TIME CODE

VISION

SOUND

10.00.00.00

10.00.20.24

 

10.00.00.00

08.02

 

 

 

CAPTION (over hospital images)

EMERGENCY IS A HOSPITAL IN SIERRA LEONE WHICH PROVIDES FREE TREATMENT TO THE VICTIMS OF WAR AND POVERTY

Music Sulyman Jalloh- Mebenala

10.00.08.02

22.11

Luca Rolla in synch- cutaways hospital

LR.People who are coming here are all people in need of urgent surgical treatment after a fresh trauma or children in need of urgent medical attention.

10.00.11.13

14.12

CAPTION :

LUCA ROLLA: MEDICAL COORDINATOR

 

10.00.23.16

24.22

Sara with child

How many months?

10.00.24.22

10.00.38.06

Shots of children in hospital

LR: Emergency decided in 2001 to come to Sierra Leone to give a good level of care and dignity to people who otherwise would be forgotten

10.00.39.15

41.19

TITLE : EMERGENCY

over shots of hospital

 

10.00.46.05

40.06

CAPTION : SARA

 

10.00.57.20

01.06.04

Sara in synch

S:This is just something quick that I do to pick up the very sick ones. Now we are going to start.

10.01.07.06

10.01.30.00

Sara talking to patients

S:We need silence. We're going to explain to you the rules of the place so please sit down.

If I give you the yellow, the yellow, you go and sit on this bench.

If I give you the green you stay seated. I will call you later

10.01.34.07

 

10.01.39.13

Sara

Mother

Sara

S:Why did you come?

Mother:He has a cough

S:Is he still coughing?

10.01.44.15

 

 

 

10.02.01.15

Sara

Mother

 

Sara

Mother

S:This one is small

Mother:It's her tummy, it has been making terrible noises

S:How many days old?

Mother: She's two weeks and throughout the night she didn't sleep. It was making noises

10.02.04.00

10.02.07.09

CAPTION: SUDDENLY SARA IDENTIFIES AN EMERGENCY

 

10.02.10.03

10.02.12.17

Sara carrying child

S:I'm going with an emergency to D ward

10.02.12.18

10.02.24.06

Shots of child being treated

LR: In paediatric department, everyday from Monday to Saturday, at least 100 children plus the emergency cases which you cannot plan and always arrive

10.02.25.06

10.02.28.21

Sara

S: There was respiratory distress and vomiting and we aspirated

10.02.29.00

10.02.39.17

Shots of child being treated

LR: The hospital's bed capacity is 100 beds divided between the surgical and trauma department and medical and paediatric department

10.02.39.20

10.02.52.15

Sara counting

S:How many empty beds? 1, 2, 3, 4, 5, 6 , 7, 8.

This is for this one

10.02.55.03

10.03.09.19

Child being treated

LR: We also receive a lot of medical cases especially the consequences of severe malaria. Unfortunately in Sierra Leone it is still very common disease that brings mortality

10.03.18.24

 

 

 

 

 

 

 

 

 

 

 

 

 

10.04.00.16

Sara back outside in conversation with a boy

S: Young man are you sick? Where's your mother?

Boy: She's not here.

S: So you are alone? Don't you go to school?

Boy: I go

Sara: So what made you not go to school and come to hospital?

Boy: I've got a cold

Sara: A cold! So you decided to come?

Fine I am happy for you

laughs

So you decided no school today, hospital, I am not well.

Sara: So you are a winner. Do you understand? You have to queue and register over there

 

10.04.03.23

 

 

 

 

 

10.04.22.04

Sara talking to nurse in triage

Sara: When I am in doubt, I prefer to take children above five years because if they go to another hospital they will pay. So we try to select the children...

Sara: How old?

Woman: seven

Sara: How old?

10.04.27.23

 

 

 

 

 

10.04.48.21

Sara talking to mother

Sara: I cannot see you today. Ok?

Please, I am sorry. This child is sick, I know.

So you don't want to go home and sit and wait for tomorrow.

How old? Two years? That's fine

So you're not going to have to pay in another hospital

 

Mother leaves.

Sara with head in hands.

 

10.05.06.22

 

 

 

 

 

 

 

10.05.39.03

Sara in synch and images of weighing and measuring

S: Now we start, Now my day starts. 9.40

So I selected 120 patients with yellow and green tags during the normal triage, plus two emergencies. After registration they are going to take the body weight and the height.

After that they take the vital signs. It's a system. Like a chain

This is the only way we can see 120 children per day

10.05.41.10

 

10.05.50.01

Sara talking to mother

S: Ma I cannot see the child toaday. We are full now. Of course I take the priorities and I triage all of them

10.05.52.16

10.05.59.05

Sara plays with girl

S: I will send you away, I will send you away. You are just laughing

10.06.06.22

 

 

10.06.10.24

CAPTION: SUDDENLY A YOUNG GIRL CALLED KADIATU IS BROUGHT IN AS AN EMERGENCY

 

10.06.20.09

 

 

 

 

 

 

10.06.46.12

Dr and Sara attending to little girl

Mother: Yesterday she got sick. She got an injection yesterday and medicine

Doctor: Did you bring her papers?

Mother: I didn't bring the papers. I just rushed out.

Doctor: We need to admit but we don't have a bed right now. We will do a referral paper and send you to another hospital

10.06.55.03

 

 

 

10.07.08.15

Sara

S: I need a motorcar to transfer a child from Goderich.

After she had convulsions at home the mother brought her here. She's unstable now but unluckily we don't have a bed

10.07.11.07

 

10.07.13.07

CAPTION: SUDDENLY A SECOND EMERGENCY IS BROUGHT IN

 

10.07.25.14

10.07.28.15

 

S: Did he convulse in the house?

10.07.33.07

10.07.35.08

CAPTION: KADIATU HAS GONE INTO A CONVULSION

 

10.07.54.12

58.06

Sara

S: we need to get ready to take them in the car

10.08.02.19

 

24.21

Sara talks to mother

S: This is like the passport of the child so keep it. Listen to me. This one, give it to the doctor when you reach Cottage. This is a referral letter. Ok?

Do you understand? Sorry yeah.

10.08.39.13

43.07

Sara at car

S: Baby Sesay? Climb up

 

Car gets ready and leaves

 

10.09.12.00

14 14

CAPTION: DR, MIKE IS DOING THE ROUNDS ON D WARD

 

10.09.16.00

18.12

 

CAPTION: SIX YEAR OLD JOSEPH IS VERY POORLY INDEED

 

10.09.18.12

 

 

 

 

10.09.46.01

Dr Mike attending to Joseph

Dr Mike: Admitted five days ago with a long standing history of cough, intermittent fever and weight loss. No improvement since admission.

So our current working diagnosis, very severe pneumonia, TB Meningitis, HIV infection. So the plan is to add streptomycin

10.09.54.19

59.12

Dr Mike and team examine a baby

Dr Mike: On examination good general condition

Nurse: Fever throughout the night

10.10.05.11

11.14

Dr Mike with baby

The plan is to continue antibiotics for at least seven days

10.10.16.07

28.16

Nurse

Nurse: We work early, which is eight o'clock to four o'clock and the night which is four o'clock to eight AM in the morning. Although it is difficult, we try our best

10.10.28.19

36.05

Second nurse

Nurse: The doctors, especially the doctors in the paediatric department in Emergency, we say bravo to them because they work very hard

10.10.52.06

57.18

CAPTION: MILOS AND MARCO

 

10.11.09.13

25.03

Marco and Milos doing the rounds on an adult ward.

Marco: You didn't eat food yesterday?

Nurse: He said he didn't want food

Marco: Food is like medicine. Tomorrow rice. You should eat well. Tomorrow we will give you rice. Then you can go home.

10.11.25.24

 

 

 

 

 

 

10.11.52.08

Milos and Marco at the bed of a crash victim

Milos:This is a crash victim. Unfortunately we could not save his arm so it was amputated below the elbow.

Marco: He was crossing the street when he was hit by a mini bus. Were you in town when the motorcar hit you? Yes in the town. The bad thing was it dragged you didn't it? After he was hit he was dragged.

 

10.11.53.00

 

 

 

 

 

 

10.12.49.08

Crash victim

Man: When I was crossing I just felt myself being hit. Dragging me. Stranded. Allah, Jesus. People came shouting. The driver got out and ran away.

I work in a hotel. I prepare food for people and I have to use both of my hands. I'm not feeling too good because I have three children. I have three kids. All of them go to school.

So I live only to God now

10.13.00.17

 

 

 

 

10.13.25.07

 

Marco: Kadi, does your foot hurt now?

Milos: She's six years old right?

Marco: She sustained this fracture in the provinces and was mistreated by a medicine man. She developed gangrene in one week. Now all the limb is necrotic and amputation is the best option

10.13.35.00

40.12

CAPTION: KADI IS SEVERLY ANAEMIC AND NEEDS A TRANSFUSION BEFORE SHE CAN BE OPERATED ON

 

10.13.44.06

10.14.18.10

Images of xray and operating theatre

Music "Life of Today" by Sinbob

10.13.57.21

14.02.12

 

CAPTION: MANY OF THE PATIENTS ARE VICTIMS OF ROAD TRAFFIC ACCIDENTS

 

10.14.21.00

 

 

 

10.14.45.03

Images in operating theatre

LR: In 2011 we performed 2000 operations and in 2012 we performed 3300. 80% of the activities are done in an autonomous way by the national staff and for the major cases they still need the support and supervision of the expatriate staff

10.15.07.00

10.15.59.21

Images of sterilisation

Music : Xander Project- Indonesia

10.15.27.00

29.24

Images of operations

Nurse: Mama relax, everything is fine

10.15.38.20

41.12

 

Nurse: We are finished

10.15.59.21

16.12.10

Men with bone operations

Man: We don't pay.

2nd Man: They don't ask for money. They feed you. They give you clothes. Sleep free. Eat free.

10.16.25.06

 

 

10.16.38.24

ICU unit- looking at baby

Giovanna" 19 days of life

Nurse: 3.33 kilograms

G: 3.33 so it is increased or decreased?

Milos: Increased

G: Increased? No, gimme five

10.16.37.07

39.12

CAPTION: GIOVANA

 

10.16.44.09

46.23

Walking away from baby

G: She's less ugly than she was before

10.16.53.16

 

 

 

10.17.08.15

Woman patient

Marco: In the end she has closed the right humerus, open the right forearm, close the right femur. We give priority to the open fracture.

G: Tell her she must drink

Marco: Today we will let you eat and drink

10.17.11.24

 

 

 

 

10.17.29.11

Milos talking to female patient

Milos: Mama, it's broken here. Do you feel it?

No? It's broken here, it's broken here and here and here. That's the reason you cannot sit up. But we'll fix you.

Saturday we operate and we fix everything and then you can sit up

10.17.39.00

48.14

At the bed of a burns victim boy

G: As he is now we go on phenobarbitone IV and we see how he behaves and we keep him on fluids today

10.18.01.13

13.00

With Ellie Komba the road traffic victim

Milos: We'll put two leans, one here, one here and gently turn you on your side. We'll clean you and dress you. You won't feel anything. We'll give you something for the pain.

10.18.13.19

25.15

Changing EK's dressing

G: I'm here. I'm here to help you. No that way. Don't worry, you do nothing. We move you. You must trust me.

10.18.26.22

33.06

 

Milos:Dressing trolley on this side. Then this bed comes here. This is for head, this is for legs

10.18.35.05

40.11

CAPTION: ELLIE KOMBA WAS HIT IN THE BACK BY A BUS AND WAS SO BADLY INJURED SHE'S LUCKY TO BE ALIVE

 

10.18.40.11

44.20

CAPTION:HER BACK WAS CUT OPEN. HER PELVIS BROKEN. HER ARMS AND LEGS TORN

 

10.18.50.06

54.01

Changing dressing

G: We're just taking away the soaked dressing

10.19.01.11

15.03

EK being changed

G: She's just cold

Milos: Take the gauzes and just clean, nothing else

G: Tomorrow she will go in the operating theatre anyway. Mama. Shake your foot

10.19.15.04

 

 

 

 

 

 

10.19.53.23

EK's dressing being cleaned and changed

LR: When she arrived she had major trauma on the back with all intestines outside. Plus she has multiple fractures on the femur, on the humerus and on the radius. The main part at the beginning of our attention was to stabilise her condition especially the abdominal problem. We ran her to the operating theatre and she had a long operation of four or five hours

 

 

Thank you ICU

10.19.59.13

20.01.13

CAPTION: NEXT DAY

 

10.20.05.11

08.17

CAPTION: KADI, THE SIX YEAR OLD NEEDING AMPUTATION HAS DIED IN THE NIGHT

 

10.20.15.00

18.11

CAPTION: ELLIE KOMBA, THE ROAD TRAFFIC VICTIM, IS IN THE OPERATING THEATRE

 

10.19.59.13

20.18.11

Shots in operating theatre

Music: Bottle by The Furious

10.20.21.18

30.14

Operating theatre

Surgeon: The right hip is higher. And apart from that you can see four fractures

10.20.31.18

36.14

CAPTION: AFTER THREE DAYS OF CLEANING SHE CAN FINALLY BE STITCHED UP

 

10.20.47.11

 

 

 

 

 

10.21.20.00

 

Giovanna: She was hit by a car from the back and cut, as if it was an axe. She also has a very bad injury on the arm and leg. The skin has been taken away and this is very difficult to manage. In the future she will need skin grafts all over the body. But she has survived and she is awake and there's no nuerological defects.

10.21.28.16

30.19

CAPTION: THE LAUNDRY...

 

10.21.34.03

 

 

 

 

 

 

 

 

 

 

 

 

10.22.15.21

Laundry

Laundry guy: without laundry..no emergency

2nd guy: We are part of the life saving process of emergency. We contribute a lot to the surgical processes in the hospital.

3rd guy: We are working with the theatre and we work together. Without laundry the theatre cannot function.

4th guy: When they do the operation in the theatre they send it down this side. We bring it to this area to wash it properly then put it in the machine.

3rd Guy:They do not allow us to wash them with our hands because of the germs and diseases that come from different patients.

10.22.23.14

35.19

Laundry

Laundry guy: Sierra Leoneans in General had a problem after the war with hospitals. The coming of Emergency has been a revelation. People are benefitting a lot in the surgical area.

10.22.44.01

23.06.10

 

Nurse: She has been improving greatly, but it is not easy as you can see. She had polytrauma. She's conscious. She can speak. The only thing for now she is under anaesthetic but she's conscious. We have cases that are like this before and they recovered so I hope and I think she is going to recover too.

10.22.47.13

49.22

CAPTION: ELLIE KOMBA IS BACK IN I.C.U

 

10.23.06.24

 

 

 

 

 

 

 

 

 

 

32.16

Milos and nurse at Ellie Komba's bed

Milos: Tell me, fever?

Nurse: No fever

Milos: No spikes of fever and urine output?

Nurse: Urine output is good.

Milos: Is she fully awake?

Nurse: Not fully yet because they said when she is fully awake to start sips. She's not fully awake yet.

Milos: Start sips in 5 or 10 minutes. Then later we can treat her

Noise from patient

Milos: Ah, fully awake

10.23.33.07

47.13

Nurse

Nurse: Some people recover fast, some people it takes time depending on the diagnosis so I think she will be here first for some period but she will recover. That I am sure of. Definitely.

10.23.47.16

24.07.19

Giovana

Giovanna: I've worked for 40 years in Italy, in a big city, Milan. A lot of trauma. A lot of accidents but I've never seen what happens here.

People drive used cars. They can't drive properly and cars have no brakes

10.24.08.12

24.11.05

CAPTION: O.P.D. - OUT PATIENTS DEPARTMENT

Screaming child

10.24.13.10

 

 

 

27.05

Nurse attending child with leg injury

Nurse: she was knocked down by a vehicle. She was on her way home from school. She was about to cross and was knocked down by a vehicle.

I'm finished, I'm finished

10.24.28.01

 

42.07

OPD people and child, getting scanner

Sara: Mariama don't be afraid. We're going to look at your belly. I asked for a chest xray because I thought it was TB. But it's not TB.

Even Michael looked. It's not TB

10.24.57.07

25.03.06

 

Marco and Michael looking at screen

Marco: You see the kidney is normal, you see? The spleen?

10.25.09.01

22.06

Looking at scan

Marco: to me it looks more like a solid mass which means the only thing you can provide is a surgical exploration of the abdomen which is not the next step I would advise.

10.25.23.20

 

 

40.06

Sara

Sara: Because the surgeon thinks it is a splenic mass we're going to refer the child to another hospital for more investigation and possible surgery

10.25.41.21

26.51.05

 

Music: Xander Project- Indonesia mix down

10.25.51.08

26.00.22

Shots of hospital

LR: We are the referral centre for the whole country in traumatology and for infant and paediatric surgery

10.26.01.17

05.08

CAPTION: BURNS AND ROAD TRAFFIC ACCIDENTS FREQUENTLY REQUIRE SKIN GRAFTS

Music continued

10.26.24.20

 

 

42.01

Operating theatre doing skin graft

LR: We have at this moment 379 national employees counting from none medical to medical staff and ex-patriot staff in the field we are 13 ex-patriots

10.26.48.20

 

 

 

 

54.14

CAPTION: BACK ON D WARD. KADIATU, BROUGHT IN YESTERDAY WITH RESPIRATORY DISTRESS, IS MAKING PROGRESS

 

10.26.55.08

27.07.18

Nurses doing wash out

Nurse: when we put in the bag you can see there is green liquid and we were asked by the doctor to do a stomach washout so we are going to wash the stomach

10.27.13.08

 

 

 

 

 

36.22

Shots of childrens ward

Nurse: This is the contents of the stomach before. Thats why we decided to do the wash out. I'm monitoring the third transfusion. We do the vitals at 15 minute intervals twice, then 30 minutes twice then once an hour after that until the end of the transfusion. In case of any reaction or side effects

10.27.37.07

 

 

 

 

 

28.06.08

Children's ward

2nd Nurse: Working with children makes you learn a lot because the child will never complain to you, especially the young infants. They won't tell you -this is how I am feeling. We get some very difficult cases but thank God, with the help of our doctors and us, we work very hard to save lives. This month we admitted 107 patients and we just had two deaths.

10.28.05.24

10.29.59.00

Children's wards

Music: Bottle- The Furious

10.28.12.01

16.16

CAPTION: JOSEPH, THE SIX YEAR OLD BOY WITH TB MENINGITIS, IS VERY POORLY AND MAY NOT SURVIVE THE NIGHT

 

10.28.41.13

43.08

Children's ward

Sara: He seems stable

10.28.48.02

54.13

Sara and nurse

Sara: Me, I miss my mum

Nurse: me too I miss my mum

10.29.21.01

23.21

CAPTION:JOSEPH DIED IN THE NIGHT

 

10.29.27.17

30.22

Sara

Sara: At the end of the day you're destroyed but you're happy anyway

10.29.31.07

35.19

CAPTION: ELLIE KOMBA HAS BEEN DISCHARGED AND IS NOW IN PHYSIO-THERAPY

Music- as above

10.29.36.00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10.29.54.20

CREDITS:

THANKS TO

EMERGENCY HOSPITAL, SIERRA LEONE

 

SARA RADIGHIERI

DR. MARCO NECCHI

MILOS JONIC

DR MICHAEL MAWANDA

DR. SEBASTIANO GIRMENIA

DR. YILLIAH JOHN

DR. ANTON LUGO

DR. GIVANNA ZANETTI

 

CAMERA ASSISTANTS

GIBRILLA KAMARA

EUGENE SWARAY

 

MUSIC

THE FURIOUS

XANDER PROJECT

SINBOB

 

CAMERA

SINNEH N SESAY

HAZEL CHANDLER

 

DIRECTOR

HAZEL CHANDLER

 

THANKS TO ALL THOSE PATIENTS WHO WERE FILMED

Music as above

 

END

10.29.59.00

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