Peg Byron

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In the hills of central Sierra Leone, there is a tiny village called Jimmi Bagbo. Obviously, it is a remote place. Since it is in a post-conflict country in West Africa that has some of the world’s worst rates of child and maternal survival, you can be sure too that there are scant health services.

Last November, I went to Jimmi on a typically hot, humid day, tagging along with three nurses who would provide a special pre-natal health clinic. About 70 pregnant women waiting on a shaded concrete pavilionen ergetically clapped and sang to greet us.

The health care team – a nurse practitioner who is dean of Long Island University’s School of Nursing, one of her former students, who grew up in Jimmi and is now a nurse practitioner at New York Presbyterian Hospital and a pediatric nurse – are volunteers for a new non-governmental organization dedicated to maternal and child health, Sa Leone Health Pride (SLHP). I was there, on my first trip to Africa, to help document their work and get a glimpse of the region at the heart of my master’s thesis about maternal mortality for LIU’s United Nations Graduate Studies Program.

We also received a rousing welcome from village leaders, who proffered thanks with two live chickens before we walked up a dusty path to the pavilion that served as a waiting room, with rows of benches and a table that held boxes of index cards with clinic registration information. I was already wilting in the heat, but the women were vibrant, wearing colorful traditional clothes or western-styled tee shirts with wrap-around skirts (the preferred choice among the under-20 set).

Most of them, in their second or third trimester of pregnancy, had walked for hours that morning over rutted, hilly roads still partly destroyed by the violent civil war that ended in 2002. These were, I realized, the current day “survivors” who could manage the strenuous trip, unlike many women afflicted with extreme anemia, malnutrition, malaria, parasites from contaminated water and other common and deadly scourges.

While the nurses worked non-stop in cramped, airless rooms, I sat under a tree at a small table to talk to women about pregnancy and childbirth. Then and throughout the trip, I was in ridiculous comfort relative to most of those around me, but this day’s effort ranks as one of the most frustrating things I’ve tried to do. As a former journalist, I have often conducted interviews about difficult topics. Now I was a foreigner with an interpreter – a nice guy but a man nonetheless – trying to explore intimate and sometimes painful personal histories via translations of various Mende dialects. The women helped me as best they could.

Almost everyone told of tragedy. Many had five or six children (matching the fertility rate) and had lost at least one child at birth or at an early age, often seeing their children die suffering, for easily treatable causes. Each woman made a plea for access to basic health care.

Seventeen-year-old Jaltu Swaray, in a red Gap tee shirt, braids framing her round face, was seven months into her first pregnancy. She was adamant that she would finish school after she had her baby. The teenager also was resigned that in an emergency she would have to be carried to a clinic by hammock (the local version of an ambulance). She urged the translator to use the firmest expression to convey that she “strongly” wants a clinic for her village.

Back in Freetown, I got to see another side of SLHP’s emerging efforts when the nurses switched hats to negotiate with top government and university officials. Their long-term goal is to develop a major nurse education program.
The current lack of skilled medical personnel is blamed for about 2,100 deaths per 100,000 women who become pregnant each year; a girl at age 15 stands a one-in-eight chance of eventually dying from a pregnancy-related cause.

I don’t know yet about Jaltu’s fate.