The countries of Guinea, Liberia and Sierra Leone face severe economic hardships if help is not brought in and fear is not alleviated.

The International Monetary Fund (IMF) met to decipher the plan to action. The plan was to offer zero-interest loans to help cover the three countries of concern, if only partially. Loans would provide relief “by around $130 million to help them meet financing gaps worth $300 million,” the Wall Street Journal reported. The IMF said the countries would need an additional $130 million to “cover the next six to nine months.”

Numbers predicted by the World Bank and IMF for next year are looking grim for economic growth in Sierra Leone, expected to drop from 11.3 percent to eight percent, growth cut more than half for Liberia to two-and-a-half percent growth and Guinea falling from three-and-a-half percent to just under two-and-a-half percent.

These predicted cuts in growth come after farmers have ceased to go into their fields, stores have closed up shop and because of fear of contracting Ebola, tourism has halted. It is predicted in Sierra Leone, there will be a one-third drop in agricultural output.

World Bank president Jim Kim responded to economic predictions pointing out that the crisis is not just about money. “The sooner we implement an effective response and decrease the level of fear of Ebola’s spread, the more we can limit the epidemic’s economic impacts.”

U.S. President Barack Obama addressed the nation September 16 concerning the Ebola outbreak and what the U.S. response would be, announcing the country will lead in the global effort of aid and will be deploying 3,000 members of the military and assist in the building of new healthcare buildings.

In addition to Obama’s pledges, the World Health Organization is asking for $1 billion to fight the spreading of the disease.

First signs of Ebola were seen in Guinea in March. The virus has now spread to Sierra Leone, Liberia, Democratic Republic of Congo, Senegal and Nigeria. The disease has taken 2,630 lives with 5,357 known infections as of September 19.

– Kori Withers

Sources: BBC, Wall Street Journal, Wall Street Journal 2, Reuters, New York Times
Photo: Flickr

malnutrition in sierra leone
Sierra Leone has both one of the highest malnutrition rates and one of the highest child mortality rates.  More than a third of children are chronically malnourished; in 2010, 22 percent were underweight, 44 percent were stunted, or had a low height for their age and eight percent were wasted, or had a low weight for their height.

The child mortality rate is 267 deaths per 1,000 children. Almost half of these premature deaths are caused by malnutrition.

The major influence in the high malnutrition rate is the lack of breastfeeding. Only eight percent of infants are breastfed. The rest are given insufficient substitutes, sometimes water.

Because of the conflict in Sierra Leone’s recent past, malnutrition has only recently come into focus as a concern. Even now, malnutrition is one of the most neglected areas of concern for the country. Despite Sierra Leone’s economic growth, the number of underweight children has increased 24 percent.

With such a high rate of malnutrition, many organizations are working to lessen the number of those malnourished.

One focus has been to vary diets, many of which consist mostly of rice. Farmer Field Schools were developed to increase agricultural productivity, but they have now been adapted to teach farmers how to raise more nutritious crops.

These Field Schools also connect farmers to markets where they can sell their crops.

Mother-to-mother support groups have also been set up.  These target the community level by educating women to teach others.  They also report instances of malnourishment that they see.

A total of 1,228 Peripheral Health Units are running in Sierra Leone, too.  They serve around 5,000 people each by providing medical care and nutrition services.

The WFP, UNICEF and WHO have also started their own supplementary feeding programs and centers.

There are 63 WFP-organized supplementary feeding centers in western Sierra Leone, which have reached almost 50,000 children.  They are funded by the government of Japan.

Children who are under 70 percent of a normal body weight are admitted.

The centers give children sugar, oil and a modified cereal that is enriched with micronutrients.  The UNICEF centers provide high-protein biscuits, therapeutic milk and a complex of vitamins and minerals.

Parents also receive health and nutrition education from the centers.  Many parents believe that milk and eggs are bad for children, and this education corrects these notions.  They also teach parents how to provide supplemental feedings.

After they provide rations and education, the centers continue to monitor the progress of the children.  They check to make sure children do not develop pneumonia or diarrhea, and they check to ensure that the child’s health improves.

Sierra Leone faces many struggles as they attempt to combat malnutrition.  The constraints for aid range from low funds, to a lack of data for what is needed, to low governmental support.

Staff are often underqualified, and there is frequent turnover.  The low numbers of personnel lead to less knowledge being passed to the people who need it, as information is diluted passing from person to person.

Mothers have low incentives to help their children because they are often blamed for their children’s poor health.  They see it as shameful to admit their children are malnourished, so they do not seek help.

Many nutrition efforts have seen an added strain from the recent Ebola outbreak, as well.  Sierra Leone has been upgraded to a Level Three food emergency, the highest threat level.

Despite these setbacks, Sierra Leone is working hard to increase the health of its population.  The country is making progress, but there is still work to be done to decrease malnutrition in the country.

– Monica Roth

Sources: WFP, UNICEF, Reuters, New Internationalist
Photo: Sorenbosteendahl

Dr. Sheik Umar Khan, Sierra Leone’s national hero due to his work in treating those with the deadly Ebola virus, has caught the disease. The Ebola doctor has since died after treating over 100 patients.

The current Ebola outbreak is the worst ever recorded, spanning three countries with over 1,000 people infected and 604 dead. Historically, Ebola killed 90 percent of those infected, but with improved awareness allowing the disease to be caught earlier, it has dropped to 60 percent. Once symptoms appear the disease is highly contagious and patients must be treated in isolation units. Those treating the patients are at a high risk for contracting the virus.

At the hospital where Dr. Khan was working, in the city of Kenema, nurses complained of improper equipment to protect them from Ebola. After eight nurses caught the disease in one week, and three died, the nurses went on strike and Doctors Without Borders stepped in to address the situation at the hospital, but not before Dr. Khan fell ill.

Dr. Khan was being treated in an isolation unit by Doctors Without Borders. It has now been confirmed that the Ebola doctor has died from the virus.

Most people who die from Ebola do so within 10 days of falling ill, due to hemorrhaging. The first recorded instance of humans contracting Ebola was in 1976 in South Sudan and the Democratic Republic of the Congo. The virus is named after the Ebola River, which flows through the Democratic Republic of the Congo.

Ebola is spread by coming into contact, directly or indirectly, with the bodily fluids of people or animals that have the disease. Symptoms include weakness, fever, aches, diarrhea, vomiting, rash, red eyes, sore throat, chest pain, difficulty breathing and swallowing and both external and internal bleeding.

Before the Ebola outbreak, Dr. Khan specialized in treating Lassa fever, which is similar to Ebola and is contracted by approximately 100,000 to 300,000 people a year in West Africa. When the Ebola outbreak began, Dr. Khan immediately turned all his attention to it, but not without stating “I am afraid for my life.” One silver lining is that the government may step in and take greater measures to address the outbreak now that the virus has struck a prominent figure.

– Taylor Lovett

Sources: NPR, CNN, CDC
Photo: Washington Post

ebola in sierra leone
The Ebola outbreak spreading across Africa has become increasingly fatal over the past couple of months. The incubation period for Ebola ranges from two days to 21 days, and when not treated early on, has about a 90 percent fatality rate.

According to WHO, 630 people total in the West African countries of Sierra Leone (442 people infected, 206 deaths), Guinea (410 people infected, 310 deaths) and Liberia (196 people infected, 116 deaths) lost their lives to Ebola. One of the most recent victims of the disease includes one of the leading doctors in Sierra Leone, Sheik Umar Khan, who contracted the virus while attempting to help treat others afflicted by Ebola.

Psychologist Ane Bjoru, who has begun work in Sierra Leone, however, explains the impact of Ebola beyond purely the physical effects of the virus. In her article in The Guardian, she explains that as a non-medical staff member, a large part of her job is helping hygienists, who have to deal with disposing of the dead bodies, deal with this “new and disturbing experience” and much of her work “involves helping them with counseling and support.”

Ane Bjoru explains that to treat Ebola in Sierra Leone the hygienists are responsible for cleaning the blood and stool produced by the patients, and are confronted with a confusing mix of emotions when dealing with the dead bodies. They are filled with sadness from the loss, fear from the contagious bodies, and especially in Sierra Leone where the dead are usually dealt with by the elders of the society, some of the hygienists feel they are too young to be involved with this part of the life cycle.

Ane Bjoru, through her work, seeks to build a wider community of people to help citizens of Sierra Leone deal with the emotional consequences of the Ebola outbreak.

— Jordyn Horowitz

Sources: World Health Organization, The Guardian 1, The Guardian 2, BBC News
Photo: The Guardian

The governments of many West African countries reportedly believe that the current Ebola outbreak could get worse due to citizens refusing treatment for the virus. The epidemic spans several countries, ranging from Guinea (where the outbreak was first spotted four months ago) to Sierra Leone. Despite the severity of the epidemic, health workers have struggled to administer aid due to uncooperative citizens.

Ebola, first detected in what is now the Democratic Republic of Congo in the mid-1970s, is a disease spread through contact with the blood and bodily fluids of infected persons or animals. It can cause fever, vomiting, bleeding and diarrhea. It is considered to be one of the world’s most deadly viruses, leaving only 10 percent of those who become infected alive.

“We are seeing a lot of mistrust, intimidation and hostility from part of the population,” said Marc Poncin, the emergency coordinator for a medical charity called Medecins Sans Frontieres (MSF). “What we are seeing are villages closing themselves off, not allowing us to enter, sick people hidden in the community. They don’t come and seek healthcare anymore.”

Citizens have been reportedly going into hiding, believing that a hospital visit is paramount to a death sentence. Health officials have been chased from villages, and in the eastern part of Sierra Leone, officials had to fire tear gas to prevent relatives of the recently deceased from claiming bodies to bury them; interfering with the infected bodies allows for the disease to spread.

According to the World Health Organization (WHO), around 888 Ebola cases have been reported, resulting in around 539 deaths. The WHO has labeled the epidemic as “precarious”. To handle the increasing amount of infections, MSF doubled its number of available beds. Yet, the organization feels that this outbreak could just be the “tip of the iceberg” – the beginning of a much more serious problem.

“If we are to break the chain of Ebola transmission,” said Manuel Fontaine, the Regional Director for West and Central Africa for UNICEF, “it is crucial to combat the fear surrounding it and earn the trust of communities. We have to knock on every door, visit every market and spread the word in every church and every mosque.”

In order to treat people effectively, citizen cooperation with health officials is necessary. According to Poncin, people in Gueckedou, Guinea shun the local center, where around 20 percent of the infected patients survive.

“People see people arrive more or less OK and then they die there. So they start to mistrust the treatment center,” said Poncin.

The same is true for the center in Kenema, located in the eastern region of Sierra Leone. According to Augusta Boima, a Red Cross worker, the people believe that going to the hospital will result in their death.

Many local residents have begun to associate Ebola with witchcraft, while others consider it an evil brought by aid workers. This has led to a clash of beliefs, as it is customary for families in the West African region to wash the bodies of their deceased. However, the bodies of those affected and killed by Ebola are laden with the highly contagious disease.

“For us to now have to give our beloved dead relatives away to people who will wrap them in a plastic bag and dump them in a grave without us washing and honoring them is hard to stomach,” said a Sierra Leone leader.

There are now around 603 Ebola-caused deaths and according to the WHO the situation is only worsening. Eighty-five new cases were reported in the week of July 8, and 68 deaths were reported from Sierra Leone, Liberia and Guinea in the past week.

– Monica Newell

Sources: Reuters 1, Huffington Post, Reuters 2
Photo: ThisIs50

mental health
Mental health is a largely neglected concern in many African countries. Efforts are often allocated in favor of more publicized issues such as HIV/AIDS, water sanitation and maternal health. Thus, those living with mental disorders are oppressed by media, social stigma, and government disinterest. Many fail to recognize that general and mental health are inseparable. To fight poverty successfully, both issues must be dealt with equal significance.

Sierra Leone only offers one psychiatric hospital to its citizens and its distance and limited space is discouraging. Sierra Leone’s mental health system is lacking and after its decade-long civil war, restorations and improvements to the country’s policy and infrastructure are imperative. Recently, new mental health initiatives are surfacing in Sierra Leone’s communities thanks to the vision and leadership organizations and individuals provided.

University of Makeni’s Department of Mental Health is part of the Catholic Church-run private university in Sierra Leone. It is a far-reaching department that coordinates counseling activities for those in need and mental health training for nurses.

Makeni Mental Health Department endeavors to stimulate development in political, economic, social and religious aspects in Africa. The department was conceived by the Fatima Institute which also started the Mental Health, Behavioral Change and Social Inclusion Programme. The program hosts various events and activities including counseling, sensitization and training in their movement to eliminate social stigma people living with mental health illness face. Promoting positive behavioral change is also an integral part of the program’s philosophy.

Children’s mental health is part of the keystone to a nation’s future. The Child Protection Knowledge and Information Network (CPKIN) strives to evaluate and better understand how to improve support systems for vulnerable children. In a post-war environment, many children are displaced from family or have lost their family altogether. These children have seen and experienced physical and sexual abuse, often leaving a wound in their mental health. Their weakened psyches make them subject to further exploitation.

CPKIN is a project developed by a coalition between UNICEF, Child Fund Sierra Leone and the Ministry of Social Welfare’s Gender and Children’s Affairs. CPKIN connects internal children’s mental health support in communities and villages with the formal child protection sector. Text message technology will serve as the backbone of this communication system between village chiefs, child protection volunteers and the sector.

Questions will be sent to chiefs and volunteers via text messages in order to prompt these members of the support system to discuss and critically evaluate the efforts being done for the children’s well-being. CPKIN is a dynamic survey because members are able to evaluate and improve their efforts on a community level, while the responses they send through text messaging is used to improve the Child Protection Policy on the political level.

Sierra Leone’s government has also outlined a new mental health policy, which intends to make mental health services a part of the public health sector. The document acknowledges the severity of Sierra Leone’s neglect to mental health and the importance of mental health in living a holistically sustainable life.

In lengthy detail, the policy document assesses the meager situation of those afflicted by mental health disorders, general and specific objectives, areas for action (treatment, rehabilitation, etc.), required services, as well as long- and short-term goals.

It is an optimistic initiative full of promise as it recognizes the social and economic barriers faced by those living with mental illness and acknowledges the stakeholders in need, such as mothers, children and those with HIV/AIDS.

It is a document that proves the government is well aware of the issues encasing mental health. However, there is an arduous trek separating promise and reality. It will take time before the policy is fully realized but the announcement of this policy is definitely something to celebrate.

Mental health support initiatives in Sierra Leone range from direct aid to policy reform. It’s enriching to see such solid growth of mental health support in Sierra Leone but there is still much to be done before the nation can haul itself into a stabilized future.

– Carmen Tu

Sources: Harvard Center for International Development, IPA, WHO, Republic of Sierra Leone
Photo: The New York Times Blog

sierra leone
Sierra Leone has adopted a new method to facilitate discussions about corporal punishment and the violence it perpetuates. Supported by UNICEF’s Learning for Peace program, groups of performers write original plays that deal with the consequences of violence.

One theater performance is titled “The Stepson.” The lead character is a young boy who is beaten by his stepmother before going to school and being physically punished again there. This leads him to run away from home. The goal of the play is to educate and open up dialogue about corporal punishment in Sierra Leone, while providing alternatives for conflict resolution.

Performances like this are not new to development efforts. Other programs around the globe are using theater to effect change in their communities. The Bedari Theatre Programme in Pakistan builds on the Punjabi tradition of street theater to facilitate conversations and change in regards to child marriage. A group in Timor-Leste, called Damas, consists of an all-female ensemble that challenges gender stereotypes through their subject matter and by turning Shakespeare on his head to cast women in male roles. The Theater of the Oppressed, which has spread from its Brazilian heritage to the far corners of the globe like India and Australia, works to give marginalized persons a voice through performance.

In all of these participatory programs, education is key. In Sierra Leone, school is part of the problem. Corporal punishment scares children away from the classroom; a group of students enlisted by the rebels in Sierra Leone’s civil war came back after fighting and killed their teachers because of the violence inflicted on them in school. Theater provides a way to educate the population in a safe and engaging way that challenges the conventional classroom culture.

The performances also educate the performers. PETA, a Phillipine group, found that when children who scavenged in the garbage to survive were involved in theater workshops, they became more confident and articulate. Often, the cast of a performance will include local volunteers, and groups will interview community members to create a realistic, relatable script. This allows the performances to be culturally appropriate and to open up dialogue.

The community will often not respond well to people in authority, but a grassroots conversation fostered by entertainment creates opportunities for people to engage with each other on a topic.

There are other advantages to using theater for development. It is portable, recordable, and cost-effective, particularly when enlisting volunteers from the community to help write and act. It is also public, so people do not feel invaded by the message, but instead volunteer to come see the performance. A major advantage is that understanding and engaging with the performances does not require literacy, so performances are accessible to all.

Theater binds communities together in appreciating each other’s talents and having conversation. It is fun, so people want to be involved, which allows more advocacy efforts to reach more people.

Despite the good work theater does in initiating change in communities, there are some drawbacks. One drawback is the time involved in creating a work. When volunteer writers and actors get together, it can take a lot of time to construct a coherent, rehearsed play. This is a disadvantage when a new topic becomes immediately relevant. The large groups involved can also sterilize the message in order to please everyone.

The government can be another issue. Since governments often provide funding, they sometimes attempt to use theater performances to push their own agendas. Or, in the case of Ghana, the government will shut down programs out of fear the performance will not support current political systems.

People also expect theater to make drastic changes on its own. Theater works best when coupled with other advocacy efforts, like the dialogue sparked by the Sierra Leone performances.

The 20th annual conference for Pedagogy and Theatre of the Oppressed began on Thursday, July 3. Hosted by the University of Nebraska, the conference will aim to improve the development work done by theater performance and give marginalized people a stronger voice.

– Monica Roth

Sources: Oxford Journals, UNICEF Girls Not Brides, Jana Sanskriti, ActNow,
Photo: Girls Not Brides

solar power
The Abu Dhabi Fund for Development announced a new loan program that would provide Sierra Leone with Dh 33 million, or about $8.9 million, to construct a new solar power plant near Freetown, the capital and a major urban area. Called Solar Park Freetown, the project would provide an extra six megawatts to Sierra Leone’s already burgeoning solar power networks.

In addition to providing manufacturing jobs to people who need it, Solar Park Freetown will bolster Sierra Leone’s shaky central power supplies. Much of Freetown’s power comes from the Bumbuna Dam, which, according to a 2011 World Bank report, produces less than 20 megawatts of power during the dry season. Sierra Leone’s grid only provides 13 megawatts per million people, about 3.5 times less than nations with similar socio-economic conditions. The weak electrical grid forces many citizens to purchase expensive oil and gas, and electric power remains scarce.

New central solar power initiatives will help solve this problem. Adding to the grid’s capacity with works like Solar Park Freetown will help satisfy energy demands and improve quality of life in Freetown. Dr. Kaifala Mara, Sierra Leone’s Minister of Finance, believes that the project will help people “overcome the difficult economic conditions by improving the performance of the main economic sectors, leading to advancing sustainable development” for the nation.

Centralized power, however, is only part of the story. For the 97 percent of rural Sierra Leoneans who lack access to the grid, individual solar home systems and decentralized generators can provide crucial electric power for a multitude of purposes. In town centers, street lamps run on solar power, and solar radios help citizens communicate and learn about current events. Both homes and community buildings like churches and schools can purchase individual solar energy systems to generate electricity.

The usefulness of solar energy in Sierra Leone creates economic opportunities. Open-air markets selling solar components are common, and installation companies can profit from the demand for new systems. Other entrepreneurs have built solar recharging stations and charge small fees for people to power their smartphones and other mobile devices. Using Sierra Leone’s cell network, which uses solar-powered relay stations, businesses can communicate and share data more easily and optimize earnings.

Despite the explosion of solar technology, obstacles hinder greater national access to electricity. Not all solar panels are created equally, and not all vendors can tell the difference between low-quality and high-quality panels. Moreover, some dishonest manufacturers will claim that their products are better quality than they are or even sell non-functioning parts. Even if everything works, not all Sierra Leoneans have the technical skills to properly install solar systems, making progress slower.

Financing more decentralized solutions can be difficult. Sierra Leone does not offer subsidies to people looking to buy solar home systems, and many people in rural areas are not close enough to banks to get loans. For these reasons, not everyone can afford all of the components needed to generate electricity. Centralized power, especially in urban areas, will need to offset the shortcomings of off-grid systems.

Solar power has the potential to greatly increase energy access in Sierra Leone and accelerate its economic growth. Both internationally financed central power systems like Solar Park Freetown and private solar setups in rural areas will create jobs and provide a stable source of energy for millions.

– Ted Rappleye

Sources: Gulf News, Awareness News Sierra Leone, The World Bank
Photo: Forbes

An outbreak of Ebola has been linked to more than 330 deaths in Guinea, Sierra Leone and Liberia, according to the latest numbers from the World Health Organization.

The outbreak, which is ravaging West Africa, is “completely out of control,” says a senior official of Doctors without Borders, who also notes the organization is stretched to its limit in response to the epidemic. Bart Janssens, the director of operations for MSF in Brussels, reported that the epidemic is now in its second wave and, more than ever, the international organizations and governments providing aid need to send in more health experts, as well as increase the public educational messages regarding how to stop the spread of the disease.

The outbreak, which began in Guinea earlier this year, appeared to slow before ravaging in recent weeks, including spreading to the Liberian capital. With multiple locations of breakout and movements across several nations, the outbreak shows no signs of slowing. Janssens noted, “I’m absolutely convinced that this epidemic is far from over and will continue to kill a considerable amount of people, so this will definitely end up the biggest ever.”

This is the highest number of deaths associated with the Ebola virus, which is considered one of the most virulent in the world. At this point, Liberia has declared a national emergency.

With a real political commitment from the governments of the infected nations and a more effective response, the epidemic could perhaps be controlled. However, currently the Ebola outbreak is the worst it has ever been, “It’s the first time in an Ebola epidemic where [Doctors Without Borders] teams cannot cover all the needs, at least for treatment centers,” Janssens said.

The underdevelopment of these countries plays an important role in the spread of the virus. “The affected countries are at the bottom of the human development index,” Janssens noted. “Ebola is seriously crippling their capacities to respond effectively in containing the spread.”

— Elizabeth Malfaro

Sources: CBS News, USA Today
Photo: CNN

Of the deaths of children under 5 in Sierra Leone, 57 percent are the result of malnutrition, and both the ministry of health and government officials in Sierra Leone have begun work to reduce this horrifying statistic by joining Scaling Up Nutrition and by signing the Nutrition for Growth agreement.

As Sierra Leone recovers from its civil war, which ended in 2002, officials are attempting to shift the focus from malnutrition treatment to malnutrition prevention. Officials have been tracking the correlation between sanitation, education and malnutrition in order to improve prevention techniques.

In an interview with The Guardian, Aminata Shamit Koroma, the director of food and nutrition at the ministry of health in Sierra Leone, noted that women with a higher level of education were more likely to have access to adequate sanitation and less likely to have malnourished children.

In his efforts to prevent malnutrition in children, Koroma has been centering her campaign on breastfeeding and emphasizing to mothers the importance of breastfeeding their infants during the first six months of life. She has been spreading awareness through radio commercials and mother support groups.

Koroma has also been encouraging grandmothers to attend these mother-to-mother support groups so that they can impart their knowledge of child nutrition onto new mothers who might not be aware of the nutrients their children need. The Sierra Leone National Food and Security Food Policy of 2015-2016 also targets fathers so that they support their wives in breastfeeding. Besides emphasizing the future health of their children as a motivating factor, the initiative informs the families that if the mother is breastfeeding her child, they do not have to buy extra food for the child during the first few months of life.

The nutrition policy will also regulate the marketing of supposedly comparable and superior breast milk substitutes in order to ensure that mothers are not tricked by false sales promises. While Koroma knows it is unlikely that infant malnutrition will be eradicated within the next year or two, she recognizes the importance of the steps she is taking as she encourages the people of Sierra Leone to begin to change how they view infant health.

— Jordyn Horowitz

Sources: The Guardian, WHO, ACDI VOCA, Scaling up Nutrition
Photo: Mission News Wire