For improvements of the City Garden Clinic, together with Smarter Hospital Foundation we work on projects basis. Together we define and develop projects, raise funds and the implementation of the projects is done by the team in Makeni.

Donation can be done directly to the Smarter Hospital Foundation

The Future City Garden Clinic by Dr. ABD

New projects – Introduction

City Garden Clinic (CGC) is a self-sufficient hospital in Makeni, Sierra Leone and is registered with the Ministry of Healthcare. It has a capacity of 64 beds, an outpatient clinic, a small basic laboratory, an operating theatre and a local staff of around 50 employees. The target group is the population of Makeni and the surrounding area (more than 250,000 residents).

Mr. Toine van Moorsel lays the foundation stone for City Garden Clinic

CGC was founded 12 years ago by Sierra Leonean Dr. ABD Sesay, initially as a small day clinic. Due to the high demand for high-quality health care, the clinic has grown under his leadership into a four-storey hospital that is now well-known. During those years, all available resources were used to expand and further develop the hospital, leaving no money for structural maintenance. As a result, the infrastructure and facilities of the lower two floors are in need of a thorough refurbishment and repairs since all this has now fallen below an acceptable standard, making maintaining the required hygiene difficult and endangering. Furthermore at present the hospital has no adequate facility to isolate patients with contagious diseases.


Moreover, a major shortcoming is the total lack of facilities for the responsible processing of medical and bio-medical waste in accordance with the applicable government regulations. Until recently, use could be made of the facilities of another hospital, but that is no longer possible. Currently, medical waste, including waste from the operating room, is being dumped and burned outside of Makeni in an agricultural area, which is still tolerated to date. However, not being able to use the right facilities can lead to the closure of the hospital. Suitable land to set up such a facility is available.



The health care system in Sierra Leone can be described as (very) weak, certainly outside the capital Freetown. For example, there are only 2 doctors per 100,000 inhabitants. A number of basic medical specialties such as simple Urology and simple Orthopedics / Trauma care are almost completely absent, although there is a great need for it. Dr ABD has experience with these types of care, especially Urology, but the right infrastructure and equipment is still lacking.

To be able to provide this care, an X-ray device must be purchased. As there is no suitable space available in the hospital, the device must be installed in a new building that meets the government’s radiation shielding requirements. In addition, an anaesthesia device must be purchased so that gas anaesthesia can be applied.

In addition, some specific orthopaedic instruments must be acquired. Furthermore, the functionality of the laboratory must be expanded with the introduction of bio-chemical analysis equipment and a blood bank must be set up in which the special blood refrigerator must have a guaranteed power supply, solar energy. To this end, the laboratory must be expanded, which is possible by adding the neighbouring office, which is currently not being used.




At this moment, together with the Smarter Hospital Foundation we are working on the following projects in cooperation with “Wilde Ganzen”:

Preparing City Garden Clinic for the fight against Corona

Renovation of City Garden Clinic 

Extension of diagnostic and treatment possibilities in City Garden Clinic

Furthermore we are working on the project See & Treat in cooperation with World Hope International and the Female Cancer Foundation in The Netherlands

Project implementation

The projects will be carried out by City Garden Clinic under the auspices of and supported by the Smarter Hospital Foundation, a Dutch non-profit NGO ( and in collaboration with Wilde Ganzen ( Smarter Hospital is responsible for fundraising for the projects. Wilde Ganzen has approved the projects and project budgets and cooperation agreements between Wilde Ganzen, Smarter Hospital and City Garden Clinic have since been signed. Wilde Ganzen will increase funds raised by Smarter Hospital with 50% to the approved budget (for example, for every € 100 raised, Wilde Ganzen adds € 50). For the Corona related project the subsidy of Wilde Ganzen is even 100%

Project management

The project will be carried out under the leadership of Dr ABD Sesay and supervised by Dutchman Ruurd van Rooijen (Rudi mr.) who has been working in Sierra Leone for more than 10 years and who has gained extensive experience with many large and small new building and renovation projects, often also in collaboration with Wilde Ganzen. To name a few projects, the completion of an orphanage in Yele (4 buildings), the renovation and partial new construction of 5 primary schools in Yele, the construction of a nursing department of 22 beds, installation of a large solar energy system and various small hospital facilities.

Mr. Rudi is a board member of the Smarter Hospital Foundation.


“Sustainability”: Maintenance and future-proofing

To date, the hospital has been able to generate sufficient income from patients to cover the operation entirely independently, without being dependent on donors. When the projects are completed, it is expected that more patients will come to the hospital due to the more professional appearance and especially due to the specialization in Urology and Orthopedics / Trauma care, for which there is an enormous demand. The extra costs associated with these specializations are included in the price that patients have to pay for the care they need.

As patients have to pay a little more than the actual costs (in order to be able to treat patients who are really unable to pay), the expectation is that the income will increase considerably, in particular through the provision of specialized care, so that the future structural maintenance can also be included in the operating budget.

Regarding personnel future-proofing, the son of Dr. ABD has recently completed his medical studies abroad and is currently doing internships in various hospitals in Freetown. He has the ambition to follow in his father’s footsteps, will start working at City Garden Clinic after his internship and in due course, when his father withdraws, he will take over the management of City Garden Clinic. In addition, Dr. ABD supports a number of students in their studies to become an assistant physician (Community Health Officer), nurse, pharmacist or accountant and who, after qualification, can supplement the current staff or provide for follow-up in the future.  As far as current employees are concerned, many have been working in CGC from the start or early stage of expansion and are particularly motivated to bring the hospital and themselves to a higher standard. The renovated hospital with the new equipment (and associated training) will only increase motivation and work ethics, resulting in even better care.

Donations can be transferred to the Smarter Hospital bank account:

IBAN No: NL09ABNA0552434507
Citing “Donation Wilde Ganzen”