× Pregnant women relax outside the prenatal care center at Wellbody Clinic in Kono District, Sierra Leone.
Pregnant women relax outside the prenatal care center at Wellbody Clinic in Kono District, Sierra Leone.
Pregnant women relax outside the prenatal care center at Wellbody Clinic in Kono District, Sierra Leone.
Photo by Emma Minor / PIH

In 2014, during the height of history’s deadliest Ebola outbreak in West Africa, the government of Sierra Leone invited Partners In Health to help halt the spread of the virus. Knowing that the epidemic was ultimately rooted in weak health systems, and that Sierra Leone already struggled with some of the world’s worst health outcomes, we eagerly accepted, with one stipulation. True to our mission, PIH would make an open-ended commitment to Sierra Leone, partnering with the Ministry of Health and Sanitation to strengthen the country’s overall health system.

After providing non-stop emergency care in Ebola Treatment Units, helping successfully end the outbreak, and initiating an ongoing Ebola Survivor Support program, we transitioned to work that continues today: building a robust health system in a country where extreme poverty means most people can’t access available health care, which itself is often inadequate as facilities go without necessary staff, supplies, and infrastructure.

In lockstep with the government, PIH is improving health care in Kono District, a remote, impoverished region in the east, and in capital city Freetown, where specialized health facilities serve the country’s entire population of 7 million. And given that Sierra Leone has the world’s highest rate of maternal mortality—women have a 1 in 17 chance of dying from pregnancy or childbirth—we’re investing heavily in ensuring that expectant mothers have access to the care they need to give birth safely.

In Kono, our network of community health workers connect families with necessary care at Wellbody Clinic and Koidu Government Hospital (KGH), where PIH helps deliver high-quality primary and secondary care. By supporting clinical training and mentorship, infrastructure improvements, and supply chain, we’re ensuring that clinicians are empowered with the knowledge, skills, equipment, and medications they need to treat patients within comfortable, dignified spaces.

At Wellbody Clinic, we’ve built a maternal waiting home that provides women with complicated pregnancies a place to stay as their due dates approach and be guaranteed continuous care and a facility-based delivery. This vital resource, combined with our overall investments in the clinic’s maternity ward, have led to the stunning achievement of three years without a maternal death at Wellbody.

And at KGH, we ensure 24-hour electricity and plumbing, meaning clinicians and patients have nonstop access to a functional blood bank, a working X-ray machine, and a sterile, well-lit operating room. What’s more, we’ve established never-before available facilities and services such as an adult emergency ward, which provides a space and systems to effectively triage patients in need of urgent, lifesaving care; a noncommunicable disease program, which provides ongoing care to patients with chronic conditions like diabetes, asthma, and hypertension; and a mental health program, which provides essential medications and support to people living with mental disorders like psychosis and bipolar disorder.

In Freetown, we partner with the Sierra Leonean government to improve mental health care and treatment for multidrug-resistant tuberculosis (MDR-TB) at Sierra Leone Psychiatric Teaching Hospital (SLPTH) and Lakka Hospital, respectively. All of the care delivered today at these facilities is unprecedented: before PIH and the government’s partnership, MDR-TB treatment was entirely unavailable in Sierra Leone, while only one psychiatrist worked in the country with barely any access to medications.

We’ve helped transform SLPTH, the country’s only dedicated mental health facility, to be a dignified, well-resourced hospital in which to deliver and receive care. The facility had been without electricity, running water, or an adequate supply of modern medications since it opened in 1820. For safety reasons and lack of proper resources, many patients spent days and nights chained to their beds. Now, thanks to PIH’s support, SLPTH has electricity, plumbing, clinical mentorship, and pharmacy shelves stocked with essential drugs. Staff now deliver effective care to patients in a clean, comfortable space where chains are no longer used, or even necessary.

Our joint establishment of MDR-TB care at Lakka Hospital has also transformed that facility. We complement the government’s investment in fighting MDR-TB by infusing Lakka with the resources necessary to cure the drug-resistant strain of the world’s leading infectious disease killer: a robust supply chain to ensure the availability of critical equipment and drugs for managing TB complications; the addition of clinical mentors with expertise in the disease; and continual building renovations to make receiving and delivering care more comfortable and dignified. We also partner with the government to ensure 24-hour electricity and running water at the facility, in addition to providing support packages to outpatients who couldn’t otherwise afford food or transportation to the hospital for check-ups.

All of PIH’s work across Sierra Leone is transforming health for some of the most vulnerable people in the country, and in the world. And it’s only just beginning thanks to our enduring partnership with the Ministry of Health and Sanitation and a new partnership with longtime PIH supporters John and Hank Green. Together, in the global epicenter of maternal mortality, we’re embarking on a groundbreaking plan to save women and children’s lives by building the Maternal Center of Excellence at KGH. This facility will not only offer top-notch care to pregnant women and newborns, but also contribute to our expanding evidence base that modern medicine can and should thrive in settings of poverty.