Healthcare has been a topic of
intense debate in the United States these past few years. We argue about the
best way to go about taking care of the poor, and how to care for those who
have no insurance. Should they be prioritized behind those with insurance?
Should everyone be penalized going without insurance? Should an insurance
company be allowed to deny coverage due to a pre-existing condition? What we
often forget during these conversations, important as they are, is that many
Americans are fortunate just to have insurance. In Sierra Leone, insurance is
not a topic discussed in the news media or at the dinner table, because nearly
all medical care in Sierra Leone is paid for out of pocket.
Healthcare
in Sierra Leone is managed by a mixture of private, government and
non-government organizations (NGOs). The country is divided into districts and
each is run independently, generally decently effectively. Though the
infrastructure may have been destroyed during the war, it is gradually
recovering. However, the public health situation in Sierra Leone is somewhat
bleak – the average life expectancy is only 48. In 2007 the country had the
highest child mortality rate in the world, and although it has been steadily
improving since then, the maternal mortality rates remain some of the highest
in the world. The country also suffers from periodic epidemics of disease, such
as yellow fever, cholera and meningitis.
The
lack of institutionalized insurance in Sierra Leone is a big factor, as
healthcare (preventative or otherwise) is extremely cost-prohibitive in a
country where 70% of the population lives below the global poverty line. Sierra
Leone has launched several public health initiatives, mostly aimed at reducing
the maternal / infant mortality rate, and the United Nations continues to
assist Sierra Leone in rebuilding its hospitals and medical centers. A
sophisticated and comprehensive healthcare system is still a long way off.
While our system is not perfect, we should appreciate the basic healthcare most
of us enjoy access to, and assist our neighbors in Sierra Leone any way we can
to reconstruct a healthcare system that will best serve the needs of their
community.
Marisa N. | Volunteer Blogger
Khadarlis for Sierra Leone
marisa@khadarlis.org
