While recording videos for his “Poverty Makes You Sick” campaign, Paul Farmer traveled to Freetown, Sierra Leone to interview Ebola survivors. During his campaign, Sierra Leone’s government contacted Farmer’s organization, Partners in Health (PIH), to help contain the outbreak. Thanks in part to PIH’s efforts, the country survived the virus; however, Farmer wanted to help strengthen its healthcare system by focusing on maternal mortality in Sierra Leone.

PIH recognizes that “99% of maternal deaths happen in developing countries;” however, extreme poverty denies Sierra Leonean mothers access to affordable maternal care. The country’s lack of medical professionals and supplies complicates the situation as it prevents expecting mothers from receiving valuable knowledge and prenatal care. Sierra Leone has only 1.4 doctors, nurses and midwives per 10,000 people, significantly lower than the ratio of 44.5 recommended under the Sustainable Development Goals. The country only has one medical school which produces around 30 graduates annually. Overall, Sierra Leone has a shortage of 32,000 doctors, nurses and midwives as there are only 1,000 qualified healthcare workers today.

These detrimental factors contribute to Sierra Leone’s high maternal mortality rate. According to UNICEF, “With 1,360 mothers dying per 100,000 live births, Sierra Leone has the worst maternal mortality ratio in the world.” When considering the effects of Ebola, PIH notes that pregnancy and childbirth place one out of every 17 Sierra Leonean mothers at risk of death.

Despite these staggering statistics, PIH has contributed to reduced maternal mortality rates in Sierra Leone. After defeating Ebola, PIH continued its partnership with the Sierra Leonean government. By creating “six [medical] facilities across three districts,” PIH is working to safeguard every Sierra Leonean mother’s right to affordable and quality healthcare.

Over the last five years, PIH has reduced maternal mortality in Sierra Leone by:

Supporting Kono Community Members

PIH focuses on revitalizing healthcare in rural Sierra Leone, particularly the Kono District, which experienced the most devastation from the decade-long civil war. To earn the trust of the Kono community, PIH “employs a network of community health workers (CHWs).” CHWs connect their neighbors, families and friends to local healthcare services. They provide weekly check-ins and even accompany patients to healthcare facilities. CHWs also act as an invaluable support system for expecting mothers as they provide comfort, reassurance and prenatal resources. To assist expecting mothers and other vulnerable community members, PIH also provides transportation to and from medical facilities, equips CHWs with food packages and performs home repairs. Without a doubt, this ensures the safety of expecting mothers, newborns and children.

Supplying Resources to the Wellbody Clinic

While improving community relations, PIH works to enhance Sierra Leone’s existing healthcare system. PIH refurbished medical facilities, like Wellbody Clinic, providing Sierra Leoneans with access to modern medicine. For expecting mothers, PIH built maternal waiting rooms within the Wellbody emergency room and established an ambulance service for the Kono district. As women prepare to deliver, they can expect twenty-four-hour electricity, running water and advanced oxygen production supplies.

Should any complications arise after delivery, PIH connected the Wellbody Clinic to a functioning blood bank. All of these measures ensure mothers’ survival before, during and after childbirth. Clearly, Sierra Leonean women trust the Wellbody Clinic as the facility saw a “77% increase in facility-based deliveries” over the last two years. Instituting Specialized Healthcare Options: Alongside these resources, PIH supplied the Wellbody Clinic with the district’s only surgeon. This surgeon can perform safe emergency C-sections should any complications arise during childbirth. Thanks to PIH’s specialized support, “there have been no maternal deaths in four years” at the Wellbody Clinic.

While PIH radically transformed Sierra Leone’s maternal healthcare, COVID-19 presents a new albeit more daunting challenge. Beth Williams, a network leadership coach for Partners in Health Engage told The Borgen Project that, “COVID-19 negatively impacted Sierra Leone’s maternal and child health.” In the wake of a new virus, Farmer’s organization will continue to address maternal mortality in Sierra Leone.

As an affiliate of PIH, Partners in Health Engage will launch a fundraising campaign to support Sierra Leonean mothers during COVID-19. This arm of the organization plans to raise $100,000 for the new PIH Sierra Leone Maternal Center of Excellence (MCoE). Despite COVID-19, Williams maintains that MCoE will provide “a gold-standard of inpatient and outpatient maternal and newborn healthcare, which will serve as a model for other developing countries.”

Given the success of its Ebola campaign, PIH is well-positioned to see Sierra Leone through the reminder of the COVID-19 crisis. PIH Engage advocacy will supplement the Wellbody Clinic’s accomplishments and further reduce maternal mortality in Sierra Leone. Indeed, PIH’s focus on maternal welfare and the installation of its MCoE will offer a “blueprint for how to systematically end preventable maternal deaths around the world.”

– Kyler Juarez
Photo: Flickr