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Sierra Leone

Sierra Leone is home to about 16 ethnic groups, each with its own language and customs. Despite the nation’s natural wealth, a vast majority of the population live in poverty.

Sierra Leone experienced substantial economic growth in the years following a decade-long civil war. However, the 2014-2015 Ebola epidemic had a disastrous effect on the country's economy, education system, and healthcare infrastructure.

Médecins Sans Frontières began working in Sierra Leone in 1986, and current projects aim to contribute to the recovery of the health system following the Ebola outbreak and combat high mortality rates among children and pregnant women.

MSF teams work in a number of districts across the country, providing medical care, staff training, and supplies for health units.

Ebola Recovery

Sierra Leone has some of the worst health indicators in the world, especially for maternal and child mortality. Even before the Ebola outbreak, people in Sierra Leone had limited access to medical care and the health system was both under-resourced and overburdened.  

It is estimated that up to 10% of the country’s already limited health professionals were killed by the virus. In Kenema district alone, more than 200 health workers died of the disease.

The deadly Ebola outbreak of 2014-2015 led to many of medical staff either fleeing or falling victim to the disease. Of 1,100 health workers in Sierra Leone, over 300 were infected with Ebola

Sierra Leone was finally declared Ebola-free on 17 March 2016 and the country is now struggling to rebuild its shattered health system. People are still reluctant to visit health centres. In rural areas, most peripheral health units (PHUs) became barely functional. They are dilapidated, with no water or electricity and, more often than not lack staff and medical stocks.

MSF trains, mentors, and supervises Ministry of Health staff and community health workers to improve health promotion, as well as infection prevention and control. Improving water, sanitation and hygiene (WASH) standards are a priority.


Mother and Child Health

Delivering a child still poses huge risks for women in Sierra Leone. The country’s maternal mortality rate is among the highest in the world.

Malaria is the key cause of death among children under five, and many also suffer from severe or acute malnutrition.

Seeking care often means travelling far and paying for expensive drugs and services without any certainty of being cured. Instead of paying a hefty fee for travel, only to arrive at a health post that has neither the facilities nor the health workers to treat them, many people find it more practical to stay in their villages and turn to traditional healers, who accept gifts such as rice or crops in return for their services.


“We are working towards making the Ministry of Health staff autonomous. To reduce mortality, they should be able to handle complicated cases, detect and refer the cases, and explain to the patients what exactly is happening to their health. If the staff don’t explain it to them, they will not seek healthcare.”

Francis Mbuthi
MSF Project’s Medical Focal Point

To gain people’s trust in the health system, MSF is working alongside the Ministry of Health in training local staff, providing medical stocks and reaching out to far-flung communities, in order to minimise the number of deaths by preventable causes – particularly among women and children.

An outreach team of MSF nurses and midwives take turns working alongside Ministry of Health staff to improve practical skills in diagnosis and treatment.


Health Promotion

Health promoters engage traditional healers and birth attendants in discussions surrounding public health, acknowledging their role as first responders who can help speed up the referral of patients. This involves engaging the community on malaria and cholera prevention, good hygiene practices, family planning and teenage pregnancies across villages and townships.

Training human resources is a crucial step in getting Sierra Leone’s health system up to speed. A higher number of skilled health workers will improve the services provided in primary healthcare structures and enable an effective response to disasters and outbreaks.


Find out more about Sierra Leone