Sierra Leone: Bringing healthcare closer to the people
Anthropologist Bernadette Schauberger has been on assignment with MSF/Doctors Without Borders in Sierra Leone since April 2016.
Anthropologist Bernadette Schauberger has been on assignment with MSF/Doctors Without Borders in Sierra Leone since April 2016. Because of the Ebola epidemic in West Africa, the country’s health system has been badly hit – many health professionals died, limiting access to health care, and lack of routine vaccinations during the epidemic has lead to outbreaks of preventable diseases. Here Bernadette blogs about how the team is trying to bring medical care closer to the people.
My second assignment with MSF has brought me to Sierra Leone in West Africa for nine months. Like my first assignment in South Sudan, I’m working here as an anthropologist, focusing on health promotion and health education. 
Our project is in the north of the country, where we are working to strengthen the ailing health care system and trying to reduce the high maternal and child mortality rates. To do this we are scaling up our support to the Hospital of Kabala, where staff from MSF works in partnership with staff from the Ministry of Health.
Health promotion here in the hospital means offering information and training on the subject of hygiene, malnutrition, malaria, and other regular diseases. 
We also work with a network of community health workers in the surrounding villages. They are essential, detecting diseases and knowing when emergency aid is needed: for example, rapid tests and medication for malaria. They also bring women in labour and emergency cases to the nearest health centre. 
Health promotion activities

Health promotion activities. Photo: MSF 

We also carry out training and education in the villages, which often lie far away from the nearest health centre. So we try to make health-related topics available to a wide segment of the population.
My day starts either in the office where I prepare training sessions or materials with my small team. Most of our materials are audiovisual, since a large part of our target audience cannot read or write. Otherwise we are in the hospital where we advise people as needed. Often, we are also in the surrounding villages to support local health workers, providing training or seeing patients that have been discharged from the hospital and will need follow-up.
Being in Sierra Leone right now means that we don’t have to be afraid of bombs and war and that we are able to move freely – which isn’t always the case on an MSF assignment. But the hygienic conditions are very poor and the risk of malaria is enormous. The possibility of outbreaks is our daily companion.
We carry on regardless because our work is really necessary for many people here - because large sections of the population do not have access to the health system for structural or financial reasons. 
The barely existent infrastructure means that people do not come to the hospital, or get there only under very difficult circumstances. Our health workers are trying to make up for this gap, especially in remote locations. They are the part of the health system which is closest to the people. 
Best regards,