Maternal Mortality in Sierra Leone

Maternal Mortality is one of the biggest problems in Africa – for a woman it‘s even more dangerous to get a baby than suffering from diseases or war.

Maternal Mortality is one of the biggest problems in Africa – for a woman it‘s even more dangerous to get a baby than suffering from diseases or war.

Sierra Leone counts among the countries with the highest maternal mortality rate worldwide, which is partly owed to the many years enduring civil war. In the country one in eight women risk dying during pregnancy or childbirth compared to a one in 76 average in the rest of the developing world and one in 8.000 in the developed world. Thousands of women bleed to death after giving birth. Most die in their homes. Some die on the way to hospital; in taxis, on motorbikes or on foot. In Sierra Leone, less than half of deliveries are attended by a skilled birth attendant and less than one in five are carried out in health facilities.

„We have a situation in Sierra Leone where the pregnant mothers would like to go to quack doctors and birth attendants during pregnancy and delivery, but when they experience medical complications that is when they come to the hospital,“ said Dr Francis Smart from the Health Ministry‘s reproductive health division. „Most times those mothers, when they arrive, are already at the point of death.“ A MSF report cited the experience of one woman who said she had four stillbirths at home before finally giving birth to a healthy baby once she was able to get to a hospital and have a caesarean section. Midwifery is a way that some Sierra Leonean women find to make a living for their families in a nation where at least 65% of the population is unemployed. But many of the women lack the skills to run the delivery homes that they operate.

Hawa, a 60-year-old traditional birth attendant who runs a delivery home in the province of Kailahun in the southeastern part of Sierra Leone, said traditional delivery is an age-old practice that Sierra Leonean mothers know well. „I have been in this practice for over 35 years now and I have not experienced any death,“ she said. „We, the traditional midwives, are helping the health programme in Sierra Leone. For example, when a woman is in serious pain at midnight and there is no hospital near she would definitely come to the traditional midwife.“

Medical professionals and Sierra Leonean women themselves say another reason they go to the midwives is because they lack the funds to pay for hospital care,and in many cases they don‘t even have the transportation costs to bring them to a health centre.

© Toby Binder - Image from the Maternal Mortality in Sierra Leone photography project
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The eleven years enduring civil war has destroyed a big part of the infrastructure. In case of emergencies during deliveries bad roads and the lack of ambulances often imply the death of the women.

© Toby Binder - Fatmata Kammal has been in labour for hours already in this local Health Center in Bandajuma.
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Fatmata Kammal has been in labour for hours already in this local Health Center in Bandajuma.

© Toby Binder - Fatmata Kammal arrived at Bandajuma in the morning after a four hour walk.
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Fatmata Kammal arrived at Bandajuma in the morning after a four hour walk.

© Toby Binder - Fatmata Kammal has been in labour for hours already in this local Health Center in Bandajuma.
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Fatmata Kammal has been in labour for hours already in this local Health Center in Bandajuma.

© Toby Binder - Image from the Maternal Mortality in Sierra Leone photography project
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Young mother Timmah Mohamad with the traditional birth attendant Howa Boima in front of the wooden birth bed where she delivered her baby recently.

© Toby Binder - Felicitous birth at a Health Center in Lalehun. Bouindu Moiulo, Senya Momoh & Mossah Koromo.
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Felicitous birth at a Health Center in Lalehun. Bouindu Moiulo, Senya Momoh & Mossah Koromo.

© Toby Binder - Fatmata Kammal two days after having delivered her baby at Nixon Memorial Methodist Hospital.
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Fatmata Kammal two days after having delivered her baby at Nixon Memorial Methodist Hospital.

© Toby Binder - Image from the Maternal Mortality in Sierra Leone photography project
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Sampa Kabbia next to a frame for drip infusions at the Nixon Memorial Methodist Hospital in Segbwema; she lost her baby four days ago during delivery.

© Toby Binder - Traditional birth attendants at the labour ward of Nixon Memorial Methodist Hospital.
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Traditional birth attendants at the labour ward of Nixon Memorial Methodist Hospital.

© Toby Binder - Batu Wudie next to her daughter Marnie, who lost her child during delivery at the Medecins Sans Frontieres hospital in Bo.
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Batu Wudie next to her daughter Marnie, who lost her child during delivery at the Medecins Sans Frontieres hospital in Bo.

© Toby Binder - Newborn twins at the maternity ward of the Medecins Sans Frontieres Hospital in Bo.
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Newborn twins at the maternity ward of the Medecins Sans Frontieres Hospital in Bo.

© Toby Binder - Ambulance of Nixon Memorial Methodist Hospital in Segbwema.
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Ambulance of Nixon Memorial Methodist Hospital in Segbwema.

© Toby Binder - Three days after the delivery Fatmata returns to her house in Daru, where she shares one room with four other persons.
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Three days after the delivery Fatmata returns to her house in Daru, where she shares one room with four other persons.

© Toby Binder - Funeral of a women who died during her fourth pregnancy.
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Funeral of a women who died during her fourth pregnancy.

© Toby Binder - Funeral of a women who died during her fourth pregnancy.
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Funeral of a women who died during her fourth pregnancy.