More than 2 years have passed since Sierra Leone granted pregnant women, new mothers, and young children free health care, but their needs often remain unmet. Amy Maxmen reports.
Marta Amara's water broke on Nov 5, 2012. Community members carried her in a hammock to the nearest health facility, nearly 10 km away from her village in rural Sierra Leone. A baby's tiny arm emerged soon after she arrived, but not its head. Realising that the birth would be too complicated in a centre ill-equipped for surgery, staff urged her to pay a taxi driver the equivalent of US$29 to take her on a 2-hour trip to the district hospital in Kenema. They arrived after nightfall to discover a hospital lacking electricity.
Amara then paid for transportation to an emergency clinic operated by Médecins Sans Frontières (MSF). By the time she arrived, her baby was dead and she was internally bleeding from a hole in her uterus. MSF obstetrician and gynaecologist Betty Raney stitched the wound, which saved Amara's life but rendered her infertile. “Women and children die because of delays in care”, Raney says. She sees preventable deaths daily, despite the country's 2-year-old policy for free health care for pregnant women and children younger than 5 years.