Babes in arms
International aid agencies such as Concern are prioritising community involvement in health and education projects, often through the local chiefs. At Kunturloh health clinic in Freetown, the chief is trying to account for the high rate of teen pregnancy there. In Ireland, teenage pregnancies have hovered at around five per cent for almost half a century. In Sierra Leone, 40 per cent of maternal mortality happens in women under the age of 20. The chief says girls are targeted and raped when they are sent to fetch water for their families in the evenings in a practice known as “Water for Water”.
With a smirk, he adds: “Some of the problem lies with the girls themselves, because they go chasing the boys.”
At an ante natal clinic in Freetown, Husanatu Jalloh is one of 100 expectant mothers waiting in the baking outbuilding. She looks so fragile; it is hard to believe she is even 18. She is 32 weeks pregnant with her second child. Her first baby died at 17 months from pneumonia, she says, deadpan. She left school at 16 for her first pregnancy. “They don’t allow them to go to school when they are pregnant; it’s a bad example,” says one of the nurses.
Dr Mahony says she was appalled to hear about the secret societies, which most girls join before marriage. Female genital mutilation is carried out as part of the initiation process.
Violence is part of life here. “I was horrified by the level of rape and violence and women’s descriptions of being hit by their husbands. And if husbands weren’t happy, then it was acceptable for them to hurt their wives and that’s a very frightening attitude,” says Mahony.
At Freetown’s Princess Christian Maternity Hospital, Dr Philip Koroma is agitated. Maybe it’s because he is jumping up and down to fling open the window every time the power goes off, which is five times in half an hour. Koroma says being the main national referral centre has its drawbacks.
“One woman yesterday delivered at home and experienced postpartum haemorrhage. She went to a hospital nearby, who referred to us, rather than deal with the haemorrhage. That is so the death is not recorded as being theirs. . . ” “The workload is too tight,” he says, head in his hands. Five obstetric consultants are working there, but four are retired and have returned on short-term contracts. “I am now responsible for the whole country,” he adds.
In general, the lack of skilled workers and professionals is crushing. In 90-odd health clinics in the Tonkolili district, not one doctor is involved, even on an advisory basis.
The new clinic at Kunturloh has been open for three months and local official Mohammed K Turay is concerned. He worries that the wall around the clinic will collapse because of a build-up of water from the adjoining hill. We look at the wall, and arms outstretched, he says: “There is nowhere for the water to go. This building is open three months and it would be a shame to see all this work undone.”
Deirdre Veldon and Brenda Fitzsimons travelled to Sierra Leone with Concern. For more on Concern’s 1,000 DAYS campaign see: concern.net