With large numbers returning, new crises are now possibilities
24 September 2001
Sierra Leone - With the ongoing demobilisation and disarmament of troops involved in the long civil war in Sierra Leone, a fragile calm exists in Sierra Leone. However the return of the population to their homes is bringing the possibility of following crises for the country.
Total land area: 71,740 km2
(almost twice the size of the
Infant mortality (< 1 year): 170 deaths per 1,000 live births*
Life expectancy: 37.2 years*
One doctor per: 14,300 people (estimate 1984)*
Drinking water: 28 % of the population has access to safe drinking
No. of refugees: estimated at 145,000 in neighbouring countries
No. of displaced persons: 2.5 million
The civil war in Sierra Leone has been one of the most violent in
Africa, claiming over 50,000 lives and displacing 2.5 million people
(half the total population). Many of the people leaving Sierra Leone
have found refuge in neighbouring countries such as Guinea.
Since September 2000, over 50,000 refugees have returned to Sierra
Leone from Guinea, but an estimated 85,000 still remain there. Many
returnees have now become Internally Displaced Persons (IDPs), as
their homes are still unsafe. In both the current and former
rebel-held territories the medical needs are enormous.
Now the large influx of refugees returning from Guinea threatens to
trigger a new emergency in and around the government-held capital of
Freetown, as homes in the more distant countryside are still too
unsafe for habitation. Refugees are also reportedly returning through
RUF-controlled areas in the east of the country.
Medical needs in the areas currently or formerly controlled by the RUF
rebels are considered enormous. Some of those areas had been without
support for up to three years. Nine years of ongoing civil war have
almost totally destroyed the health care system in Sierra Leone. The
vaccination rate is low and epidemics of malaria, yellow fever, lassa
fever, cholera and measles have broken out in recent years. The
secondary health care is virtually non-existent.
MSF in Sierra Leone
MSF first intervened in Sierra leone in 1986 during a cholera
epidemic. Today, the organisation is active in wide areas of the
country and, with the current political situation, MSF is gaining
access to populations previously beyond reach.
Activities extend from basic health care service to emergency surgery
to psychological support and care for the war-wounded as well as
nutritional and medical activities.
MSF programs are in key cities and towns, including Freetown, the
countryside and in the IDP camps. In addition to medical and
nutritional aid programs, MSF is monitoring the resettlement of the
IDPs and providing surgical care as well as psychological support
to the affected populations.
In Mile 91, a small town that was a focal point of IDPs who were
trapped during the ongoing civil war, MSF activities have now
expanded to cover the entire Tonkolili District, supporting health
posts and hospitals, including providing emergency surgery.
The current situation has meant an expansion of MSF activity into RUF-held
territories and MSF has been able to provide support to three health
posts and the local hospital under the Tonkolili programme. As of June
this year, MSF has also restarted activities in the formerly
MSF currently has active projects in the Tonkolili, Bombali,
Kambia, Port Loko and Moyamba Districts as well as in Kenema and
*Source: L'état du monde 2001