FREETOWN: Seven-year-old Carlos Kamara needs urgent surgery on a collapsed lung after he swallowed a toy whistle. Instead, all he can do is lie in pain in a half-empty hospital ward waiting to be seen.
A doctors' strike in Sierra Leone has paralysed an already threadbare health system in one of the world's poorest countries, leaving its biggest and busiest hospitals in disarray, the sick unattended.
It represents a new low in Sierra Leone whose ranks of medical staff were hit by the Ebola outbreak of 2013-16 that killed 250 medical workers out of nearly 4,000 in total.
That came after a diamond-fuelled, 11-year civil war that ended in 2002 and cost the lives of about 50,000 people.
Recovery has been hobbled by a steep drop in the price of one of Sierra Leone's biggest exports, iron ore, hampering investment in public health.
"Seeing my son like this, in so much pain ... the government must resolve this quickly or soon there will be blood on everyone's hands," said Kamara's mother Khadija in a children's ward at Freetown's Connaught Hospital.
A first attempt to remove the whistle on Dec. 3, the day before the strike began, was unsuccessful. Now he lies in bed, barely able to sit up and sip water, a tube running from his chest to a bag filled with bloody fluids.
In ten days after that initial surgery, he has been seen twice, his mother said.
The doctors in public hospitals are protesting against low wages and poor conditions which include a lack of the simplest medical aids, like oxygen.
"PEOPLE ARE DYING"
"It brings us no joy to do this," said Dr Sulaiman Lakkoh, a senior infection prevention specialist at Connaught who joined the strike last week. "People are dying in our absence, but not as many as will die if the government continues to neglect hospital conditions."
Representatives of Sierra Leone's Medical and Dental Association (SLMDA) said the strike could stretch into next week before agreement is reached with the health ministry.
Health Minister Alpha Wuri declined to comment.
Community health workers without formal medical training, as well as international medics working for charities who have come to help, are taking care of patients.
Many people have chosen to stay away from hospital during the strike if possible, and most of Connaught's wards were empty. Yet dozens of patients meandered around the courtyard or slept on cardboard mats in halls, waiting to be assigned a bed.
The country's only maternity hospital, the Princess Christian Maternity Hospital, is as busy as ever and in chaos, said aid sources on condition of anonymity.
Saidu Teteh Kamara, a middle-aged man unrelated to Carlos, has waited at Connaught for four days to be treated for jaundice, his eyes yellow and stomach swollen to the size of a beach ball.
"The government must take this seriously or people will die who didn't have to," he said, talking slowly and gripping his stomach.
(Writing by Edward McAllister; Editing by Andrew Cawthorne)