In April, Sierra Leone's reproductive health minister, Dr Samuel A.S. Kargbo, of the efforts he and others had made to introduce abolish healthcare charges for pregnant women and children. Here, in a further post, he suggests that Sierra Leone now has some positive lessons to offer the world.
FREETOWN, Sierra Leone -- Since won its independence from Great Britain nearly a half-century ago, two events have improved the lives of every single citizen in the country.
The first was the end of our horrible civil war in 2002. After more than a decade of fighting, the coming of peace allowed everyone – old to young, school teacher to farmer – the freedom to walk the land after years of fear.
The second happened only this past April: the launch of nationwide free health care for pregnant mothers, women who are breast-feeding their children, and all children under the age of five. Every single individual – from village to city – has been affected by this initiative.
According to the World Health Organization, Sierra Leone for years has had one of the worst maternal health records in the world. But now we are seeing the beginnings of major improvement. More people are seeking health care, and in the process we are cleaning up our health care system.
Today – only five months after the launch of this healthcare reform - as the United Nations starts its three-day Millennium Development Goals summit in New York City, we also are beginning to find lessons in Sierra Leone's experience that can now benefit other countries.
We savor this moment. For too many years, people looked at my country as one of the most dangerous places in the world. Now we are starting to compile a record, through the care of women and children, which show Sierra Leone is one of those countries in the developing world leading the way in how to best save lives.
Here are some of our lessons.
First: Don't wait to provide free healthcare. Just start. You can never prepare everything to start a system of free healthcare. Everything will not be in place. In fact, free healthcare has actually allowed us an opportunity to fix things that plagued our system as we go, like payroll and drug inventory issues – a chance that we wouldn't have had otherwise.
Second: Get everyone on board - don't work alone in a corner. Build a team among both public and private groups. Our success comes from a sector-wide approach – everyone has a role, no matter who they are. Some people have little money and big ideas. Others have big money and big ideas. We welcome all good ideas, and obviously, whatever support – financial and technical – that others make in a common alignment of our goals.
That leads to the third lesson: Never lose sight of the goal. That goal is to save the lives of women and children.
At times, the launch of free health care has been tough and it won't be easy going forward. Before, staffing was a big issue. Salaries were too low. Many staff members had left government hospitals for health facilities run by non-governmental or faith-based groups. Some staff were only going to work sporadically. There weren't enough people to provide the necessary care.
But now we have increased salaries 200 to 500 percent. This is bringing workers back to the government and back to their jobs. The launch of free healthcare also launched an effort to clean our payroll. Outside consultants combed through records and took off the names of more than 700 people who had died or who had taken other jobs. We then added more than 700 workers (many were working as unpaid volunteers in clinics and hospitals) to the payroll.
We also installed a much better management system for our drugs, building in a transparent system of procurement. Our spending and distribution of materials is now accountable.
And all of us in Sierra Leone, in just five months, have personal stories to tell about how the launch of free health care has made a difference.
Here's mine: Just two weeks ago, my driver, Alex, received a phone call. It was the hospital. His wife, Fudia, had just given birth to a boy they named Samuel. Fudia had needed a Caesarian delivery because of complications. After getting the news, Alex rushed to see her.
What struck both Alex and me was how this wouldn't have happened before.
Before, Fudia would have been taken to the hospital in the midst of labor, and when complications arose, the medical care would have stopped. Someone would have called Alex saying he needed to get to the hospital to pay for a C-section delivery before the operation could take place. The operation would cost between $200 and $500. Alex would have turned to me and asked for help. I would have searched around for someone to deliver the money to the hospital. All that time would have passed before a doctor and nurses could deliver the baby. All that time was endangering the Fudia's life, and the unborn baby's.
Now, because of free health care, a team at the hospital delivered their baby boy. The only phone call Alex received was to tell him that mother and child are healthy. This is one example among many. We are saving the lives of mothers and their children. That is something to celebrate not only in Sierra Leone, but around the world.