Maternal and child mortality remain high in Sierra Leone, and its health system is still struggling to recover from the 2014-16 Ebola outbreak, which killed approximately 10 percent of health workers.
Doctors Without Borders/Médecins Sans Frontières (MSF) teams work in hospitals, primary health facilities, and in the community to increase access to health care, fill gaps in the provision of essential medicines, and help develop the country’s health workforce. Our focus is on maternal and child health care, but we monitor the health situation across the country, ready to respond to emergencies as required.
In 2018, we continued to support Magburaka district hospital’s maternal and child health services, introducing water and sanitation improvements, a blood bank, and enhanced infection prevention and control measures. Our teams assisted 3,226 births and conducted 16,324 ante- and 4,371 postnatal consultations during the year, as well as supporting referrals, training staff, and conducting community outreach work.
We offer medical and psychological care to victims of sexual violence in Magburaka hospital and the surrounding health facilities, and during the rainy season, we supported seven community-based malaria management sites with screening, treatment, and referrals.
We continued working in the pediatric and maternity wards and the emergency department at Kabala district hospital in Koinadugu throughout 2018, and supported the referral system for the entire district. We also had a team supporting the community health center community health workers, traditional birth attendants, and the health post.
Having increased the capacity of the hospital and community health facilities, raised the standard of emergency, pediatric, and maternity services, and strengthened the referral system, we handed all activities over to the Ministry of Health at the end of the year.
We support 13 primary health facilities in Gorama Mende, Wandor and Nongowa chiefdoms in Kenema district, providing clinical supervision and training, assisting with referrals, filling significant gaps in the supply of essential drugs and medical equipment, and conducting community outreach and health promotion activities.
The foundations of a new hospital were laid in Hangha town in January 2018 and by the end of the year the facility was nearing completion. Scheduled to open in March 2019, the hospital will offer a full range of pediatric services including an emergency room, an intensive care unit, an inpatient therapeutic feeding center, a general pediatric ward, and an isolation ward, as well as a laboratory and a blood bank. Longer-term expansion plans include the introduction of maternity and radiology services.
Human resources for health
While laying the physical foundations of the hospital in Kenema, we also set about training staff through the MSF Academy for Healthcare – set up in 2016 to improve the skills of medical and paramedical practitioners in low-resource settings with a shortage of trained professionals.
Training was provided to 160 health workers in Kenema district in 2018. Another 50 (25 nurses and 25 midwives) went to Ghana for a 24-month scholarship program, and 12 joined nurses from South Sudan on an 18-month anaesthetics diploma course. The nurses and midwives from Sierra Leone will return to work in the new hospital in Kenema, and the project will serve as a pilot to develop the tools and expertise needed to meet training needs in other countries such as the Central African Republic, the Democratic Republic of Congo, and South Sudan.