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A Doctor Opens His Doors to the Victims of Sierra Leone's Rebels

Episcopal News Service. April 15, 1999 [99-050]

(ENS) Despite the searing television images of exhausted refugees and the rubble created by NATO missiles, Kosovo remains far from the only trouble spot in the world today. Dr. Kojo Carew knows that only too well. At two small, overworked clinics in Freetown, the capital of Sierra Leone, he and his wife, Dr. Lynette Palmer, treat victims of the vicious warfare that has plagued their country for more than eight years.

"I decided in 1997 that those who have received the brunt of the rebel war should benefit from the best that the country has in private care," said Carew, who opened the doors of the 20-bed clinics he heads to take in hundreds of patients who had been wounded or maimed by marauding rebels.

The most recent wave of violence by the army of rebels seeking to overthrow the country's government began in northern Sierra Leone in late December. On January 6, rebels attacked Freetown. Fighting forced many out of their homes, he said, recalling that his clinics, Netland Hospital and Curney Barnes Memorial Hospital, were packed.

"At the peak, we had 111 patients in beds all around," he said. "We used the garage space, utility rooms, the corridors. Wherever there was space, there were patients. And we had the relatives of patients who stayed, too. They were terrified to go back to their homes.

"And apart from the bed patients, we had 70 to 80 others who had less serious wounds but who had nowhere else to go, so they stayed on the hospital campus for protection and for feeding because we provided meals to patients."

At one point about 300 people filled the buildings and grounds, he said. People arrived in a steady stream, many bearing wounded relatives on pushcarts or on their backs. "Often people came late to the hospital," Carew said, meaning that many were trapped in their homes, unable to get to the hospital until days after they had been wounded. By that time, he said, they had become weak through loss of blood and were susceptible to infections. Rebels struck in many neighborhoods, inflicting the machete wounds -- cutting off hands, arms, ears, tongues, and feet -- a technique for which they are infamous.

For a few days at the beginning of the recent attacks, Carew said, he and his wife worked on their own, bearing the brunt of the costs. "The International Red Cross came to my rescue, and they have been at my side since the present onslaught began on January 6."

Deep commitment

The couple's commitment to caring for their patients runs deep. During a recent interview, Carew studied a photograph of a young woman lying in one of his hospital's beds and remembered her story -- just one of the thousands of stories of people he has heard and helped.

"This is a 23-year-old mother," he said. "She has a three-month-old baby. The rebel soldiers put their house on fire, and they took the baby from her in order to throw it into the fire. She resisted, and they shot her. We managed to save her leg, but she was so sick when she arrived at the hospital that she couldn't nurse her child. So I went to my house and got some of the milk that my wife and I had for our six-month-old son, Jermaine Nnamdi, and gave it to the woman's child.

"They're still in the hospital, but they're doing fine now," he added, pointing with a smile to the picture of mother and baby, who was peacefully nursing again.

Another patient's story brought Carew to the United States for a recent short visit. Sylvester Kaikai, a 24-year-old, had been shot in the head by rebels. Although his condition had been stabilized at the hospital in Freetown, it was clear that a neurosurgeon would be needed to remove the bone fragments embedded in the man's brain and to deal with the bullet itself, which was resting on the floor of his skull. A way was found to airlift the man to a Little Rock, Arkansas, hospital, where a neurosurgeon performed the work without a fee. Carew accompanied his patient and watched the operation.

The man's prognosis is good, said Carew, noting that while the bone fragments had been cleaned out, the bullet was left in place. "It is near a very delicate area," he said, "but it is at the bottom of the skull, so it won't move. It's best to leave it there."

Carew took time during the man's post-operative recovery to fly to New York City for a brief visit with, among others, Richard Parkins, director of Episcopal Migration Ministries, who toured Freetown and a number of refugee camps in Sierra Leone last year.

Beyond evil

The conflict in Sierra Leone is unusual, Parkins said recently, because "it's not ethnic, it's not tribal, it's not even political. It's about greed." At the center of it all are the country's rich supply of diamonds as well as Sierra Leone's growing importance as an international transfer point for illegal drugs. And, Parkins added, the exploitation of the country's large pool of very poor people, who are being recruited to fight.

This includes children, Carew said, explaining that often the rebels kidnap youngsters, feed them cocaine, arm them with machetes and send them out to hurt as many people as they can.

"This is beyond evil," Parkins said. "There's almost no way to explain it."

Further, it poses problems for future attempts at reconciliation. "What do you do with a nine-year-old who has seriously wounded people in his own village?" Parkins said. "Even their own mothers won't take them back, and there are thousands of these kids."

Carew nevertheless retains some optimism, in part because of his faith. He is an Anglican, a member of St. George's Cathedral in Freetown. "My father is still a member of the choir there," he smiles.

While the atmosphere remains tense in Freetown, the violence has abated slightly in recent weeks so Carew's hospital campus now houses only 76 patients. Some patients have been moved to the country's national stadium in Freetown, a sports facility that is now home to 40,000 displaced persons, most of whom live there without shelter.

Asked if he would flee the country with his wife and son, Carew replied that he will stay, "Sierra Leone is my country, and it's a beautiful country," he said. "I cannot see ever leaving it."

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