On a sunny Tuesday afternoon, 35-year-old Jembeh, clearly in pain and supported by two men, was rushed into a small labour room at the Talia community maternal health centre in eastern Sierra Leone.
The centre is the only one of its kind in Kailahun District, providing maternal and newborn care to around 5,000 women and girls.
A dire health situation
Sierra Leone has one of the highest maternal death rates worldwide, according to a 2017 UNFPA report.
Badly hit by both the civil war and the Ebola crisis, Kailahun District is one of the poorest in the country, with a predominantly rural, hard-to-reach community close to the border with Guinea. Also known as the “birthplace of Ebola”, the district witnessed the first case of the deadly virus in the country.
But, while the Ebola crisis largely reversed efforts to provide universal coverage of quality health care across Sierra Leone, isolated communities like Talia are taking matters into their own hands to ensure that mothers and babies get timely care.
Communities lead their own development
At the entrance to the clinic, nurse Jestina, who has been working as a maternal and child health aide for over five years, explains:
“That tiny room you see there is our labour room. Imagine when we have two or three similar cases and have to do our work in this open space, ” she says, pointing to a narrow hallway.
Six years ago, the Talia health centre was located in an old private building, temporarily offered to the community by a local resident.
When the owner asked his building back, the people of Talia had no other option but to build their own. Community members consulted with the village chief and were granted a plot of land. Then, with the Village Development Committee’s guidance, they started to pool resources and contributed whatever they could towards the construction of a new community-owned facility.
People donated anything they could afford - their time, their livestock or crops - and were able to raise the walls of the clinic, including a much larger maternity ward, a store, a reception and an office space.
But the funds ran out, and with the next harvesting season uncertain because of the changes in climate, the building project came to a halt.
In August 2017, UNDP’s team travelled to Kailahun to carry out a needs assessment to help vulnerable border communities bounce back from the shock of the Ebola epidemic.
“The Ebola epidemic exposed the failures of the healthcare system, along with a deep-rooted poverty.” — Ghulam Sherani, UNDP Sierra Leone
The team was impressed by the Talia community initiative and provided support to complete the clinic’s construction, as part of a project to help rural communities get back on their feet and access basic services, funded by Japan.
Now the new clinic is almost operational and boasts brand new latrines and accommodation quarters for the health staff, as well as a hand pump for safe access to clean water.
Five other community health clinics and 95 hand pumps were rehabilitated in the 3 districts closest to the Guinea border.
“As you can see, people are seated comfortably and we, the staff here, are happy because the maternal health clinic is in good shape, ” says Sadia Kamara, a maternal and child health aide in Rosenor Village, Kambia District.