A A PhotojournalPhotojournal on Kabala on Kabala Maternity Complex Maternity Complex

UNICEF Freetown, January 2008UNICEF Freetown, January 2008

Social DataSocial DataPopulation (2004)Population (2004) -- 284,000284,000Total land area (kmTotal land area (km²²)) -- 12,12112,121Number of ChiefdomsNumber of Chiefdoms -- 1111Number of ethnic groups Number of ethnic groups -- 33Number of Number of PHusPHus -- 5555Estimated population per PHUEstimated population per PHU -- 8,5158,515Referral Hospital Referral Hospital -- 11Number of Medical DoctorsNumber of Medical Doctors -- 22Primary school enrolment Primary school enrolment -- 85%85%Primary school pupils/teacher ratioPrimary school pupils/teacher ratio -- 110:1110:1% access to water % access to water -- 5353% access to safe sanitation% access to safe sanitation -- 3434

Source: DACOSource: DACO--SL 2004SL 2004

KoinaduguKoinadugu is the largest district in is the largest district in Sierra Leone. The chiefdoms and Sierra Leone. The chiefdoms and villages are situated miles apart. villages are situated miles apart. Difficult road networks connect Difficult road networks connect those chiefdoms and villages, those chiefdoms and villages, which have always made it which have always made it difficult for the provision of difficult for the provision of services, monitoring and services, monitoring and supervision.supervision.

The south east of the district is The south east of the district is largely inaccessible from the main largely inaccessible from the main town, Kabala, and many other town, Kabala, and many other areas can only be accessed by areas can only be accessed by motorbike.motorbike.

The District has a very good soil and The District has a very good soil and climatic conditions for agricultural climatic conditions for agricultural activities, and used to be the leading activities, and used to be the leading vegetable and livestock producer in vegetable and livestock producer in the country. the country.

However, insecurity caused by the However, insecurity caused by the war led to massive loss of livestock.war led to massive loss of livestock.

The District has one of the lowest The District has one of the lowest statistics in the national sociostatistics in the national socio--economic index. The awareness economic index. The awareness level of most of the people towards level of most of the people towards education, health and sanitation education, health and sanitation and good governance has been and good governance has been slow in unfolding. slow in unfolding.

Even though many children are Even though many children are going to school, yet girlgoing to school, yet girl--child child education has not been education has not been prioritisedprioritisedmainly due to cultural practices.mainly due to cultural practices.

About 69 per cent of the population About 69 per cent of the population of the Northern Province, of which of the Northern Province, of which KoinaduguKoinadugu is the largest district, is the largest district, does not have access to improved does not have access to improved water sources. Most of the water sources. Most of the numerous gravity fed schemes fell numerous gravity fed schemes fell into disrepair even before the war, into disrepair even before the war, and support to the sector has been and support to the sector has been negligible. negligible.

Even though UNICEF and Even though UNICEF and partners are constructing some partners are constructing some water wells and boreholes in the water wells and boreholes in the district, yet greater effort is district, yet greater effort is required throughout the district in required throughout the district in order to bring access to safe water order to bring access to safe water and sanitation to an acceptable and sanitation to an acceptable level. level.

Maternal and Child HealthMaternal and Child HealthThe Infant and underThe Infant and under--5 5 mortality rates in the Northern mortality rates in the Northern Province of which Province of which KoinaduguKoinadugu is is the largest is estimated at 149 the largest is estimated at 149 and 252 respectively, per 1,000 and 252 respectively, per 1,000 live births (MICS 2005)live births (MICS 2005)

UNICEF health intervention in UNICEF health intervention in KoinaduguKoinadugu District is closely District is closely link to the reduction of maternal link to the reduction of maternal and child health. With only two and child health. With only two doctors for more than 300,000 doctors for more than 300,000 people, poor road infrastructure people, poor road infrastructure and difficult terrain, health care and difficult terrain, health care delivery service remains a delivery service remains a serious challenge.serious challenge.

The need to construct a maternity The need to construct a maternity ward in Kabala, capital of ward in Kabala, capital of KoinaduguKoinadugu District came about District came about when a German media team when a German media team visited the then Kabala visited the then Kabala Government Hospital on the 12 Government Hospital on the 12 December 2005. December 2005.

The maternity ward was a single The maternity ward was a single room with three beds, a room with three beds, a labourlabourward with dated equipment.ward with dated equipment.

Paramount Chief Paramount Chief YembehYembehMansaray III of Mansaray III of WaraWara WaraWaraYagalaYagala Chiefdom gave land Chiefdom gave land to UNICEF for the to UNICEF for the construction of the maternity construction of the maternity ward. The turning of the soil ward. The turning of the soil was done by was done by BockarieBockarie BallaBallaMarahMarah of Mongo Chiefdom. of Mongo Chiefdom.

The German National The German National Committee provided the Committee provided the funds through UNICEF and funds through UNICEF and construction by MODCON construction by MODCON started in December 2006started in December 2006

The construction was completed The construction was completed in 2007, making it the second in 2007, making it the second maternity ward built by maternity ward built by UNICEF. The first was supported UNICEF. The first was supported by the Italian National by the Italian National Committee for UNICEF in Committee for UNICEF in Kenema. A third maternity ward Kenema. A third maternity ward is being built in is being built in KoiduKoidu also with also with support from the German support from the German NatcomNatcom. It is likely that . It is likely that BontheBontheDistrict will have the fourth. In District will have the fourth. In the next three years (2008 the next three years (2008 –– 2010), 2010), UNICEF will replicate the UNICEF will replicate the construction of maternity wards construction of maternity wards in the remaining 10 districts. in the remaining 10 districts.

The Kabala Maternity Ward was The Kabala Maternity Ward was officially handed over to Dr. officially handed over to Dr. SoccohSoccoh KabiaKabia, the Minister of , the Minister of Health and Sanitation on behalf of Health and Sanitation on behalf of Government and the people of Government and the people of KoinaduguKoinadugu District, by the District, by the UNICEF Representative, UNICEF Representative, GeertGeertCappelaereCappelaere on 13 December 2007. on 13 December 2007. The Maternity Ward will handle The Maternity Ward will handle complicated obstetric emergencies complicated obstetric emergencies and contribute to the reduction of and contribute to the reduction of maternal mortality in the district. maternal mortality in the district.

Before he handed over the Before he handed over the structure, the UNICEF structure, the UNICEF Representative called on the Representative called on the community to discourage early community to discourage early marriage and teenage pregnancies marriage and teenage pregnancies that contribute to maternal deaths that contribute to maternal deaths and obstetric complications. and obstetric complications.

The District Medical Officer, Dr. The District Medical Officer, Dr. Samuel A.S. Samuel A.S. KargboKargbo guided the guided the UNICEF Rep and the Minister UNICEF Rep and the Minister through the various units of the through the various units of the maternity ward. maternity ward.

The Maternity Ward consists of The Maternity Ward consists of 50 beds, postnatal, antenatal and 50 beds, postnatal, antenatal and surgical wards.surgical wards.

Dr. Samuel Dr. Samuel KargboKargbo on his usual ward on his usual ward rounds in the morning assisted by a rounds in the morning assisted by a team of dedicated staff.team of dedicated staff.

The Maternity Ward is equipped with The Maternity Ward is equipped with a modern operating theatre that can a modern operating theatre that can handle emergency obstetric handle emergency obstetric complications.complications.

FinaFina Kamara delivered her baby Kamara delivered her baby through Caesarian Section, the baby through Caesarian Section, the baby weighing 4.5 kg (10 lbs). Here, she is weighing 4.5 kg (10 lbs). Here, she is receiving some tips on basic child receiving some tips on basic child care by the UNICEF Health Officer, care by the UNICEF Health Officer, Frederica Wyse. Frederica Wyse.

Before now, the baby might have Before now, the baby might have died. If the mother had lived, she died. If the mother had lived, she would suffered from Vistula, or would suffered from Vistula, or other complications. other complications.

Thanks to the construction of the Thanks to the construction of the Maternity Ward, these Maternity Ward, these complications are now things of the complications are now things of the past.past.

The Maternity Ward encourages The Maternity Ward encourages exclusive breastfeeding starting exclusive breastfeeding starting within the first hour after delivery, within the first hour after delivery, even with a mother whose nipples even with a mother whose nipples are very short. The national are very short. The national average for exclusive average for exclusive breastfeeding is estimated at 8%. breastfeeding is estimated at 8%. In Northern Province, it is 12%. In Northern Province, it is 12%.

TedaTeda KoromaKoroma, one of many happy , one of many happy mothers who delivered at the mothers who delivered at the maternity ward. Others like maternity ward. Others like TedaTeda, , had their first babies at the had their first babies at the Kabala Maternity Ward. Kabala Maternity Ward.

The Maternity Ward will be The Maternity Ward will be complemented by the newly complemented by the newly reconstructed Kabala reconstructed Kabala Government Hospital funded by Government Hospital funded by the World Bank. It has an the World Bank. It has an antenatal and underantenatal and under--5 clinics. 5 clinics.

The Hospital will be opened by The Hospital will be opened by the Ministry of Health and the Ministry of Health and Sanitation by the end of January.Sanitation by the end of January.

The evening glow of the sun set The evening glow of the sun set behind the hills overlooking behind the hills overlooking Kabala town.Kabala town.

This signals the end of my mission This signals the end of my mission and the dawn of new beginning in and the dawn of new beginning in our quest to ensure that no our quest to ensure that no woman dies during the act of woman dies during the act of giving birth. The death of a giving birth. The death of a pregnant woman is a loss for not pregnant woman is a loss for not only the family, but also the only the family, but also the community and country.community and country.

All mothers should take their All mothers should take their healthy babies home. healthy babies home.