Healthy, Wealthy and Wise? Healthcare in Sierra Leone

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