By patricai.ngevao@awokoewspaper.sl
Freetown, SIERRA LEONE – On a hot April afternoon in Kroobay Community, one of the densely populated slum areas in Freetown, the capital city of Sierra Leone, Musu, who concealed her other name sits with her son on a bench outside their house. Right next to her is a raw sewage drain that runs in front of her doorstep.
Musu’s 3-year-old son, Amadu, looks weak and tired. He is suffering from diarrhoea, a disease he has been battling with already since birth, according to the 36-year-old mother of three.
“Kroobay, like other slums, lacks improved basic infrastructure including water, sanitation, hygiene services, housing, employment, and access to food and nutrition,” says Musu, adding that the resulting communicable and noncommunicable diseases afflict many of them.
The United Nations Human Settlements Program (UNHS) defines a slum as a wide range of low-income settlements and/or poor human living conditions, which include the vast informal settlements that are quickly becoming the most visual expression of urban poverty.
According to UNICEF data, diarrhoea is a leading killer of children, accounting for approximately 9 per cent of all deaths among children under age 5 worldwide in 2019. This translates to over 1,300 young children dying each day, or about 484,000 children a year, despite the availability of a simple treatment solution.
“Thousands of us live in this community with limited access to improved primary health services. With the increase in population every day, pressure increases on the already poor living conditions we are faced with,’’ said Musu.
A resident close to the health care center at Kroobay disclosed to Awoko that the health care center attracts a lot of pregnant women and lactating mothers, further disclosing that it is been rumored that they pay for the health service rendered to them even though the service was pronounced free since its inception.
However, the Chief of Kroobay, Pa Alimamy Marouf Conteh pointed out that he has never seen the nurses collecting money from these women who go there. “I visit the hospital on some days and on other days, I refer my people to go there,” he added, stressing that even though it is rumored, he has never been a witness to that.
On the other hand, Adama Bockarie who had visited the center some weeks ago with her son to receive treatment after home remedies failed to offer relief to her son’s ailment, told Awoko that she left the facility unsatisfied with the services and even more unpleased as she did encounter out-of-pocket health expenses.
“Even though the service is supposed to be free, having this healthcare center is nothing different from going outside of Kroobay for medical service. This is too much for people like me who have very little to spend on medical expenses,” she said.
Trying to get their own side, the journalist who visited the community health center was told by the nurses that they cannot comment on the said rumor until the journalist go through the necessary process, stressing that they have been warned not to respond to any questions put forward to them by media persons until there is an approval from the relevant stakeholders.
It could be recalled that on September 2019, during the official launching of the National Action Plan for Health Security (NPHS), President Bio, stated that universal health care is a down payment on a fairer, safer, and more prosperous future for our people and our country.
“In Sierra Leone, the biggest challenge in implementing the improved primary health care service is of equitable distribution of health care to all. As slum dwellers, they are the most vulnerable to lack of improved health care service, basic determinants of good health as well as to curative services from government sources,” said a health personnel.
“The slums have very poor access to improved health services. For rational policy making, the access to improved health care service by underprivileged populations are essential,” the personnel added.
Access to primary healthcare is widely acknowledged as key to reducing the global burden of morbidity and mortality. In 1978, the World Health Organization launched the Alma Ata declaration in a bid to promote access to essential healthcare services while acknowledging health as “a foremost human right.”
While this agreement was ratified by a majority of Low and Middle-Income Countries (LMIC), time has shown that the resolutions of the Alma Ata declaration remain unfulfilled globally.
According to UN data, in 2020, about one in four urban dwellers lived in slums or informal settlements. This translates into more than 1 billion people, 85 per cent of whom live in three regions – Central and Southern Asia (359 million), Eastern and South-Eastern Asia (306 million), and sub-Saharan Africa (230 million). The region with the highest percentage of slum dwellers is sub-Saharan Africa, where more than half the urban population live in slums.
To achieve the Sustainable Development Goals, the world’s 1 billion slum dwellers must be given the support they need to lift themselves out of poverty and live free from exclusion and inequality. PSN/11/4/2023
