From Awareness Times Newspaper in Freetown

Neya Chiefdom like many other places may lose out of the Free Healthcare Programme
By Sayoh Kamara
Apr 28, 2010, 17:20

Neya Chiefdom in the Koinadugu district like many other areas of the country will not benefit from Government’s prophesied free healthcare programme that was supposedly launched yesterday 27th April 2010 as the country marked 49 years of independence. This is obvious because of the history of neglect that chiefdom has suffered in the hands of past governments and even the present one.

This might seem ludicrous to those who may view this piece as a criticism of government’s effort at ameliorating the state of health as it affects pregnant and lactating mothers and their babies in the country. But this is a concern expressed on behalf of millions of Sierra Leoneans who may not receive an iota of benefit from this much trumpeted programme. The programme itself is laudable. It is its design and modus operandi that is of concern and for which I am sounding this concern on behalf of the millions of voiceless people including those in Neya chiefdom who will not be benefiting from the largesse.

Neya chiefdom has and is by all indications, at the bottom of Sierra Leone’s national development index, and as such, when government Ministers like Alhaji Ibrahim Ben Kargbo want to give an example of remote and backward areas of Sierra Leone where poverty and general under development is rife, they feel convenient to cite Kurubola, the chiefdom headquarters to clearly epitomize what ever message they want to impart in that direction. The backwardness of Kurubola is not destined by God. It the design of a mischievous political system carved by certain people, who take pleasure in ripping from the poor and hapless for their selfish interests. The story had been and is still is; government officials and politicians go to Kurubola (Neya) only when they want to rip something from there, but when it is their turn to take something to the people, they give the excuse that the area is remote and inaccessible.

When this government came to power in 2007 with its ‘Agenda for Change’ programme, it was generally believed that areas of the country such as Neya chiefdom would be removed from their peripheral being and brought to at least the periphery of the centre where they would benefit from crumps falling from development programme from the main centre. That has not been the case. As a matter of fact, Neya chiefdom is even more neglected now than any other time in the history of this country. Neya chiefdom is the worst place in the whole of Sierra Leone for a woman to get pregnant, and the worst place in the whole of the country for a woman to survive during child birth. If not for the fulfillment of nature and the desire of the African woman to bear children no matter under what circumstance, women in Neya would have stopped giving birth to babies at least to save their own lives. They are now aware that the customary and traditional practices they are used to during child birth are risky but have no better alternative. As a matter of fact, even with all the pomp and fanfare surrounding the planned launching of this programme, the women of Neya chiefdom are not even aware of it. It is only in Neya chiefdom in the whole of Sierra Leone that people resort to the interventions of traditional healers when there is a case of still birth. To them the belief is that one of the ancestors of either of the couples is angry and therefore would have to be appeased for the woman to deliver safely. This process has also accounted for thousands of unnecessary deaths of women and their babies in that chiefdom.

The chiefdom is cut off from Kabala, the district headquarter town by all means reasonably possible. The distance by road from Kabala to the chiefdom headquarter, Kurubola is 110 miles of a permanent rugged and life-risking road. The chiefdom is an amalgamation of four former fiefdoms (chiefdoms) now sections, with two of these, Sardu and Kulor completely cut off from the chiefdom’s main centre by mountainous terrain that is trekked through footpaths alone. Intermittent solace in terms of medicare, reaches the people of these two sections from Koidu, the district headquarter town of Kono district in the East. Apart from that, they remain at the mercies of quack doctors and dispensers, who perform all sorts of healthcare service including gynecological and caesarian operations. Most of the maternal mortality rates are accrued from the aftermaths of these unprofessional medical service deliveries to the people. The free healthcare service policy is appealing on paper, but when one looks at it critically, one would realize that it is as discriminatory and selective as the political intention behind it is. Only government owned/managed hospitals will administer the policy. I wonder how pregnant and lactating women of Neya chiefdom who will have to trek at best for two days to reach the Kabala Government hospital would actually benefit from this programme. This means those who cannot access such facilities are counted out!

This will be a mockery of government’s Agenda for Change which highlights several concerns for considerations which inadvertently encapsulates the Millennium Development Goals 4 and 5.

The government acknowledges that the maternal and child mortality figures on Sierra Leone are not only alarming and appalling but that they are equally unacceptable especially in the 21st century. Sierra Leone has been on record to be the worst place on the globe for pregnant women. The figures speak for themselves. One in eight women die from pregnancy related complications and one in twelve children die before celebrating their first natal days.

In its quest to meet the MDG targets in maternal and child mortality, the government of Sierra Leone launched the Reproductive and Child Health Strategic Plan in 2008. A year later, the 5 year Health Sector Strategic Plan which aims at ensuring successful implementation of the Basic Package of Essential Health Services (BPEHS) with the ultimate aim of improving service delivery was also launched. According to the government, the BPEHS ‘ensures the provision of minimal essential quality of care for all…’ and that ‘…in order for it to succeed all barriers to accessing service delivery must be removed.’

Ironically however, Kurubola and its environs, like many parts of Kono, Kambia, Port Loko, Tonkolili, Moyamba, Bonthe, Kenema, Bo, and Kailahun will not overcome the barrier of inaccessibility due to bad roads and distance when this free healthcare is launched and possibly, throughout the period it is technically expected to last.

May be had the proponents of such a fantastic idea sat awhile to ask; how can we reach our targets throughout the country, they would have realized that they have not been very smart in their thinking. They only thought of the immediate effect so as to gain political capital out of it, while shelving the actual rationale of the policy, which is to reduce the maternal and child mortality in the country.

I will therefore end by stating that the idea is nationalistic but its implementation is radically political. The Kabala government hospital cannot and has never served the whole of Koinadugu district; so is the Koidu government hospital which cannot serve the whole of Kono or the Kailahun government hospital which cannot service Kailahun. Even the Connaught hospital has never served the whole of Freetown. Thought should have been given; in fact, thought should be given to the empowerment of other outstanding healthcare service providing centers which should include private-owned establishments such as those of religious missions.

Bottomline, the Free healthcare is a laudable venture but Neya chiefdom, like so many others around the country, will unfortunately count out of this benefit for there are only three peripheral health units (PHUs) serving a population of over 30 thousand, half of which are women and the young. These PHUs will not be partaking in this national free healthcare service programme. So, for the people of Neya this free healthcare programme will be a fairy tale and to those who might be wishing for it, at most, it will only come by in their dreams.

© Copyright 2005, Freetown, Sierra Leone.