International Activity Report 2005
Sierra Leone

International Staff: 41
National Staff: 458

Aiding survivors of war

Eleven years of armed conflict destroyed much of Sierra Leone's existing infrastructure, and though the country is now stable, most of its people have minimal or no access to basic health services. Women and children are especially vulnerable. In a country where most people survive as farmers and large families are believed to be essential, women are expected to have as many children as possible. Many die in childbirth or on their way to get help, or suffer serious complications; and many babies do not survive infancy.

MSF works in the pediatric and maternity wards of the district hospital in Kambia, in northwest Sierra Leone. MSF provides staff for emergency and obstetric surgery and all needed material for the laboratory. In addition, the MSF team works with six peripheral health units in Kambia district, providing supervision, training local health workers, and supplying medical materials and drugs. Outreach workers go into the nearby communities to provide health education.

MSF runs a similar program in Tonkolili district, working at the district hospital in the town of Magburaka, supporting six peripheral health units and conducting outreach and education. In both districts, the MSF team gives life-extending antiretroviral (ARV) treatment to HIV-positive, pregnant women. MSF staff also educate mothers about how to care for their babies without exposing them to the virus. This work is done in collaboration with the national AIDS secretariat. MSF has established "maternity houses" in Kambia and Tonkolili, where women in the final weeks of pregnancy can stay near the hospital in case of complications. MSF staff carry out around 3,600 consultations per month in Kambia, and 4,200 per month in Tonkolili.

In Southern province, MSF provides basic health services at the Gondama Medical Center located near Sierra Leone's second largest city, Bo. Though the facility initially served mainly refugees, it now primarily helps Sierra Leoneans who live in the district.

The facility includes a pediatric ward, an adult ward, an intensive care unit and a therapeutic feeding center for malnourished children. The MSF team admits more than 400 people each month. Most patients suffer from diseases such as malaria and respiratory infections.

In 2000, MSF set up a consultation area in Taiama camp, in the country's western Myamaba district, which was home to internally displaced Sierra Leoneans. By 2002, the population of the camp had risen to 6,000 — and shifted to housing mostly Liberian refugees. During 2004, many Liberian refugees returned home, and the camp's population decreased. MSF continues to provide basic health care, vaccinations, pre-natal and postpartum services and maternity care for the camp's remaining residents. Teams provide similar care in the Kenema district's Tobanda and Largo camps.

MSF supports eight health clinics located near refugee camps in Southern province. Though more than 20,000 Liberian refugees continue to live in the camps, most of the clinic's patients come from nearby communities. In addition to basic health services, these clinics give nutritional treatment for mothers and their children, mental health support and a program for victims of sexual violence. MSF staff conduct more than 20,000 consultations in these clinics each month.

MSF also responds to medical emergencies in the country. In August and September 2004, MSF responded to a cholera outbreak in Freetown, treating more than 1,800 patients.

In November 2004, MSF closed a clinic in Kailahun district, following the reopening of the public hospital. More than 1,200 consultations had been carried out at the clinic each month since it opened in 2001.

MSF has worked in Sierra Leone since 1986.