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MSF in Sierra Leone, 2006/2007
Field Staff: 505
Reason for Intervention:
All articles on Sierra Leone »
Six years of peacekeeping and rebuilding have led to a relatively politically stable Sierra Leone. Whilst mobile phones have largely replaced the Kalashnikovs and machine guns commonly used during the decade-long civil war, the post-conflict situation still represents a struggle for survival – now one predominantly against malnutrition, malaria infections and women’s health issues.
MSF continues to provide free and quality healthcare in the southern town of Bo. The Gondama Referral Centre on the periphery of Bo hosts an intensive care unit, a pediatric unit and a Therapeutic Feeding Centre (TFC) for malnourished children. MSF admits approximately 600 patients every month in the centre and approximately 150 children in the TFC. MSF also supports five public health clinics in the neighboring area – where approximately 26,000 curative consultations take place monthly.
Implementing prevention and treatment for malaria
Malaria is hyperendemic in Sierra Leone and is the number one killer. Children below the age of five and pregnant women are the most vulnerable. In the Gondama Referral Centre, children under five represent 75 percent of the total admissions, 92 percent of these children arriving because of malaria or the consequences of malaria. Every month an average of 7,000 confirmed cases are treated with an increase up to 10,000 during the peak malaria season. MSF has worked closely with the Ministry of Health (MoH) to change the malaria protocol to artemisinin-based combination therapy (ACT). Implementation has been slow and three years on, many people affected by malaria do not have access to efficient treatment. It is a challenge to ensure that ACT is continuously supplied to all clinics throughout the country. In an effort to prevent an overwhelming amount of child mortality, MSF decided to bring medical care closer to where people live. Before MSF mobile clinics were set up, people had to walk long distances to reach a health structure. This often meant that patients would die or reach a critical state before obtaining treatment. MSF created a community health-related program addressing nutrition, malaria and maternity through information, bed net distribution (to prevent mosquito bites) and medical treatment. Between June 2006 and April 2007, MSF outreach teams tested 17,000 persons with Paracheck – a rapid malaria test – and handed out nearly 40,000 bed nets. Severe cases of malaria are referred to Gondama.
Developing women’s clinics
Sierra Leone has one of the highest maternal mortality rates in the world. In the MSF Gondama women’s clinic all women are welcome for free treatment. The clinics offer a complete primary healthcare package, with a separate small structure dedicated in each clinic to reproductive health, known as the women’s clinic. This concept has been developed successfully in Sierra Leone and may serve as a model that can be implemented elsewhere. In each clinic, ante-natal, post-natal and basic obstetric care, family planning, treatment for sexually transmitted infections and care for survivors of sexual violence are offered. MSF has also been working in Kambia and Tonkolili districts, supporting local hospitals and several clinics, with a focus on maternal health and children under five years old. By July 2007, MSF was able to transfer these activities to the Ministry of Health.
MSF has worked in Sierra Leone since 1986.