Medicine versus myth in Sierra Leone

From Global development | The Guardian Mon Nov 26 2012, 00:01:17

The Guardian International Development Journalism competition professional winner visits Sierra Leone, where lack of medical staff results in many preventable deaths

Even though Mamie Kemokai has had 12 children, she hesitates to call herself a mother. "Not one of my children is still with me today, not one," she says quietly, her right hand cutting through the air emphatically before falling to rest limply in her lap. Kemokai lives in the remote village of Bendu Kpaka, around 200 miles south of Freetown, the capital of Sierra Leone. As she tells her story rain pelts down outside, turning the one dirt road that leads through the 30-house settlement to a mud slick.

Sierra Leone has the highest rate of under-five mortality in the world, according to a Unicef report published this year. Nearly one in five children die before their fifth birthdays, despite President Ernest Koroma's introduction of a free healthcare programme in 2010 for under-fives, pregnant women and breastfeeding mothers. In Kemokai's case, 10 of her 12 children died before their first birthday.

"I don't think the free healthcare initiative has failed, it just faces many challenges," says Heather Kerr, country director for Save the Children in Sierra Leone. The biggest problem, Kerr says, is the shortage of trained medical staff: "You can put up as many hospitals as you like, but if you have no one to fill them, it's just another building." In Sierra Leone there are 1.9 health workers per 10,000 people. That translates into one nurse, doctor or midwife for every 5,263 patients (compared with 77 patients per health worker in the UK).

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