Renovation and extension City Garden Clinic cooperation with “Wilde Ganzen”

The goal of this project is to renovate and extend the City Garden Clinic hospital in Makeni, Sierra Leone. The project is supported by the Wilde Ganzen (Wild Gees) foundation in the Netherlands and every 100 EURO that is donated 50 € will be added by the Wilde Ganzen. The total budget that we need for our plans is € 160,000 which is divided into 2 phases, below we described how we divided this budget.

Donation can be done directly to the Smarter Hospital Foundation

Project Description

City Garden Clinic (CGC) is a self-sufficient hospital in Makeni, Sierra Leone and registered with the Ministry of Healthcare. It has a capacity of 64 beds, an outpatient clinic, a small basal laboratory, an operating room 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 Leonees 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.

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 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.


Medical director Dr. Erdi Huizenga and Dr. ABD Sesay

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. Both doctors at City Garden Clinic have experience with these types of care, 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 anesthesia device must be purchased so that gas anesthesia can be applied.


In addition, some specific orthopedic 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 neighboring office, which is currently not being used.


“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 project is 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.


Dr Abdu Sesay

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.

Project implementation

The project 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 project. Wilde Ganzen has approved the project and project budget 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).

The content of the project consists of two phases, phase 1 includes the renovation and construction activities, phase 2 the acquisition of equipment (and the associated training). With regard to phase 1, the construction of the building for the X-ray equipment and the implementation of the waste treatment facilities (including in particular the incinerator and the well for placenta / body tissue) have the highest priority.

Project management

The project will be carried out under the leadership of the City Garden Clinic facility manager, 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 buildings 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 and the medical director of CGC, the very experienced Dutch tropical doctor, Dr. Erdi Huizenga (who has been working in Africa for more than 13 years, of which the last 10 years in Sierra Leone) are both members of the Smarter Hospital Foundation.

Details Project

Phase 1 which starts in early 2020.

  • Renovation main building
  • Renovation outside toilets
  • New construction for X-ray device
    • Structural work (Skeleton)
    • Roof & ceiling
    • Electrical installation
    • Tiling the floor
    • Paintwork
    • Concrete walkway to hospital
  • Medical waste processing facility
    • Incinerator
    • Closed pit for placentas, body tissue
    • Closed pit for ash remains
    • Closed well for needles

Phase 2, which starts in 2021, mainly consists of purchasing the following equipment:

  • Bio Chemistry Analyzer MED LAB DIAGNOSTICS
  • Glostavent Helix Complete Anesthesia System DIAMEDICA
  • Blood bank Fridge + Solar System; Solar from Energy Independent
  • Digital X-ray

Donations can be transferred to the Smarter Hospital bank account:

IBAN No: NL09ABNA0552434507
O.v.v  “Donatie Wilde Ganzen”