By Sulaiman Banja Tejan-Sie
Kidney deaths in Sierra Leone before now were as horrifying as they were in the early 1940’s when Dr. Willem Kolff (1911-2009) invented the first dialyzer (artificial kidney) – an invention inspired by him having to watch helplessly as a young man died slowly of kidney failure in a small ward at the University of Groningen Hospital in the Netherlands.
Kolff was challenged as a result of this tragic incident to device a mechanism that would aid the kidneys cleaning and clearing task so as to reduce the pressure on that critical organ, and in the process enhance its efficiency and prolong the quality of life of the victim. Work on Kolff’s invention began on the eve of the eruption of World War II. Once the Nazis overran the Netherlands, Kolff was forcefully relocated to a hospital in a remote part of the country.
IMPROVISATION
Although materials were scarce, Kolff improvised, using sausage skins, orange juice cans, a washing machine and other common items to cobble together a toxin clearing rudimentary device which would protect the kidneys and enhance their efficiency.
Today, kidney dialysis is a revolutionary life saver that has helped sustain the lives of tens of millions of people all over the world. A disease that was once a life sentence can now be successfully managed enough to give victims the chance of a normal life
My personal experience in this regard was to watch a very good friend of mine, a kidney patient, who was resident in the United Kingdom but loved holidaying here in his motherland but at least twice a year each time he was here, he had to travel to Conakry in Guinea for dialysis at least once every week because under Koroma and the APC, we had no dependable dialysis centre. How I was filled with trepidation and anxiety for him and hoped for something to be done for the hundreds who cannot afford such travel and other expenses and helplessly and consistently die from a treatable ailment.
LEADERSHIP
The story of Dr. Kolff resonates resoundingly with the precarious balancing act that President Bio has employed in his determined bid to rescue a nation that was so deeply sunk in the morass of lawlessness, illiteracy, poverty and disease under the APC just five years ago. To empathise with the enormity of Maada’s challenge, just take a cursory look at these figures which may reflect the rudimentary washing machine from which Dr. Kolff out of pure selflessness and determination built the modern dialysis machine. Let’s take a walk down memory lane. President Koroma courtesy of the confidence the international committee had in President Kabbah, is among a few lucky leaders to inherit a debt free third world country. He also inherited a robust economy with 1.6 billion USD in the national treasury and hundreds of trillions of Leones, but when he left office in 2018, in spite of the fact that he had inherited a debt free country and because of unbridled corruption under his administration, he left a national debt of over 2 billion dollars and 463 trillion Leones and a country whose economy was in a state of near collapse. Such was the enormity of APC’S loot that the IMF, World Bank and other international creditors abandoned the country and vowed never to continue doing business with such a banana republic.
Fast forward five years on, under Bio’s guiding hand, Sierra Leone is a stable democracy with a brand-new international airport, a country where hope has been restored by the government’s funding of tuition fees, school feeding, school buses, examination fees etc. for over 2.6 million pupils. A country where close to 50 percent of the populace now has access to electricity especially in the rural areas.
Fast back to health matters. On that front and in line with Dr Kollf’s revolutionary inventive skills, under President Bio’s watch a country which only had a decrepit, broken down dialysis machine in its major referral hospital in 2018 can now boast of four dialysis stations treating over 700 patients in major referral hospitals all over the country in addition to private dialysis clinics which had sprung up as a result of private investment in the health sector courtesy of government policy in that direction.
To show how serious President Bio was about the transformation of the health sector, our nation welcomed the first delivery of critical drugs by drones as far back as November 2019 months after the Bio administration assumed office. This unique lead has over the years significantly improved access to medicines for communities in remote and hard to reach areas of Sierra Leone. In addition to contributing to the reduction of maternal – related deaths, this cyber health initiative presented the possibility of numerous cross-sectoral use-cases that fostered informed decision-making at the highest levels of government.
MATERNAL MORTALTY
The maternal mortality rate in Sierra Leone pre – 2018 was nothing short of alarming. During Koroma’s misrule, 1 in 20 women faced a lifetime risk of dying in pregnancy or childbirth. The mortality rate of infants and children under 5 were also among the highest globally: the statistics made grim reading, 122 deaths per 1,000 live births. Many of these deaths were preventable if the right care was available. The succeeding Bio regime on the contrary adopted the mantra of: “no woman should indeed die from obstructed labour or a postpartum hemorrhage, nor should any child from diarrhea, pneumonia or malaria”, and set to work towards achieving this feat through massive investment in the health sector.
Under Ernest Bai Koroma’s APC, Sierra Leone recorded one of the highest rates of under-five mortality in the world with 94 deaths per 1,000 live births according to the 2017 Multiple Indicator Cluster Survey report. Tackling neonatal and child mortality in Sierra Leone, especially those that arise from preventable causes, and meeting the global target of reducing the neonatal mortality ratio to at least as low as 12 deaths per 1,000 live births and under-five mortality to at least as low as 25 deaths per 1,000 live births remained a major challenge for them and a great concern for most Sierra Leoneans who voted them out the following year in 2018.
Today, through increased investment in the sector and other proactive interventions by government and its development partners, neonatal mortality per 1000 live births has dropped to 20 which is by far better than the current West Africa average rate of 28. Also, under five stunting children dropped to 30% as compared to the Africa average of 34% under President Bio’s watch.
The Bio led government in its determination to further improve health care in the country has increased investment in access to basic health care services through increased budgetary allocation to health care generally from 6% to 11.6% and also increase in the number of new and rehabilitated health facilities across the country from 1397 in 2018 to 1569, thereby adding 2000 new beds to our hospitals.
To further bolster access to healthcare services in our rural communities, government has also introduced ”hospitals on wheels” i.e. mobile hospital buses which are providing critical healthcare service countrywide to over 20,000 patients in 12 districts in the country, and has increased the healthcare workforce through the training and deployment of over 5000 pin coded healthcare workers countrywide, while recruiting 8700 Community Health Workers (CHW) which is a 50 percent increase on what used to obtain under the APC. The Bio administration has also funded the training of 21 medical doctors in specialist areas abroad to fill the gaps in critical areas which had always been lacking. Tens of doctors have also been locally trained under the STEM programme through which government provides scholarships for all university students pursuing courses in science, technology, engineering, mathematics and medicine.
VACCINES
One of the key health strategies adopted by the Bio administration for tackling and reducing these preventable deaths included the boosting of vaccination programmes as a preventive measure which has over the years effectively helped to protect children from vaccine preventable diseases and other childhood health malaise. To this end, Bio’s administration worked in partnership with development partners including UNICEF to strengthen the country’s health system by boosting health service delivery through improved provision of vaccines and ancillary materials like cold chain equipment.
Another critical landmark is that government in partnership with UNICEF and with funding from the United States Agency for International Development (USAID) procured and installed 95 sets of solar fridges in health facilities across the country to help with the sustenance of the cold chain process for drugs. In addition, thirty- two Cold Chain Technicians were trained in equipment installation, repairs and basic preventive maintenance and the provision and installation of maintenance toolkits. The Bio government remains committed to further reducing the number of children suffering preventable deaths and this is evident in the marked improvement in our nation’s global health indicators. The aforementioned investment in solar equipment and capacity enhancement has directly improved immunization service delivery countrywide especially for children under the age of five.
CERVICAL SCREENING
Government has also sought to expand specialist health infrastructure facilities across the Western Area with the refurbished eighty (80) bed Kingharman Road hospital, the one hundred (100) bed Rokupr hospital and the refurbishment and expansion of the 34 Military Hospital to a one hundred (100) bed edifice complete with a Chinese built modern diagnostic clinic. Furthermore, the government has just turned the sod for the construction of an ultra-modern branch of the prestigious American Medical Hospital within the precincts of the 34 Military Hospital for the additional training of medical doctors and other critical health personnel. Today, screening for the early diagnosis of cervical cancer is operational in eight (8) healthcare facilities in the country. A major feat from what obtained under Koroma’s led APC government.
In its continued bid to drastically reduce the infant and maternal mortality rate and increase life expectancy, the Bio administration has further established a national blood transfusion unit that has significantly increased access to safe blood services. To date, government has also established 220 solar refrigeration centres in a bid to increase vaccine and blood storage across the country.
CONCLUSION
In conclusion, as a result of the several government interventions and investments in improving the well-being of its citizens, there has been significant improvement on several health outcome indicators during President Bio’s administration notably:
There has been significant improvement in the life expectancy of the Sierra Leonean from 53 in 2017 to 61 in 2023, a major decrease in maternal mortality per 100,000 live births from 599 in 2018 to 420 in 2022 a rate that outscores what obtains in West Africa where the average is 534, and a massive drop in neonatal mortality per 1000 live births to 20 as compared to the West Africa average of 28. The availability of essential drugs in hospital and other healthcare facilities, the boosting of vaccination and the increase in health personnel over these five years have witnessed a whopping increase of 90% in health care delivery countrywide to the amazement of international donors and our development partners. Like Dr. Kollf, President Bio is a revolutionary who is transforming Sierra Leone’s health landscape from a rudimentary level to a modern and dependable status reflective of how Dr. Kolff transformed washing machine to futuristic dialysis machines that have become major life savers today. A vote for President Bio in 2023 will be a vote for continued and dependable health care delivery, longevity and an improved quality of life for the Sierra Leonean.