Sierra Leone: Maternal health in a time of Ebola
By Sabrina Mahtani, Amnesty’s West Africa Researcher.
Ebola has affected every area of life in Sierra Leone, and made it even more challenging for pregnant women to get the care they desperately need. Activist Fatou Wurie talks about her personal experiences of maternal health care there.
I want to tell you about a young girl I met two years ago. I walked into a community health centre expecting to meet 50 traditional birth attendants for a training seminar. Instead, I walked into a labour ward and saw a placenta discarded on the floor. A young mother was bleeding and in tears, and her new-born baby boy was fighting against the odds to live.
The midwives in their neon pink uniforms asked me to help clean the mother up while they resuscitated the baby. I didn’t ask questions, but mechanically helped the mother clean up and calm down. The new-born was still not breathing, his airway was blocked and the small health centre did not have the equipment they needed to save his life.
Eventually, I took the baby to the nearest town hospital and the mother soon followed. Grateful, she cried as she watched her child sleep safely – for the first time since his birth – in a neonatal incubator. This experience altered my perspective forever. It was then that I truly understood what being helpless looked like. But I also understood that, with the right resources, lives can be saved.
Decline of health services
Today, pregnant women across Sierra Leone are still struggling to get the health care they need. Seven women die every day due to maternal complications, and one baby dies every hour. That makes 9,000 new-born deaths every year. Unfortunately, since Ebola has hit, the use of routine maternal and new-born health services has declined.
Ebola has placed a huge strain on our already weakened health care system. Right now, clinics are suffering from a lack of equipment, drugs and workers. Many health care centres are only treating Ebola cases.
What’s more, the disease creates fear between health care workers and patients. Deaths of health workers and Ebola patients have scared many women away from seeking medical help. Fever and bleeding, common during pregnancy, are also symptoms of Ebola, so health workers are reluctant to treat and admit pregnant women. A young pregnant mother’s chance of surviving childbirth still remains far too slim. It does not have to be this way.
Too many stillbirths
A couple of weeks ago I accompanied burial teams to collect the body of a still-born baby at a military hospital in Freetown. Together with the father, we took the body to the cemetery, which has been newly expanded for children and new-borns. We found too many tiny graves, some freshly dug, others closed and neatly organised as “un-known, new-borns”. Far too many were labelled “stillbirths”.
I wondered about the increase in stillbirths. Was it due to the decline in antenatal visits – making women more susceptible to infection during childbirth? The truth is, we don’t know. But we do know that far too many mothers and babies are dying from preventable causes. And that’s because people are staying away from health facilities due to myths about catching Ebola and a decrease in the quality of health care.
Helping mothers survive
This is why I work with MamaYe, a campaign that focuses on the survival of mothers and babies in Sierra Leone and five other African countries. MamaYe strives to ensure that communities have adequate and safe health clinics. In order for a clinic to be safe, it must have basics such as safe running water, good sanitation, consistent electricity, skilled birth attendants and drugs.
This has never been more necessary than during this time of Ebola. As the outbreak continues to hit communities hard, our government and donors need to build up Sierra Leone’s health care system, especially for mothers and babies. Every time we lose a baby that dies before they see their first birthday, we lose a potential leader, doer, activist or citizen who can shape our country’s future.
Learn more about Amnesty International's Health Network.
Out of Reach: The Cost of Maternal Health in Sierra Leone, Amnesty International report, 2009 (PDF)
At a Crossroads: Sierra Leone’s Free Healthcare Policy, Amnesty International report, 2011 (PDF)