Hunger in Sierra Leone

Of Sierra Leone’s population of 7 million people, more than half are living below the poverty line. In 2019, the UN Development Programme Index ranked this West African country 181st out of 185 countries based on “average achievement in three dimensions of human development—a long and healthy life, knowledge and a decent standard of living.” Such a ranking is significantly influenced by the fact that millions of Sierra Leoneans are affected by food insecurity and many children are malnourished. Here are five facts about hunger in Sierra Leone. 

Five Facts About Hunger in Sierra Leone

  1. More than 3 million Sierra Leoneans lack reliable access to adequate food. In total, over 40% of Sierra Leone’s population is food insecure. Over 50% of Sierra Leone’s population lives on less than $1.25 per day, so many people struggle to buy sufficient and nutritious food. According to the 2019 Global Hunger Index, about one out in every four people in the country are undernourished.
  2. Nearly 40% of children suffer from stunted or impaired growth as a result of chronic malnutrition. This can permanently impact health and cognitive development. Families living in poverty are less capable of providing their children with an adequate variety of nutrients in their diets. In 2018, the rate of mortality for children under five years old was 10.5%; about half of these deaths are attributable to malnutrition.
  3. Sierra Leone ended an eleven-year war in 2002, and was hit by the 2014 Ebola pandemic; these have greatly exacerbated rates of poverty and hunger in Sierra Leone. The long-term conflict dismantled national infrastructure in both rural and urban areas, resulting in a lack of effective basic social services  Beginning in May 2014, the Ebola crisis resulted in almost 4,000 deaths and a serious economic downturn in Sierra Leone. The country is still dealing with the aftermath of these events.
  4. Irregular rainfall has significantly reduced rice production in recent years. Rice is a staple food in Sierra Leone, but local agricultural production is no longer sufficient to meet the needs of the population. In 2018, the majority of rice-growing households produced only half as much rice as they expected. Therefore, instead of exporting rice, which would improve economic growth, the government has spent hundreds of millions of dollars importing the staple.
  5. The COVID-19 pandemic is putting more people at risk of acute hunger and starvation. According to the United Nations’ World Food Programme (WFP), without sufficient aid, countries with high levels of food insecurity may face “mega-famines.” The WFP has also reported that food insecurity could double worldwide in 2020, affecting 130 million more people.

Solutions

Many organizations have taken action to address food insecurity and malnutrition in Sierra Leone. In 2018, Action Against Hunger aided 8,000 people with food security programs that reduced malnutrition among children and increased dietary diversity. The WFP, UNICEF, and Sierra Leone’s government are distributing nutrient-dense food to young children and mothers to reduce child malnutrition.

The WFP also provides food to children in schools and supports smallholder farmers. In May 2020, the WFP assisted more than 17,000 people by distributing over 47 metric tons of food assistance, transporting 900 metric tons of improved seed rice to smallholder farms, and providing cash payments to more than 1,000 farming households

The World Bank has provided Sierra Leone’s government with $100 million to deal with economic challenges during the pandemic and reduce poverty. The UN is attempting to coordinate a global response to the pandemic that would require $4.7 billion to “protect millions of lives and stem the spread of coronavirus in fragile countries,” including Sierra Leone. 

Conclusion

These facts about hunger in Sierra Leone show that this issue is widespread and likely worsening during the COVID-19 pandemic. However, with multiple NGOs and members of the international community working to address this problem with food assistance and aid for farmers, there is hope for improvement; Sierra Leoneans may experience lower rates of hunger and malnutrition in the near future. 

Rachel Powell
Photo: Flickr

Healthcare in Sierra LeoneSierra Leone is a small nation located on the coast of West Africa. While the country boasts an abundance of natural resources, it is also a poor nation, with a healthcare system in dire need of improvement. Here are 9 facts about healthcare in Sierra Leone.

9 Facts About Healthcare in Sierra Leone

  1. Sierra Leone has one of the lowest life expectancies on the globe. In 2018, the average life expectancy in Sierra Leone was 54.3 years. This places the nation among the bottom five in the entire world. In comparison, the average global life expectancy is 72.6 years.

  2. Sierra Leone faces high rates of infant and maternal mortality. Similar to life expectancy, infant and maternal fatality rates help gauge the quality of a nation’s health care system. In 2015, 87.1 infants died per 1,000 births in Sierra Leone, while 1,360 mothers died per 100,000 births. In the U.S., just 5.4 infants died per 1,000 births, and only 14 mothers died for every 100,000 births. Birth-related deaths generally occur when there are delays in women seeking, reaching and receiving care.

  3. All people living in Sierra Leone are at risk of malaria. Malaria is endemic to the nation, and poses a great health risk. In fact, four out of every ten hospital visits in Sierra Leone are due to malaria. Children are at particular risk, and the disease contributes to the nation’s high number of child fatalities. However, rates of the illness are falling across the country due to preventative practices such as sleeping under insecticide treated nets. Earlier diagnoses and treatments also contribute to the lowered rates of illness. By the end of 2020, the Ministry of Health and Sanitation in Sierra Leone hopes to have decreased cases by 40 percent.

  4. The Ebola outbreak of 2014 hit Sierra Leone particularly hard. Despite its relatively small population, there were more cases of Ebola in Sierra Leone than any other country. To be exact, there were a total of 14,124 cases in the country, including nearly 4,000 deaths. The first case was reported in May 2014, and Sierra Leone was not declared Ebola-free until February 2016. According to the World Health Organization, the virus was able to spread so widely due to the weaknesses of the healthcare in Sierra Leone. These weaknesses included too few healthcare workers, not enough oversight and a lack of resources.

  5. Disabled residents face tough conditions. Approximately 450,000 disabled people live in Sierra Leone, including those who were maimed in the decade-long civil war that ended in 2002. The government does not currently provide any assistance to the disabled. Those with disabilities resort to begging on the streets of Freetown, the nation’s capital. Disabled youth turned away from their families (due to the family’s inability to support the youth) often form their own communities on the streets. Employment can also be hard to achieve due to discrimination. Julius Cuffie, a member of Parliament who suffers from polio, brings awareness to the disabled’s struggles. Hoping to bring the disabled’s issues to the forefront, Cuffie pushes for the Persons with Disabilities Act.

  6. Corruption exists in Sierra Leone’s healthcare system. According to a 2015 survey, 84 percent of Sierra Leoneans have paid a bribe just to use government services. Additionally, about a third of the funds given to fight the Ebola crisis are not accounted for. This translates to roughly 11 million pounds, or almost 14 million dollars. Sierra Leone has a literacy rate of about 40 percent. As a result, many health care services overcharge unknowing residents for basic services. A new initiative, put together by the nation’s Anti-Corruption Commission, advises residents to report cases of bribery.

  7. In 2010, Sierra Leone began offering free health care. The Free Healthcare Initiative (FHCI) aims to decrease the nation’s high maternal, infant and child mortality rate. The government also hopes the initiative improves general health across the country. The ordinance provides a package of free services for pregnant women, lactating mothers and children under the age of five. The program has not been without its challenges, however, due to the aforementioned weaknesses of previous systems of health care in Sierra Leone. That said, the initiative has resulted in a number of positive changes. For example, there has been an increase in the number of healthcare staff, a larger willingness for parents to seek care for their children and a reduction in mortality for those under five.

  8. There has been an increase in efforts to strengthen emergency medical response in Sierra Leone. Road accidents kill thousands each year in the country. In response to this, the First Responder Coalition of Sierra Leone (FRCSL) was created in 2019 to improve the state of urgent medical care. Five national and international groups in Makeni, a city in northern Sierra Leone, founded the coalition. The group aims to provide emergency care, treat the high numbers of injuries and resolve the low amount of pre-hospital treatment in Sierra Leone. In its first two months, the FRSCL trained 1,000 Makeni residents, equipping each one with a first aid kit. The coalition hopes to train 3,500 more in the next six months. It also plans on expanding out of the northern province in the next five years. Hopefully, the FRCSL’s efforts will save thousands of lives from vehicle accidents in the coming years.

  9. CARE is working to improve sexual and reproductive health for women and girls in Sierra Leone. The humanitarian agency began working in the country in 1961. Goals of the organization include providing medical supplies and contraceptives, giving training to healthcare workers and working with the community to eliminate attitudes that prevent women from discovering their rights to sexual and reproductive health. CARE is currently present in approximately 30 percent of the country’s communities, particularly in areas that have high rates of HIV infection and teenage pregnancy. One Sierra Leonean mother, named Fanta, credits CARE with educating her about proper breastfeeding and health practices, leading to the survival and continued health of her daughter.

Healthcare in Sierra Leone is an issue that is complicated by the nation’s high rates of poverty, many endemic diseases and tumultuous political history. While shocking statistics, such as the country’s low life expectancy and high maternal and infant mortality rates paint a grim picture, there are signs of progress being made, and there is potential for much more change on the horizon.

– Joshua Roberts

Photo: Flickr

English in Developing Nations
When discussing the development of some of the lower-income nations of the world, the English language has a tricky history. Some countries label English as their national language when a majority of their populations speak something else. There are also organizations, such as the Peace Corps, that teach English in developing nations with the intention of providing the students with more opportunities. However, some have widely debated the effectiveness of teaching English in other nations and its relation to development. This begs the questions: How might English improve a developing nation and what are some past results?

Expectations

The intentions behind teaching English in lower-income areas are usually positive. In 2011, the British Council identified four benefits of the English language including that it improves employability, provides international mobility, is a key for unlocking development opportunities and is a neutral language. Here is a breakdown of each of these points.

  1. Employability: English for the purpose of employability assumes that someone with English skills will be more competitive for a job.
  2. International Mobility: English for the purpose of increasing international mobility assumes that people with English skills are able to travel to other countries more easily, through methods such as studying in international schools or working in other countries.
  3. Development Opportunities: English as a key for unlocking development opportunities assumes that a lot of published information and research is in English and that acquiring English skills can grant access to a lot of that information.
  4. Neutrality: English as a neutral language occurs when an institution or country has several dialects, possibly with complex social connotations attached to them, that hinder easy communication. People can use English as a linking language to unify groups.

These four roles outline how people could ideally use English to help developing nations, but history has proven that it is rarely that simple or effective.

Reality

Now, with the establishment of the theoretical ways that English can help people, here is some evidence to show if reality meets the expectations.

In regards to English’s ability to help employment opportunities, a Sierra Leonean wrote a piece in 2020 in which she discussed this very problem. Sierra Leone’s schools teach English and most government positions speak it, but a majority of the population speaks Krio, a dialect similar to English.

This writer labeled English as a “burden on a majority of citizens aged 18-40.” She stated that children struggle to learn due to its usage in classrooms and that jobs often go to unqualified people because they can speak English. Essentially, they feel that it is unfair that people have labeled English as such an important skill while teachers ineffectively teach it to students. She acknowledged that English can be an opportunity to make citizens more globally competitive, but that there seems to be a disconnect between the education system and the people. In this instance, the mishandling of the execution of teaching English did not measure up to the expectations.

Despite the structural shortcomings, there are some observed benefits for English in developing nations. A 2011 study that the British Council commissioned concluded that learning English in a developing country can increase an individual’s earning power by around 25 percent. The study gathered the data from five countries: Nigeria, Bangladesh, Pakistan, Cameroon and Rwanda. The data revealed that the English speaking countries (Nigeria, Bangladesh and Pakistan) received more investment from other English speaking countries such as the U.S. and U.K. However, the report also shows that urban elites reap most of the benefits of speaking English, as they tend to have access to better schooling and higher-paying jobs.

Another benefit of speaking English is that some countries that outsiders previously did not visit, such as Sierra Leone, Mozambique and Ethiopia, are now growing tourist destinations. Many think that locals’ abilities to communicate with said tourists can increase interaction and commerce. In 2018, Africa accounted for only 1 percent of tourism earnings worldwide. Because of this largely untapped market, a lot of policymakers and business owners are hoping to find ways to appeal to more travelers.

African migrants often move to places such as the U.S. or the U.K. to flee economic hardships and human rights abuses. According to the 2019 census, African languages are the fastest growing in the United States.

However, English skills can greatly affect the success of African migrants entering English speaking countries. The BBC published a story in 2005 on Africans’ success in the U.K. It stated that “African-born immigrants are doing better than many other migrants.” It found that 81 percent of South Africans, 73 percent of Zimbabweans, 61 percent of Nigerians and 12 percent of Simoleans had employment. These figures deduced that English competency plays an important role in an African migrant’s ability to find employment in the U.K. and most likely other English speaking nations.

The Need for Balance

Essentially, what the evidence suggests is that teaching English as a tool for development could be beneficial, but currently there are a lot of obstacles surrounding the actual implementation process. English carries the stigma of colonization in several countries, so people often meet it with resistance. Conversely, in places such as Pakistan, people treat English as superior to native languages, which causes rifts between populations rather than unifying them.

Clearly a balance is necessary and there are specialists and organizations attempting that now. One method that seeks to maintain the integrity of native language while also presenting the opportunity to learn English is “Mother Tongue-Based Multilingual Education.”

A paper that Tove Skutnabb-Kangas wrote in 2013 cited examples of MLE in practice in Nepal, Sápmi and Ethiopia, and highlighted the positive effects the program had on students.

There are organizations, such as the Asia-Pacific Multilingual Education Working Group, that are currently attempting to utilize this method in places such as Thailand and Cambodia to strike a balance when integrating English in developing nations around the world.

English does seem to be a viable option for development in some instances, but in others, it can lead to added societal tension and obstacles for students. As implementation and teaching programs progress, hopefully, they will work out the negatives so citizens of low-income nations can just focus on creating more opportunities for themselves.

Lindsey Shinkle
Photo: Flickr

Sanitation in Sierra LeoneSierra Leone is a country on the west coast of Africa with a population of more than 7.5 million people and is perhaps most widely known for its turbulent diamond trade. The country’s heart resides in its lively capital, Freetown and it attracts many visitors with its beautiful beaches and vibrant rainforests. Despite its rich natural resources, the country struggles when it comes to providing adequate sanitation services for its citizens. Here are 10 facts about sanitation in Sierra Leone.

10 Facts About Sanitation in Sierra Leone

  1. A decade-long civil war severely impacted the country’s infrastructure. Ensuring access to safe water and sanitation services has been a top priority during Sierra Leone’s post-conflict governance reform. However, there is still much work to be done to restore services that halted during the war in the 1990s.
  2. Waste management is a major challenge. The Minister of the State, Office of the Vice President, Mohamed Alie Bah said in 2017 that the increasing amounts of solid waste need to be addressed, as the problem will only worsen with expected population growth. The Ministry of Health and Sanitation in Sierra Leone is troubleshooting the most effective and sustainable ways to address the problem with the hopes of improving overall health and wellness in their communities.
  3. Nearly 3 million people lack access to clean water. As a result, millions drink from freestanding water such as ponds and unprotected wells, which increases the likeliness of exposure to infections and parasites. According to a 2017 report, risks associated with poor water, sanitation and health facilities are the second largest cause of death and disability. The Water Project is an example of one nonprofit working to improve clean water access in Sierra Leone. To date, the group has built wells that have benefited 7,000 Sierra Leoneans to date.
  4. Diarrheal disease is a leading cause of child death. Drinking unclean water that contains bacteria or parasites can lead to an infection in the intestinal tract. Diarrheal disease usually results in malnutrition and dehydration, which can become fatal. In Sierra Leone, more than 1,400 children die from diarrheal diseases each year.
  5. Sierra Leone is trying to improve water quality and availability. Officials in Sierra Leone are aware of the importance of providing adequate drinking water and are currently taking steps to conceptualize, budget and fundraise for systems that would hopefully improve the country’s water supply. Due to a lack of funding, it appears that the project will be a collaborative effort between several sectors and organizations. An anticipated $164 million annual investment is needed to create and maintain rural and urban water supply facilities. Even with donations from organizations such as the World Bank and UNICEF, the monetary goal is expected to be missed by a large margin, around $130 million.
  6. Sierra Leone has one of the world’s highest maternal mortality rates. While a majority of maternal deaths are caused by severe bleeding, 11 percent of the deaths are caused by sepsis. Most maternal deaths are treatable and preventable, and this statistic is another indicator of the changes that still need to be made. Over recent years, the Ministry of Health and Sanitation in Sierra Leone has partnered with the World Health Organization to implement several health initiatives, including the Emergency Obstetric and Newborn Care training program, which aims to ensure health care professionals have the knowledge needed to manage child-birth related complications.
  7. Hand-washing facilities are often lacking. According to a report published by the Government of Sierra Leone in 2017, 27 percent of people in urban areas have access to hand-washing facilities with soap and water, and only 15 percent of people in rural communities have the same access.
  8. Household toilet facilities are often inadequate. Nationally, only 16 percent of households have an improved toilet facility, which is defined as “a non-shared facility constructed to prevent contact with human waste.” These facilities reduce the spread of diseases such as cholera and typhoid. Conversely, 18 percent of households nationwide do not have access to any toilet facilities, and instead, must defecate outdoors.
  9. Poor menstruation hygiene management affects girls’ education in Sierra Leone. Girls in Sierra Leone can face several challenges while menstruating, especially while attending school. The quality of restroom facilities can vary at schools, but oftentimes there are not bathrooms with running water or separate facilities for girls. This leads to girls having difficulty disposing of pads and managing their periods, which can leave them feeling embarrassed or distracted during classes. Others miss school altogether during their periods.
  10. Training is being offered to prepare Sierra Leone for future disasters or outbreaks. The CDC offers water, sanitation and hygiene (WASH) training to help at-risk countries strengthen their infrastructure and workforce to ensure they are prepared to prevent, detect and respond to infectious disease threats. There are several facets to the training, such as Outbreak Investigation Training, which trains public health staff to detect and respond to waterborne diseases, and training to teach students how to test water samples for contamination.

Improving sanitation in Sierra Leone has been a priority for the nations’ leaders for decades. While finances continue to be a challenge, improvements have been made thanks to the efforts of organizations within the country, such as the Ministry of Health and Sanitation, as well as organizations outside of the country, such as the World Health Organization.

– Lindsey Shinkle
Photo: Flickr

Technological Innovation in Sierra Leone
After a civil war in the 1990s and early 2000s and an Ebola outbreak in 2014, Sierra Leone is slowly recovering by investing in its future through technological innovation. The President of Sierra Leone, Julius Maada Bio, stated that “Science and technology is the bedrock for the development of any modern economy.” With its labor force consisting of more than 60 percent of subsistence farming and its GDP being agriculture-based, the West African country has its sights on technology to help diversify its economy. UNICEF, Sierra Leone’s Directorate of Science, Technology and Innovation (DSTI) and businesses are working together to improve the lives of Sierra Leoneans.

UNICEF and DSTI

President Bio created the Directorate of Science, Technology and Innovation (DSTI) in 2018 to further his vision of developing a technology sector in the country. Dr. David Sengeh is the first Chief Innovation Officer of DSTI. UNICEF and DSTI have partnered to support the use of digital data. One result of the partnership is the Free Quality School Education Initiative. The initiative uses data science to help grant free education to every child and give fast feedback on test scores and the quality of education. MagicBox is an open-source data-sharing platform that UNICEF is investing in which includes partners such as Google and IBM. People can use MagicBox to map epidemics in order to reduce the spread of disease and it has helped Sierra Leone since 2014. Its first use was during the 2014 Ebola Crisis in West Africa. It can also collect private and public data on education and poverty.

Drone Medicine Transportation

UNICEF and the DSTI are also testing drones that could deliver medicine and vaccines. Drones could also send pictures and digital data of natural disasters to mitigate hazards to the public. Sierra Leone is the fourth country that UNICEF drone-tested. Aerial imaging, used for mapping infrastructure, transportation and agriculture, helps elevate the country’s development. Since it is one of the least developed countries in the world, drone data pertaining to infrastructure is a good first step in development. For example, only 10 percent of the roads are paved, making transportation slow and difficult. During the rainy seasons, rural floods cut off communities for up to six months. Drones could reach the communities, especially those with HIV and AIDS.

GEN-350

The GEN-350 is a new technological innovation in Sierra Leone that produces drinking water out of the air. Watergen created the generator called GEN-350 in its mission to provide affordable water to countries that lack clean drinking water. The generator simply needs electricity to operate. The GEN-350 can produce up to 900 liters of water a day. About 50 percent of the population lacks clean drinking water, so the generator reduces the possibility of waterborne disease. Waterborne diseases are one of the main causes of death in the country. Water sources for Sierra Leoneans include ponds, puddles and wells that chemicals from mining and agriculture have contaminated. Watergen’s GEN-350 is a long-term solution to clean and affordable water for those in poverty in Sierra Leone and the world.

Technological Innovation Ongoing

The Bill & Melinda Gates Foundation’s $773,000 grant to DSTI’s GIS Portal in 2019 expresses increased interest in Dr. Sengeh’s goal to provide “real-time information for timely access and receipt of services, and optimize service delivery specifically in the provision of maternal healthcare services.” Although technological innovation in Sierra Leone is in its infancy, the government shows initiative with the creation of the DSTI.

A civil war between 1991 and 2002 tarnished its economy, but the country is seeing development as companies such as Watergen and organizations such as UNICEF provide solutions to alleviating the effects of poverty, such as poor education and polluted water.

– Lucas Schmidt
Photo: Flickr

All As One is Fighting Child Poverty
All As One is an orphanage fighting child poverty in Freetown, Sierra Leone. Sierra Leone is one of the poorest countries in the world – 70 percent of the population lives below the poverty line. The 340,000 orphaned children feel the disparities of this country in particular. They have a one in five chance of dying before they reach the age of 5 and a 57 percent chance of never learning to read.

Recently, The Borgen Project had the opportunity to speak to the Executive Director of All As One, Deanna Wallace. During the interview, Wallace noted that All As One has been working in Sierra Leone over the past 20 years and that the orphanage has impacted “the lives of over 35,000 children and young adults, helping to bring change to a generation of children.”

How All As One Fights Child Poverty

Four main factors cause poverty in Sierra Leone including corruption within the government, insufficient infrastructure, lack of education and inadequate civil rights. Children often die at birth due to low-quality health care or starvation. The problem of child poverty worsened after the 2014 Ebola outbreak, which left thousands more children orphaned and impoverished.

All As One is fighting child poverty in Sierra Leone by taking care of its most vulnerable children and young adults. The orphanage provides them with a home, education, medical care and other amenities as needed. While All As One does not offer adoption services, the amenities it does provide help these children establish a healthier lifestyle.

Wallace stated that, “All As One helps fight poverty on the ground level, mainly through education, so that their children can find jobs and support themselves as adults.” The organization also gives micro-loans to entrepreneurial young women with dreams of starting a business. In addition, All As One provides nourishing meals to 100 children every day, with hopes that these children escape the grips of poverty.

The organization currently has about 45 children in care and about 55 daily patrons from the surrounding community, who visit for schooling and food.

Life At the Center

Life for a child at All As One involves going to school, doing homework, completing small chores, having playtime in the afternoons, attending church on Sundays and occasionally going on outings. Reflecting upon these offerings, Wallace said that “the children we care for have it better than so many [children in Sierra Leone] like those who are forced into the workforce as a child.” A staggering 51.3 percent of children in Sierra Leone are subject to child labor.

Recent Strides in Fighting Global Poverty

Recently, five All As One students received the opportunity to take a university entrance exam. Although the test typically has a 95 percent failure rate, all five AAO students passed the exam and were able to continue on to attend university. Victories such as this encourage All As One to continue its fight against poverty in Sierra Leone.

– Emily Joy Oomen
Photo: Flickr

Infection Prevention and Control in Sierra Leone
Sierra Leone did not have an existing infection prevention and control program before its 2014-2016 Ebola epidemic. However, infection prevention and control is an essential element aiding in eradicating and preventing cross-infection among the community, patients, health care providers and hospital visitors.

The Current Course of Action

The Ministry of Health and Sanitation, with the help of the Centers for Disease Control and Prevention (CDC), has made significant strides in an attempt to get Sierra Leone’s health sector back on the right track. This partnership involves the implementation of the National Infection Prevention and Control Action Plan (IPC) to prevent future infection and disease. The IPC will enable the equipping of health facilities and open up conditions for the resources required for standard and transmission-based precautions. Further, the goal of the IPC aims to prevent and contain health care-associated infections.

The CDC’s Involvement

Disease threats are spreading faster than ever before but the CDC’s efforts in Sierra Leone have helped improve the country’s prevention, detection and ability to respond to infectious disease outbreaks. These abilities remain especially key before outbreaks become epidemics with the potential to affect global populations.

The CDC has played an important role in infection control in Sierra Leone, even establishing a country office in 2015 to focus on global health security. The CDC has been diligently working with Sierra Leone on surveillance, emergency management, strengthening laboratory and the workforce capacity to respond to disease outbreaks.

More than 700 CDC staff members served on over 1,000 deployments to Sierra Leone after the Ebola outbreak. Further, this makes it the CDC’s largest outbreak response ever in a single country. Sierra Leone, as of November 2015, is Ebola-free.

Keeping Infection and Disease Under Control in Sierra Leone

Sierra Leone has taken a different approach to sustain the infection prevention and control. The country has invested in ongoing training for its health care workers. These efforts have helped ensure a safe working environment for all, with lower health care-associated infection risks. Health care workers and hospitals have improved their disposal of waste practices, hiring individuals to clean, along with disposing of the waste.

In addition, Sierra Leone has heightened awareness of infection prevention and control with the aid of supported sanitation and hand hygiene campaigns. These campaigns aid in the creation of a culture of hand-washing and have drastically reduced cross-infection among patients, thus eradicating Ebola.

As Dr. Keiji Fukuda, the WHO Assistant-Director General, states, “When health workers are infected at work, this puts other health care workers at risk. Understanding where the breach in these measures is occurring and taking the steps needed to fully implement infection prevention and control measures can put an end to these infections.”

Na’Keevia Brown
Photo: Flickr

Maternity Crisis in Sierra Leone
There is a maternity crisis in Sierra Leone. The country has the highest maternal death rate in the world, with one in 17 women dying from pregnancy or birth complications. This number could be even higher, as Sierra Leone’s 2017 Maternal Death and Surveillance Report estimated that seven in 10 maternal deaths go unreported. Below are seven facts about the maternity crisis in Sierra Leone.

Top 7 Facts About the Maternity Crisis in Sierra Leone

  1. The Majority of Maternal Deaths are Preventable: The top causes of maternal death in Sierra Leone are bleeding, pregnancy-induced hypertension, infection and unsafe abortions, all of which are preventable through adequate medical treatment, according to the World Health Organization. Bleeding is a particularly difficult problem for under-served rural areas where mothers do not have access to health care facilities. Another issue facing mothers is infrastructure. People poorly maintain many roads between towns and clinics and these make for a difficult journey for sick and laboring women. Again, road maintenance is a simple problem that can help reduce maternal death in Sierra Leone.
  2. The Majority of Mothers are Under 20: One hundred and twenty-five out of 1,000 mothers in Sierra Leone are under age 20 according to a 2017 United Nations Population Fund (UNFPA) study. Maternity in Sierra Leone is particularly dangerous for adolescent mothers and 20 percent of maternal deaths in Sierra Leone were among teenagers. Beyond maternal death, pregnant teenagers in Sierra Leone lose out on life prospects – a 2015 law banned pregnant girls from attending school, and parents describe teenage pregnancy as the “ultimate shame” for a family.
  3. The 2014-2015 Ebola Crisis Halted Progress: Before 2014, Sierra Leone was making progress in reducing maternal death – from 2000 to 2015, maternal deaths dropped by 4.4 percent. However, the Ebola epidemic caused an immediate increase in maternal death through 2015. Sierra Leone planned to meet many Millennium Development Goals by 2015, but the May 2014 Ebola outbreak reversed progress, particularly in maternal health. Not only did Ebola put a strain on general health care in Sierra Leone, but it also dramatically reduced the number of health care workers in the country. A 2016 World Bank report estimated that maternal death could increase by 74 percent due to the extreme shortage of health care workers in the country.
  4. Programs for Maternity Care Still Need Funding: There is a dearth of doctors in Sierra Leone. For example, in the district of Bonthe, there are nine doctors for 220,000 patients and only 44 percent of births receive support from a nurse or midwife. Unfortunately, between the civil war from 1991 to 2001 and the 2014 to 2015 Ebola outbreak Sierra Leone, the burgeoning health care system in Sierra Leone lost momentum. The E.U., the U.N. and UNICEF have all devoted funds to maternity in Sierra Leone in addition to Partners in Health and other nonprofit organizations. Donations are critical to moving forward with maternal health.
  5. Sierra Leone’s Government has Committed Itself: President Julius Maada Bio announced in October 2019 that Sierra Leone increased its health budget from 8.9 percent to 11.5 percent of the country’s national budget to help combat dangerous maternity in Sierra Leone. On October 18, 2019, Sierra Leone opened a $1.6 billion maternity facility in Freetown to better serve the country’s largest city. Sierra Leone also launched a free health initiative in 2010 to help improve pre- and post-partum care. The government’s goal for maternity in Sierra Leone is to meet Millennium Development Goals by 2030, reducing the global maternal mortality ratio to less than 70 per 100,000 live births.
  6. Nonprofits are Deeply Involved: Multiple nonprofit organizations, including UNICEF, Partners in Health and the Borgen Project have covered issues with maternity in Sierra Leone. Partners in Health has been particularly successful, building a maternal waiting home and opening a health clinic in Kono in 2018. UNICEF provided safer water for mothers to help with illness and sanitation. These nonprofits prove that the crisis is not insurmountable.
  7. Celebrities are also Getting Involved: In October 2019, vlogbrothers, run by Hank and John Green, pledged $6.5 million to Partners in Health as part of his family’s initiative to bring awareness to maternity in Sierra Leone. John Green discussed how he traveled to Sierra Leone and saw first-hand the lack of hospital electricity, medical equipment and transport. He praised the efforts of the Partners in Health in developing a large-scale hospital system and making systematic changes and he asked anyone who can donate to do so. Currently, the vlogbrothers have a goal of $240,000 per month in donations – so far, they have approximately $194,000. The vlogbrothers are also providing updates on their donations and work with Partners in Health in Sierra Leone.

Motherhood should not be a gamble. Families around the world deserve to look forward to pregnancy and birth and not feel distressed. Multiple organizations are pushing for progress, but more is necessary. Support in any form, from awareness to donations, can only help the crisis of maternity in Sierra Leone.

Melanie Rasmussen
Photo: Flickr

Sierra Leone Health Care
Access to quality health care in Sierra Leone has been an ongoing struggle for many people in the country due in part to a history of war and conflict. Poor living conditions also have an impact on the percentage of the population with access to essential, life-saving health care services. Of note, in Sierra Leone, 73 percent of rural citizens live in poverty. Fortunately, both local and international powers are making attempts to change the status quo in order to create a more promising future for Sierra Leoneans. Keep reading to learn more about efforts to improve.

5 Ways Health Care is Improving in Sierra Leone

  1. In September 2017, the Ministry of Health and Sanitation proposed the National Health Sector Strategic Plan. The plan outlines how years after the Ebola outbreak of 2014, the disease still impacts survivors’ daily lives. The Ministry of Health and Sanitation proposes a long-term recovery plan to last until 2021. The proposal states its vision of “A well-functioning national health system that delivers efficient and high-quality healthcare and ultimately contributes to the socio-economic development of the country. This care must be of high quality, accessible, affordable and equitable to all Sierra Leoneans.”
  2. In 2017, the International Organization for Migration began the Strengthening Sierra Leonean National Health Care Capacity through Diaspora Engagement project. This project connects health care professionals in Sierra Leone with residents in rural areas, providing them with free health care assistance. Over 1,000 people living in the Moyamba District benefited from it because it provided surgeries, dental care and examinations to those who needed them. Although the project lasted for only two years, ending in March 2019, a new Mobile Health Clinics campaign began shortly afterward in May 2019 in association with the Sierra Leonean Ministry of Health calling to continue to serve those in need of health care in rural towns.

  3. In March 2019, The United Nations Development Programme distributed 15 vehicles to the Ministry of Health and Sanitation in Freetown, Sierra Leone. Because the country has many roads and other areas that are difficult to travel on foot, the vehicles allow people to deliver health care supplies to those in need more safely and quickly. The United Nations also trained Sierra Leoneanese, including 360 women, in the management of the Health and Sanitation facility. “Health-related issues shouldn’t be restricted to one agency,” said the UNDP’s Resident Coordinator, “there should concerted efforts from all stakeholders. Development starts with healthy people.”

  4. According to the World Health Organization, hand hygiene has served as a major issue within the country. Many people in Sierra Leone do not have access to clean water to wash their hands, which aids in the spread of diseases. In response to this and to support World Hand Hygiene Day each May, Sierra Leone now has handwashing stations near hospitals. WHO has also held events educating locals about the importance of handwashing to keep both individuals and communities disease-free.

  5. In September 2019, Sierra Leone’s government opened Rokupa Hospital in Western Urban District, Freetown, aiming to improve health care services for women and children. An estimated one in 17 women in the country dies due to complications from childbirth and the facility aims to provide women with access to better maternal health care. The hospital has added 4,000 new health care staff and increased the financial investment for health services by 2.1 percent. On top of the Sierra Leoneans government, the U.K. government and the United Nations Population Fund also funded the construction of the new facility.

Sierra Leone may have a long way to go to improve its health care, but its significant progress is impressive. With increased efforts, the country should be able to provide even better care in the future.

– A. O’Shea
Photo: Unspash

Food Insecurity in Sierra Leone

More than 40 percent of Sierra Leoneans experience food insecurity. This largely stems from the nation’s high poverty rate—53 percent of the population lives below the income poverty line—and the fact that 60 percent of the population performs low-paying subsistence agriculture work.

Efforts to address food insecurity in Sierra Leone, including those by the World Food Programme, the International Fund for Agricultural Development and Action Against Hunger, concentrate on combating these root causes and providing food to those in need.

Even though the food insecurity rate in Sierra Leone is still high, it has improved over the last several years, declining from 49.8 percent in 2015 and 43.7 percent in 2018. The percentage of households that are severely food insecure also decreased significantly, falling from 8.6 percent to 2.4 percent between 2015 and 2018. Still, approximately 3.2 million Sierra Leoneans continue to be food insecure and 170,000 are severely food insecure.

Furthermore, malnutrition in Sierra Leone is a persistent problem because of food insecurity. A 2018 survey found that 24 percent of households reported consuming food from less than three food groups in a week. This diet can have a dangerous impact, especially on children as malnutrition affects their physical health and making educational attainment more difficult.  Of note, 31.3 percent of children in Sierra Leone suffer from stunted growth due to chronic malnutrition.

3 Organizations Combating Food Insecurity in Sierra Leone

  1. The World Food Programme
    The World Food Programme (WFP), active in Sierra Leone since 1968, works to provide aid to those experiencing food insecurity and malnutrition, as well as addressing some of the causes of persistent food insecurity in Sierra Leone. Some of the organization’s main goals are ensuring access to food for all, achieving lower malnutrition rates and helping smallholder farmers become more financially prosperous. To accomplish these goals, the WFP provides food assistance to those affected by disasters and emergencies, provides cash assistance to the chronically food-insecure and trains smallholder farmers to strengthen their market access and profits.One of the WFP’s most impactful programs is its school feeding program, which was launched in 2018 in Pujehun and Kamiba, two districts experiencing some of the worst food insecurity in the nation. A significant side effect of food insecurity in Sierra Leone is low schooling rates, especially for girls. To reduce the number of children a family needs to feed, parents sometimes arrange child marriages for their daughters. This effectively ends their education because girls who are married are rarely able to continue going to school.Providing meals at school helps encourage families to continue sending their children to school and helps reduce the associated cost for the family. It also ensures vital nutrition and can help reduce malnutrition and its effects, including stunting of growth. The Pujehun District has a stunting rate of 38 percent, one of the highest in the country, which reflects a significant need for a program like this.The school meals are not meant to be a substitute for home-cooked food, but they help ensure that children do not go hungry during the day and provide a consistent source of essential nutrients. The school feeding program reached more than 29,000 children, including 14,000 girls, in its first year.
  2. Action Against Hunger 
    Action Against Hunger has been active in Sierra Leone since 1991. Their programming is focused on improving sanitation, hygiene and water access, as well as food security. To decrease food insecurity in Sierra Leone, Action Against Hunger grows leguminous plants and vegetables to help diversify food and income for farmers. They also develop savings and credit groups to increase financial opportunities for smallholder farmers.In 2018, Action Against Hunger helped a total of 215,433 people, 8,000 of which benefited from food security and livelihood programs. They also strengthened 32 health facilities and helped improve nutrition for mothers and children under 5.
  3. The International Fund for Agricultural Development
    In March 2019, the government of Sierra Leone and the U.N. reached a $72.6 million deal to improve food security and rural income in the nation. The International Fund for Agricultural Development (IFAD) is providing a $5.9 million loan, a $5.9 million grant and allocating an additional $40.8 million to use for the deal between 2019 and 2021. The additional funds are being provided by the government of Sierra Leone and the private sector. This project seeks to tackle poverty and food insecurity in Sierra Leone by strengthening agricultural systems and empowering farmers.  Women and youth are hoped to make up at least 40 percent of the project in an effort to promote gender equality and provide opportunities for young people.IFAD will invest in agricultural mechanization, water management and irrigation, as well as create field schools for farmers and provide them with opportunities for greater financial security. The goal is to increase production and expand markets to raise smallholder farmers’ incomes, thereby tackling one of the root causes of food insecurity in the nation.

Sara Olk
Photo: Wikipedia