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The day after my visit to the Central Medical Stores, I go to see the largest public maternity hospital in Sierra Leone’s capital, Freetown. This is the hospital that receives patients referred to it from community clinics throughout Freetown and surrounding areas.
I’m given a tour of the wards, including those for admitting, ante-natal care, general delivery, and for special cases with complications. I stop in the admitting ward to ask the head nurse, Frances Sessay, about the initiative begun on April 27 to abolish user fees for pregnant women and children under five years.
She is tolerant and patient despite the interruption my visit presents. “We had a tremendous upsurge in patients right after free health care was announced, but it has settled down somewhat now,” Sessay said. “There was so much suppressed demand, people who were ill sat at home waiting for April 27 before coming.”
Princess Christian is also where the training of many of the country’s new nurses takes place. I meet a group of nurse trainees in the general labor ward in their neat blue uniforms and crisp white caps. They explain to me that there have been five babies delivered overnight.
These trainees and recent new hiring of nurses is expected to help Sierra Leone provide sufficient nurses to meet the upsurge in visits brought on by the free health initiative. But even so, the country is still experiencing a dire shortage of other types of health care workers, including of doctors. Many doctors and nurses have chosen to leave the country because of the difficult working conditions and abysmally low salaries in the public health service. The nurses note that even very basic amenities such as regular running water or electricity are not available in many of the country’s community health centers.
But they welcome the recent hiring that has doubled the number of health workers and the modest increase in salaries the government agreed two months ago in order to retain the new hires. The salary increase, which was made possible with the help of the UK’s Department for International Development and other international donors, came as welcome relief because until very recently Sierra Leone’s doctors and nurses had been among the lowest paid in Africa.
But life for nurses, especially in rural areas remains very difficult. I remember that yesterday, Sierra Leonean health care advocate and former nurse Victor Koroma mentioned that the payroll system and lack of banking facilities outside of Sierra Leone’s capital has made it necessary for nurses in some rural areas to present themselves in person in the capital to pick up their pay. “Nurses shouldn’t have to come to Freetown to pick up their salaries,” said Koroma. “We still need to work on this.”
Pamela's previous blog: A Visit to the Central Medical Stores in Freetown, Sierra Leone
View the photo gallery: Maternal mortality in Sierra Leone