Healthcare in Sierra Leone is generally charged for [1] and is provided by a mixture of government, private and non-governmental organizations (NGOs). There are over 100 NGOs operating in the health care sector in Sierra Leone. The Ministry of Health and Sanitation is responsible for organizing health care and after the end of the civil war the ministry changed to a decentralized structure of health provision to try to increase its coverage. [2]
Sierra Leone is divided into 13 health districts that correspond to the districts of Sierra Leone except for the Western Area Rural and Western Area Urban districts which are combined into the Western Area Health district. Each district has a health management team and an average of 50 peripheral health units (PHU) and over 100 technical staff. The management team is responsible for planning, organizing and monitoring health provision, training personnel, working with communities and supplying equipment and drugs. [2]
The PHUs are designed to be the delivery point for primary health care in the country and there are three main types.
In April 2010 Sierra Leone launched "Free Health Care Medical Insurance", a system of free healthcare for pregnant and breast-feeding women and children under five. [3] [4] A UN population Fund representative said that medical equipment had been ordered and some drugs distributed as part of the new healthcare scheme but the coverage was not yet 100%. [4] The initial set up cost of the scheme was $19 million and it is expected to save the lives of more than a million mothers and children. [4]
Healthcare workers had gone on strike over the plans in March 2010 arguing that free healthcare would increase their workload and working hours, the government settled the dispute with pay rises of 200-500%. [4] Observers argue that many of the women concerned do not even know they have a right for free medical care and that the law would remain a paper tiger if more earnings from the extractive sector was not invested in the countries healthcare system. [5]
The scheme is funded mainly by the United Kingdom and United Nations who have paid to refurbish hospitals, supply drugs and pay healthcare professionals' wages. [4] The UK alone has agreed to pay for a years worth of drugs for the program and the World Health Organization has provided blood banks in each major town. [6] The British government's funding came from the Department for International Development (DFID) and amounted to $22.6 million to fund the scheme for the next three years from a total allocation of $70.5 million for the 10-year-long "Reproduction and Child Health Care" plan. [7] UNICEF also received $7 million from DFID to provide medicines for pregnant women. [7]
There were about 80 hospitals in Sierra Leone in 2020. [8]
Traditional medicine forms part of the primary health care system in Sierra Leone. The traditional medicine programme, run by the Ministry of Health and Sanitation, has constructed a training school at Makeni, a healing centre at Kono and conducted workshops to promote co-operation between traditional medicine practitioners and orthodox medical workers. Members of the programme have also located and collected plants from throughout Sierra Leone used for medicine. [9] The use of traditional medicine in Sierra Leone is common especially for the treatment of malaria [10] and among hypertensive patients, [11] pregnant women, [12] infertile women [13] lactating mothers, [14] Ebola survivors [15] and healthcare students. [16] [17]
Makeni is the largest city in the Northern Province of Sierra Leone. The city is the capital of Bombali District, and is the economic center of the Northern Province. Makeni is the fifth largest city in Sierra Leone by population. The city of Makeni had a population of 80,840 in the 2004 census and a 2013 estimate of 112,428. Makeni lies approximately 110 miles east of Freetown. Makeni is home to the University of Makeni, the largest private university in Sierra Leone.
Partners In Health (PIH) is a Boston-based nonprofit health care organization founded in 1987 by Paul Farmer, Ophelia Dahl, Thomas J. White, Todd McCormack, and Jim Yong Kim.
Princess Christian Maternity Hospital is a hospital in Freetown, Sierra Leone nicknamed the 'Cottage Hospital'. On May 2006 Ahmad Tejan Kabbah re-opened the hospital alongside Connaught Hospital.
In terms of available healthcare and health status Sierra Leone is rated very poorly. Globally, infant and maternal mortality rates remain among the highest. The major causes of illness within the country are preventable with modern technology and medical advances. Most deaths within the country are attributed to nutritional deficiencies, lack of access to clean water, pneumonia, diarrheal diseases, anemia, malaria, tuberculosis and HIV/AIDS.
Wellbody Alliance is a 501(c)(3) registered nonprofit organization working to provide healthcare as a human right in Kono District, Sierra Leone. In addition to running a primary care facility, Wellbody operates a women's center and will open a birth center in 2015. They also focus on the prevention and treatment of HIV/AIDS and tuberculosis and provide medical services to amputee victims from the 11-year Sierra Leone Civil War. Their response effort during the Ebola virus epidemic in West Africa has received widespread media attention. These efforts include supporting four treatment facilities in rural Kono, house-to-house contract tracing and surveillance, the large-scale distribution of protective gear throughout Sierra Leone and an emphasis on sensitive community engagement to help stop the spread of the virus.
Traditional African medicine is a range of traditional medicine disciplines involving indigenous herbalism and African spirituality, typically including diviners, midwives, and herbalists. Practitioners of traditional African medicine claim to be able to cure a variety of diverse conditions including cancer, psychiatric disorders, high blood pressure, cholera, most venereal diseases, epilepsy, asthma, eczema, fever, anxiety, depression, benign prostatic hyperplasia, urinary tract infections, gout, and healing of wounds and burns and even Ebola.
Masanga Hospital or Masanga Leprosy Hospital is a NGO supported government hospital that provides healthcare in paediatrics, maternity, general medicine and surgery. It is located in Tonkolili district, Northern Province, Sierra Leone, West Africa. The hospital was ransacked and used as a rebel stronghold during the Sierra Leone Civil War, but having reopened in 2006 it is now a functioning rural hospital once more. The hospital is run by a partnership between several European charitable organisations: Masanga UK, Sierra Leonean Adventists Abroad (SLAA), Masanga Netherlands and Masanga Denmark. Though in the long-term the hospital aims to be fully government-funded, presently it currently subsists on charitable donations. Free healthcare is offered to under fives and pregnant women, and also to locals of limited means.
As of 24 September 2012, a cholera outbreak in Sierra Leone had caused the deaths of 392 people. It was the country's largest outbreak of cholera since first reported in 1970 and the deadliest since the 1994–1995 cholera outbreak. The outbreak has also affected Guinea, which shares a reservoir near the coast. This was the largest cholera outbreak in Africa in 2012.
The Welbodi Partnership is a Sierra Leone and UK-registered charity that works exclusively in Sierra Leone, where it collaborates with official and non-official partners to support the provision of pediatric care. The charity was founded in 2007 by British entrepreneur Tom Cairnes along with Dr Matthew Clark, a UK pediatrician who visited Sierra Leone as a medical student. They now serve on the charity's Board of Directors. The name Welbodi is derived from the Krio word for “health”. Welbodi is based at the Ola During Children's Hospital (ODCH) in Freetown, which is Sierra Leone's only paediatric referral and teaching hospital.
The 2013–2016 epidemic of Ebola virus disease, centered in Western Africa, was the most widespread outbreak of the disease in history. It caused major loss of life and socioeconomic disruption in the region, mainly in Guinea, Liberia and Sierra Leone. The first cases were recorded in Guinea in December 2013; later, the disease spread to neighbouring Liberia and Sierra Leone, with minor outbreaks occurring in Nigeria and Mali. Secondary infections of medical workers occurred in the United States and Spain. In addition, isolated cases were recorded in Senegal, the United Kingdom and Italy. The number of cases peaked in October 2014 and then began to decline gradually, following the commitment of substantial international resources.
An Ebola virus epidemic in Sierra Leone occurred in 2014, along with the neighbouring countries of Guinea and Liberia. On March 18, 2014 Guinean health officials announced the outbreak of a mysterious hemorrhagic fever "which strikes like lightning." It was identified as Ebola virus disease and spread to Sierra Leone by May 2014. The disease was thought to have originated when a child from a bat-hunting family contracted the disease in Guinea in December 2013.
Organizations from around the world responded to the West African Ebola virus epidemic. In July 2014, the World Health Organization (WHO) convened an emergency meeting with health ministers from eleven countries and announced collaboration on a strategy to co-ordinate technical support to combat the epidemic. In August, they declared the outbreak an international public health emergency and published a roadmap to guide and coordinate the international response to the outbreak, aiming to stop ongoing Ebola transmission worldwide within 6–9 months. In September, the United Nations Security Council declared the Ebola virus outbreak in the West Africa subregion a "threat to international peace and security" and unanimously adopted a resolution urging UN member states to provide more resources to fight the outbreak; the WHO stated that the cost for combating the epidemic will be a minimum of $1 billion.
The Ebola virus epidemic in West Africa has had a large effect on the culture of most of the West African countries. In most instances, the effect is a rather negative one as it has disrupted many Africans’ traditional norms and practices. For instance, many West African communities rely on traditional healers and witch doctors, who use herbal remedies, massage, chant and witchcraft to cure just about any ailment. Therefore, it is difficult for West Africans to adapt to foreign medical practices. Specifically, West African resistance to Western medicine is prominent in the region, which calls for severe distrust of Western and modern medical personnel and practices.(see Ebola conspiracies below.)
In late October 2014, the United Kingdom sent a hospital ship, the Royal Fleet Auxiliary's Argus, to help the aid effort against the Ebola virus disease epidemic in Sierra Leone. By late October Sierra Leone was experiencing more than twenty deaths a day from Ebola.
Cases of the Ebola virus disease in Nigeria were reported in 2014 as a small part of the epidemic of Ebola virus disease which originated in Guinea that represented the first outbreak of the disease in a West African country. Previous outbreaks had been confined to countries in Central Africa.
Alternative medicine describes any practice which aims to achieve the healing effects of medicine, but which lacks biological plausibility and is untested or untestable. Complementary medicine (CM), complementary and alternative medicine (CAM), integrated medicine or integrative medicine (IM), and holistic medicine are among many rebrandings of the same phenomenon.
Corruption is endemic in Sierra Leone. Transparency International's Corruption Perception Index has ranked Sierra Leone 119th out of 179 total countries The 2018 Global Competitiveness Report ranked Sierra Leone 109th out of 140 countries for Incidence of Corruption, with country 140 having the highest incidence of corruption. Corruption is prevalent in many aspects of society in Sierra Leone, especially in the aftermath of the Sierra Leone Civil War. The illicit trade in conflict diamonds funded the rebel Revolutionary United Front (RUF) forces during the civil war, leading to fighting between the Sierra Leone Army and the RUF for control of the diamond mines. Widespread corruption in the health care sector has limited access to medical care, with health care workers often dependent on receiving bribes to supplement their low pay.
Nahid Bhadelia is an American infectious-diseases physician, founding director of Center for Emerging Infectious Diseases Policy and Research (CEID), an associate director at National Emerging Infectious Diseases Laboratories (NEIDL) at Boston University, and an associate professor at the Boston University School of Medicine.
Claire Bayntun is a British physician specialised in global public health, director of Global Leadership Programmes, assistant professor at the London School of Hygiene & Tropical Medicine, advisor on health security and health protection, and trained mentor who coaches health leaders. She is vice-president of the Royal Society of Medicine, London.
John J. Lowe is an American infectious disease scientist, Assistant Vice Chancellor for Health Security at University of Nebraska Medical Center, and Associate Professor in the Department of Environmental, Agricultural and Occupational Health at University of Nebraska Medical Center College of Public Health. In 2014, he led Nebraska Medicine hospital’s effort to treat and care for Ebola virus disease patients and led the University of Nebraska Medical Center’s coronavirus disease 2019 response efforts.