In Sierra Leone, the Ebola crisis that began in 2014 forced businesses to close and essential services to be stretched and suspended.
Then in August 2017, the country was again devastated by another disaster – a mudslide – that claimed over 500 lives and estimated 1000 persons were reported missing, with over 6000 families displaced from their communities and living in temporary shelters.
The crises have had a devastating impact on everything from livelihoods to infant mortality – and VSO has been working to strengthen infrastructure and services ever since.
- Over 600 pregnant women supported to deliver safely at health facilities
- Gender-based violence cases halved in Kenema
- 60 community volunteers trained as male advocates against GBV
Tackling gender-based violence
Gender-based violence and discrimination are hidden problems in Sierra Leone. Domestic violence tends to be seen as a 'private issue'. This and other types of
gender-based violence including rape and sexual assault (GBV) go under-reported.
VSO supports local organisations to help tackle the issues through education and engagement – supporting survivors and holding perpetrators to account.
This year, VSO’s male-engagement program in partnership with local organisation FINE-SL is addressing sexual reproductive health issues and gender-based violence against women by engaging men as advocates for change.
This presents a shift from conventional gender empowerment programs that target women and girls directly – ignoring men who are often the decision-makers and perpetuators of the violence or abuse.
The FINE-SL also works with community leaders to establish referral pathways for women affected by gender-based violence (GBV), those in need of health services for treatment of STIs, family planning, antenatal and postnatal care. The community has embraced these pathways as part of their response against some of the social evils against women.
- 60 community volunteers recruited and trained as MAPEs (male advocates and peer health educators) to engage men on a range of issues including sexual and gender-based violence, rape, female genital mutilation, sexual and reproductive health, child marriage and child abuse.
- MAPEs recruited local men to join a total of 22 husband schools that were trained through a six-month programme that helped raise awareness and encourage behaviour change.
- This led men to generally play an increasingly supportive role for their partners and offer practical support around their homes, and in accessing health services for their children.
- The Kenema police family support unit reported a reduction in cases from an average 100 per month to 50-60 per month
- At institutional and policy level; VSO in partnership with FINE-SL made major gains in the harmonisation of bye-laws through the consolidation of existing policies in the Child Rights Act, the Domestic Violence Act and the Sexual Offences Act to prevent Female Genital Mutilation (FGM), child marriage and sexual and gender-based violence across three chiefdoms in Kenema District.
Improving maternal healthcare
Since the Ebola outbreak, which killed over 3,585 people including 221 healthcare workers, the entire health system was weakened creating further strain on access and delivery of health services especially MNCH services.
The government of Sierra Leone with its development partners and friends henceforth continued working towards strengthening the delivery of healthcare services and working towards improved health outcomes for pregnant women, lactating mothers and children under five.
Doctors for Development
The ‘Doctors for Development’ project recruited four GP volunteer doctors from the UK to work with the government hospital Makeni to help reduce maternal
and neo-natal mortalities whilst boosting demand for MNH services at community level.
Key to this intervention was the pilot use of the portable battery powered Ultrasound-scan machine technology, the first of its kind in Sierra Leone; to support and strengthen the early detection of pregnancy complications in women at five BEmONC centers serving over twelve catchment communities.
VSO with technological and technical support of General Electric supplied five V-scanners, installed with solar panels and conducted trainings for 14 health staff on the effective use of the equipment in detection of complications in pregnant women. This led to a large turn-out of pregnant women accessing antenatal care services at these health facilities with v-scanning services.
- A considerable increase in patient intake for the first antenatal visit was recorded from 207 patients within October to December 2017 to 242 patients within January to March 2018.
- 54 health workers trained ( 5 doctors,49 health staff)
- 3,789 patients reviewed by UK volunteer GP, 9,580 patients reviewed by national staff trained by Volunteer GP
- Over 600 women supported to deliver safely at these facilities
- An increase in first antenatal visits for pregnant women from 207 visits within October to Dec 2017 to 242 visits within Jan to march 2018.
- An increase in health centre deliveries conducted within the same periods from 205 deliveries to 229 deliveries directly implying an increase in confidence levels of pregnant women and the general community in accessing antenatal care and institutional delivery as opposed to seeking antenatal care and delivery services from traditional birth attendants
Justice for women who face violence in Sierra Leone
In Sierra Leone domestic violence tends to be seen as a 'private issue'. In Kenema, VSO has been supporting local organisation FINE-SALON to raise awareness of women's rights and the law, change attitudes, and support survivors to prosecute their perpetrators.
Rebuilding health services after Ebola
VSO volunteers have returned to Sierra Leone after ebola and are working to rebuild health services after such a huge trauma.
What makes VSO different?
VSO is working in Sierra Leone at all levels of society: from direct community action, partnerships with regional and national organisations, all the way up to governmental departments. This gives us a unique insight into the issues most gravely affecting the country. On top of that, it means we can work with people at all levels of society, which means our approach has a much better chance of taking root and having a lasting effect.
"VSO is not just a partner but rather an enabler that places its partners first. The VSO staff were also very much behind making sure we collectively succeed to not only end Ebola, but most importantly, change attitudes, culture and practices for improved health outcomes."
Water Sanitation and Hygiene Network
VSO’s main partner in Sierra Leone is the Ministry of Health and Sanitation, alongside civil society organisations including Water Sanitation and Hygiene Network (WASH-NET), Fambul Initiative Network for Equality (FINE-SALON) and Engineers without Borders.
Other strategic partnerships include WaterAid and the Liverpool School of Tropical Medicine. Through our support last year, partners made improvements in:
- Telling people about the rights of women
- Access to clean and safe water
- Telling people about better hygiene and sanitation
- Death rates of women and babies during childbirth
- Availability of critical, lifesaving equipment
- Training health workers
"A lot new ideas were learnt and could be applied in EWB’s future strategic planning, like VSO’s People’s First approach. It showed clearly how effective VSO’s programmes have been."
Engineers Without Borders
Phone: +232 78 761915 / +232 79 251888
Address: 192, Upper Kandeh Drive, Off Wilkinson Road, Freetown, Sierra Leone