Sierra Leone

In Sierra Leone, the main barriers to accessing health care are cost and distance. Doctors Without Borders/Médecins Sans Frontières (MSF) is currently focusing on combating malaria, providing maternal and pediatric healthcare, and treating malnutrition.

MSF supports the Gondama referral center in Sierra Leone. It offers inpatient services for women and children and malaria treatment, as well as a therapeutic feeding program. MSF also runs five outpatient clinics in collaboration with local health authorities and supports 30 smaller rural health posts to make treatment more accessible for people in remote areas. In 2008, MSF performed more than 417,000 consultations.

Malaria: the number one killer
In Sierra Leone, the entire population is at risk of contracting malaria, especially children under five and pregnant women. Although artemisinin-based combination therapy (ACT) is supposedly free in Sierra Leone, people still cannot afford the registration fees, the doctor’s consultation or the cost of other drugs that they might need. In 2008, MSF treated more than 180,000 people with malaria using ACT, free of charge.

During 2008, MSF built up a network of 140 community malaria volunteers and taught them how to diagnose and treat the disease. As the volunteers are based in their own villages, they help overcome the geographical barrier to accessing malaria treatment.

“I feel very happy to be a volunteer because I am saving lives, especially the lives of children," said Jabaty, a 31-year-old man chosen to be a volunteer by his village. "My village has benefited very much because our people no longer have to walk for miles to the nearest clinic.” Through the use of a rapid diagnostic test it is easy for Jabaty to make a diagnosis. If malaria is detected, he will provide ACT to the patient. “I have treated people every day, and we have had 44 malaria cases in the last three weeks. They are all very happy because they got treatment quickly and they are all well.”

Maternal health and malnutrition
Sierra Leone has one of the highest maternal mortality rates in the world. The five health clinics and the Gondoma referral center offer services for women, such as antenatal, postnatal and obstetric care; normal and complicated deliveries, including Caesarean section; family planning; treatment for sexually transmitted infections; and care for survivors of sexual violence.

Malnourished children receive nutritional rehabilitation through a therapeutic feeding center at the Gondoma hospital. A therapeutic feeding program in the mobile health clinics also makes it possible to treat more children at home.

Johan Mast, MSF’s head of mission in Sierra Leone, stressed the importance of tackling the country’s health problems appropriately.  “The huge number of people still lacking basic health care due to financial, geographical and human resource barriers is worrying," Mast said. "Increased efforts need to be directed at providing appropriate diagnostic tools and making sure that patients receive adequate treatment. Free access to healthcare is an issue of huge importance.”

MSF has worked in Sierra Leone since 1986.

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