To the hero of 2018: the nurse serving in rural Sierra Leone

Imagine yourself being a nurse, earning USD 110 a month, which makes you the main breadwinner of a family and extended relatives, married to a daily wage worker, who more often than not won’t find work. You have two children – a son and a girl, who you work hard for to keep in school, paying all formal and informal fees necessary. Then your employer, the government, posts you to a veryvery remote area, more than 8 hours from where your family lives, in an area with a different tribe and local language, with no warning, in the middle of a school year, and expecting you to resume work in your new duty station within two weeks. You are not given any relocation or transport money, but are expected to pay this out of your salary. You are also not given any salary increase – even though you could really use that, given you will have to continue to pay for your children’s home. You reach your new duty station via public transport and motorbike, and face a dilapidated staff quarter, barely any drugs available for treatment, and a community that is suspicious of this person from the capital. The chief sees you as his personal mistress, allowing him to sexually harass you, and given he is the local authority, who do you complain to?! The journey home to your family costs a third of your monthly salary, so you only go back once a quarter, and even though you wish you could bring your family to your new duty station, there are no schools in close reach – or the quality of the local school is not up to standards. Even to access your monthly salary, you have to travel 3 hours to the district capital, if you are lucky enough to be banking with a bank that has a local branch. To call your family, you have to walk 15 minutes to a spot that has network coverage. Once or twice a year a delegation from the district capital comes on supervision, and intimidates you with pages of checklists telling you a hundred things you need to change, of course with zero additional resources.
When you go back to visit your family, you know you are risking lives in the community where you serve, because no one is there to cover for you. Furthermore, when you finally see your children and husband again, you realize that he has found himself a mistress in the meantime, and you don’t appreciate the suspicious strangers walking in and out of your home, with vulnerable children being there.

Sounds grim, no? This is the reality for more than 500 nurses in Sierra Leone, serving in the most remote health facilities. 81% of all rural health workers are female – often having no other options but to comply to postings, as they lose their job otherwise.
I doubt anyone who is reading this post would agree to such work conditions, yet in Sierra Leone, these nurses still serve their communities in hard-to-reach, barely equipped health facilities, with small salaries and lots of demands placed on them. I have spent a lot of time in the last few months working with the government to better recognize, reward and motivate these health workers, and given that the majority of them are women, we spent time with communities, local authorities, health workers and policy-makers to discuss gender-specific issues. It is horrifying, and humbling, to hear all their stories, and to understand their struggle and their fight better. Female health workers in remote areas are my heroes of the year – and they deserve to be much more recognized for their sacrifice and service to this country. They are some of the strongest women that walk on this earth. I am sorry I have not seen your struggle earlier, and I salute you for your bravery and your service. You are heroes.

 

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