Many people know Sierra Leone from the civil war, which lasted from 1991 to 2002, and the black-market “blood diamonds” that fueled it. But as was made clear during the Ebola epidemic of 2014 and 2015, the country’s underfunded, underequipped, and understaffed health care system has been plenty lethal, too.

Partners In Health began working in Sierra Leone in the fall of 2014. For the first year, we focused on responding to the Ebola outbreak. At the request of the Ministry of Health and Sanitation, we worked primarily in Port Loko district, an Ebola hotspot outside the capital of Freetown, and in the remote Kono district, a day’s drive to the east.

In Port Loko, we staffed Maforki Ebola Treatment Unit, Port Loko Government hospital, and seven community care centers. In Kono, PIH clinicians operated four community care centers and improved pediatric and maternity care and general medicine in Koidu Government Hospital and Wellbody Clinic. During the height of our response, PIH-supported sites provided a total of 336 beds.

Much of our work took place outside clinic walls. We hired more than a thousand community health workers, including Ebola survivors, who fanned out into the countryside to identify the sick, help them find treatment, and combat stigma surrounding Ebola survivors.

Currently we are working with local and national officials to map out our transition from Ebola emergency response to health-system strengthening.

Our short-term priority has been the National Survivor Eye Care Program. Growing out of PIH's work in Port Loko district, the national program is set up to screen all of the country’s 4,000 Ebola survivors for complications due to the disease. Roughly 15 percent of survivors seem to contract uveitis, an inflammation of the eye that can lead to blindness.

We are also doing daily rounds in hospitals and clinics to treat patients suffering from malaria, malnutrition, complicated pregnancies, and more in both districts. Logisticians have stocked pharmacies. And community health workers help survivors find jobs, apply for government-issued ID, re-establish their lives.

Lastly, we are remodeling facilities—adding incinerators to properly dispose of medical waste, installing generators to guarantee continuous electricity, fixing broken plumbing, and building and rehabilitating patient wards, triage units, and waiting areas.