Hundreds of health workers all
across the country have gone unpaid for the last two years as a result of a deliberate
policy of the Ministry of Health and Sanitation and the Government of Sierra
Leone. These health workers are known as Maternal and Child Health (MCH)
Aides and are of lower rank than the State Enrolled Community Health Nurses
(SECHN), but nationally they form the front line troops in the battle against
disease. All across the country, in villages and towns these MCH Aides are to
be found in Community Health Posts (CHPs),
Community Health Centers (CHCs) and Maternal and
Child Health Posts (MCHPs), small medical outposts
that are the first line of defense in the country’s fight against sickness.
The MCH Aides, in their distinctive pink uniforms, are reputed to be better
known and trusted in communities throughout Sierra Leone than their more
senior colleagues, the SECHNs and SRNs. In theory, as the name implies, the MCH Aides’ main
focus is on childbirth and the ante-natal and post-natal periods. In
practice, communities all across Sierra Leone rely on them to
treat all manner of ailments, although they have clear instructions to refer
cases above their competence to higher level institutions. Their training is
shorter (two years) than the SECHNs, and entry
requirements are lower, but they are given instruction in general medicine.
With donor support, Sierra Leone
has ramped up its training of MCH Aides in recent years. This has been one of
the strategies to combat Sierra
Leone’s very low ranking in the WHO
Maternal Mortality and Infant Mortality Indices (read Sierra
Leone Last in Maternal Mortality). In Freetown,
at the District Medical Office at ClineTown, the biennual intake is approximately 100 students. Other
districts across the country have similar programs. The class
of 2010 graduated in 2012 and to date these MCH Aides are yet to
receive their first salary, even though they have been posted to health
institutions across the country. When natinpasadvantage
visited the Ministry of Health recently, before the Ebola outbreak, and
inquired into this problem ( readInterview
with Sierra Leone’s Chief Medical Officer), we found an attitude of
indifference. The Chief Medical Officer revealed that this was a systemic
problem (and, by implication, policy) stretching back decades. Now these MCH
Aides have suddenly become doubly, triply important as the first point of
contact with the dreaded Ebola. From the point of view of the indifferent
that we found at the Ministry of Health, a single mother in labour has implications for only two lives, but one Ebola
case wrongly handled could potentially have disastrous implications for
hundreds. Sadly, several MCH Aides are reported to have already lost their
lives after contracting the disease.
Meanwhile, the government
reportedly will be introducing an emergency budget in Parliament today (July
10, 2014) making provision for Ebola-related expenditures. The popular FM98.1
morning show today reported a case of a confirmed Ebola patient who left his
home area in the East of the country and sought treatment at a government
hospital in Freetown,
where he was admitted for several days before his condition was diagnosed.
This is the second such incident reported in recent days.
