By Ahmed Sahid Nasralla (De Monk)
Country Director UNDP Sierra Leone, Samuel Doe, has urged rural communities in the small West African country to stay healthy by accessing and helping in maintaining health facilities in their localities.
“Like all developing countries, Sierra Leone is faced with so many challenges and health is a major one. Health is important because development starts with healthy people. There would be no development if the people who should do the work are not healthy,” he said.
Doe was speaking during a tour of the Southern and Eastern regions of Sierra Leone officially handing over Maternal Child Health Posts (MCHP) to communities through the Kailahun District Council and District Health Medical Team (DHMT). UNDP Sierra Leone supported the rehabilitation and construction of these health facilities with funds from the Government of Japan.
Six of the MCHPs are in Kailahun District, Eastern Sierra Leone: Talia, Bandajuma Sinneh and Sengema in Luawa Chiefdom; Mendekele main Upper Bambara Chiefdom; and Sandia and Gbandiwulo in Kissi Tongi Chiefdom. During the Ebola outbreak (2014-2016) these border communities were among the hardest hit by the killer disease. The first Ebola case in Sierra Leone was reported in Kailahun district and at the peak of the outbreak the district was recording more than 80 new Ebola cases per week and more than 50 bodies were buried in just 12 days in makeshift graveyards close to the Ebola treatment center, according to the World Health Organisation.
The facilities are equipped with observation rooms,outpatient wards, Expanded Program on Immunization ward, Ante-natal and post-natal wards, drug stores, consultation rooms, labour rooms, typical toilets, incinerators, placenta pits and health staff quarters.
The MCHPs will render services to a catchment population in all six communities of about 22,500 in 56 villages.
Doe was particularly happy about the fact that the health posts have moved from small family homes donated by kind community members to bigger permanent structures.
Bintu Alhaji, and her colleagues, attended the handing over ceremony at Talia with her two-months old baby strapped to her back. She had delivered under difficult conditions at the makeshift health post donated by a community elder identified as Pa Sellu Bockarie. She looked in high spirit as they danced in celebration to accustomed rhythm from their native drums.
“Before now, it was difficult for us and the nurses.I am happy for this new hospital and I look forward to come regularly with my children for check-up,” said Bintu.
Equally, the nurses were in high spirit. “We are happy about the new structures. We never honestly imagined we could have such facilities in this town,” said Nurse-in-Charge at Talia MCHP, Jestina Alpha. Jestina has been an MCHP aide for six years at Talia.
However, challenges of water supply, electricity, refrigerator and mobility cut across the facilities.
In Talia, digging of bore holes or water wells doesn’t seem feasible as there are no traces of water underneath within a reasonable distance from the new health post. The only possible location for a well or hand pump is at a swamp down a steep hill about 100 meters from the MCHP.
In Bandajuma Sinneh, the previous health post has gone three months without water due to a faulty hand pump. The drugs and vaccine refrigerator is also not functioning due to a faulty part.
The nurses said they use ‘Chinese lamps’ or torch lights to see their way in the rooms during the day and night. Before now the nurses lived in rooms within the MCHPs, and they claim to pay motorbike fares from their personal pockets to do outreach and to travel to and from the district headquarter town to fetch drug supplies.
The project, titled ‘Building a resilient community health system to prevent infectious diseases in post-Ebola country Sierra Leone’ implemented by SEND Sierra Leone, has three components: governance, livelihood and health. Under the governance component, according to UNDP Sierra Leone Project Officer Isata Mariam Bangura, there are Village Development Committees (VDCs)and Facility Management Committees (FMCs) which support the project monitoring and reporting to the Kailahun district council through the councilors and other community stakeholders..
The livelihood component supports gender sensitive trainings to involve women in governance and business in Kailahun district and the health aspect of the project supports the rehabilitation and construction of health facilities in six towns in three chiefdoms of Luawa, Kissi Tongi and Upper Bambara as a support in addressing the issue of Infant and Maternal mortality in Sierra Leone.
“We hope these facilities will reduce the number of women and children who lose their lives during pregnancy and birth,” said Doe.
Sierra Leone is among countries with high incidences of maternal and infant mortality.
“Our responsibility now as DHMT, District Council and community is to take ownership of these new structures and ensure we maintain them. Let these facilities render the intended services to the people of Kailahun District,” said Francis Lansana, Acting DMO Kailahun District.
He added: “We want to jubilate next year when we come to visit and find out no woman or child has died in the hospital.”
In addition, the Kailahun District Council Chairman Sahr A. K. Lamin expressed gratitude to UNDP Sierra Leone and the Japanese government but particularly praised the contribution of the communities to the construction of the MCHPs.
In Talia for example, the community actually started the construction of their own health building before the intervention of UNDP Sierra Leone.
However, in Bandajuma Sinneh the initial community response was one of denial. The Project Manager for SEND Sierra Leone, Mohamed Jalloh, explained how attempts were made to beat him and drove him away from the community.
“When we started the project here there was a lot of denial and lack of cooperation from the community. At some point the people attempted to beat me and they drove me away. I am happy that we have reached this far, and everybody is happy,” said Jalloh.
In fact, during the handing over ceremony the Councilor Jacob Yankuba Amara pledged a bag of rice and assured he would mobilize the youth to help fence the health post.
Meanwhile, Country Director for SEND Sierra Leone, Joseph Ayamga, said the challenge now is to ensure the MCHPs are well equipped with the requisite materials, drugs and qualified and committed health nurses in charge.