Sierra Leone, with a population estimated around 5.9 million in 2012, emerged from a 10-year civil war in 2002. Recovery has been slow and, though the country has experienced substantial economic growth in recent years, it remains ranked 177 out of 187 by the United Nations Human Development Index and over half the population live in extreme poverty. Significant development and health challenges lie ahead. The maternal mortality ratio remains high at around 1,360 deaths/100,000 live births (2015 est.), and there are large disparities between urban and rural areas, with the majority of the population living in the latter. However, the recent launch of the Free Health Care Initiative indicates the Government’s commitment to improve the health of the population, especially for mothers and children.
Less than half of the pregnant women are attended by a suitably experienced birth attendant. The charity has been continuing midwife skill exchange visits, medication distribution, baby bundles to encourage hospital births across Freetown and in Magburaka District.
In November 2011 LFAM was contacted by ABC News who were working on a feature about Maternal Mortality in Sierra Leone and happened to be visiting at the same time as LFAM and the training team. The following clip, featuring CEO Angela Gorman, shows a graphic account of the risks to women giving birth in Sierra Leone. Click Here
Sierra Leone was hit by the Ebola outbreak from 2014-2015. Its healthcare infrastructure was further disseminated after so much progress had been made. Healthcare professionals either died or walked away (who could blame them), in total 3955 people died from Ebola, and it rocked the country. The charity could not conduct midwifery training during that time as it was unsafe so we divested funds to increase the supply of Misoprostol (to treat post-partum haemorrhage) as medics did not know if women were haemorrhaging after giving birth either due to Ebola or to a birth complication. We also increased the supply of baby clothes as businesses were shutting down as a consequence. Following the outbreak we returned back to Sierra Leone to resume the midwifery training which was more important than ever due to the fact that so many medical staff had died.
Liberia, with a population of around 4.2 million, continues to rebuild its health system following the devastating civil war (1989 -2003) that saw its infrastructure destroyed and many of its health workers emigrate. More than half the population lives in poverty with approximately one-quarter living in extreme poverty. Liberia ranks at the bottom of the Human Development Index. Maternal Mortality remains very high, at 770 per 100,000 for 2011. The total fertility rate is also high, at 5.9 children per woman, and only 10% of married women use modern methods of contraception.
In 2007 Life For African Mothers was approached by UNFPA requesting that the charity extends its support into Liberia. The lifetime risk of death in pregnancy and childbirth is 1:8, which is one of the highest in the world and was brought to the attention of the public by a BBC programme called ‘The Toughest Place in the World to be a Midwife’ which was first screened in February 2011.
During the first visit in 2008 Angela Gorman was informed by a senior doctor in Monrovia that at that time the country had just two consultant obstetricians and twenty seven fully qualified doctors for the whole population. The consequences of the situation were that midwives had undertaken roles for which they had no training but felt that they were trying to do their best in the worst possible situation. The charity is currently working with several hospitals in the capital, Monrovia, providing clinical skills sharing workshops, medication distribution and baby bundles to encourage hospital births.
Cameroon, on the Gulf of Guinea, is a Central African country of varied terrain and wildlife. Its inland capital, Yaoundé, and its biggest city, the seaport Douala, are transit points to ecotourism sites as well as beach resorts like Kribi. The global MDG 5 target for maternal health is to reduce the number of women who die in pregnancy and childbirth by three quarters between 1990 and 2015.When applying this target to Cameroon, maternal mortality should fall to 168 cases per 100,000 live births. In the period 2007-11 Cameroon had a reported maternal mortality ratio of 670 deaths per 100,000 live births (this figure was estimated at 690 deaths per 100,000 by UN agencies/World Bank in 2010). Based on the data reported by the country, Cameroon is unlikely to achieve the maternal mortality target by 2015. Part of the goal also stipulates that 100 per cent of births must be attended by a skilled health professional. In the period 2007-12 this figure stood at 64 per cent, so progress towards this target is also off track. So LFAM have decided to help!
From June 2015 LFAM have started to supply health centres in Cameroon with Misoprostol. This is after Angela (CEO) met representatives from the Welsh Cameroonian Women’s Group, who then discussed the possibility of supporting their local health centre in Cameroon. Further, we now help to supply and distribute vitamins, essential in the development of healthy pregnant women and their babies. This is due to a partnership formed with a company called Oxford Vitality. Richard and Alistair from the company joined LFAM on the most recent trip to Liberia and witnessed the impact their donations can have.
Information Source The State of the World’s Midwifery 2014