Doctors Without Borders provides medical care to some of the world's most vulnerable people in more than 70 countries around the world. The stories of Kandeh Jalloh and Wara Kamara illustrate what an immense impact access to health care can have on women's lives.
Many women in Sierra Leone die from complications during pregnancy or delivery, and close to one out of five babies dies during or just after birth. MSF is helping mothers and babies by reducing medical risks and making needed medical care more available. In Sierra Leone women often live far from hospitals, so in Kambia and Tonkolili districts, MSF has established "maternity houses" where women in their final weeks of pregnancy can stay until they deliver. In these facilities, MSF treats HIV-positive pregnant women to prevent mother-to child transmission of the virus.
MSF clinics see approximately 2,000 patients per month in each district. MSF staff is also integrating HIV and tuberculosis (TB) care in MSF-supported public health units, and in the maternal and pediatric wards of secondary health facilities. Please read about how MSF medical assistance helped Wara Kamara and Kandeh Jalloh through their pregnancies.
Kandeh Jalloh
Kandeh is about 25 years old and has just given birth to a healthy baby girl in the MSF maternity ward of Magburaka hospital. But she lives in Kendeya, which is some eight hours away on difficult roads towards the Guinea border. She arrived at the hospital on July 4th, stayed in the maternal "waiting house" and gave birth on July 23rd. This is her story...
© Pep Bonet
I was born in Kendeya and my husband is a farmer. We rent a small piece of land and pay for it with part of the harvest. When I was going to have my first baby I was very happy. Everything seemed to be normal when I was feeling the pains. The traditional helper from the village was with me. She said it was all right. Then the baby seemed to get stuck. I tried a lot and pushed a lot but when it came out it was a dead baby.
It was three years more before I got the second pregnancy. Then the same thing happened with the baby. It got stuck and it died before I could get it out. And it happened two more times, so four babies I lost in my own house because they would not come out.
Every time I went to the same two ladies in the village who know the traditional ways. I thought about the hospital that was closer than here. But it was two days walking from my house. And when you get there they would make you pay money. We are poor and we have no money. So I had to stay at home. And the babies would not stay alive.
When I was pregnant again I wanted to try to get to a hospital. I was asking my husband all the time and worrying him about how we should go to the big hospital, we must go to the big hospital. Then one day he finally said, "If you want to go there, now you can go". So I decided that I should come on my own.
I tried to save money by walking all the way to another village that is on the new road. That took one whole day. So that is why I started walking before I was having the birth pains. The transport on the road to here cost a lot of money, $6.50. It all had to come from selling what we grow on our farm.
My husband is very pleased. The hospital has done the best
for me. I have had all the traditions in the village but I never had a child. Now I am here and I have a live baby. The next time I will come here again and I will come early because that is a help.
Kandeh went into labor and things progressed normally until the cervix was dilated to about 7cms. The midwife had been monitoring the fetal heartbeat and there were suddenly signs of distress. Kandeh was moved into the operating theater, where it was decided that she should have a Caesarian section. The baby girl was delivered in good health.
Wara Kamara
Wara is a Sierra Leonean woman who lives in a village called Royark, several hours journey away from the maternity ward and its obstetric care in Kambia hospital. She gave birth after spending three weeks in the "Waiting House", having been referred there by the MSF clinic nearest to her home.
© Pep Bonet
I had one child already, a boy, who is four years old. At the time of delivery I had problems and felt very sick and it took me two weeks to be able to walk and do things in the house.
When I was pregnant again this time I was here in Royark. And I was worried all the time that I might have the same problems in delivering this baby. My grandmother too was worried and she took me to a clinic near to here, where they gave me some medicine. But still I was not feeling good and so when I was at eight months I went back again.
For me, I know that if I was at home I would have the same problems that I had with my first pregnancy; bleeding and dizziness. But now I was in the labor ward and at six in the evening I gave birth. I was crying because there was too much pain. I could not get up until the next morning and I was not feeling good. The problem was that I was bleeding after the birth. They had to put a bag with a drip because I was not in a good condition. They also gave me an injection and I was in the hospital ward for two days afterwards. But the bleeding stopped soon.
I want to have more babies but I know now that I must go to Kambia early. I have to go before delivery so that I can be always under anesthesia and for it to be in time.
Wara had post partum hemorrhage, which causes around a quarter of deaths in maternity cases in Sierra Leone. Because she was in hospital she was given an oxytocin drip and an injection of ergometrine to shrink the uterus and stop the bleeding.
