Preserving Maternal and Child Health Care in Sierra Leone During the Time of Ebola: The Experiences of Doctors with Africa

Sierra Leone is one of the poorest countries in the world. The Ebola virus disease outbreak further affected the already impaired health system, especially health care services to women and children. This chapter assesses the extent to which maternal and child hospital services were maintained during the Ebola epidemic in the Pujehun district in Sierra Leone. Measures to control the Ebola epidemic were based upon prevention of infection, case management, and surveillance. These included organizing a rapid response to Ebola cases; isolation and clinical management of persons suspected of being infected; safe burials; triage, contact tracing, and quarantine; training and provision of personnel protective gear to health care workers; infection prevention and control; human resources management; and community sensitization. The numbers of admissions in the Pediatric Ward of the Pujehun Hospital in 2014 showed a significant decrease after the beginning of June—this was when the first Ebola case was reported in Sierra Leone. This reduction of pediatric admissions also occurred in the period from July to December, declining from 424 in 2013 to 312 in 2014. There were 716 admissions to the Maternity Ward in 2014 (781 in 2013, p 0.07) with no statistical differences. The total number of deliveries occurring in the Pujehun Hospital was 460 in 2014 (453 in 2013, p 0.41), with a reduction between June–August 2014, before resuming a positive trend. Factors such as competent local leadership, continuity of care, staff protection, human resources management, and community involvement, all combined to help contain the local spread of the Ebola epidemic while keeping the overall functioning of the hospital mother and child health care services functioning.