In Sierra Leone, the Ebola crisis that began in 2014 forced businesses to close and caused essential services to be stretched and suspended.
Then in August 2017, the country was again devastated by another disaster – a mudslide – that claimed over 500 lives and over 6,000 families displaced from their communities and living in temporary shelters.
These crises have had a devastating impact on everything from livelihoods to maternal and infant mortality – and VSO has been working to strengthen infrastructure and services ever since.
Doctors for Development project supported medical assessment of 13,369 patients.
Reported incidents of gender-based violence (GBV) have halved in Kenema District.
27 health facilities equipped with improved water and sanitation facilities.
Tackling gender-based violence
Gender-based violence and discrimination are hidden problems in Sierra Leone. Domestic violence tends to be seen as a 'private issue'. This and other types of gender-based violence including rape and sexual assault (GBV) go under-reported.
VSO supports local organisations to help tackle the issues through education and engagement – supporting survivors and holding perpetrators to account.
This year, VSO’s male-engagement program in partnership with local organisation FINE-SL is addressing sexual reproductive health issues and gender-based violence against women by engaging men as advocates for change.
This presents a shift from conventional gender empowerment programs that target women and girls directly – ignoring men who are often the decision-makers and perpetrators of the violence or abuse.
FINE-SL also works with community leaders to establish referral pathways for women affected by GBV, those in need of health services for treatment of STIs, family planning, antenatal and postnatal care. The community has embraced these pathways as part of their response against some of the social ills experienced by women
- 60 community volunteers recruited and trained as MAPEs (male advocates and peer health educators) to engage men on a range of issues including sexual and gender-based violence, rape, female genital mutilation, sexual and reproductive health, child marriage and child abuse.
- MAPEs recruited local men to join a total of 22 husband schools. They were trained through a six-month programme that helped raise awareness and encouraged behaviour change.
- This led men to generally play an increasingly supportive role for their partners and offer practical support around their homes, as well as help in accessing health services for their children.
- The Kenema Police Family Support Unit reported a reduction in cases from an average 100 per month to 50-60 per month
- At institutional and policy level; VSO in partnership with FINE-SL made major gains in the harmonisation of bye-laws through the consolidation of existing policies in the Child Rights Act, the Domestic Violence Act and the Sexual Offences Act to prevent Female Genital Mutilation (FGM), child marriage and sexual and gender-based violence across three chiefdoms in Kenema District.
Since the Ebola outbreak the entire health system in Sierra Leone has been weakened creating further strain on access to health services and their delivery, especially to pregnant women and newborns.
The government of Sierra Leone with its development partners and friends has continued working towards strengthening the delivery of healthcare services with a particular emphasis on improved health for pregnant women, lactating mothers and children under five.
Doctors for Development
The Doctors for Development project recruits GP volunteer doctors from the UK to work with the government hospital in Makeni specifically five basic emergency obstetric and new born care to help reduce maternal and neo-natal mortalities whilst boosting demand for health services at community level.
Key to this intervention has been the pioneering use of the portable battery powered ultrasound scanners, the first of their kind in Sierra Leone, to support and strengthen the early detection of pregnancy complications in women at five basic emergency obstetric and newborn care centers serving twelve communities.
VSO, with technological and technical support of General Electric, supplied five V-scanners, installed solar panels and conducted training
s for 14 health staff on the effective use of the equipment in detection of complications in pregnant women. This led to a large turn-out of pregnant women accessing antenatal care services at these health facilities with V-scanning services.
- A considerable increase in patient intake for the first antenatal visit was recorded from 207 patients within October to December 2017 to 242 patients within January to March 2018.
- 54 health workers trained (5 doctors, 49 health staff)
- 13,369 patients assessed for various medical conditions and disease by national staff and volunteers
- Over 600 women supported to deliver safely at these facilities
- An increase in health centre deliveries conducted within the same periods from 205 deliveries to 229 deliveries directly implying an increase in confidence levels of pregnant women and the general community in accessing antenatal care and institutional delivery
Saving Lives Programme
VSO in partnership with UNFPA under the CHANGES Consortium implemented the Saving Lives programme. The project, funded by DFID, is equipping health facilities with complete water and sanitation facilities and implementing infection prevention control protocols. This strengthening of Sierra Leone health systems aims to reduce maternal and child deaths in the country. So far:
- 23 health facilities in Kenema district and 4 in Western Area have been equipped with 3-seater pour flush systems. Each has a compartment that is disability friendly and one that is designed for use by pregnant woman. Each system includes three washroom compartments and two handwashing points served from a 1,000 litre PVC tank.
- Systems incorporate clinical waste management zones with incinerators and disposable facilities for medical waste including sharps. These 27 health facilities serve a total population of 170,545 people.
VSO in partnership with the Office of the National Security, Ministry of Health and Sanitation and WASH-NET continued working towards building the resilience capacities of communities to cope with shocks and stresses that come with occurrence of disasters.
This initiative has worked to implement disaster risk reduction and resilience initiatives across six districts, this includes:
- Equipping the Disaster Management Department under the Office of National Security with equipment to set up a data management and analysis point where information on disasters or emergencies nationwide can be collected, analysed and key actions taken.
- Community social mobilisation campaigns were conducted by sanitation and hygiene community volunteers selected from these communities and trained by WASHNET.
- 75 community volunteers identified and trained as Disaster and Risk Reduction and Resilience volunteers in six districts identified as high risk areas for disaster.
- Developed a trainers guide for community facilitators to further train Disaster and Risk Reduction volunteers in respective communities.
What makes VSO different?
VSO is working in Sierra Leone at all levels of society: from direct community action, partnerships with regional and national organisations, all the way up to governmental departments. This gives us a unique insight into the issues most gravely affecting the country. On top of that, it means we can work with people at all levels of society, which means our approach has a much better chance of taking root and having a lasting effect.
VSO is not just a partner but rather an enabler that places its partners first. The VSO staff were also very much behind making sure we collectively succeed to not only end Ebola, but most importantly, change attitudes, culture and practices for improved health outcomes.
Water Sanitation and Hygiene Network
VSO’s main partner in Sierra Leone is the Ministry of Health and Sanitation, Office of the National Security, Disaster Management Department, alongside civil society organisations including Water Sanitation and Hygiene Network (WASH-NET), Fambul Initiative Network for Equality (FINE), Sierra Leone and Engineers without Borders.
A lot of new ideas were learnt and could be applied in EWB’s future strategic planning, like VSO’s People’s First approach. It showed clearly how effective VSO’s programmes have been.
Engineers Without Borders
Phone: +232 78 761915 / +232 79 251888
Address: 192, Upper Kandeh Drive, Off Wilkinson Road, Freetown, Sierra Leone