63 Degrees North

ENCORE: When the doctor is out


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ENCORE: This episode was first published in Oct. 2023. Sierra Leone used to be the most dangerous place in the world to give birth. Without enough doctors to do C-sections, women and babies were dying. But what if you didn't need a doctor?

This week, the story of two determined surgeons and a no-so radical idea that is saving lives in Sierra Leone — one emergency operation at a time.

You can read more about the non-profit organization the doctors created at capacare.org

Our guests on the show are Håkon Bolkan, Alex van Duinen and Emmanuel Tommy. You can download the episode transcript here:


Here are some of the articles discussed in the show:

  • Bolkan, HA et al. (2015) Met and unmet need for surgery in Sierra Leone: a comprehensive retrospective countrywide survey from all healthcare facilities performing surgery in 2012. Surgery
  • Brolin, K et al.  (2016) The Impact of the West Africa Ebola Outbreak on Obstetric Health Care in Sierra Leone. PLOS ONE
  • Bolkan, HA et al.. (2017) Safety, productivity and predicted contribution of a surgical task-sharing programme in Sierra Leone. British Journal of Surgery
  • Treacy, Laura; Bolkan, Håkon Angell; Sagbakken, Mette. (2018) Distance, accessibility and costs. Decision-making During Childbirth in Rural Sierra Leone: a Qualitative Study. PLOS ONE
  • Drevin, Gustaf; Alvesson, Helle Mölsted; van Duinen, Aalke Johan; Bolkan, Håkon Angell; Koroma, Alimamy philip; von Schreeb, Johan. (2019) ”For this one, let me take the risk”: why surgical staff continued to perform caesarean sections during the 2014–2016 Ebola epidemic in Sierra Leone. BMJ Global Health
  • van Duinen, Aalke Johan; Kamara, Michael M.; Hagander, Lars; Ashley, Thomas; Koroma, Alimamy Philip; Leather, Andy J.M.. (2019) Caesarean section performed by medical doctors and associate clinicians in Sierra Leone. British Journal of Surgery
  • van Duinen, Aalke Johan; Westendorp, Josien; Kamara, Michael M; Forna, Fatu; Hagander, Lars; Rijken, Marcus J.. (2020) Perinatal outcomes of cesarean deliveries in Sierra Leone: A prospective multicenter observational study. International Journal of Gynecology & Obstetrics


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