Maternal and Newborn Health Care Crisis in Sierra Leone

A Volunteer Nurse’s Assessment

J. Beryl Brooks, the Developmental Clinic Coordinator for Improved Pregnancy Outcome at Memorial University Medical Center in Savannah, is part of a team of medical volunteers who traveled to Sierra Leone in May to conduct a rapid assessment of maternal and newborn health care in health facilities there. This humanitarian mission is in response to a re-emerging crisis in country where maternal and newborn mortality is among the highest in the world. Here she shares a portion of her journal in which she recorded her personal observations of the trip.

After we arrived at the Lungi airport in Sierra Leone, we took an exhilarating (bumpy) ferry ride to Freetown. I met Dr. Asibey, a pediatrician from Ghana who will be working on the team, on the plane and we were able to talk together briefly during the stop in Monrovia. She is very nice and very enthusiastic about the assignment.

The Project HOPE staff had paved the path for us, so getting from airport to hotel went smoothly. We then met the rest of the team: Mariam, HOPE’s in-country coordinator; Sheka, the driver; and Dr. Little, a neonatologist from Dartmouth, NH. The next day we met with the Chief Medical Officer for the Ministry of Health for Sierra Leone, who was also very helpful.

After Freetown, we traveled to Bo, about a three-hour ride, passing through many villages and forested areas along the way. At the Bo District Health Compound, local staff members attended a workshop on Helping Babies Breathe® presented by Dr. Little with some assistance from Dr. Asibey and me. The staff was very interested and had a lot of questions.

We also met with local officials including the District Health Officer and did a walk-through assessment of the hospital and facilities. Other assessments here included a rural clinic and the labor and delivery area of the hospital – where we assisted with the delivery of a beautiful baby boy.

We noted that the clinic we visited seemed farther from town than it actually was because of the rough condition of the road – a difficult journey for a sick or laboring patient traveling from the health clinic to the Bo District Hospital, especially since most transportation is on the back of a motorbike.

Upon entering any facility, staff directs you to wash your hands, and your temperature is taken and shown to you – an attempt to prevent the resurgence of Ebola.

At the end of the week, we went to the postpartum unit of the hospital where they were prepping a case for surgery. After observing the surgical prep, we headed to the antenatal and postnatal clinic, which involved climbing over rebar and other construction materials and debris. We envisioned what it must be like for pregnant women and mothers with newborns to negotiate this same obstacle course.

There, Dr. Asibey was able to help stabilize a malaria case that came in with active seizures. She also helped another patient with severe anemia and possible renal failure.

This was a very long day due to a severe lack of supplies and equipment. Some medications were unavailable at the hospital pharmacy, so Mariam went to the local pharmacy to purchase them. The staff is very nice, trying to do the best they can, but definitely could use help.