Sierra Leone, the country with the shortest life expectancy in the world, JICA's challenge to protect lives

2024.10.29
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- Koroma Kiyomi Local Staff Sierra Leone Office
In Sierra Leone, 1,200 pregnant women and 27,000 infants losing their lives for a year. The spread of infectious diseases also claim thousands of lives every year. Many of these lives could be saved if the adequate health system was in place. JICA is working with the government of Sierra Leone to help as many people as possible envision a healthy and bright future.
I moved to Sierra Leone in 2005 and have been working at the JICA office since 2006. In 2005, even in Freetown, the capital city of Sierra Leone, days without electricity lasted for months, and on the rare occasion that electricity passed, "The electricity was on!" , the voices of children running around screaming echoed throughout the town. Anytime when I saw stranded person dying on street corner, I felt a sense of loss that there was nothing I could do, so it was very hard to spend time in Freetown, where aftermath of war was seen at every corners..
In the two decades since then, while I have been involved in various activities of JICA, and I met many Sierra Leonean who were very proactive for developing the nation. They are usually very gentle, calm, and good-natured people, but they would be very proactive to overcome issues when they faced with difficulties.
Many of you may remember the Ebola epidemic in West Africa in 2014-2015. Television and magazines extensively reported Sierra Leonean health workers who were wearing fully equipped protective suits and valiantly treating patients with deadly diseases. However, what is not well known to the public is that at that time, JICA's Japan Disaster Relief (JDR) Team was conducting emergency relief activities, and it was the first to deliver supplies such as tents, plastic sheets, plastic water tanks, and small generators. These supplies helped set up temporary facilities to house the rapidly increasing number of Ebola patients. A few months later, several Ebola patient centers were built with the help of Western countries, and even now, 10 years later, people are still grateful to Japan for sending relief supplies in the first place.
Temporary Ebola Center: Plastic sheets provided by JICA were used for partitions.
At the beginning of the pandemic, few patients visited medical institutions or Ebola centers for fear of Ebola, a disease that was said to be fatal for lack of a silver bullet. At that time, people did not have knowledge about Ebola infection yet. Therefore, many of the patients’ families took care of the patients at home, thinking, "If the patients are not going to live anyway, at least I want them to spend the last hours at home with their family." This had led to a further spread of infection. The government instructed medical staff to go door-to-door to find Ebola patients. JICA was quick to respond to the government's directive and provided motorbikes for health staff to visit each house.
Medical staff visiting each house on a motorcycle provided by JICA
In addition, all schools were closed for nearly a year, and the children studied independently while listening to the teacher's lessons that were played unilaterally on the radio. Children who did not have access to the radio were deprived of the opportunity to study. And none of the children were allowed to play outside with their friends, because they were prohibited from going out unnecessarily.
When the Ebola response was in place and the number of infectious decreased slightly, the Sierra Leone Ministry of Basic and Senior Secondary Education decided to reopen schools. Therefore, JICA provided free cleaning and handwashing supplies to children so that they could learn safely at school, and repaired and expanded the school in cooperation with other support organizations.
Children wash their hands before entering the classroom for the first time in 9 months
Even after the Ebola outbreak was brought under control, JICA continued to provide much cooperation in Sierra Leone. A senior official of the Sierra Leonean Ministry of Health, who had returned from a training program at JICA Okinawa, said: "I want to spread the Maternal and Child Health Handbook that I saw in Japan to Sierra Leone." She repeatedly appealed to the then Sierra Leonean Minister of Health, the Permanent Secretary and the Chief Medical Officer: "I don't think we should sit idly by and let the current situation where many pregnant women, fetuses, and babies born are dying. By creating and using a maternal and child health handbook, medical staff, patients and their families will deepen their knowledge of maternal and child health, and the current mortality rate will surely improve." She visited the JICA Sierra Leone branch many times to ask for help in the preparation of the Sierra Leone version of the Maternal and Child Health Handbook. Struck by this enthusiasm, the JICA Sierra Leone branch pledged to cooperate, and other UN agencies and NGOs also mobilized staff with expertise in the field of maternal and child health at the local offices to prepare the Maternal and Child Health Handbook. The "Pilot Survey on the Preparation and Introduction of the Maternal and Child Health Handbook," which began in 2019, was recognized as effective in 2022, and the Minister of Health of Sierra Leone announced that it would be officially approved by the government. Due to the tight financial situation, there are still many challenges to be solved before it can be disseminated nationwide, but she and JICA will continue to struggle until the Maternal and Child Health Handbook is delivered to 250,000 pregnant women every year.
A mother holding a maternal and child handbook waiting for a newborn checkup
For a long time, Sierra Leone has been labeled as "the country with the shortest life expectancy in the world" and "the country with the highest risk of dying in pregnancy” in relevant international study. So until two years ago, maternal mortality was not preferable topic to be discussed by the Ministry of Health and everyone working in the health sector.
In 2023 Health Sector Review meeting was totally deferent mood than past meeting. The maternal mortality rate announced by the Minister of Health had drastic reduction figural 60% from previous year When the announcement was made, the Minister of Health was overwhelmed with emotion and reiterated his gratitude to all those who were present. The average life expectancy and maternal mortality rate are still not good compared to Japan, but I believe that Sierra Leone with their restless efforts shall achieve better health situation for mothers and children for their brighter future.
These stories are just a few examples, but I have met many energetic Sierra Leonean people who are motivated and doing their best. From Japan geographic distance is there, but I hope you will visit Freetown and feel its energy.
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