a coastal slum of Sierra Leone's capital, Freetown, are keeping a diary for the BBC News website about their work.

In this instalment, nurse Adama Bangura brings the latest from Kroo Bay clinic, where nearby shanty houses have been built on a rubbish dump on the banks of the Crocodile River.

"My colleague Adama Gondor, who runs this clinic, has been away attending her graduation and I have been left in charge.

The biggest emergency we have faced in her absence has been a possible case of pre-eclampsia - a condition where the pregnant woman has high blood pressure and swells up.

It may kill both the baby and the mother.

A young pregnant woman came in. It was her first birth and she was in labour.

She had a high temperature and as soon as we asked her to push she started having fits and her blood pressure went up.

We knew she might have pre-eclampsia and that she needed to go to the hospital as quickly as possible.

We called her relatives and told them that they must take her to the hospital - fast.

First they pleaded with us, saying, "Please let her stay. She will make it... she can deliver here."

They were worried about possible medical fees at the hospital.

We had to explain how serious it was - that both mother and baby could die, but that if they got her to hospital everything would be fine.

Lack of facilities

They decided to take her - every family member gave a bit of money and they rushed her to the hospital.

Happily, the next thing we heard was that she safely delivered her baby.

But it is not always like that.

Sometimes we refer people and they don't have the money - they tell us they are going to the hospital and then they go home.

It is really difficult to convince people in the community here as they are poor and don't always understand how serious certain conditions are.

When we hear such things we become sad, it makes all our work seem in vain.

Patients who come to our clinic pay between $1 and $2 for treatment, less than at the hospital. But we don't have the facilities, drugs or the equipment to treat serious cases, so we have to refer them."


Source: BBC