Concord Times Newspaper is one of the oldest and credible local print media newsroom in Sierra Leone. Concord Times published in its February 19, 2014 publication contained an article written by  Journalist: Mohamed Massaquoi stated that Sierra Leone: Northern Region Tops FGM Activities – 2013 Demographic Health Survey (DHS) Reveals. This article was also published on All Africa Online Newspapers.

The article stated that the Demographic and Health Survey (DHS), (2013) conducted by Statistics Sierra Leone in partnership with the Ministry of Health and Sanitation puts the northern region of Sierra Leone at the top of FGM activities in the country.  Retrieved from: http://allafrica.com/stories/201402191575.html

According to the World Health Organization, female genital mutilation (FGM), sometimes called female genital cutting (FGM/C) or female circumcision, is the cutting or removal of all, or a portion of the female genitals for cultural (not medical) reasons. There are different ways it is practiced according to the location or culture in which it is being done.

         Despite the fact that Sierra Leone is a signatory to the 1988 Convention for the Elimination of Discrimination against Women (CEDAW) and many other international Human Rights instruments, there is still high prevalence of FGM/C and its related consequences on the health and wellbeing of women.

          In sierra Leone, FGM/C “Bondo Society” is wide spread regarded as a rite of passage for women into womanhood.  Apart from the Creoles in the Western Area, all other ethnic groups engage in the practice. This is inherent in a set of valuable cultural and traditional practice that nurtures purity and equip women with effective home management skills relevant for society at the time. In the 19^th century, FGM/C Bondo Society was a form of non-formal school conducted for matured females who are prime for marriage and lasted between one to thee months. This tradition was practiced mostly during the dry season after harvest; when there is plenty food and less work. Most women that were initiated to this society were already either traditionally engaged or betrothed to their future husband. Women move straight into their husband’s homes after the completion of the Bondo Society initiation ceremony. As a result of this, Bondo calls for all initiates to be virgins; clearly putting a stop to promiscuity before initiation. It is abominable, according to Bondo precepts, for a girl not to be found a virgin when going through the process. Being found a virgin during this process brings respect and honor to both the women and their families in the society. Today, FGM/C has been generally used to define who ‘a real Sierra Leonean woman is’. In some female gatherings and communities, women who are not initiated are stigmatized, discriminated against. They are seen as outcasts or ‘unclean and referred to as incomplete women.

            Female Genital Mutilation/Cutting (FGM/C) serves as the premise for other forms of Gender Based Violence and child abuse in the country regardless of the huge investment and interventions carried out to curb this deadly practice. Types I and II FGM/C is reported to be predominantly practices in the country.    According to the DHS, (2013), report, 75% had some flesh cut and removed, 9% were sewn closed, and less than 1% was cut without any skin removal.  More women in rural areas (94%) had been circumcised than in urban areas (81%). The results also show that FGM was highest in the Northern Region with 96% and lowest in the Western Region with 76%. The report added that circumcision was more prevalent among older women as 98% as of women aged 45-49 as compared to 74% of women aged 15-19 years. UNICEF, (2011), stated that FGM/C was 88% in 2010 but there has evidence that the practice was slowly diminishing, with 70% of women aged 15-19 being cut, compared to 96% of those aged 45-49 years. FGC was slightly less practiced on women with higher education, in wealthier homes and in urban areas. Only 22% of the women surveyed wished the practice to be discontinued compared to 72% who wanted it to continue.

DHS, (2013), reported that one of the main reasons why the Bondo secret society heads are so stubbornly opposed to the elimination of FGM, is that they regard this practice as their only source of livelihood.  “I am part of it because I am making money out of it. We don’t have alternative means of livelihood, so we depend on initiation fees being paid by parents for their children to be initiated. We also benefit from gifts being brought to the ‘Bondo bush’ for us the initiators,” said one of teh Digba/Sowei’s Bondo is now a kind of a cliché that carry so much fuss and “August meeting effect”. Nonetheless, parents especially mothers continue to go all out to make sure that their children go through the school before they reach 18 thereby continually unleashing suffering on them.

             The World Health Organization (WHO), FGM/C has both short and long term effects on women and girls. Some of the harm and known physical complications caused by the removal of, and or damage to, healthy, normal female genital tissue in the short term include severe pain, shock, excessive bleeding (Haemorrhage), difficulty in passing urine, tetanus or sepsis, open sores in the genital region and injury to nearby genital tissue and infections. In the long term, all types of FGM, particularly infibulation have been found to be associated with reproductive health morbidities, increased risk of childbirth complications, cyst, infertility, and cervical cancer. Sierra Leone’s high rates of teenage pregnancy and school drop-out are also linked to Bondo Societies, as once initiated many girls are considered ready for marriage.The effects of the practices are sufficient grounds for the legislation of the practice. However, the government does not have a clear policy on FGM/C and there are no laws explicitly banning the practice. Politicians in Sierra Leone do not think issues such as FGM/C need to be talked about, because they use FGM as a way of getting the votes of women, (African Development Bank, 2010).

Evidence in the video below is enough justification for legislating FGM/C in Sierra Leone. Disclaimer – This video is graphic; do not watch if you are not psych-emotionally strong!

All stakeholders, International Non Governmental Organisations, United Nations Organizations including  local organizations and stakeholders and hugely invested to curb teh practice yet,  the Sierra Leone government is yet to commit itself to proscribing the practice despite being part of so many international conferences seeking support for FGM to be banned.

Legislate against FGM/C and Save  Sierra Leone Women and Girls!

References

African Development Bank (2010), Joint Donor Gender Assessment Report: DFID Sierra Leone ols. 1 and 11,

Gender-Based Violence in Sierra Leone, (2008),: A National Research

UNICEF, 2011), Children’s Situational Analysis: Sierra Leone

UNICEF, (2013), Female Genital Mutilation/Cutting: a statistical overview and exploration of the dynamics of change

Sierra Leone  Demographic Health Survey, (2013),.

WHO Press, World Health Organisation, (2012), Geneva, Switzerland: Retrieved from: http://www.who.int/reproductivehealth/publications/fgm/9789241596442/en/index.html.

Awoko Newspaper is a local print media newsroom in Sierra Leone. Awoko in iyts Februaty 16, 20104 news paper published news about the launch of the Sierra Leone 2014 Mental Health Care Operational Strategy by the Minister of Ministry of Health and Sanitation.

Retrieved from: http://awoko.org/2014/02/10/sierra-leone-news-2014-mental-health-operational-manual-launched/

The launch of the 2014 Annual Mental Health Operational Strategy for me is a step in the right direction and an excellent initiative demonstrated by the current government towards enhancing the wellbeing and enjoyment of rights of people with disabilities including those with mental disorders in the country. Moreover this is also a proof of the continued government commitment in the implementation of the Mental health Policy and 2010-2018 Strategic Plan to increase access to health care delivery services that seeks to improve the health of the nation’s citizens.

             Sierra Leone in recent past has one of the worst health indicators in the world with extremely low life expectancy rate, high adult illiteracy rates of 48% in men and 71% in women. According to the Millennium Development Goal (MDG) report, (2010), in 2005 under-five mortality rate stands at 267/1000, maternal mortality in 2000 was at 1800/100,000 births and 875/100,000 in 2008 while HIV and AIDs stands at 1.5% of the country’s population.

World Health Organization (WHO) report, (2012), stated that 715,000 people in Sierra Leone are currently suffering from mental disorders, with only 2,000 receiving treatment. This creates a treatment gap of over 99% in the country’s due to the protracted neglect in the area of mental health and the country’s limited resources. The Ministry of Health and Sanitation (MoHS) mental health needs assessment report, (2005), found the prevalence rates to be 2% for psychosis, 4% for severe depression, 4% for severe substance abuse, 1% for mental retardation and 1% for epilepsy in the population. This makes the situation 4 times higher than the estimated global prevalence of 3% for severe mental illness. The Human Rights Commission report, (2013), highlighted the shortage of qualified medical personnel being one of the problems affecting the effective operations of the national psychiatric hospital. The hospital had only three trained psychiatric nurses and one psychiatric doctor. The nurses assigned at the hospital refused to report for duty due to the stigma associated with working in a psychiatric hospital. The non-availability of a counseling unit also remains a major challenge.This situation is worsen by drug/substance abuse and high rate of alcohol consumption in the country. WHO ProMIND profile mental health report, (2012), stated that in 2008, about 90% of admissions to the Sierra Leone psychiatric hospital were drug-related while the Sierra Leone Youth Report, (2012), stated that 15% of youth in the country are engaged in drugs/substance abuse. WHO, (2012), mentioned that an average of 9.7 litres of alcohol per capita is consumed by Sierra Leoneans as opposed to 6.2 litres per capita for the rest of the WHO African region. High alcohol consumption is often associated with mental disorders, as well as physical illness, unsafe sex and increased risk of road accidents. The MDG, (2010), report indicated that the deplorable situation of the country is as a result of poor infrastructure, poor social service delivery, lack of access to primary health care facilities and services, entrenched poverty, in effective governance, corruption and a host of other issues.

 An interesting bit about Sierra Leone is that, most mental disorders were treated using traditional means and religious methods. Religion attributed some of these disorders as caused by “Demons” and therefore take people suffering from some of these diseases to churches and pastors for deliverance. (See Video)

          Regardless of the abysmal situation described above, the country has made significant strides towards improving the primary health care system in the country including mental health services. WHO, (2012), report highlighted that the launching of the National Mental Health Policy  in 2009  led to the integration of mental health in the Ministry of Health and Sanitation (MoHS) and the launch of the 2010- 2018 National Mental Health Strategic Plan in 2010. Also, 187 mental health care workers including nurses and Community Health Officers (CHO) from across the country where trained in 2011 and 2012 with the support of Mercy Ships, i WHO & MoHS. The implementation of strategic plan contributed to the introduction of Certificate and Diploma training courses in Psychiatric Nursing at the College of Medicine and Allied Health Sciences (COMAHS) in 2012. In addition, there is also increased community awareness raising and education across the country on metal health issues by state and non-state actors to enhance early identification and treatment of persons with mental disorders.  

            In response to further address the mental health issues in the country, the national  2014 Mental Health Operational Strategy was launched to provide a clear direction in addressing priority areas in the National Mental Health Strategic Plan across the country. The National Mental Health Program Director, Dr. Andrew Muana, stated during the launching that the strategy is a component of the National Mental Health Strategic Plan, 2014-2018.  He also noted that the operational plan marks the launch pad for implementation of teh remaining mental healthcare model in Sierra Leone that caters for the involvement of communities along side  health facilities at all level of the country’s health care delivery system.

            The 2014 operational plan highlighted a focus on human resource capacity development on mental health, as well as the provision of scholarships and allowances for 40 Community Health Officers and 35 Nurses to pursue relevant postgraduate diploma courses in mental health and the recruitment and training of a Mental Health Specialist and health professionals.The  Sierra Leone Psychiatric Hospital, will serve as  a tertiary hospital for patient management, and also as a referral, teaching and research hospital for mental healthcare.

            Responding to mental health issues in Sierra Leone is not a one-day journey considering the huge mental health needs and complexities that comes with that. Nonetheless, the implementation of this plan will contribute to increase mental health care workers in the country’s labor market whose expertise can be utilized to address immense mental health issues in the country.

     “Little drops of Water make a mighty ocean”

 This article was written and published by Augustine Samba – Journalist of the Awareness Times Newspaper on Feb 7, 2014, 17:04

Awareness Times Newspaper is a credible local Non-Governmental print media house that informs the people on current affairs and social issues on a daily basis.

Retrieved from: http://news.sl/drwebsite/publish/article_200524709.shtml on 2/7/2014

This article is focused on the Government of Sierra Leone’s effort to increase all year round access to potable water both within dwelling houses and through Public taps or stand pipes for its population in Lungi, Kafu Bullom chiefdom, Port Loko District, Northern Sierra Leone.

The provision of pipe-borne potable water supply is an excellent initiative and a major stride made by the government of Sierra Leone to increasing access to all year round safe drinking water to citizens of this locality; as this remains the primary responsibility or every state to its populace.

Safe drinking water is a basic necessity that to a greater extent determines the good health of a nation and contributes to the overall wellbeing and quality of life of any type of population while unsafe drinking water can be a significant carrier of diseases such as trachoma, cholera, typhoid, and schistosomiasis, diarrheoa etc. In addition to its association with disease, access to all year round potable water has significant impact on women and children, who bear the primary responsibility for carrying water, often for long distances particularly in rural communities.

Sierra Leone is a country with huge water resources and located on 12 river basins. Five of which are shared with Guinea and Liberia while the seven rivers: Great Scarcies, Sewa, Moa, Rokel, Tia and Little Scarcies are in the country, (Rand McNally, 1993). Moreover, the country also has a number of water falls, streams, lakes, natural springs, etc to address the huge water needs of the its citizens but much has not been invested to tap the great available resources.

According to the Sierra Leone Multiple Indicator Cluster Survey, (2010, pp 59-61), improved sources of potable water includes: pipe borne water into (dwelling, compound, yard, or plot), public tap/stand pipe, tube well or bore hole, protected hand pump well, protected spring and rain water collection. Nonetheless, only 57% of Sierra Leonean population has access to improved potable water sources; 76% in western area and 48% in the three provinces. Ninety eight percent of the population in the western area has access to improved water sources compared to 48% in the North where Lungi is located. Only 32.5 % of the country’s population has access to water within the dwelling, compound or yard. The most important improved sources of water is the protected well which is only accessed by 34%, 28% and 21% of the population in the East, North and Southern provinces respectively. Surface water, water from streams, unprotected hand dug water wells, springs, ponds, rivers are the mostly used unprotected sources of drinking water.

            This appalling water situation in the country is a significant contributor to the cholera outbreak in 2012 that affected 23, 220 and claimed the lives of 300 people countrywide according to the Cholera outbreak, Emergency appeal report, (2013, p. 4.). Therefore increasing access to safe drinking water is a huge contribution by the state to improve the quality of life of its populace.

            Apart from all year round access to water being a key contributor to good health and easing the burden of women and girls, Lungi is hosting the country’s current international airport and hence remains the first point of entry into the country by foreign nationals and international partners. The lack of potable water sources in such a community speaks volumes and helps in painting a picture about the country. Therefore is but commendable that the government is investing in this sector and providing such a great resource for her people in this part of the country.

Water Challenges in Sierra Leone (Watch Video)

However, my concern with this great initiative bears on the sustainability or the continued all year round access to pipe-borne potable water being provided to these communities. Sustainability remains a critical factor to assessing the financial and social viability of this investment and its related impact on improving the quality of life of the project beneficiaries both in the short and long term. Sustaining could be challenging if the people for which this resource is provided for are not involved in the decision making process and if adequate awareness and education is not provided for them prior to the completion of the project.      

  In Relation to the above, I would like to understand which approaches and action steps have been taken to ensure the effective management, maintenance of the water system and the continued provision of potable water to the beneficiary communities through the following?. How is the community going to contribute to the management of the water system upon project completion? How is the water system going to be managed? Who manages it? Who provides for the purification of the water before it is distributed to the community? Who is responsible for replacement of parts and routine maintenance of this system?  Are the project beneficiaries expected to pay water bills or rates? How and where do they pay? Who manages the funds?. I am asking all of these questions to help us as Sierra Leoneans think through the use of effective approaches that will enhance effective management, ownership and sustainability of development initiatives after project phase out.

References

            Emergency appeal final report, (2013), Sierra Leone: Cholera outbreak. n° MDRSL003 GLIDE n° EP-2012-000041-SLE, International federation of Red Cross and Red Crescent Societies

          Sierra Leone Multiple Indicator Cluster Survey, (2010, pp.105-113)