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“Community health workers are great, but only when you give them very specific tasks to do,” says Dr Edi Atté of Médecins Sans Frontières (MSF). “If you give them more responsibility it becomes problematic, because they are not trained healthcare workers.”
Atté runs the hospital specialising in paediatric and obstetric care that MSF opened in Gondama, southern Sierra Leone, in 2003. The road there is long, windy and bumpy. It is hard to imagine making the journey as a mother suffering from birth complications or with a seriously ill child, but these are the types of emergency cases that come here.
“We started to provide free healthcare before the government, and I think we have done a good job. Every day we send out five ambulances [in two different directions] in the Pujehun district to collect sick patients or pregnant women. We have now been able to reduce maternal mortality by around 40%,” Atté says, his posture relaxed and confident, a smile on his lips despite the taxing work. The reduction meets millennium development goal 5 – to improve maternal health. “But there are still so many problems here. Infant health is a big problem because we are in a very high malaria risk area. Maternal health is a problem because so many health centres do not even have one qualified midwife. And the roads – I am sorry, I know the country is poor, but the roads really are a disaster.” MSF welcomed the free healthcare initiative introduced by the government. “But now they need to take the next steps. Drug supply and transport must be improved for the health system to move forward.”
Source: The Guardian