The United Nations has designated Sierra Leone as the most dangerous place to have a baby. In fact, it has the highest maternal mortality rate in the world at 1,360 deaths per 100,000 live births. On average, most women have at least six babies in Sierra Leone.
In a previous post I mentioned the Aminata Maternal Foundation that helps pregnant women in Sierra Leone. An Australian organization, it was started by a woman, Aminata Conteh-Biger, who became a sex slave during the Liberian Civil War. Now, she is giving back to expectant mothers after so many years away from her home country.
This video shows the work of the Aminata Maternal Foundation and how it oftentimes becomes difficult for young pregnant girls to receive permission from family and elders to deliver in a hospital or health center. It also shows the frustration of healthcare workers who try to teach entire villages about the importance of proper maternal healthcare.
For two years Ebola has drastically ravaged three West African countries – Sierra Leone, Guinea and Liberia – and has taken the lives of 11,300 people according to the Guardian UK. Over 28,000 people were diagnosed with Ebola and still live with the pain and stigma of the disease. Since Liberia has not reported a single Ebola case in 42 days, the World Health Organization officially declared an end to the Ebola epidemic. Sierra Leone and Guinea have already been declared Ebola-free with 90 days of no new reported cases. However, just last week another Ebola case was discovered in Sierra Leone in the death of a 22-year-old woman, causing an outbreak of at least 100 people. Twenty-eight people have been quaratined.
In January I wrote that I would be looking closely at the effect of Ebola on maternal health and mortality in the Ebola-affected countries – Liberia, Sierra Leone, and Guinea. Today unfortunate news was released by the World Bank and The Lancet.
According to the new report, Health-care worker mortality and the legacy of the Ebola epidemic and New Wave of Deaths From Ebola?: The Impact of Health Care Worker Mortality (PDF), it is estimated that 4,022 more women will die during childbirth in these countries on top of their already high maternal mortality rate due to the deaths of 240 health workers (doctors, nurses, and midwives) collectively across all three countries. Liberia lost the most health workers at 83. Guinea lost 78 and Sierra Leone lost 79 health workers. That translates to an increase of maternal deaths by 38% in Guinea, 74% in Sierra Leone, and 111% in Liberia. Due to the nature of health work a disproportionate rate of health workers died during the Ebola epidemic as opposed to the general population. Those health workers, of course, were critical to the health systems in all three countries whose systems were already on troubled ground before Ebola ravaged west Africa.
In September 2014 the Centers for Disease Control along with Sierra Leone’s Ministry of Health studied traditional burials in order to create a Standard Operating Procedure (SOP) for safe and dignified burials for those who die from Ebola. As of October 2014, a SOP for safe, dignified medical burials was approved and released by the Sierra Leone National Emergency Operations Center. This is a far cry from the insistence upon cremation by the Liberian government in the summer of last year.
As of January 2015, 2500 people have died from Ebola in Sierra Leone. Today when someone dies from Ebola, families have a greater chance of their loved one being buried with dignity without having to touch the deceased who are highly infectious.
Below are photos of an IFRC (International Federation of Red Cross) team removing a body of a young man on December 24, 2014 who was suspected of having Ebola. His family held a small ceremony in the young man’s memory. The body was then driven to the cemetery where it was buried based on the standard operating procedure created in October 2014.
As part of the Western Aera Surge Operation in Sierra Leone, the Sierra Leone Red Cross Society is undertaking safe and dignified burials ensuring that those who have died from the disease are treated with respect, while also ensuring the safety of communities. This is critical work, often performed by volunteers, and undertaken at the most dangerous time. Volunteers must wear full personal protective equipment and work in teams of seven.
With an overall population of 5.9 million people in Sierra Leone, 200 women will die today from complications during childbirth. Every year, 2400 women lose their lives due to pregnancy related causes in Sierra Leone. And, close to 10,000 babies die every year during their first month of life. There has been notable progress in Sierra Leone to end maternal and newborn deaths in the small, coastal country, but the mortality rates are not decreasing fast enough.
Based on this year’s data from Save the Children’s State of the World’s Mothers Report , Sierra Leone was ranked as one of the worst places to be a mother for the past eight years. Ranked at #172, only Central African Republic, Guinea Bissau, Mali, Niger, DRC and Somalia are worse. And, according to this year’s State of the World’s Midwifery Report only 24% of all pregnancy needs are met by midwives in Sierra Leone.
Mamaye Sierra Leone is calling on its government to commit more resources to save the lives of women and their newborns. The Free Health Care Initiative has allowed countless women to deliver their babies in clinics, but unfortunately, these clinics are often void of the basic necessities for a safe delivery. In fact, over half of the clinics in Sierra Leone are not equipped to provide proper, quality maternal and newborn health care. One in six facilities in Sierra Leone are able to perform signal functions such as administering life-saving drugs, performing caesarean sections, newborn resuscitation, or blood transfusion, according to Mamaye.
What Does Sierra Leone Need to Save More Mothers and Babies?
Mamaye Sierra Leone says that the government needs to allocate more funds to emergency obstetrics and newborn care nationwide.
Mamaye Sierra Leone also says there needs to be a rapid scale-up of health workers who can provide safe delivery services to women across Sierra Leone.
And, thirdly, Mamaye Sierra Leone says there needs to be quality care across all health services.