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The worst place on earth to be born

 Street News Service 23 August 2019

Young girls are dying during child birth, many children are perishing before the age of five and there is little knowledge of how to control disease and sexual infections. In light of a troubled recent history, Sierra Leone faces many pressing challenges on the issue of public health and education. One charity however, aims to change the script for one of the world’s poorest countries. (779 Words) - By Samantha Bailie


SNS(EU)_The worst place on earth to be born

 Mobilisation of children under five and nursing mothers during “Mami Pikin Webody Week” (Mother and Child Health Week) in Tonkolili District of Sierra Leone. Photo: Samantha Bailie.

Most people in developed nations expect to give birth to a healthy baby that grows into a healthy child.  Sierra Leoneans however do not enjoy this basic human 'right'. One in four children dies before their fifth birthday in the West African country, giving it the highest child mortality rate in the world.

Concern Ireland, led by Country Health Programme Coordinator, Rajeev Vishwakarma, aims to change such morbid statistics. The charity is operating in five chiefdoms of western urban and rural districts of Sierra Leone to assist the most vulnerable people. This includes women of reproductive age (pregnant and lactating mothers) and children under 5 years old in order to reduce the child mortality rate. 

Sierra Leone is officially the worst place in the world for a child to be born. Hospitals are too hot and overcrowded and there is little antenatal care.  Even when babies do make it through labour, they are instantly exposed to diseases like Malaria, Diarrhoea and Acute Respiratory Infections (ARIs). 

"We are attacking disease through prevention, promotion and treatment. We work with different organisations like the Ministry of Health and Sanitation (MoHS), Government of Sierra Leone, UNICEF and Voluntary Service Overseas (VSO) to deal with these issues and other maternal and child health needs," says Vishwakarma.

Despite the input of such a varied group of well meaning organisations, diseases like HIV and AIDS remain problem in Sierra Leone with Sub-Saharan Africa having the highest infection rate in the world. 

"Our health programme's primary objective is Preventing Mother-to-Child Transmission (PMTCT) to support government efforts, ensuring universal access to PMTCT services. [The] overall goal is to reduce mother to child transmission of HIV among childbearing women by 50% by end of 2010 with specific objectives that include increasing male involvement in PMTCT by 75%," says Vishwakarma.

Malnutrition is another major underlying cause of infant mortality in Sierra Leone. One of the most harmful cultural practices is the lack of breastfeeding. In many parts of Sierra Leone new born babies are fed a diet of water and rice instead of breast milk.

Unfortunately this means that babies are given a higher exposure to potentially contaminated food and water. Considering only 10% of mother's breastfeed exclusively for the first 6 months, this is a huge problem.

In spite of the widespread nature of this problem, Vishwakarm is confident that Concern Ireland is attempting to address the issue.

"We are educating and sensitizing pregnant women and mothers through conducting 22 regular sessions on different topics including pregnancy monitoring and care, nutrition and breastfeeding. We are improving access to improved drinking water and we have a Food Income and Market programme in operation to enhance food security in target areas," he says.

"We have initiated Community Led Total Sanitation (CLTS) approach to promote environmental sanitation.  Community health workers and traditional birth attendants have been trained to conduct house to house visits for health promotion to identify and refer cases related to malnutrition and immunization drop outs. A pilot initiative is in progress to open a community based 'mami pikin welbody kitchen' (Mother and Child healthy kitchen) to promote community health and nutrition for pregnant women and children under fives through integrating pregnant women and mothers' club sessions, hygiene promotion, preparation and use of low cost nutritious recipes in the daily food basket." 

In spite of such programmes and initiatives however, many of Sierra Leone's deeply embedded cultural practices are also detrimental to child survival. Early and underage marriage and non-attendance at school is commonplace and can lead to child exploitation.

"We are addressing issues related to teenage pregnancy and underage marriage such as encouraging children to stay in school, and encouraging parents to actively ensure their children attend school.  Teenage pregnancy is on the rise in Sierra Leone and people are frightened to send their girls out to school. Concern [Ireland] has been liaising with community heads and elders, involving parents, teachers and women groups to take necessary action by setting bylaws to establish social control and it also raised issues at various platforms to deal with these issues," says Vishwakarm.

Another of the main challenges now and for the future in Sierra Leone is how to address food security and nutrition while rebuilding agriculture, ensuring people will have the right foods to eat and be educated nutritionally. This is another aspect of development that Concern Ireland is aiming to address. 

"We have a Food Income and Market (FIM) programme which is working towards food security and reducing the hunger gap through agricultural development, market access, promoting micro-enterprises and animal husbandry.  We have a health management committee to promote group farming to generate income for health facilities, to promote diversified and nutritious foods in the household daily food basket," Vishwakarma states.

In recent years Sierra Leone has made remarkable progress in reducing maternal mortality and increasing access to reproductive healthcare, however many challenges remain. With the assistance of groups like Concern Ireland, Sierra Leonean women and their children may finally be able look towards a more healthy and prosperous future.


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