Yealie Mansaray (right) examines Ebola survivors for eye complications in Port Loko District, Sierra Leone.
(Photo by Rebecca E. Rollins / Partners In Health)

With experts warning in 2014 that the Ebola epidemic in West Africa could kill millions, Partners In Health eagerly embraced the government of Sierra Leone’s request to help with the response. And that first year was all about Ebola, all the time.

We focused primarily on a hotspot outside the capital of Freetown and in a remote region a day’s drive to the east—staffing and equipping treatment units, hospitals, clinics, and community centers. We hired nearly 1,000 Ebola survivors and trained them in how best to assist their neighbors—by fanning out, identifying the sick, accompanying the infected through treatment, and combating social stigmas surrounding the disease. When the epidemic formally ended in 2016, one out of every 10 Ebola survivors in the country was once a PIH patient.

While others packed up, we buckled down. From the start, we pledged to support the Ministry of Health and Sanitation not just during the headline-making emergency, but for years to come. Like PIH’s work in Haiti, Rwanda, and seven other countries, our goal was, and is, to help build a durable, top-quality health care system for all.

We’ve made a good start. Right away, there was plenty of follow-up care required. Ebola survivors complained about vision loss and more, and PIH staff helped discover that Ebola could cause an otherwise rare ocular disease called uveitis. With the help of local health care workers and partners, we screened 3,058 survivors and prevented blindness in 379.

Maternal mortality also was an immediate concern. A high rate was no surprise, given the country’s underfunded, underequipped, and understaffed health system, but the epidemic had scared people away from health care, making pregnancy even more lethal. The result was that one out of every 17 women in Sierra Leone died during a pregnancy, a delivery, or its aftermath. 

To combat this and more, we have focused in the country’s east. We do daily rounds in hospitals and clinics, operate an ambulance service, stock pharmacies, add incinerators to properly dispose of medical waste, install generators to guarantee continuous electricity, and fix broken plumbing, while building and renovating patient wards, triage units, and waiting areas. We help local clinicians improve the quality of care they deliver, and modernize medical record systems. The list goes on, and will only continue to grow.

But while there’s much to do, the ministry and PIH also have much to celebrate. Take, for example, one busy clinic that we support: In a country with the highest maternal mortality rate outside of a war zone, it hasn’t seen a single maternal death since 2016.