After having seen the largest maternity hospital of Freetown, today I have the chance to visit some of Sierra Leone’s community health centers in vulnerable communities in the capital. These centers in Freetown are on the front lines of delivering the free basic health care service to women and children which the government announced April 27. They are responsible for basic ante-natal care, for those deliveries that are not likely to result in complications, and for important efforts to educate the public on sound health practices.
The health centers can sharply reduce the number of unattended deliveries at home that are one of the primary reasons for Sierra Leone’s shockingly high maternal death rates during labor and delivery. They are also essential to combating the easily treatable diseases, such as diarrhea and malaria, which are primarily responsible for high number of deaths among children under five.
I visit the George Brook Community Health Center, a community away from the center of the city made up of small homes perched on the surrounding steep hillsides. A nurse at the center is sitting quietly at a table carefully compiling statistics. She stops to show me the sharp upturn in the number of visits that women have made to the centre for deliveries. She explains that women are also making more ante-natal visits, which offer the opportunity to speak to patients about good health and nutrition practices.
Efforts are starting to pay off
My next visit is to Kroo Bay, a small community not far from the center of Freetown. The neighborhood is intensely crowded. There are small make-shift homes as far as the eye can see, tightly packed one against the other, most made from metal sheeting. How can they possibly avoid being swept away in Freetown’s frequent torrential downpours? The community has no municipal drainage system. Earlier in the day I had passed by and watched as rainwater from the upper parts of the surrounding city rushed down, around and even through, the small homes on the hillside to the sea below.
I climb downhill to the health center. It is not far from sea and one of the only buildings in the area with a concrete foundation. I walk into the small building, and greet a nurse filling out paper work at table near the doorway. She is surrounded by a group of women and other family members from the community. They are waiting patiently on news of a woman who is in labor in the delivery room behind us.
A man steps forward and introduces himself. He is Momodu Tarawally, and he explains that he is in charge of public health outreach and education for the community. He proudly shows me around the center, and explains the work he and others have been doing to encourage better health practices.
This includes encouraging breast feeding, and promoting basic sanitary habits such as frequent hand washing, and the use of insecticide-treated bed nets. He points outside at the muddy, unpaved walkway in front of the center, and explains that the lack of sanitation has led to outbreaks of water-borne diseases such as cholera during past rainy seasons. But he explains with pride that the public education efforts are starting to pay off – there hasn’t been an outbreak during this rainy season.
Pamela's previous blog: A visit to Sierra Leone's Princess Christian Maternity Hospital
View the photo gallery: Maternal mortality in Sierra Leone