10.29, 19 February 2010
This is my first blog for
Midwives. I am writing from Sierra Leone, I’ve been here just over a month working for a UK charity called
Health Unlimited as part of the
Vodafone Foundation ‘World of Difference’ Programme. I am here for one year and will be writing regularly for
Midwives about my work.
Health Unlimited is a UK charity which works to help the poorest and most marginalised people assert their right to health. They are one of the few non-governmental organisations working in this remote, rural area. I will be working with them as a midwifery trainer in Northern Bombali District. I will work with midwives and other maternal health workers in a Kamakwie Wesleyan Hospital, with health workers and traditional birth attendants in a number of the rural health posts and the new Makeni School of Midwifery.
Sierra Leone emerged from ten years of devastating civil war in 2002, which left the infrastructure, including the health system, in tatters. In 2009, Sierra Leone was ranked 180th out of 182 countries on the human development index (which uses indicators relating to life expectancy, education and income to measure development) and currently has among the highest maternal and infant mortality rates in the world.
I spent six months volunteering with
VSO as a midwife trainer in a community hospital in Sierra Leone in 2008. I fell in love with this beautiful country and its incredibly resilient, positive people, but also sadly witnessed some of the individual tragedies, which are behind the appalling statistics. I am happy to be back in Sierra Leone for another year, even though it can be a challenging place to live and work, as I believe that training more midwives, developing the skills of existing health workers and raising awareness within communities of how to avoid ill health and when to seek health care will work towards reducing the extremely high maternal and child mortality rates.
It feels like an exciting time to be working in maternal health in Sierra Leone as there is currently a strong drive to create positive change. The Ministry of Health and Sanitation has recently developed a
National Health Sector Strategic Plan, devised guidelines for a
Basic Package of Essential Services and started National Maternal Death Review Committees. Free healthcare for pregnant or lactating women and children under five is being launched at the end of April. This will remove the financial barrier which currently prevents many women (often those most in need) accessing health care. I am sure that there will be challenges in the implementation period and this is not the only barrier preventing women from accessing health care, but all of these developments are steps in the right direction.
I have spent the last four days in Makeni, the biggest town in Bombali District; teaching at the midwifery school which opened last month. This is an exciting initiative to increase numbers of trained midwives in Sierra Leone. This is desperately needed as currently there are only 95 qualified midwives in the country. Until now the only training school for midwives was in Freetown. Having trained in the capital, many midwives are reluctant to work in rural parts of the country once they qualify; meaning women in rural communities have little or no access to care from a trained midwife. There are 75 midwives in this first intake who are being trained in the provinces to work at community level. I will have the opportunity to work with these students, not only in the midwifery school, but also on their clinical placements both in the hospital in Kamakwie and in the rural health posts creating a link between their classroom-based and practical learning.
My journey to and from the school is very different from sitting in the congested traffic of Peckham High Street. I walk past houses with families sitting outside, women cooking on open fires, children rolling tyres with sticks and babies being carried on mother’s backs. In London, it is easy to feel almost invisible as you go about your daily life, everyone is so busy and focused – here it is impossible to go unnoticed. Each house I pass a noisy chorus of ‘Oporto’ (white person) begins as soon as the children catch sight of me, followed by lots of laughter as I try out my few Temne words in greeting. I then catch an ‘Ocada’ or motorbike taxi, which I have to admit to being terrified of when I first came to Sierra Leone, but now enjoy, the cool breeze on the journey is a welcome break from the constant heat and humidity. Later today I leave on the very bumpy road to Kamakwie, where I will begin my first period of work with the maternity staff in the Mission Hospital.
Please
click here to visit my World of Difference blog or
here to visit my blogspot or visit me on
twitter – my username is zoe_vowles.
See you next month!
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