Mercy Ships’ Education, Training, and Advocacy (ETA) department is supporting a new program aimed at reducing surgical infection rates at Connaught Hospital in Freetown, Sierra Leone. As a component of its Safer Surgery program, 20 nurses are attending a two-week, hands-on training about sterilisation processes.

Mercy Ships has partnered with the Sterile Processing Education Charitable Trust (SPECT) to administer the training. SPECT is a nonprofit organisation founded in 2013 to address a critical gap in healthcare: the lack of effective sterile processing education and training in resource-constrained settings.

“These participants are learning the standards for sterile processing in surgical environments, how to clean materials, how to store materials, and the best practices to keep a safe operating room so that they can reduce surgical site infections as much as possible,” said Massiami Soumahoro, Education Training and Advocacy Program Officer.

“We want this training to contribute to strengthening the entire healthcare system in Sierra Leone, and make sure that the nurses who will be trained during this period will not only serve in Freetown but will go on to impact the entire healthcare system in the country.” Research on surgical site infections (SSIs) in low-resource settings reveals considerably high rates compared to wealthier countries, often ranging between 10.9% and 70%. This variability is largely attributed to limited access to infection-control resources, such as proper sterilisation equipment as well as infrastructure challenges that impact postoperative care and follow-up.

Studies conducted in various low- and middle-income countries (LMICs) report that these elevated SSI rates pose significant health risks and economic burdens on both patients and healthcare systems. This underscores the need for targeted interventions to reduce infection rates in these regions.

To address these challenges, SPECT worked directly with nine nurses from Connaught Hospital’s Operating Theater and another 9 from the wards. Two participants are staff from the hospital’s Infection Prevention and Control (IPC) unit.

These nurses gathered in a training facility for two weeks, listening to lectures, watching presentations, and actively participating in sterile cleaning and processing exercises. They dressed in scrubs and gloved up, began soaking metal tools and devices in different mixes of water, and specialised soaps and chemicals.

Participants began taking turns scrubbing over different metal tools, from scissors, tweezers, prongs, and scalpels; removing organic material that had become caught in their intricate grooves. They inspected each other’s work, providing feedback and tips as each nurse took a turn at a soapy bowl.

Each one learned what to do at different stages, from how to prepare a cleaning station to the correct disposal of the dirty water, ensuring that tools would not be contaminated after they had been cleaned.

Larry Lawrence, an operating theatre nurse, said the course helped him greatly.

“This training has helped me understand how to sterilise the instruments properly, immediately after an operation. We’ll also be able to go back and train other staff on how to do this,” he said. “The rate of infection in the hospital will get better through the intervention of Mercy Ships.”

Another student, Kardiatu Kamara, a nurse in Connaught’s oncology ward, echoed the sentiment.

“This course is important because if we keep on working without sterile processing, we’ll create many burdens in our health sectors. If we treat patients without using these sterilised processes, or if we use instruments without processing them, we’ll find out that we have so many cases of infection. As a result, it will cause a burden to the government, health workers, and patients,” she said.

“It’s a privilege for me to say a very big ‘thank you’ to the government of Sierra Leone and Mercy Ships. As you have been training us in sterile processing and mentoring us, we are so grateful. I just want to say a very big thank you – bravo, bravo to you all. May God continue to bless you and thank you for everything,” she said.

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