Connaught Hospital in Freetown is the country’s oldest principal adult referral hospital founded in 1912. Despite being home to some of the country’s finests consultants , specialists and other highly trained and qualified professionals but many still find it difficult to go there when the need arises.

Most tend to opt for less equipped or small facilities, remain at home, or turn to traditional remedies regardless of the levity or seriousness of their condition. This bypass is obviously costing lives and one of the main reasons for late presentation.

As Sierra Leone’s principal referral center for complex surgeries, critical emergencies and specialist consultation it serves patients from all over the country, some of the cases are referred by private practitioners. Public attitude towards the hospital may have been shaped by personal experience, culture and beliefs and the perception that it reflects the general state of public services. One patient who accompanied a friend to the hospital said she would not choose Connaught after the incident that involved her mother, she was rushed to Connaught after an attack and was stabilized few days later after she was discharged she suffered another attack and unfortunately lost her life. Another patient described the total opposite experience, she said after receiving IV fluids at a small clinic with any proper diagnosis she felt worse, she was rushed to Connaught and recovered quickly following treatment.

Although my training in the teaching hospital as a medical student and now in my own interaction as a new medical doctor under the supervision of senior colleagues I have been able to observe a range of patients’ experiences and happenings at the hospital. I am not in any way dismissing or reducing any of the concerns people raise, because they are often rooted in real experiences or opinions. Largely in other words I have also seen that many patients arrive at Connaught very late in the course of their illness. In most of these cases, the patients ended up losing their lives or ending up in a terrible condition.

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Definitely, the primary health centers and private clinics are most times the first choice for many people, especially first choice for many patients especially since they are usually closer, easier to relate to, and have shorter waiting times. In the urban areas like Freetown and Bo, private clinics have increased in recent years, attracting patients with a more relatable service; however, some of these facilities lack the man power, skills and or equipment needed to manage serious medical conditions. Timely referral is really required because it is difficult for patients to tell what and what to take to their primary health facilities, but too often, these clinics delay, making it harder to save lives.

The World Bank database shows that more than 70 percent of current health expenditure in Sierra Leone in 2022 came directly from out of pocket spending. With limited health insurance options, awareness or willingness and other formal health financing systems not widely practiced, many people find it difficult to resolve these government facilities.

At Connaught Hospital, a 2018-2021 retrospective study published in BMC Cancer reported that 47 percent of breast cancer patients presented at Stage IIIB and 13.8 percent already had metastatic disease on arrival (BMC Cancer, 2025). Similar patterns can be noted in other urgent conditions such as appendicitis, stroke and severe infections, where patients tend to seek help from under equipped clinics, traditional healer such, or spiritual providers, losing valuable treatment time and this can be the only mistake a patient can do that can cause them their precious lives. While Connaught faces its own form of challenges, especially if you can’t afford very expensive hospital bills, it still remains the only hospital in the country able to deliver full surgical, emergency and specialist care under the same roof. Connaught may be of help to you, if you present early.