Tuesday, April 28, 2009
Diplomatch: Football for Sierra Leone
As the players, friends and colleagues from the United Nations, took to the artificial turf football pitch at Manhattan’s Pier 40 in New York City, fans cheered knowing this was a game with a difference.
3,000 miles away and a world apart, children in football mad Sierra Leone, a nation at the bottom of the Human Development Index still recovering from the effects of a brutal civil war, would soon benefit from this beautiful game.
This past Saturday two teams made up of United Nations diplomats, including the Secretary General, participated in ‘Diplomatch’, a charity football game to benefit Play31, an NGO that provides footballs and equipment to communities in Sierra Leone so that children can exercise their right to play.
According to Ban Ki-moon, Secretary General of the United Nations, “This is a small, but symbolic event. We are participating to show solidarity with the people of Sierra Leone, to give hope to children in a war torn country known for the use of child soldiers. The UN takes this very seriously.”
Play31 was founded on the idea of Article 31 of The Convention on the Rights of the Child, which stipulates that every child has the right to play. In Sierra Leone the organization provides children with the most basic necessity for play: a football.
The organization believes in the unifying power of the game of football and attempts to use the ‘beautiful game’ as a way toward creating peaceful societies.
Play31 began in Sierra Leone, partnering with local NGO Forum of Conscience, an organization that works to reconcile people and communities torn apart during the war. Play31 provides material and logistical support for football games that are part of a follow up to community reconciliation ceremonies.
Founder of Play31, Jakob Silas Lund, said that there would be a two-fold benefit from Diplomatch. First, from the money donated through sponsorships recruited by the Ambassadors, and second, through raising awareness of both the situation in Sierra Leone and of Play31’s work in the country.
With the participation of Secretary General Ban Ki-moon and coverage on CNN and the New York Times, many more people will know about the children all over the world who live in a situation that doesn’t allow for their right to play to be realized. In the case of Sierra Leone it is poverty leading to child labour and violence leading to broken communities that creates this situation.
“It’s amazing for me, personally. Last year I was riding in the back of a 4x4 truck from Moyamba to Freetown and today we’re standing here in New York City,” said Mr. Lund.
“I met the Ambassador from Lichtenstein a year ago, I told him about Play31 and he said, ‘let’s do a match’, but it never materialized. Then I met the Ambassador from Chile and he said, ‘let’s do a match’, so thanks to these amazing ambassadors it finally came together.
The Ambassadors from Lichtenstein and Chile captained the two teams. They were also instrumental in recruiting the other players from various diplomatic missions from around the world.
For Heraldo Muñoz, Ambassador and Permanent Representative of Chile to the United Nations, football is a global game with the power to create change and rebuild broken communities. For him, the efforts of Right to Play are having a real impact.
“Right to Play symbolizes, through this game, (the right to play) for the children of Sierra Leone. They bring footballs and equipment to the children of Sierra Leone. We’ve raised some money and had a good time, and we are also working to help children stay away from violence. It’s the beautiful game,” he said.
Ambassador Christian Wenaweser has served as the Permanent Representative of Liechtenstein to the United Nations since 2002. For him the event was more than just another charity fundraising event. “We were very happy to do something fun for a good cause. You just need a ball and the will to play. This was an opportunity to get out of the UN and to have a good time for a good cause.”
Donations to Play31 can be made via their website at www.play31.org.
Friday, March 13, 2009
Photo-Voice Project Brings Tiwai And Villages Together
With images ranging from banana trees, a football, a bag of rice and a village path, residents of the eight villages surrounding the Tiwai Island Wildlife Sanctuary are sharing the things they want to protect for future generations.
The project is meant to build stronger connections to the reserve and to help protect their culture from increased tourism.
Thirty-two people participated in the photo-voice project, organized by Canadian researcher Jennifer Thompson of McGill University and the Environmental Foundation for Africa, the organization that operates the sanctuary.
Thompson had people take photos of the things in their community that the wanted to preserve for future generations.
"It's cultural conservation," she said, explaining that the project gives communities an chance to voice their concerns about the Tiwai Island project and decide what they want to keep and build on for the future.
"It's a dialog that will continue using a tool that local people don't normally have access to," Thompson said. "Using visuals to explore how people feel about a place is kind of new."
Tensions
The Tiwai Island Wildlife Sanctuary has one of the highest concentrations of primates in the world. Eleven species, including the endangered colobus and Diana monkeys and wild chimpanzees, live alongside pygmy hippopotamus and 135 different bird species.
Originally a research station, the reserve was created in 1987 as a way to provide for the communities while protecting wildlife. It was destroyed during the war, and rebuilt starting in 2001. The sanctuary received its first visitors in 2004.
Even though the creation of the wildlife sanctuary was a community-driven project, the relationship between the wildlife sanctuary and the nearby villages has been strained.
The island is known to have mineral deposits, including diamonds. But farming, mining and hunting are not allowed in the reserve, so villagers have given up potential income from these activities.
The communities do get some money from the sanctuary. Forty per cent of the visitor's fees go to fund community projects, including the ongoing construction of a mosque and a school. Tiwai also employs eight permanent workers and four night staff.
But some villagers expected to earn more money from the researchers and tourists coming to the reserve. It is hoped that Tiwai will eventually become an economic engine for the area, but this will take time.
Community Impact
Thompson hopes that the photo-voice project can help address some of the concerns and create a sustained dialog and bring Tiwai and the surrounding communities together.
Momoh Magona, the project officer with the Tiwai Island Wildlife Sanctuary, thinks the project has already been successful.
"The project is a good one," he said. "They [local villagers] like that their voices are being heard and they now feel that they are part of us."
James Gbomgbotoh, 18, lives in Kambama village near Tiwai. He participated in the photo-voice project in order to share what he had learned after moving from Bo Town.
"I'm from far away [Bo] and I heard about Tiwai and I heard it was popular. When I got to Kambama I didn't respect it," he said. "There were no zinc houses, there was bush inside the town."
Taking part in the photo voice project allowed Gbomgbotoh to identify the areas of his village that needed to be improved as well as the things that needed to be protected.
"The way I see it, whatever your eyes see, that's what you should talk about. Like the mosque, it's broken. I took pictures of the mosque. It was not built fine. If it is a place where you worship God, it should be fine," he said.
"I took a picture of the water pump because it is not enough," he continued. "When women come in the evening to take water it is dirty. If there were two or three [pumps in the community] it would be fine."
He also took a picture of the school. "My brother and sister have to walk to Vaama everyday. They've started to build a school in Kambama, but it is not done."
Ownership
Catherine Kerr, an ecotourism advisor working with the Environmental Foundation for Africa, said each village is involved with decision-making for the reserve.
The Tiwai Island Administration Committee, which meets monthly, includes representatives from the communities. Government, universities, community members and other stakeholders meet to discuss the community development projects that Tiwai is able to fund.
The VSO Secure Livelihoods Programme, which placed Kerr with EFA, works to ensure that people have a reasonable standard of living, diversify livelihoods and build skills training.
For Tiwai this means making sure that the wildlife sanctuary operates in a sustainable way while involving local people in an economic and cultural partnership.
Additional funding is being sought for programmes that will directly benefit the community, including agriculture and arts and crafts training. Villagers will then be able to supply the sanctuary with the food and goods they make.
Gbomgbotoh believes that the eight villages surrounding Tiwai do benefit from the sanctuary, even if the impact is not felt immediately.
"The way I see it, Kambama has Tiwai totally," he said. "Tiwai makes Kambama improve. Visitors who come here leave money here. This money goes to help Kambama and the other communities. When there is money for development there should be decisions taken between Tiwai and the communities. The communities own Tiwai."
Friday, November 7, 2008
Political Satire Lives!
Combining my love of basketball and the mind blowing election of Barack Obama...
http://www.theonion.com/content/news/kobe_bryant_scores_25_in_holy_shit
http://www.theonion.com/content/news/kobe_bryant_scores_25_in_holy_shit
Thursday, November 6, 2008
The end of 'politics as satire'
A day after the historic election of Barack Obama as president of the United States of America I think it has finally sunk in that things will never quite be the same again.
Taking in the election at the home of an employee of the Special Court for Sierra Leone, on a couch with some Americans and a couple of Canadians watching the over-the-top graphics on CNN and making fun of the staid and boring BBC, we sit awaiting the news.
The mood is upbeat, giddy even, as we use our great legal and political minds to deconstruct the media coverage into stand-up comedy routines. We are the John Stewart generation, where politics is satire.
A day after the election it hit me that this may no longer be the case. The hope for change that has propelled Barack Obama to power is the call for the end of politics as satire. The mandate that Obama has been given is one of a return to leadership through excellence and decision making through consensus building - for the people, of the people, by the people.
Folksy charm and a promise of a return to family values provided an effective mask for a bumbling, conservative ideologue and allowed Bush to be elected in 2000. That election turned into 8 years of unmitigated disaster. Those 8 years created not just voter apathy, but a split in the national psyche. Red or Blue, patriot or traitor, with us or against us.
The movement to elect Barack Obama was the rejection of a politics ruled by war, evangelical christian social policy and neo-liberal economic policies that has seen the country nearly go morally, as well as financially, bankrupt.
We now see how the debate on torture, secret prisons, wiretapping and limiting civil liberties, while cutting taxes and deregulating the financial markets, has turned out.
Americans and the international community cried out for the country to right itself and to try to be the America from the myth, the one from the dream, instead of the one that seemed happy to enrich the rich and subjegate the poor around the world.
With the decision to choose a community organizer, a radical shift from the parochial interests of a closed inner circle, with a leader insulated by sycophantic advisors, America is choosing to reclaim its decision making processes, to reclaim its political power. The possibilities seem endless.
Politics as satire may now be over. There will always be right wing radio hosts to make fun of, but it won't be as much fun anymore. With this new democratic mandate their blather becomes irrelevant background noise.
2009 sees the beginning of a new era in American politics and John Stewart might be out of business.
Taking in the election at the home of an employee of the Special Court for Sierra Leone, on a couch with some Americans and a couple of Canadians watching the over-the-top graphics on CNN and making fun of the staid and boring BBC, we sit awaiting the news.
The mood is upbeat, giddy even, as we use our great legal and political minds to deconstruct the media coverage into stand-up comedy routines. We are the John Stewart generation, where politics is satire.
A day after the election it hit me that this may no longer be the case. The hope for change that has propelled Barack Obama to power is the call for the end of politics as satire. The mandate that Obama has been given is one of a return to leadership through excellence and decision making through consensus building - for the people, of the people, by the people.
Folksy charm and a promise of a return to family values provided an effective mask for a bumbling, conservative ideologue and allowed Bush to be elected in 2000. That election turned into 8 years of unmitigated disaster. Those 8 years created not just voter apathy, but a split in the national psyche. Red or Blue, patriot or traitor, with us or against us.
The movement to elect Barack Obama was the rejection of a politics ruled by war, evangelical christian social policy and neo-liberal economic policies that has seen the country nearly go morally, as well as financially, bankrupt.
We now see how the debate on torture, secret prisons, wiretapping and limiting civil liberties, while cutting taxes and deregulating the financial markets, has turned out.
Americans and the international community cried out for the country to right itself and to try to be the America from the myth, the one from the dream, instead of the one that seemed happy to enrich the rich and subjegate the poor around the world.
With the decision to choose a community organizer, a radical shift from the parochial interests of a closed inner circle, with a leader insulated by sycophantic advisors, America is choosing to reclaim its decision making processes, to reclaim its political power. The possibilities seem endless.
Politics as satire may now be over. There will always be right wing radio hosts to make fun of, but it won't be as much fun anymore. With this new democratic mandate their blather becomes irrelevant background noise.
2009 sees the beginning of a new era in American politics and John Stewart might be out of business.
Monday, October 13, 2008
Concord Times wins human rights reporting award
Defending champion of the Journalists for Human Rights award for excellence in human rights reporting in the newspaper category has repeated the feat in 2008.
The award ceremony also honored Concord Times' senior reporter Rachel Horner for outstanding performance and lasting contribution to the field of investigative and human rights reporting in Sierra Leone.
Other winners included Radio Mankneh, ABC Television, WIMSAL and freelance journalist Abu Bakar Jalloh for his documentary on scrap metal.
The ceremony took place at British Council and the keynote address was given by the first lady Sia Koroma.
She talked about equality in the consideration of press freedom and the importance of investigative, as opposed to sensational, journalism.
She said the media plays an important role in the development in any country. The award is part of a continuous testing of the efficacy of the work of the media and journalists in reporting on important issues.
"I request for JHR to extend their time from five years because of the work that you have done in this country. We want the work to be sustained, so that when you leave we will always remember you for your legacy of good work."
According to Elvis Gbanabom Hallowell, country director for Journalists for Human Rights the awards ceremony was being held to recognize the work of local reporters and local media houses.
"JHR is not an advocacy organization, but to train local journalists. We are moving from a promotional journalism to a developmental journalism. JHR is neither a master nor a mistress in journalism but is here to partner with local journalists to build their capacity and promote developmental stories."
The award ceremony also honored Concord Times' senior reporter Rachel Horner for outstanding performance and lasting contribution to the field of investigative and human rights reporting in Sierra Leone.
Other winners included Radio Mankneh, ABC Television, WIMSAL and freelance journalist Abu Bakar Jalloh for his documentary on scrap metal.
The ceremony took place at British Council and the keynote address was given by the first lady Sia Koroma.
She talked about equality in the consideration of press freedom and the importance of investigative, as opposed to sensational, journalism.
She said the media plays an important role in the development in any country. The award is part of a continuous testing of the efficacy of the work of the media and journalists in reporting on important issues.
"I request for JHR to extend their time from five years because of the work that you have done in this country. We want the work to be sustained, so that when you leave we will always remember you for your legacy of good work."
According to Elvis Gbanabom Hallowell, country director for Journalists for Human Rights the awards ceremony was being held to recognize the work of local reporters and local media houses.
"JHR is not an advocacy organization, but to train local journalists. We are moving from a promotional journalism to a developmental journalism. JHR is neither a master nor a mistress in journalism but is here to partner with local journalists to build their capacity and promote developmental stories."
Beach Bars Demolished!
Under instructions from the minister of tourism, virtually all beach bars on the beach side of Lumley Road, perhaps the largest tourist attraction in Freetown, have been demolished in what has been called a beautification exercise.
At about 12 pm yesterday a large crew of workers wielding machetes, crowbars, sledge hammers, axes and shovels, with heavy police and military presence violently took down all structures, including the popular De Base, Check Point Koma, Paradise, Ramada and Sea View beach bars.
The move destroyed many small businesses and put some 115 people out of work and into a search for a new way to provide for their families.
Police and military officials blocked the road to all pedestrian traffic and access to the scene for journalists, calling Lumley Road a restricted area where no pictures could be taken.
This occurred despite repeated proclamations from government and police officials of their commitment to the freedom of press.
After some time and following the arrival of many journalists on the scene, police could no longer restrict access.
According to Umaru Deen Kargbo, owner of Sea View Beach Bar, the action of the government was unjust. No compensation for the loss of the business has been offered, despite having permission and permits to operate from the national tourist board.
"I don't feel good. It has hit me personally, economically. I started from a 'cool man drinks seller'. I invested 18 million leones into the business. I had hired 10 employees from the national tourism training institute," he said.
Sea View Beach Bar had been operating on the beach between Aberdeen and Lumley since 2001.
The businesses on the beach side of Lumley were notified in a letter from Cecil Williams, the general manager of the tourist board on July 18th, that their businesses would be shut down and structures destroyed because of the "unsightly nature and (the) conditions of Beach Bar operations".
Building inspector for the ministry of lands and country planning Antony Kargbo said no permits were issued on the beach side of Lumley.
"They are violating our laws. We are not just doing this because we want to."
Efforts by the owners of these establishments to negotiate an acceptable settlement with government proved futile.
"The minister and deputy have been very arrogant. They told us they wanted to clear the area for tree planting, solar energy light system and to stop erosion," said Mr. Antony Deen Kargbo.
The erosion of the local tourist economy might be a more serious concern than the loss of some land into the sea. New fears are emerging that the loss of the beach bars and subsequent loss of pedestrian traffic will result in safety issues for those who would walk on the beach.
"This will turn into a social disturbance. We don't want this (area) to turn into a ghetto for bad reasons."
Adikallie Carlar Kamar, the manager of the Ramada Beach Bar said that the business had been paying the national tourist board based on a lease agreement. The board decided not to renew the lease for 2009 with "no reason that we understand" and sent a notification of the demolition order.
"Nothing is progressive in this area. When we came here it was bushy. There is no compensation, no negotiation!"
According to Ramatu Osola, owner of the Ramada beach bar, the government's actions were incomprehensible when it is still very difficult to start a successful business in the country.
"This is personal. This has nothing to do with tourism. How are we going to survive? We don't know. No provision, no compensation at all. Eight years of hard work. It's not easy to establish a business, nationally or internationally. We did it to improve our country. This is the typical Sierra Leone style."
The Ramada began operation in 2004 and over US$30,000 had been invested in the business.
In a statement broadcast on the Cotton Tree News minister of tourism Hidolo Trye attempted to explain why the government felt it necessary to destroy these tourist attractions.
"Is this what we intended for this country? Is this the image we want? No. So many investments on one side of Lumley Road but not on the other. This is the end of our culture of begging."
With the destruction of these viable businesses and tourist attractions, the hopes and dreams of proprietors, the livelihoods of hundreds of families and the favorite relaxation spots of tourists and Sierra Leoneans alike are left like so much rubble at the feet of the government.
At about 12 pm yesterday a large crew of workers wielding machetes, crowbars, sledge hammers, axes and shovels, with heavy police and military presence violently took down all structures, including the popular De Base, Check Point Koma, Paradise, Ramada and Sea View beach bars.
The move destroyed many small businesses and put some 115 people out of work and into a search for a new way to provide for their families.
Police and military officials blocked the road to all pedestrian traffic and access to the scene for journalists, calling Lumley Road a restricted area where no pictures could be taken.
This occurred despite repeated proclamations from government and police officials of their commitment to the freedom of press.
After some time and following the arrival of many journalists on the scene, police could no longer restrict access.
According to Umaru Deen Kargbo, owner of Sea View Beach Bar, the action of the government was unjust. No compensation for the loss of the business has been offered, despite having permission and permits to operate from the national tourist board.
"I don't feel good. It has hit me personally, economically. I started from a 'cool man drinks seller'. I invested 18 million leones into the business. I had hired 10 employees from the national tourism training institute," he said.
Sea View Beach Bar had been operating on the beach between Aberdeen and Lumley since 2001.
The businesses on the beach side of Lumley were notified in a letter from Cecil Williams, the general manager of the tourist board on July 18th, that their businesses would be shut down and structures destroyed because of the "unsightly nature and (the) conditions of Beach Bar operations".
Building inspector for the ministry of lands and country planning Antony Kargbo said no permits were issued on the beach side of Lumley.
"They are violating our laws. We are not just doing this because we want to."
Efforts by the owners of these establishments to negotiate an acceptable settlement with government proved futile.
"The minister and deputy have been very arrogant. They told us they wanted to clear the area for tree planting, solar energy light system and to stop erosion," said Mr. Antony Deen Kargbo.
The erosion of the local tourist economy might be a more serious concern than the loss of some land into the sea. New fears are emerging that the loss of the beach bars and subsequent loss of pedestrian traffic will result in safety issues for those who would walk on the beach.
"This will turn into a social disturbance. We don't want this (area) to turn into a ghetto for bad reasons."
Adikallie Carlar Kamar, the manager of the Ramada Beach Bar said that the business had been paying the national tourist board based on a lease agreement. The board decided not to renew the lease for 2009 with "no reason that we understand" and sent a notification of the demolition order.
"Nothing is progressive in this area. When we came here it was bushy. There is no compensation, no negotiation!"
According to Ramatu Osola, owner of the Ramada beach bar, the government's actions were incomprehensible when it is still very difficult to start a successful business in the country.
"This is personal. This has nothing to do with tourism. How are we going to survive? We don't know. No provision, no compensation at all. Eight years of hard work. It's not easy to establish a business, nationally or internationally. We did it to improve our country. This is the typical Sierra Leone style."
The Ramada began operation in 2004 and over US$30,000 had been invested in the business.
In a statement broadcast on the Cotton Tree News minister of tourism Hidolo Trye attempted to explain why the government felt it necessary to destroy these tourist attractions.
"Is this what we intended for this country? Is this the image we want? No. So many investments on one side of Lumley Road but not on the other. This is the end of our culture of begging."
With the destruction of these viable businesses and tourist attractions, the hopes and dreams of proprietors, the livelihoods of hundreds of families and the favorite relaxation spots of tourists and Sierra Leoneans alike are left like so much rubble at the feet of the government.
Monday, October 6, 2008
Traditional Birth Attendants' role to change
By Rachel Horner and Kevin Hill
The Minister of Health has called for a reorganization of the way women in Sierra Leone give birth and will focus on the role of the traditional birth attendant. Currently one in eight women is at risk of dying while giving birth in this country.
“People who are in attendance aren’t able to deal with complications. Often these people are traditional birth attendants. They are not trained in any scientific way. We are going to change their role”, said Health Minister Soccoh Kabia.
According to the minister, the traditional birth attendants will be responsible for identifying pregnancies in their communities, referrals to health care providers and making sure women show up for appointments. They will also focus on antenatal and perinatal care, immunizations and dispensing vitamins, leaving deliveries to trained medical practitioners.
“We will get to the point of discouraging home deliveries. It will take time, 2 or 3 years, we must be systematic about it.”
The UN Children's Fund (UNICEF) estimates that almost half of all births in developing countries occur without a skilled birth attendant present - in Sierra Leone that number drops to only 43%. Globally, 529,000 women die every year in pregnancy or birth, according to the World Health Organisation (WHO).
Minister of Health, Dr. Soccoh Kabbia, said that as part of the APC government’s health strategy the government is trying to answer the question, “why do women die?”
10-15% of all births have serious complications, including anemia, obstructed labour and infectious diseases not addressed prior to delivery. Delay in getting these complicated cases to a qualified medical practitioner causes numerous preventable deaths.
According to Dr. Thorlie, head of Princess Christian Maternity Hospital, women are at risk when using the services of traditional birth attendants because they cannot handle post-partum hemorrhaging or any other unpredictable complications that might arise during delivery.
“Traditional birth attendants are there to do normal deliveries. They are trained by an NGO then they go practice. They used to train old women with a lot of experience dealing with births. These days they train people who have no experience.”
TBAs can also administer oxytocin drugs, which are used to encourage contractions of the uterus to facilitate delivery. Used incorrectly these drugs have the potential to do great harm.
“TBAs give the drugs anytime, given too early causes hemorrhaging”, said Dr. Thorlie.
“We need to reorganize our health system.”
Amie Kondeh is a traditional birth attendant has been in the job for over 30 years. Kondeh is very popular in the Ginger Hall community for expectant mothers said she has never had a complication during delivery and no woman has died on her watch.
However, she said that “now (recently trained) TBAs have no patience in doing delivery, they care only for the money rather than the safety of the pregnant women and the unborn baby”, she said.
“I learned this job when I was in the bondo society bush in the early ‘60s. We were trained by the head of the Bondo society to delivery pregnant women. I believe it is a gift.”
Kondeh is not educated and cannot even speak Krio, but she is confident of her ability to deliver babies, even more than trained nurses.
Women normally pay Ms. Kondeh Le50,000 or Le60,000 for delivery - a big savings over the cost of a hospital stay.
During the interview with Concord Times, a pregnant woman approached Ms. Kondeh to deliver her child. While in great pain Marie Kamara told me that Kondeh had delivered 3 of her children and that she is sure of her delivery methods.
Kondeh’s delivery room is small with a little window. It has neither proper ventilation nor light. As Marie prepared to give birth, the room was very warm. Kondeh, the pregnant women and some other women attending were sweating profusely in and out of the room.
Marie successfully delivered a baby girl. Both are healthy despite the lack of trained medical practitioners and the risk involved.
For Sister Mansary, nurse at PCMH, getting to a hospital in a timely fashion is essential for safe deliveries. “You need expert attention. Most people have difficulty in transportation, causing delays. By the time they get into the major centres it is too late. This contributes to the high rates of maternal mortality.”
The delay in getting to hospital can be exacerbated by the actions of the traditional birth attendants. “Traditional Birth Attendants are not even trained. When they finish mismanaging (deliveries) they bring them here,” said Ms. Mansaray.
PCMH handles up to 8 or 9 caesarean sections per day. Most of the patients survive, but it depends on their condition upon arrival.When pregnant women arrive at the hospital long after complications to the pregnancy have been identified, the woman and child’s chances of survival are greatly diminished.
“When they want to deliver they go to traditional birth attendants, (but) they refer these complicated cases too late”, nurse Mansaray said.
According to Sister Taylor-Young, a nurse anesthetist, the lack of qualified and trained people means that pregnant women often trust those who cannot help in the case of a complicated delivery. “Everyone is a midwife, everyone is a doctor. Finally everyone fails. Abnormalities found early (means) lives will be saved.”
Sierra Leone’s devastated health care system cannot currently manage all the births that occur in the country. If the additional case load that is now managed by traditional birth attendants hits the hospitals the system will fail unless massive donor assistance can be found.
The Minister of Health has called for a reorganization of the way women in Sierra Leone give birth and will focus on the role of the traditional birth attendant. Currently one in eight women is at risk of dying while giving birth in this country.
“People who are in attendance aren’t able to deal with complications. Often these people are traditional birth attendants. They are not trained in any scientific way. We are going to change their role”, said Health Minister Soccoh Kabia.
According to the minister, the traditional birth attendants will be responsible for identifying pregnancies in their communities, referrals to health care providers and making sure women show up for appointments. They will also focus on antenatal and perinatal care, immunizations and dispensing vitamins, leaving deliveries to trained medical practitioners.
“We will get to the point of discouraging home deliveries. It will take time, 2 or 3 years, we must be systematic about it.”
The UN Children's Fund (UNICEF) estimates that almost half of all births in developing countries occur without a skilled birth attendant present - in Sierra Leone that number drops to only 43%. Globally, 529,000 women die every year in pregnancy or birth, according to the World Health Organisation (WHO).
Minister of Health, Dr. Soccoh Kabbia, said that as part of the APC government’s health strategy the government is trying to answer the question, “why do women die?”
10-15% of all births have serious complications, including anemia, obstructed labour and infectious diseases not addressed prior to delivery. Delay in getting these complicated cases to a qualified medical practitioner causes numerous preventable deaths.
According to Dr. Thorlie, head of Princess Christian Maternity Hospital, women are at risk when using the services of traditional birth attendants because they cannot handle post-partum hemorrhaging or any other unpredictable complications that might arise during delivery.
“Traditional birth attendants are there to do normal deliveries. They are trained by an NGO then they go practice. They used to train old women with a lot of experience dealing with births. These days they train people who have no experience.”
TBAs can also administer oxytocin drugs, which are used to encourage contractions of the uterus to facilitate delivery. Used incorrectly these drugs have the potential to do great harm.
“TBAs give the drugs anytime, given too early causes hemorrhaging”, said Dr. Thorlie.
“We need to reorganize our health system.”
Amie Kondeh is a traditional birth attendant has been in the job for over 30 years. Kondeh is very popular in the Ginger Hall community for expectant mothers said she has never had a complication during delivery and no woman has died on her watch.
However, she said that “now (recently trained) TBAs have no patience in doing delivery, they care only for the money rather than the safety of the pregnant women and the unborn baby”, she said.
“I learned this job when I was in the bondo society bush in the early ‘60s. We were trained by the head of the Bondo society to delivery pregnant women. I believe it is a gift.”
Kondeh is not educated and cannot even speak Krio, but she is confident of her ability to deliver babies, even more than trained nurses.
Women normally pay Ms. Kondeh Le50,000 or Le60,000 for delivery - a big savings over the cost of a hospital stay.
During the interview with Concord Times, a pregnant woman approached Ms. Kondeh to deliver her child. While in great pain Marie Kamara told me that Kondeh had delivered 3 of her children and that she is sure of her delivery methods.
Kondeh’s delivery room is small with a little window. It has neither proper ventilation nor light. As Marie prepared to give birth, the room was very warm. Kondeh, the pregnant women and some other women attending were sweating profusely in and out of the room.
Marie successfully delivered a baby girl. Both are healthy despite the lack of trained medical practitioners and the risk involved.
For Sister Mansary, nurse at PCMH, getting to a hospital in a timely fashion is essential for safe deliveries. “You need expert attention. Most people have difficulty in transportation, causing delays. By the time they get into the major centres it is too late. This contributes to the high rates of maternal mortality.”
The delay in getting to hospital can be exacerbated by the actions of the traditional birth attendants. “Traditional Birth Attendants are not even trained. When they finish mismanaging (deliveries) they bring them here,” said Ms. Mansaray.
PCMH handles up to 8 or 9 caesarean sections per day. Most of the patients survive, but it depends on their condition upon arrival.When pregnant women arrive at the hospital long after complications to the pregnancy have been identified, the woman and child’s chances of survival are greatly diminished.
“When they want to deliver they go to traditional birth attendants, (but) they refer these complicated cases too late”, nurse Mansaray said.
According to Sister Taylor-Young, a nurse anesthetist, the lack of qualified and trained people means that pregnant women often trust those who cannot help in the case of a complicated delivery. “Everyone is a midwife, everyone is a doctor. Finally everyone fails. Abnormalities found early (means) lives will be saved.”
Sierra Leone’s devastated health care system cannot currently manage all the births that occur in the country. If the additional case load that is now managed by traditional birth attendants hits the hospitals the system will fail unless massive donor assistance can be found.
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