Mr. Joseph Fobbie, Manager (Administrator) of Adventist Health System





Waterloo Hospital is the flagship facility of the Adventist Health System of Sierra Leone, it is currently also the only facility in the System, but that hopefully will change soon.  Waterloo Hospital (WH) has many things in its favor such as:

  • Ideal location along the Waterloo-Masiaka Hwy
  • Close to the new airport
  • Committed staff with good morale
  • Intelligent competent staff
  • Good Leadership
  • Solid western connection
  • Support of the local church/mission
  • Little government competition in the health care arena
  • Good relationship with ADRA
  • Post Ebola support

WH also is exposed to a number of challenges:

  • The theatre is poorly equipped
  • The hospital is only set up for 22 beds, too few for adequate income
  • Guest housing is too limited, no room for volunteer groups
  • There is no staff housing on campus for staff who need to be on call
  • No OB coverage
  • Inadequate laundry facilities for efficiency
  • Limited Staff education
  • Inadequate facilities for administration
  • Inadequate computing power/software for maintaining accurate financial and inventory records
  • Inadequate space for PT
  • Inconsistent power and water supply
  • Lack of Blood Bank
  • Lack of climate controlled environment for lab supplies and pharmaceuticals
  • Lack of adequate cafeteria
  • Lack of conference and training facilities
  • Need for a new physician housing
  • Lack of satellite/feeder facilities

Waterloo Hospital is poised to be a major player in health care in SL.  However, unless major capital improvements are done very soon we will be passed over by the government and other NGO/private facilities.



  • Automatic BP cuff   $40-60

  • The GFI electrical outlets for the autoclaves    $100

  • Voltage transformer 220-110   $100-150

  • Hemocue test Strips   $168/100
  • Oxygen Concentrators   $500
  • Generator 4KW   $1,300
  • Industrial Washing Machines/Dryers  $2,000/ea

  • 4WD Vehicle for Community Outreach  $9,000

Our current washing machine. The clothes line works great as a dryer in dry season, not so well in rainy season.

Capital Improvements


Completion of Hospital Extension:

This will increase bed capacity to 46-50 beds (depending on configuration), giving us a men’s wing and women/children’s wing.  In the men’s wing we will have an 8 bed surgical ward and 8 bed medical ward as well as two semi-private rooms, 2 or 1 bed each.

In the women’s wing we will have an 8-10 bed post-surgical and post-natal ward, and an 8-10 bed medical/pediatric ward.  There will be two 2 bed semi-private rooms for infectious pediatric cases and 2 private to semi-private rooms for adult women (one to two women per room).


One of the new wards waiting completion

This does not include the completion of the L&D room, but that would not be necessary until April, 2017 and would probably cost around $11,000.

TOTAL (Excluding L&D) –                                    $20,000 FUNDED!

            With Labor and Delivery                          $30,000

Upgrade Theatre 

The operating theatre is not more than minimally functional due to lack of equipment and training of the staff.  By God’s grace a new functioning OR table, suction and cautery and a surgical headlight are on their way to Waterloo.  However, we are still using a desktop dental autoclave for sterilization.  And although the headlight is a temporary solution, we still need a good overhead light in the major theatre.  And we need cabinets for storage of supplies in the rooms.


Operating with 2 of 5 working bulbs, and a goose neck light that does a great job lighting the back of my hand.


  • Overhead lighting in major and minor theatre ($10,000)
  • Autoclave ($10,000)
  • Upgrade Electrical ($3,500)
  • Cabinets ($1,000)
  • Fix wall mounted cupboards ($500)

Estimated Cost                                                       $25,000 FUNDED!

Water and Power 

There is currently not reliable power or water to the hospital.  The hospital water supply comes from 3 wells, one has a solar pump.  Towards the end of dry season often the water table is low enough that it is not possible to pump water to the water tanks.  The hospital and some of the surrounding community then rely on the sole functioning well, with a hand pump to supply water.


Our one working well, with the hand pump.

The electrical situation is equally difficult.  State power is erratic at best, usually 6-10 hours during two nights a week, however there is no schedule and the voltage is low and prone to spikes making it dangerous to use delicate electronics such as computers and lab equipment. The hospital has 2 (two) 150 kva generators.  It costs $5/hour to run one, so the hospital runs the generator during the day, typically 11-4, or sometimes a little longer 6 days a week.  At night there are solar powered street lights to light the campus for security and they are effective, however the solar powered lights in the hospital are useless an hour after sunset, other than for the staff to identify large objects in their path.  The night nurses must rely on headlights.


Put an electric pump on the one functioning well, that is much cheaper than a solar pump and use it during dry season when the solar well is dry.

Pump and Installation                                                     $2,500

We are working with an American Commercial Electrical Contractor to design a battery system that would be charged with the generator during the day and provide power for lights, fans, oxygen concentrators, suction, blood bank and other necessary electrical devices during the night time.

Batteries, Chargers, Inverters, etc                                $50,000 – 75,000

Physical Therapy Building

Physical therapy has quickly demonstrated its potential to be a source of income for the hospital as well as being a badly needed service for the community.  Currently PT is being done in the Palava Hut (a large gazebo).  With the onset of the rains they will need to move into one of the future women’s wards, but by April 2017 they will need their own building.


Physical Therapy in the Palava Hut

It is proposed to use the slab on the north edge of the compound, just north of the palava hut currently being used.  There is easy vehicle access via the back entrance for outpatients.  We will need to put in drainage ditches as the building would be likely to flood without them.  The current slab may also need to be reinforced and extended.

Cost                                                                                     $75,000

Bo Clinic

In the city of Bo is an SDA compound complete with a building used as an Adventist Health Center just prior to the outbreak of Ebola in 2014.  Due to the epidemic it was closed after just 10 months.  A CHO is already on site and nurses are available.  The building needs some touch up is all to make it ready for a new clinic and the second site of the Adventist Health System

Cost                                                                                      $20,000

$10,000 FUNDED by the SDA Churches in Bo


Bo Clinic, just needs a bit of work and supplies. The Community Health Officer and Nurse are ready to start today!

Remodel/Addition Pharmacy/Storage Climate Controlled Environment 

We need a 24/7 climate controlled environment to store pharmaceuticals and lab reagents, and ultimately x-ray reagents in order to prevent spoilage and wastage.  In addition, we need consistent refrigeration to make a blood bank possible.


The building that needs to be enlarged and remodeled into pharmacy and climate controlled storage.

The plan is to remodel the building currently being used for HIV counseling, and doubling the size by building an addition to the west.  With the battery system as noted above we would be able to power the refrigeration needed to keep blood and pharmaceuticals fresh.

Remodel                                                                    $20,000

Addition                                                                     $30,000

TOTAL                                                                      $50,000


To achieve the mission of a Seventh-day Adventist hospital means having Seventh-day Adventist staff as much as possible.  One way to ensure a supply of Sierra Leonean physicians, nurses, lab techs, and other staff is to help them with the education.  In exchange they sign a contract to work the for the Adventist Health System for 5-10 years depending on the amount of their scholarship. This model has been used effectively in other African countries.  The candidates are carefully screened to ensure that the money is being used to educate quality young people.

Goal                                                                            $25,000


Patient Ward

Patient Ward

Every day we live our mission statement, to demonstrate the health care ministry of Jesus Christ. That means caring for everyone who comes to us, regardless of ability to pay. If they choose to seek care with us, we will care for them. However, that also means we have less money to purchase medications and supplies, and pay for fuel for the generator, and pay staff salaries. We do not get a regular subsidy from any organization so we rely on donations to help cover costs of indigent care. We need people who are willing to give on a regular basis to help with caring for the poorest of God’s children.