Masanga Hospital is a 120 bed government district general hospital in rural Sierra Leone – a country still dealing with the devastating consequences a civil war in the 1990s and the Ebola virus epidemic of 2014-2016.

Masanga has a strong reputation across the country for its surgical services. This reputation has been enhanced over the last 15 years as the hospital capacity has grown and a surgical training programme led by Capacare, a Norwegian charity, was established with its base in Masanga Hospital. This programme trains community health officers to perform lifesaving surgeries and graduates of this programme now perform over half the surgeries in the country.

Additionally, Masanga has become a centre for trauma and surgical care with patients travelling from the capital Freetown, and even as far as Guinea and Liberia. Comparatively, the anaesthetic capabilities are significantly less developed at Masanga and throughout Sierra Leone. Anaesthesia techniques across the country suffer from an overstretched work force and very limited equipment and medications required for the safe practice of anaesthesia. This leads to patients dying needlessly from anaesthetic complications during surgery due to an absence of reliable anaesthetic techniques and equipment.

In the last few years there have been some small steps in the right direction including the hiring of an experienced anaesthetic nurse as head of department at Masanga and the purchasing of new equipment such as an anaesthetic machine.

The Bangor Masanga Partnership was established in 2024 by members of the Ysbyty Gwynedd Anaesthetic Department who have previously visited Masanga Hospital and the nurse anaesthetist who leads the department at Masanga. The partnership aims to support the development of anaesthetic services at Masanga through reciprocal visits by members of both teams, training courses, equipment procurement and financial support for running costs.

Staff at Ysbyty Gwynedd have much to learn from the ingenuity and adaptability of professionals at Masanga who practise in a demanding environment with severely limited resources. The partnership hopes to emulate the success of surgical training at Masanga by contributing to anaesthesia development across the country through ‘train the trainer’ programmes. Current and prospective projects include:

- Masanga’s head of department to visit Ysbyty Gwynedd in November 2024

- A regional anaesthesia course to be delivered at Masanga in February 2025

- Purchasing a new anaesthetic machine and ventilator for Masanga’s operating theatres

- Establishing a high dependency unit (HDU) at Masanga for care of the sickest patients following major surgery and providing ongoing training for staff

There is a great deal of excitement and enthusiasm for the new partnership at both institutions and we are sincerely grateful for any support going forwards.