When the doctor is out

Sierra Leone used to be the most dangerous place in the world to give birth. Without enough doctors to do C-sections, women and babies were dying. But what if you didn't need a doctor?

This week, the story of two determined surgeons and a no-so radical idea that is saving lives in Sierra Leone — one emergency operation at a time.

You can read more about the non-profit organization the doctors created to fund their training programme at capacare.org

Our guests on today's show are Håkon Bolkan, Alex van Duinen and Emmanuel Tommy.

Here are some of the academic articles discussed in the show:

• Bolkan, Håkon Angell; Schreeb, Johan; Samai, Mohamed; Bash-Taqi, Donald Alpha; Kamara, T. B.; Salvesen, Øyvind. (2015) Met and unmet need for surgery in Sierra Leone: a comprehensive retrospective countrywide survey from all healthcare facilities performing surgery in 2012. Surgery
• Brolin, Kim; van Duinen, Aalke Johan; Nordenstedt, Helena; Hoijer, J; Molnes, Ragnhild; Frøseth, Torunn Wigum. (2016) The Impact of the West Africa Ebola Outbreak on Obstetric Health Care in Sierra Leone. PLOS ONE
• Bolkan, Håkon Angell; van Duinen, Aalke Johan; Waalewijn, Bart; Elhassein, Mohamed; Kamara, T. B.; Deen, G F. (2017) Safety, productivity and predicted contribution of a surgical task-sharing programme in Sierra Leone. British Journal of Surgery
• Treacy, Laura; Bolkan, Håkon Angell; Sagbakken, Mette. (2018) Distance, accessibility and costs. Decision-making During Childbirth in Rural Sierra Leone: a Qualitative Study. PLOS ONE
• Drevin, Gustaf; Alvesson, Helle Mölsted; van Duinen, Aalke Johan; Bolkan, Håkon Angell; Koroma, Alimamy philip; von Schreeb, Johan. (2019) ”For this one, let me take the risk”: why surgical staff continued to perform caesarean sections during the 2014–2016 Ebola epidemic in Sierra Leone. BMJ Global Health
• van Duinen, Aalke Johan; Kamara, Michael M.; Hagander, Lars; Ashley, Thomas; Koroma, Alimamy Philip; Leather, Andy J.M.. (2019) Caesarean section performed by medical doctors and associate clinicians in Sierra Leone. British Journal of Surgery
• van Duinen, Aalke Johan; Westendorp, Josien; Kamara, Michael M; Forna, Fatu; Hagander, Lars; Rijken, Marcus J.. (2020) Perinatal outcomes of cesarean deliveries in Sierra Leone: A prospective multicenter observational study. International Journal of Gynecology & Obstetrics

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