I came here as District Medical Officer (DMO) in May 2000, before the end of the war.

Before the war there was close to 103 Peripheral Health Units (PHUs), most of which were destroyed in the war. When I came there were about fifty functioning PHUs.

Recently through the help of government and its donor partners –MSF,  CAUSE - Canada, Tera Tech, NaCSA and the cooperation of the communities, we have been able to increase the number of functional PHUs to 8 4.

District Medical Officer, Moyamba District

Not all the PHUs have proper structures; some are ordinary buildings offered to us by the community. As you may know, we took that extra mile of using improper buildings as Health Centers just to make health care services accessible to the people.

 In a bid to deliver affordable and quality health services to the people, we have made quite a number of interventions which address all the elements of Primary Health Care (PHC).

The District Health Management Team (DMHT) was set up chaired by the DMO and charged with the responsibility of ensuring timely, effective and quality health care services to the district population.

Membership to the DMHT is drawn from all the departments of the health sector in the district, including the District Council and health related NGOs.

We plan, implement, monitor and supervise all health activities, and report to the respective Directors in the Ministry of Health and Sanitation (MOHS).

Various programmes are assigned to different members of the team, who work with the PHU staff at the Chiefdom level; each Chiefdom has a Chiefdom In-Charge, who is normally a Community Health Officer (CHO), manning the PHU.

 The various PHUs have different nomenclatures ranging from Community Health Centre (CHC) to Community Health Post (CHP) and to Material Community Health Post (MCHP).

The CHC in an ideal situation is supposed to be manned by a CHO, assisted by MCH Aide, a dispenser and vaccinator.

These centers render safe motherhood, reproductive health and EPI services in addition to regular health talk to community members.

There is a high prevalence of Onchocerciasis in the district, which leads to blindness. This of course, was due to a halt in previous interventions caused by the war.

This year, (2005) we started the Community Directed Treatment with Ivermectine (CDTI). Though our targeted therapeutic coverage was 55%, we achieved 67% in 1000 villages.

Our greatest success is in EPI services, for which the role played by the District Council deserves commendation; the devolution makes it possible to have a high coverage in this area.

At the beginning of 2005 EPI coverage came to a record low of only 40%.

But with the devolution process and the Rapid Result Approach (RRA) we were able to increase the coverage to an unprecedented 80% which we have maintained through out- reach services, mobile clinic and effective supportive supervision.

WATSAN services are ongoing with the chlorination of wells and training of well owners on how to safely chlorinate their wells.

We hire “Blue-flag volunteers” to detect water related and other diseases within the community.

This district used to have outbreaks of watery and bloody diarrhea every year.

But with vigorous health education, we have not had such incidents since 2005, which means effective work is being done.

We have revitalized the registration of births through the help of the Government of Sierra Leone (GOSL) and Plan Sierra Leone,

Achieving over 100% coverage, which we have sustained by continuous registration in the PHUs, and sensitization on Radio and in meetings

Indeed, there has been much achievement, but we still have a lot of constraints; 45% of the constructed health centers lack staff quarters, while 15% of functional PHUs are housed in improper buildings.

Another major constraint is staffing; we lack both professional and auxiliary staff in all cadres, which has debilitating effects on the health care delivery in the district.

At the hospital for example, there is no state-registered nurse, while there are only two sisters (One as acting Matron), seven nursing aides and about 30 volunteers who are neither professional nor enrolled.

In the PHUs, we have only seven CHOs and three dispensers, while only one PHU has a potter.

On the other hand mobility has greatly improved; at least the hospital can now boast of two ambulances (one in need of repairs) and three vehicles for PHC as compared to one each last year. 

The PHUs engage in school health activities, giving Mebendazole (de-worming tabs) to school going children as well as vitamin A supplementation in various routine campaigns.

We also do mass sensitization on Voluntary Canceling and Confidential Testing (VCCT) for HIV/Aids encapsulating a few PHUs.

We also work on prevention of mother-to-child-transmission.

In this vein we have earmarked 7 sites for VCCT and have trained CHOs in the management and case detection of HIV/Aids in their centers.