Sierra Leone has long struggled with some of the world’s worst health outcomes—including a maternal mortality epidemic in which 1 in 17 women runs a lifetime risk of dying during pregnancy or childbirth. Extreme poverty prevents most families from accessing health care. And in many cases, the care they need isn’t available, given the country’s severe shortage of trained clinicians and that most health facilities lack necessary infrastructure and supplies.
West Africa’s historic Ebola outbreak in 2014 and 2015 intensified all of these problems, and further crippled Sierra Leone’s already weak health system. So when the government requested PIH’s help to end the outbreak, we agreed—and we committed to staying in the country long past Ebola, to strengthen the health system overall.
Today, in partnership with the government, PIH supports six health facilities across three districts in an effort to build a health system that protects every Sierra Leonean’s right to health, especially those most vulnerable to sickness and injustice.
Transforming Health in Kono District
In Kono, a rural eastern district famous for its diamond mines and role in Sierra Leone’s decade-long civil war, PIH is investing in every level of the health system. We operate Wellbody Clinic; support care at Koidu Government Hospital, Kono’s only hospital; and are beginning to support smaller primary health clinics throughout the district.
In the Community
PIH employs a network of community health workers (CHWs), who link patients to health facilities and social support. CHWs maintain close relationships with patients and their families, making regular home visits during which they check in on patients’ health and well-being, refer and accompany them to care, and connect them with social support from PIH, such as food packages, housing repairs, transportation, and educational opportunities like adult literacy courses.
In Health Facilities
PIH’s ongoing investments in clinical training, infrastructure, and supply chain are turning once shuttered facilities into models of how the benefits of modern medicine can be provided in settings of poverty. We’ve introduced resources as basic as 24-hour electricity and running water, to as advanced as oxygen production and a functioning blood bank in Kono. We employ the district’s only surgeon and psychiatrist. We’ve built maternal waiting homes and an emergency room, and established an ambulance service and chronic disease care. And we maintain a steady flow of vital medical supplies and medications to equip clinicians, pharmacists, and lab technicians with what they need to deliver care.
This comprehensive support has provided Kono’s population unprecedented access to quality, specialized health care, from mental health care to C-sections to management of illnesses like diabetes and heart failure. Patient numbers continue to rise, and health outcomes are improving: At Wellbody Clinic, there have been no maternal deaths in four years, and over the past two years, both Wellbody Clinic and Koidu Government Hospital have seen a 77 percent increase in facility-based deliveries.
Specialized Support in Freetown
We make similar investments, in partnership with the government, at Lakka Government Hospital and Sierra Leone Psychiatric Teaching Hospital (SLPTH), the country’s only specialized facilities for tuberculosis and mental health care.
At Lakka, we’ve introduced never-before-available care for multidrug-resistant tuberculosis, are renovating hospital infrastructure to make it more comfortable for inpatients, and provide social support, like food packages and transportation stipends, to ensure that patients can adhere to treatment and attend their appointments.
And at SLPTH, our supply chain has introduced life-changing medications for patients with severe mental health conditions, while building renovations mean patients now stay in a comfortable facility with electricity and plumbing. Thanks to these investments, SLPTH has become much safer and more dignified for receiving and delivering care.