International Activity Report 2002
Sierra Leone

Restoring healthcare services after civil war

International staff: 60 National staff: 500

After a decade of horrific civil war, Sierra Leone is moving toward stability. The peace process culminated in May 2002 with a relatively calm election, and a 17,000-strong United Nations force is now deployed throughout the country. Yet regional instability continues, with renewed war in neighboring Liberia sending Liberians across the border to Sierra Leone; at the same time, thousands of Sierra Leoneans are returning home from Guinea in precarious conditions and with insufficient aid.

In May 2002, MSF issued the report "Populations Affected by War in the Mano River Region: Issues of Protection," which condemns the United Nations and government-run resettlement programs in Sierra Leone as "poorly planned, badly organized and ineffectively implemented, [resulting] in a process that more closely resembles eviction than resettlement."

The civil war had prevented MSF's constant presence in unstable regions. With the demobilization and disarmament, however, MSF extended assistance to neglected areas, helping restore healthcare services to districts formerly controlled by the Revolutionary United Front (RUF). MSF rehabilitated and supports the district hospitals in Makeni and Magburaka – the RUF heartland – and provides crucial assistance to 12 clinics. The hospital in Magburaka provides the only facilities for emergency surgery in the northern districts. MSF also runs a therapeutic feeding center (TFC) and clinic in Port Loko, and supports a hospital and six clinics in Kambia district.

In the southern towns of Moyamba and Kenema, MSF offers primary health care through eight health units and pediatric services in hospitals and clinics. A mental health project for internally displaced persons (IDPs) and returnees in Kenema ended in June 2002, after the sudden resettlement organized by the government and the United Nations emptied the IDP camps. In Kailahun, MSF runs a TFC and a 50-bed inpatient facility.

MSF supports health services in six refugee camps near Pujehun and Bo, as well a 435-bed hospital in Bo, a hospital in Kono district, and a hospital and ten clinics in Koinadugu district.

In December 2001, MSF ended its surgery program in the capital Freetown; counseling and pain control for war wounded ended in June 2002. Local doctors continue to do surgery, with MSF giving follow-up support for pain management. In March 2002, MSF passed control of two small hospitals in Freetown to the Ministry of Health.

MSF first worked in Sierra Leone in 1986.