Imagine starting a country from scratch. That's what it feels like everyone is doing in Sierra Leone, a country now 10 years out of a civil war, but still struggling to restore infrastructure to pre-war levels.
It's not a disaster zone and it's not like countries such as Brazil or Nigeria with extremes of wealth and poverty, luxury living and slums. Almost everyone – eight out of 10 – in Sierra Leone is poor according to the UN development index.
That said, the country is bursting with energy and optimism. “Sierra Leone is not going backwards,” says Dr Mohamed Yilla, an obstetrician and country director for Evidence 4 Action, a programme funded by British aid aimed at reducing maternal and baby mortality.
“With the windfall taxes coming from the mines, the potential for improvement is enormous,” he says.
Although the country is wrought with development challenges, it has one of the brightest prospects in Africa with gross domestic product growth projected at an astonishing 17 per cent this year. This is thanks to the mining of diamonds and iron ore transported on 85-carriage-long trains to the Freetown port for delivery to China.
Malnutrition and violence
Ireland is also playing a part. This year, Sierra Leone has been elevated to a partner country for Irish Aid, with funding for malnutrition and gender inequality including sexual violence.
“We are enormously optimistic about the Irish Government and the potential in Sierra Leone. The Government is doing a lot, donor co-ordination is strong, including a close group of 4 EU donors. Everybody is working together to rebuild the country,” said the Irish charge d'affaires in Freetown, Sinead Walsh.
The impressive Irish operation is run by women and headed by Harvard-educated Walsh, her policy chief Dr Andrea Breslin and her deputy Paula Molloy. Walsh, who worked for Concern in Rwanda and the Afghan/Pakistan borders, says huge strides have been made since the civil war ended in 2003.
And with the economy booming, the important thing “is to focus in on the sometimes neglected issues such as gender equality and women's rights so that nobody gets left behind in the country's progress and everybody can contribute to building the future of Sierra Leone”.
One of the programmes funded by Irish Aid is a series of Rainbo sexual assault clinics. For Princess Squire, a counsellor, and her sister, midwife Annie Mafinda, the World Health Organisation's report last month about the prevalence of gender-based violence came as no surprise. They run the Rainbo clinic in Freetown and last year dealt with about 1,000 cases, predominantly rape.
But the important point is that the numbers reporting assaults has more than doubled since the first Rainbo centre was opened in 2003, reflecting a growing awareness that violence against women is a punishable and treatable crime.
“For more and more women, there is a realisation that what a man can do, a woman can do, so they won't accept what's gone on before,” says Mafinda who with her sister runs the Rainbo centre in the main maternity hospital in Freetown.
These practical services backed up by advocacy programmes to push awareness and create judicial infrastructure are where Irish Aid is making a difference.
The tolerance of gender-based violence in Sierra Leone has historically been high for cultural reasons, but efforts to shift attitudes started in earnest in 2007 when domestic violence was made a crime as part of three gender-related acts of parliament passed that year.
If reporting sexual violence is the first link in the justice chain, then the traffic through the Rainbo centres is a measure of success. But just creating a structure for reporting violence isn't enough.
If the police, courts and civil service are not all working together all efforts are “handicapped” from the off, says Walsh. This is one of the reasons why part of the €11 million-plus Irish Aid provided in 2012 involves the launch of Saturday courts around the country to deal exclusively with women.
“We started funding this last November because we were seeing a situation where the Rainbo centres were providing access to courts but, if the courts were not functioning well, we were leaving these women at a loss,” says Walsh.
Malnutrition in mothers and babies is also an issue borne out of gender inequality. Between 2005 and 2012, Ireland provided €75 million to the country, primarily on health projects tackling nutrition, and reproductive and child health. One programme deals with malnutrition caused by teenage pregnancy. Almost 50 per cent of girls have given birth by 18, or are pregnant and with little or no means to feed themselves.
Tackling maternal malnutrition automatically gives children a better chance.
“By the age of two, they have already lost so much of their physical and mental potential if they suffer malnutrition. It's not just stunted growth, it's mental growth. That's why the focus is on the first 1,000 days.”
The riskiest thing a woman can do in Sierra Leone is to get pregnant – there is one in 21 chance of death in childbirth, says Yilla. His E4A programme, led by British firm Options, aims to strengthen the health system by getting people to help themselves and demand more of their politicians. I
n a country where there is a paucity of data, gathering evidence is crucial to the progress of services and infrastructures. One initiative involved scoring the midwifery clinics and sharing the information with voters before the election.
“It's a very basic checklist, electricity, running water and blood supply.These are things that are enablers to save women's lives,” says Yilla.
“People could see for example that a region in the south of the country is the least populated but the most well-funded of the lot. They started to ask questions and demand more of politicians,” he says.
“The real power lies in the ability in invoking the response in people to demand more from their health service. Often there is a feeling if someone dies it's God's will – there is a cultural fatalism.”