NYT Article: This Mom Didn't Have to Die

Great article! Actually I copied the entire article because it's just.....wow! There is a lot to think about. Also be sure to watch the video attached to the article. It actually shows hospitals in both Makeni and Bo (which is where the orphanage is, by the way).

Pray!! Many of our kids at JCC have parents who died in childbirth--either their own or a sibling's. Sadly, it is way too common in Sierra Leone. Pray for more health practitioners and specialists.

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On this trip through West Africa with my “win-a-trip” contest winner, I was reminded of one of the grimmest risks to human life here. Despite threats from warlords and exotic disease, it’s something even deadlier: motherhood.

One of the most dangerous things an African woman can do is become pregnant. So, along with the winner of my contest for college students, Paul Bowers, I have been visiting the forlorn hospitals here in West Africa. According to the World Health Organization, Sierra Leone has the highest maternal mortality in the world, and in several African countries, 1 woman in 10 ends up dying in childbirth.

It’s pretty clear that if men were dying at these rates, the United Nations Security Council would be holding urgent consultations, and a country such as this would appoint a minister of paternal mortality. Yet half-a-million women die annually from complications related to pregnancy or childbirth without attracting much interest because the victims are typically among the most voiceless people in the world: impoverished, rural, uneducated and female.

Take Mariama, a 21-year-old pregnant woman with a 3-year-old child living in a village here in southern Sierra Leone. Mariama started bleeding one afternoon before we arrived, but her family had no money and was reluctant to seek medical care. When she was already half-dead, she was finally taken into the government hospital in Bo.

She was off-the-charts anemic, but there was no blood available for a transfusion. In that situation, the woman’s relatives are checked to see if they are of the same type and can give, but Mariama was accompanied only by her mother, who was too fragile to donate blood.

The only obstetrician, serving an area with two million people, was away, so nurses suggested that in the absence of a transfusion, Mariama receive a plasma expander for her blood. But that would have cost $4, and Mariama and her mother had no money at all.

So Mariama continued to hemorrhage right there in the maternity ward. At 1 a.m. the next morning, she died.

“We did our best to save her,” said Regina Horton, a nurse-midwife at the hospital. “But we had no blood.”

I’ve seen women dying like this in many countries — on the first win-a-trip journey in 2006, a student and I watched a mother of three dying in front of us in Cameroon — and it’s not only shattering but also infuriating. It’s no mystery how to save the lives of pregnant women; what’s lacking is the will and resources.

Indeed, Sierra Leone is now making progress with the help of the United Nations Population Fund, which is renovating hospital wards, providing free medicines and trying to ensure that poor women don’t die because they can’t pay $100 for a Caesarian section. The Bush administration cut off all American funds for the U.N. Population Fund, hobbling it, but this year President Obama has moved to restore the money. Other organizations that are focused on this issue include the White Ribbon Alliance for Safe Motherhood, CARE and Averting Maternal Death and Disability.

A bill introduced in Congress in March — the Newborn, Child, and Mother Survival Act — would establish American leadership in this area. But it has attracted pathetically little attention.
If the lives of women like Mariama were a priority, there would be many simple ways to keep them alive. For example, they could routinely be given anti-malarials and deworming medicine during pregnancy to flush out parasites. They should also receive daily iron tablets to overcome anemia, and a bed net. All this would cost just a few dollars and would leave pregnant women far less likely to die of hemorrhages.

Caesarian sections are necessary for perhaps 1 in 10 births worldwide, but village women put their trust in traditional birth attendants (partly because the attendants also perform genital cutting on girls, creating a bond). Doctors and nurses often are harsh and contemptuous toward uneducated women so that patients stay away until it is too late. If doctors and nurses had as good a bedside manner as the birth attendants, hospitals would be better used and lives saved.
Still, one sees the — limited — progress in Mabinti Kamara, who is 25 and went into labor in her village. When an arm came out, it was apparent that the fetus was sideways, so the birth attendant pushed hard on Mabinti’s abdomen to complete the process.

On Mabinti’s fourth day of labor, she was finally taken to a hospital in the city of Makeni, where a surgeon found that she had a ruptured uterus. The surgeon removed the dead fetus and repaired the uterus. Mabinti then lay on her bed in pain, disconsolate at losing her child. Still, the maternity ward was filled with women like her. Just a few years ago, they all would have died. They are reminders that women can be saved in childbirth — but only if their lives become a priority.

Article: "Slum Cooker"

Definitely take a look at this!

Article: In US Poll, Most Fail a Quiz on Global Causes of Child Deaths

This article speaks to a poll from two years ago, but it is still very true today, I'm sure.

NYTimes Article: "After A Devastating Birth Injury, Hope"

Ideally, fistulas should be prevented, but prevention — which requires education, more hospitals, doctors and midwives, and better transportation — lags far behind treatment. Worldwide, there are still 100,000 new cases a year, and most experts think it will take decades to eliminate fistulas in Africa, even though they were wiped out in developed countries a century ago. Their continuing presence is a sign that medical care for pregnant women is desperately inadequate.

“Fistula is the thing to follow,” Dr. Wilkinson said. “If you find patients with fistula, you’ll also find that mothers and babies are dying right and left.”

While this article highlights a hospital in Tanzania, the problem of fistulas are a big big problem in Africa and Asia (as the article states). Mercy Ships has a clinic especially for fixing fistulas in Freetown, Sierra Leone. So....this is pretty relevant. :-/

BBC: Guinea coup

Pray for Guinea. The president, who had ruled for 24 years, died after a long illness earlier this week. Long story short, the political stability of the country--Sierra Leone's western and northern neighbor--could ultimately be in jeopardy. And even moreso the whole region will be affected. There are refugees from Sierra Leone living in Guinea and probably vice versa too. Pray for those who might be affected.

Read the article at your convenience.

Merry Christmas!

Article: Talking Dirty--The Politics of Clean Water and Sanitation

From the Massachusetts Medical Society (linked by child-survival.org)

An interesting article about global health and more specifically clean drinking water.

Click on the title and follow the link. It is a PDF document.

AFP: Sierra Leone will return property taken by former regime

Just a nice sign of the character of the president and aim to rout corruption.

The Sierra Leone government will return all property seized by the country's former military regime to their owners, Information and Communication Minister Ibrahim Ben Kargbo said Wednesday...
Property belonging to businessmen, opposition politicians and ordinary citizens was seized during Valentine Strasser's 1992-96 military rule. Once Parliament approves the plans, all property would be returned, Kargbo said.
Kargbo said the decision was "natural justice" and would honour a promise made by President Ernest Koroma to return all properties to their original owners. "The president feels that this is one of the processes to foster reconciliation" he said.

Click on the title/link to read the entire article.

Lausanne WP: The Echo of a Saint

By Christopher L. Heuertz

We walked through an open-air market, down a side street in Freetown, the capital of Sierra Leone, West Africa. The vibrant colors and smells of the fruit and vegetables filled our senses. The road was narrow yet full of life. We were surrounded by children laughing and playing all up and down the street. Nearly every vendor greeted us with warm and sincere hospitality.
Before we knew it, the market opened into what appeared to be a valley—more like a crater—on the edge of downtown. Slowly, we walked down a long concrete staircase, into the worst slum I have ever seen. Having traveled in nearly seventy countries throughout Asia, Africa, and South America, I was blown away by the density of poverty and texture of suffering that marked every detail of Kroo Bay.

Kroo Bay is the poorest slum community in the capital city of the world’s poorest country. It’s a former fishing village turned into an informal coastal slum with around six thousand residents—more than four thousand of them children.

Located below sea level, where two of Freetown’s major rivers meet and drain into the Atlantic Ocean, it floods with sewage every time there is major rainfall in the city. This forces residents to spend countless days and nights fighting to save their homes bucket by bucket.
It’s overcrowded, congested, and clogged with trash.

If it weren’t for the laughter of the children and the smiles of the vendors, it would have seemed one of the most hopeless places in the world.

Click on the title to read the entire article

Christian Post: African Witches Come to Christ Through Jesus Film

This is exciting! Sierra Leone also has a lot of similar spiritual warfare with various secret societies throughout the country. Jonathan House has shown "Jesus Film" in local languages in several villages. The church planting team and visiting short-term teams use the film on outreaches routinely. This summer, Jonathan House will be showing this film in villages throughout the Pujehun District. Pray that these villagers would be receptive of the Gospel.

Excerpt:
By Michelle A. Vu
Christian Post Reporter
Thu, May. 22 2008 05:41 PM ET

Screenings of the “Jesus” film in the Central African Republic has led to tens of thousands of commitments for Christ, dozens of churches planted, and witches being freed from dark forces, according to The Jesus Film Project.

Central African Republic, which neighbors the highly-troubled nations of Chad and Sudan, has struggled with what some might consider an epidemic of witchcraft. Local witches reportedly have the power to kill and cause excruciating physical pain, leading to great fear among villagers.
The government routinely imprisons accused witches, but has found that prison walls cannot contain their power.

When witches saw the “Jesus” film – which follows the life and teachings of Jesus Christ – in their own language, many reportedly were convicted by the Holy Spirit. They repented of their sins, were freed from their spiritual bondage, and committed their lives to Jesus Christ, The Jesus Film Project reported.

In the Bossangoa area in western CAR, people have dubbed the “Jesus” film, “The Miracle Film.”

The region’s governor has personally called the “Jesus” film team to thank them for the “miracles” the movie has done on the witches in his area.

SIM: "But Why?"

I found this great article in the magazine SIM (Serving in Mission) publishes. It was written by a missionary in Ethiopia. What a great look at poverty. Sometimes (or most of the time) poverty just seems like such an insurmountable "battle"--where do we start? I'm including the entire article instead of just a snippet--because it's just that important. You can go to the article by the title link. The rest of the magazine is also good and is available online.

"But Why?"

by Clare Meckler, Ethiopia16 May 2008

Today the two-year-old child died.
“But why?” we ask.
Because he was severely dehydrated.
But why?
Because he had diarrhea.
But why?
Because he drank dirty water.
But why?
Because his ten-year-old sister was too weak to fetch clean water from the distant spring.
But why?
Because she’s extremely anemic . . . because of intestinal parasites . . . because of unsanitary conditions.
So why didn’t the older brother go and get clean water for the family?
Because he didn’t know the nearby muddy water harbored disease.
And why didn’t he know?
Because he never had a chance to go to school and learn about microbes . . . because he had to work all day to eke out a meager crop for the family’s food . . . because erosion depleted the soil . . . because the trees were cut down for cooking fuel.
And why didn’t the mother take the sick child to the clinic?
Because she had no money for medicine.
Why not?
Because her husband had died . . . because of tetanus . . . because he stepped on a thorn . . . because he had no shoes.
“A God who cares cannot be served by those who don’t.”

You get the picture. The endless questions, the illusive blame, ever probing deeper to try to get to the true cause of the unrelenting cycle of poverty and disease. Be it war, hunger, drought, or any of the problems that plague our planet, “quick fix” bandages do nothing to heal the hemorrhage.

So fragile is the coping mechanism of struggling people that whole communities are vulnerable to events like variations in climate or deteriorating health status of family members. Our various ministries of compassion endeavor to bring better health and brighter hope to the daily lives of hurting people.

There is Someone who can save them from an endless cycle of “whys”—a God who cares deeply about their suffering. Many years ago this statement deeply impacted my life: “A God who cares cannot be served by those who don’t.” May we all learn to care as he does.

allAfrica: [Sierra Leone] Ranks Last in Child Labor

Concord Times (Freetown)
16 April 2008 Ibrahim Jaffa Condeh and Kevin Hill

Child Labor is a huge problem in Sierra Leone. Many of the JCC kids have been personally involved with it (some were even held as slaves) and to be worst among the countries surveyed--that's a huge deal!! "78% of children ages 7 to 14 in the country are engaged in child labor"--that's huge! Later in the article it cites that UNICEF that one in six children in the entire world are involved in child labor. So it's not only a Sierra Leone or Africa problem, it does affect countries around the world, just Sierra Leone is the worst of those surveyed.

An excerpt:
"According to a recently released report by UNICEF on child labour and school attendance, 78% of children between the ages of 7 and 14 in Sierra Leone are engaged in child labour. The study, which covered one quarter of the world's population, ranked Sierra Leone last among nations surveyed..."

"The achievement of universal primary education is one of the Millennium Development Goals. Child labour, which can exclude primary school aged children from accessing an education, is a major obstacle to reaching this goal The UNICEF report found that "children from poor households and from households without a formally educated household head are more likely to be engaged in child labour and less likely to attend school", a situation that shows that "poverty is the root cause of child labour." The survey considered both economic activity and household chores and tried to distinguish between acceptable work and child labour. Child labour is work done by children that should be eliminated because it violates international labour standards, harms the child, or interferes with school attendance."

BBC: The Dangers of Herbal Remedies (Kroo Bay)

The BBC has a series on their website with a diary written by a medic in Sierra Leone, specifically Kroo Bay. One of the first websites posted on this blog was one for Save the Children's work in Kroo Bay. If you haven't checked it out--you totally should. So there might be more of her articles on here at some point--it's a great section.

This specific article is this medic, Adama Gondor, talking about how herbal remedies are affecting health. It's one thing if they're topical medicines (applied to the skin), but a little more serious when they are internal medicines. Babies are especially vulnerable. Here in America, hospitals do treat most illnesses. There are a few non-mainstream providers out there, but even those seem to be regulated. In places like Sierra Leone (mainly rural areas in developing countries), there is not as much access to clinics and doctors or nurses as urban areas and especially here in America. If there are clinics or hospitals, the likelihood that a family could afford treatment at a center is slim. Though what there seem to be plenty of are traditional healers. While I'm hoping not in every instance, treatments tend to focus around superstitions and religious ceremonies (typically not Christian). In all of my anthropology classes (and especially two focused squarely on African religions and religion and witchcraft), I've heard of some really bizarre things that take place in our world. That's another blog altogether. :-) While it would be great to keep some aspects of each culture in tact, some are simply dangerous. Miss Gondor speaks well on this topic, but now that you have a broader background, hopefully it will help you understand her more.

"A severely malnourished child was brought to the clinic on Monday.

Eight-month-old babies should weigh about 9kg. The baby was eight months old, but she only weighed 4.5kg. If we assume she had the average weight of 3.3kg when she was born she should have been getting close to 9kg by now. The baby was very thin, with bad skin and looked more like an old man - it's awful to see a baby in such a condition. She also looked very hungry. We immediately referred the baby to the hospital quite far away in the east of Freetown where there is a therapeutic feeding centre. The mother took her straight there and she was admitted - the programme is free. ..."

To read the entire article, click the title.
To read and learn more about Kroo Bay and Save the Children's there, check out the special links section in the right column.

FT.com: Rice Jumps as Africa Joins Race for Supplies

Rice is THE staple food in Sierra Leone. Especially outside of Freetown, rice is part of or the entire meal for Sierra Leoneans. There are different types of sauces to cover the rice including two that contain cassava and potato leaves, respectively. Another with groundnuts (peanuts). Then there's the yummy Jollof rice. Take rice away from Sierra Leonean and you will hear about it. :-) I jest, but in reality this has the potential to affect the country and JH considerably.

By Javier Blas in Nairobi and Roel Landingin in Manila
Published: April 4 2008 15:23

Rice prices rose more than 10 per cent on Friday to a fresh all-time high as African countries joined south-east Asian importers in the race to head off social unrest by securing supplies from the handful of exporters still selling the grain in the international market.
The rise in prices – 50 per cent in two weeks – threatens upheaval and has resulted in riots and soldiers overseeing supplies in some emerging countries, where the grain is a staple food for about 3bn people.

Click on the title to read the entire article.

Network World: New Services Spur Sierra Leone Mobile Sector

The telecom sector of Sierra Leone is just constantly improving. While I was at JH for 6 months, I had a "mobile" to use which came in handy more than a few times. I sometimes joke that Sierra Leone has better mobile coverage than Iowa...which actually might not be that far off, in my opinion anyway. :-)


Though mobile phone services were once deemed too expensive for ordinary citizens in Sierra Leone, they are on the rise, thanks to creative efforts on the part of service providers.
Attitudes toward mobile services started changing two to three years ago, though mobile operator Celtel first entered the country’s small market in early 2000, followed by Millicom (now tiGo).

Telecom is the most thriving sector, after mining, in Sierra Leone, according to a report by Maxwell Massaquoi, an expert in telecom business support and operation support systems. Mobile phone use in Sierra Leone grew by 18 percent from 2006 to 2007, reaching 110,000 users, the report said.

Click on the title to read the full article.

The Economist: The Southern Star

Here's an interesting article about Botswana--a nation bordering South Africa and Zimbabwe (among others). As the article points out, the country is very unique as far as African nations go. It's the world's leading diamond producer. While it's good to learn a lot about Sierra Leone, it's also good to get a look at the context and "success" stories even though Botswana definitely isn't perfect. I'd recommend that you look into the country more because it has done some amazing things that other countries in Africa especially haven't even attempted!


Mar 27th 2008 GABORONE
From The Economist print edition

Botswana is a rare African success story but not without a few headaches.

An African president stepping down of his own accord is still depressingly rare. Zimbabwe's Robert Mugabe has been clinging to power since 1980. But next door, in Botswana, a respected president, Festus Mogae, is graciously retiring this month after ten years in office.

Botswana rarely features in the news abroad. With only 1.8m people and the world's largest output of diamonds, it has been a model of stability, avoiding the violence, corruption and boom-and-bust cycles that have plagued so many mineral-rich countries. Yet it had little going for it at independence in 1966. It had only 13km (eight miles) of tarred road. Most of its people, often drought-afflicted, scraped a living rearing cattle.

Largely covered with sand, it had little agriculture—and few white settlers: it never experienced the bitterness of land dispossession and the ensuing disharmony that poisoned race relations in South Africa, Zimbabwe and Kenya. Mr Mogae's anointed successor, Ian Khama, is half-white, but few people in Botswana think his colour matters.
Diamonds have changed the country's fortunes. Its per capita income of $5,900 is four times the regional average and higher than Malaysia's. The diamond wealth has been spent on roads, sanitation, schools and clinics, not on palaces or Swiss bank accounts. AIDS has hit the country hard, but almost 95,000 patients—86% of those who need it—get anti-retroviral treatment.

Click on title to read entire article.

Article: The Importance of Good Nutrition Early On

Even though, the article was published earlier this year, it's so completely relevant. If infants and children receive good nutrition in their first three years (regularly), their health will be better than those that do not. You should definitely take a look at this article.

JOHANNESBURG, 1 February 2008 (IRIN) -
Eating nutritious food at an early age will not only ensure a source of income as an adult but also better pay, according to a study published in the current issue of The Lancet, a leading British medical journal.

The study, conducted in four villages in Guatemala, found that boys who received atole, a gruel made of skimmed milk powder, sugar and vegetable protein, in the first two years of life earned on average 46 percent higher wages as adults, while boys who received atole in their first three years earned 37 percent higher wages on average. Those who first received the supplement after age three did not gain any economic benefits as adults.

Children and infants aged under seven in two of the villages were given atole, while those in other two settlements were given a placebo drink until 1977.

The research is the first to show direct evidence of the effects of early childhood nutrition programmes on adult economic productivity and incomes, said John Hoddinott, lead author of The Lancet's article and a senior research fellow at the International Food Policy Research Institute (IFPRI).

Until the Guatemala study, "substantial, but indirect, evidence from previous research suggested that providing infants and very young children with healthy, nutritious food is a long-term economic investment for developing countries," he told IRIN.

Follow the link to read the entire article.

IRIN Article: Maternity Health in Sierra Leone

The IRIN published an article today about the grim outlook of maternity health in Sierra Leone. As several of the JH kids' mothers have died from childbirth or the effects of childbirth, I thought this was pretty relevant. Sierra Leone has one of the worst maternal mortality rates in the world. Please read prayerfully.

"Maternity Hospital is Last Resort"


FREETOWN, 12 March 2008 (IRIN) - Two babies and several gaunt women are the only patients in the gloomy wards of the Princess Christian Maternity Hospital in Freetown.

The hospital is supposed to be the main training and referrals unit for obstetrics in the country but its handful of staff were mostly found in backrooms, drinking tea with their feet resting on the surgical tables as they wile away their days in the eerily slow-moving wards.

“This hospital is a place of last resort for patients and staff,” said Sister Kanu, a nurse, who reckons conditions for mothers and hospital staff have “barely improved” since the end of Sierra Leone’s 11 year long civil war which devastated government and social infrastructure.

“By the time women get here it’s too late and the most we can do is to save the mother,” she said. “That’s why you see so few babies.”

See the link for the rest of the article (click here)