A small West African country of approximately 6 million people, Sierra Leone is rated as the 7th poorest country in the world with one of the highest maternal and child mortality rates and lowest life expectancies. 1 child in 5 dies before their fifth birthday. They die from common, preventable causes such as malaria, respiratory infections, diarrhoeal diseases and a range of illnesses that have been largely eliminated in the western world by immunisation – tuberculosis, polio, tetanus, diphtheria, measles, hepatitis B and yellow fever. Often illness is compounded by poor nutrition. Pregnant and breastfeeding women are also highly vulnerable.
A civil war lasting from 1991–2001 devastated the nation with over 55,000 people killed and many more maimed. The country’s infrastructure was destroyed and thousands of people were displaced. Along with everything else the country’s education and health systems were left in ruin.
When the war ended in 2002, an entire generation was left without education or employment skills. Considerable progress has been made since then, consolidating peace and democracy, and improving development and economic growth.
In 2010, the government of Sierra Leone introduced a basic package of essential health services and announced free health care for pregnant and breastfeeding women and young children.
In May 2014, before these initiatives were realised, Sierra Leone was struck by the worst Ebola epidemic in global history. It had one of the least equipped health systems in the world to deal with such a highly contagious virus and became the most seriously affected country.
Traditional burial practices, misinformation about how the virus spreads and fear contributed to the vulnerability of Sierra Leone and more than 9 000 cases of the disease were recorded. The death toll and personal tragedy have been enormous. Families, livelihoods, the economy, the health and education systems and the fabric of society have again been devastated. Today, in 2016, the crisis is over but, while the people are strong and resilient, the effects are long-lasting and another long, hard recovery process is ahead.
The national health system is struggling to rebuild. It comprises a network of health facilities, including District Hospitals, Community Health Centres and Maternal and Child Health Clinics. Many facilities are under-staffed, inadequately equipped and lacking clean water, proper toilets and hygiene practices.
Sierra Leone is reliant on international support, particularly with healthcare and education. Despite their struggles, the people are among the friendliest and most optimistic you could meet. Visitors are invariably impacted by the poverty and inspired by their warm hospitality, cheerful smiles, strong faith and community values, and gratitude for what they have.
A visit to Sierra Leone is both captivating and heartbreaking. It is not a popular tourist destination, though your tourist dollars are welcome. The experience could well change your view of life, make you appreciate more the comforts and benefits of the developed world, and perhaps make you promise never to complain again. At the same time, there is so much the developed world can learn from its cheerful, innovative people. You can appreciate the power of community and spiritual values, the working model of religious tolerance, the pervading optimism and a sense of freedom from over-regulation. Above all, there may be a fresh realisation of how little you really need to be happy.