The Los Angeles Times has a fascinating report– part one of a two part series– from on the ground in Sierra Leone. Scott Kraft looks at the country’s flailing public health system and the potential impact it could have on the region. It’s a really interesting, in-depth look at a complex and deteriorating situation.

I also recommend this corresponding photo gallery, which chronicles Princess Christian Maternity Hospital in Freetown.

Excerpts from Kraft’s piece below, full article here

West Africa is of particular concern to world health officials. With shortages of medicine, trained doctors, reliable electricity, clean water and such basics as sterilized gloves, countries often lack the means to identify and deal with new disease threats.

“As we turn over more and more rocks in more and more places, we find more passages for disease,” said Dr. Scott Dowell, director of global disease detection at the U.S. Centers for Disease Control and Prevention. “Most aren’t going to be the next HIV or SARS, but it’s pretty hard to tell which ones will and which ones won’t.”

[...] The country has only two pediatricians, and Thorlie is one of four obstetricians. All work at Princess Christian.

Doctors Without Borders set up clinics in Bo, the second-largest city, during the civil war. Now it’s time to begin pulling out and move to other countries in crisis, but Jan van’t Land, the local director, says he’s worried.

“We’re in a difficult situation,” he said. “If we leave, who would take over? It might create another crisis.”

When Koroma took office in 2007, his wife, Sia, launched a global effort to draw attention to the public health crisis. An oil industry chemist before the war, she started a career in nursing during the couple’s years in London. Her evangelical work has brought some help, but she acknowledges that progress has been slow.

“We are faced with so many problems — illiteracy, poverty, youth unemployment and the need for gender empowerment,” she said. “I’m trying to be an advocate for women and children, because they are the most vulnerable.”

The plight of mothers in Sierra Leone graced the cover of yesterday’s Washington Post. Sierra Leone is home to the world’s highest maternal mortality rate: mothers face a 1 in 8 chance of dying in childbirth. This is compared to 1 in 4,800 in the United States and 1 in 20 in the rest of sub-Saharan Africa.

The story of Saio Marah highlights some of the factors behind these high mortality rates. Marah arrived at the hospital by motorbike, the predominant mode of transport in the rural Sierra Leone. She is examined by Dr. Konteh (an ophthalmologist by training), who informs that her that she had waited too long to come to the hospital: the baby’s heart rate is too fast and she needs an emergency caesarian section. But all of the surgical nurses had gone home and the operation will have to wait until the team can track its way back to the hospital.

The article continues:

It was a Monday evening, and her husband, Mohamed Barrie, said she had gone into labor on Saturday. Both of them were worried about the expense of going to the hospital, he said, and were sure she could deliver easily enough without assistance from hospital doctors. So they had gone to a neighborhood clinic where a nurse examined her and sent her home. Now she was three centimeters dilated, her water had broken and she had finally come to the only hospital in Koinadugu, a sprawling and rural expanse in the far northeastern corner of this West African nation.

(more…)

On Saturday, Britain’s International Development Secretary Douglas Alexander called on the World Bank to focus more on fighting poverty in Africa.

From Reuters:

“We want a stronger focus on poverty reduction, especially in sub-Saharan Africa, and the gender issues of poverty. I have seen myself today the female face of poverty,” Alexander said after visiting a packed clinic near Makeni in Sierra Leone.

He administered polio vaccine to a baby and medicine to its mother — a gesture of help in an area where health workers said there are just two doctors for 321,000 people.

“The clinic is so tight (crowded) we have to use the ground for deliveries. It is not hygienic,” said Nabinta Koroma, a maternal child health worker, pointing to the filthy tiled floor covered in urine from a crowd of children waiting for checkups.

Britain sent troops to shore up Sierra Leone’s capital Freetown against a rebel threat in 2000, and then helped rebuild its security forces after a decade-long war fuelled by gems dug from the mud of its rich eastern diamond fields. British aid is now turning more to development projects than security in a bid to help the country’s poor, Alexander said.

Read the full piece here.