Our work in Sierra Leone

A shattered health system in the aftermath of the West African Ebola epidemic

7-month-old Adama Musa and her mother lie on one of the beds in MSF’s newly-opened hospital in Hangha, in Sierra Leone’s Kenema district.
Sierra Leone 2019 © Sarah Murphy/MSF
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How MSF is fighting COVID-19 in Sierra Leone

MSF is part of the case management and surveillance pillars of the national Emergency Operations Center (EOC), and at district level EOCs in Kenema, Tonkolili, and Bombali districts. An MSF epidemiologist continues to work with the Ministry of Health and Sanitation (MOHS) on surveillance, infection prevention and control, and testing strategies.

From July 2020 to December 2020, in close collaboration with the district health management team, Western Area Urban, we worked with 10 community health workers from the Thompson bay wharf area in Freetown, where there are many informal settlements. We organized health promotion and distribution of hygiene kits. As the months progressed, the district medical team reported a higher number of people coming to the clinic, which demonstrated the impact of our messaging.

The health promotion activities stopped at the end of December 2020, and were handed over to community health care workers and district health management team. We will continue to monitor the COVID-19 situation in Freetown and stand ready to respond in future if needed.

What is happening in Sierra Leone?

In Sierra Leone, Doctors Without Borders/Médecins Sans Frontières (MSF) supports the recovery of the health services following the 2014–2016 Ebola outbreak, focusing on staff training, and improving mother and child health care.

How we're helping in Sierra Leone

Our teams work alongside the Ministry of Health and Sanitation in hospitals in Sierra Leone, general health facilities, and in the community to increase access to health care and fill gaps in the provision of essential medicines. Learn how you can best help in Sierra Leone and other countries.

consultations in 2019
treated for malaria

Mother and child health


MSF projects in Sierra Leone

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We are working with the Ministry of Health and Sanitation to strengthen the health system in Kenema district through comprehensive assistance to 13 peripheral health care units in three chiefdoms (Gorama Mende, Wandor and Nongowa) and our new hospital in Hangha town. The aim is to reduce sickness and death among children, and women during pregnancy and childbirth in Sierra Leone, a country with one of the highest rates of maternal and child mortality in the world.   

The hospital has a range of facilities for pediatric care, including an emergency room, an intensive care unit, an inpatient therapeutic feeding center, a general ward, and an isolation ward for patients with suspected Lassa fever, a disease that is endemic in the country. We have also built a laboratory and a blood bank.  

In the most isolated chiefdoms of Gorama Mende and Wandor, malaria prevalence and mortality rates are high. With challenging geography, poor road conditions, and dispersed communities, access to health care is extremely limited. MSF targets children under the age of five, pregnant women, and lactating mothers, providing general health care and coordinating emergency referrals for specialist care. Please donate to support our work in Sierra Leone and other countries around the world now.

Our mother and child health care program in Tonkolili continues to support Magburaka district hospital and eight peripheral health care units, with improvements to infection prevention and control measures and water and sanitation systems, donations of drugs and staff training.  As well as assisting with referrals from the health care units, we offered family planning sessions, psychosocial support, and medical treatment to victims of sexual and gender-based violence.   


In 2019, we provided logistical support to the Ministry of Health and Sanitation in Kambia district during a measles outbreak. Our teams also assisted with the catch-up measles and rubella vaccination campaigns in Kenema and Tonkolili districts by donating medical supplies, organizing transport and safe waste management, and running awareness-raising and health promotion activities.  Additionally, we helped manage Lassa fever cases in November, by sharing clinical protocols and guidelines, donating infection prevention and control materials, and medical supplies to Kenema and Tonkolili districts and deploying ambulances to transport suspected and confirmed cases. 

Human resources for health development 

The professional development of national health workers is a top priority for MSF. On December 18, the Nursing and Midwifery Council of Ghana inducted 47 Sierra Leonean registered nurses and midwives following their successful completion of a two-year MSF-sponsored Registered Diploma training course. The team will be deployed to work in our hospital in Hangha and other health facilities around the country. Another group of nurses enrolled in a diploma course in February. 

Diagnosing and treating drug-resistant tuberculosis (DR-TB) 

We also started a new drug-resistant TB project in Makeni town in Bombali district. Our teams are supporting the national TB program efforts to decentralize DR-TB diagnosis and treatment by making it available in patients’ communities.  In 2019, we helped upgrade the TB ward in Makeni by improving ventilation and building a recreation area for inpatients. The first patients started an all-oral treatment regimen, meaning no injections are required.