Reason for Intervention: Learn more... • Endemic/Epidemic disease
Field Staff: 492
Malaria is the main killer of children under the age of five in Sierra Leone.
In Bo and Pujehun districts in southern Sierra Leone, where MSF is working, malaria is the most common disease. During 2007, staff in the MSF-supported health centres treated more than 100,000 cases of malaria.
MSF is fighting malaria through diagnosis and treatment using effective tools and drugs.
Pinprick blood tests, so-called rapid diagnostic tests, are easy to interpret and suitable to use in areas where microscopy is not available. As in all MSF projects, malaria patients are treated with Artemisinin-based combination therapy (ACT), drugs that are more effective than earlier medicines, to which the malaria parasite has developed a high resistance. MSF's experience has also shown that to improve access to effective treatment of malaria, both healthcare and medicines have to be free.
Sierra Leone is one of the poorest countries in the world and even low patient fees deter people from seeking treatment.
To make malaria treatment more accessible to people in remote areas far from the nearest clinic, MSF began to support 30 smaller health posts in rural areas. In November, a pilot programme started to train community malaria workers to test for malaria using rapid diagnostic testing and to offer free treatment for uncomplicated malaria with ACT in their villages. Information and education on how to prevent and recognise malaria and to encourage people to seek care quickly are also important components in combating malaria.
To prevent people from contracting the disease, more than 64,000 bed nets were distributed in 2006 and 2007.
Gondama referral centre
MSF runs the Gondama referral centre, a hospital outside Bo town that offers paediatric and maternity care and therapeutic feeding.
Each month, the centre admits around 500 paediatric patients, 100 malnourished children and 50 pregnant women. In 2007, a new operating theatre opened where caesareans and other obstetric-related surgery are performed.
In March, an ambulatory therapeutic feeding programme started making it possible to treat a greater number of children. The children come to the health centre once a week for a medical check up and to receive their weekly supply of therapeutic food, an enriched peanut paste.
The risks of pregnancy
Women in Sierra Leone face one of the highest risks of dying from pregnancy and childbirth in the world. The five MSF-supported clinics include a special consultation area for women, where all medical staff are female. These provide ante- and post-natal care, family planning, treatment of sexually transmitted disease and medical and psychological care for victims of sexual violence. Normal deliveries also take place in the clinics while complicated cases are sent to the referral centre.
