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What next for Sierra Leone?

Sierra Leone’s beleaguered health sector

The health sector is seriously weakened [PDF] – 296 health workers suffered infection during the epidemic, leading to 221 deaths, including 11 specialist physicians. Country-wide, health staff are exhausted and demotivated.

Jennifer Kamara, who survived capture by the rebels during Sierra Leone's long civil war and then went blind, finds solace in her family life. Her grandmother (r), Sama Mansaray, tells a joke provoking a cackle from Jennifer outside their house in Binkolo Felicity Thompson Copyright ©VSO

Jennifer Kamara, who survived capture by the rebels during Sierra Leone's long civil war and then went blind, finds solace in her family life. Her grandmother (r), Sama Mansaray, tells a joke provoking a cackle from Jennifer outside their house in Binkolo, Makeni.

Throughout the Ebola outbreak, people wary of health centres stopped accessing the services on offer with tragic consequences – including a 30% increase in maternal deaths and a 24% increase in newborn deaths.

Reduced public confidence in the health sector has seen a dramatic drop in service use, including a 23% decrease in children receiving basic immunization and a 39% reduction in children being treated for malaria. Already, estimates suggest levels of under-five child mortality in post-Ebola Sierra Leone have returned to 1990 levels.

Add to this the diversion of funds from health projects to fight Ebola during the crisis and you have a  potential health disaster.

Unfortunately the destructive power of Ebola reaches far beyond the beleaguered health sector.

The price of Ebola

With the suspension of company activities during the outbreak (pdf), the private sector has been severely affected - with a 50% decline in formal employment. Sixty per cent of the manufacturing workforce has been lost, and a number of new investment ventures have been postponed.

Ebola has not only taken lives in Sierra Leone but robbed survivors of their jobs and increased household poverty. An estimated 2,258,400 people in Sierra Leone are financially worse-off because of the outbreak.

Outside of her house in Binkolo, Jennifer Kamara prepares a tray of cola nuts for sale. Jennifer, who survived capture by the rebels during Sierra Leone's long civil war, benefitted from business management training at the Binkolo Growth Center in Makeni. Felicity Thompson ©VSO

Outside of her house in Binkolo, Jennifer Kamara prepares a tray of cola nuts for sale. Jennifer, who survived capture by the rebels during Sierra Leone's long civil war, benefitted from business management training at the Binkolo Growth Center in Makeni.

Education at a standstill

During the crises, formal education stopped. With schools closing, children missed out on important exams leaving them unable to progress.

Sadly, the school closures have also been directly linked to increased cases [PDF] of child labour and exploitation, exposure to violence and a massive increase in teenage pregnancy.

Prior to the outbreak, 25% of school-age children were already not going to school. Increasing the number of children enrolled in school on a permanent basis remains a challenge before you consider those whose education has been interrupted by the outbreak - particularly reaching those from low-income households.

What next?

For our part we are working with our partners and in collaboration with the Ministry of Health and Sanitation to implement plans to reduce the number of mothers and babies dying due to preventable causes. We will work to improve services available and rebuild the trust in the health facilities as well as reach out to young women and girls to reduce the rates of teenage pregnancies and the spread of STIs.

The road to recovery will not be easy, but already ambitious plans are underway to support the recovery, ongoing development and to increase the resilience of Sierra Leone against further epidemics.

With this outbreak officially over, we can look forward to a brighter future for the people of Sierra Leone.

We will need the support of skilled individuals to volunteer in support of Sierra Leone’s recovery plan. If you are interested in supporting our work in Sierra Leone, please register your interest to volunteer:  

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