Academic journal article Current Politics and Economics of Africa

Between Wizards and Devils of the Forest on Development, Health, and Diseases in Sierra Leone *

Academic journal article Current Politics and Economics of Africa

Between Wizards and Devils of the Forest on Development, Health, and Diseases in Sierra Leone *

Article excerpt

"While some medical professionals in developing nations still complain of their patients 'ignorance,' many are becoming aware of their own ignorance of their patients' cultural perspectives." (Opala and Boillot, 1996)

Introduction

Sierra Leone is classified by the UN as one of the least developed countries. In 2008, Sierra Leone ranked 178 out of 178 in the UN Human Development Index. Sierra Leone has some of the poorest health indicators in the world, and healthcare payments are a substantial burden on households which can constitute a problem for the rural population because of the risk of further impoverishment. Childhood mortality is high in Sierra Leone: currently, 89 children per 1,000 live births die before their first birthday. About one child out of seven die before reaching age five. Maternal mortality is also extremely high in Sierra Leone: of the total deaths of women aged 1549, more than one-quarter of deaths (27%) are due to maternal causes (SSLICF Macro, 2009).

Most deaths can be attributed to nutritional deficiencies, pneumonia, anemia, malaria, tuberculosis, and now HIV/AIDS. Diarrheal diseases and acute respiratory infections are also major causes of outpatient care and illness in the country. According to Musa et al. (2014), contaminated water causes a range of life-threatening diseases, and children are the population that is most affected by them. Children's well-being is directly dependent on both the availability and the quality of water. Childhood diarrhea is closely associated with insufficient water supply, contaminated water, inadequate sanitation, and poor hygiene.

Six of the seven diseases targeted by USAID's NTDs Program, including lymphatic filariasis, onchocerciasis, schistosomiasis, and three soil-transmitted helminthes, are endemic in Sierra Leone. Non-communicable diseases like diabetes, cancer, hypertension, cardiovascular disease, and chronic kidney disease are on the increase, and now account for a significant proportion of morbidity and mortality among the population. The nation continues to struggle with a low life expectancy of 47 years; an infant mortality rate of 89 per 1,000 live births; an under-five mortality rate of 140 per 1,000 live births; and a maternal mortality rate of 857 per 100,000 births (GHI Strategy, 2011, SSL-ICF Macro, 2009).

A majority of the causes of illness and death in Sierra Leone are preventable, with most deaths attributable to nutritional deficiencies, pneumonia, anemia, malaria, tuberculosis, and now HIV/AIDS. Malaria remains the most common cause of illness and death in the country. In Sierra Leone, malaria is one of the major causes of morbidity and mortality in children under five years old. The country has a poor health status, mainly due to a high disease burden caused by environment-related communicable diseases and aggravated by poor nutrition. Children in Sierra Leone are generally malnourished. Among children, malnutrition, stunting, and poor immunization coverage are still significant problems. Malnutrition is the leading cause of death among children under five years old. Prevalence of anemia is high among both children and women. In 2008, 21% of children under age 5 were found to be underweight or too thin for their age, 36% were stunted or too short for their age, and 10% were weakened or too thin for their height (SSL-ICF Macro, 2009).

Another major factor affecting the health status of the population is poor access to clean water, which is closely related to diarrheal illnesses. Scarce availability of clean water and safe sanitation is a major factor affecting the health status of the population. Almost half of the population have no access to safe drinking water, and only 13% have access to improved non-shared sanitation facilities. The situation is worse in rural areas than in urban communities: in rural communities, up to 66% of the people do not have access to safe water. In addition, the country suffers from epidemic outbreaks of certain diseases, such as yellow fever, cholera, Lassa fever, and meningitis (GHI Strategy, 2011). …

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