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Update Sierra Leone January - March 2014

Poster of children in health centre to receive Rotavirus marklate

SIERRA LEONE LAUNCHES ROTAVIRUS VACCINE

Sierra Leone has the highest child mortality rate in the world and the majority of its children die from preventable and easily treatable diseases. Diarrhoea is one of the primary causes for illness and death of children under the age of five. Though it is not the only cause of diarrhoea, the rotavirus is the leading cause of severe and fatal diarrhoea among under five children worldwide. A person who is infected with the rotavirus suffers from severe diarrhoea and vomiting. If left untreated, this can lead to severe dehydration and death. Good news! A vaccine has now been introduced in Sierra Leone to prevent diarrhoea that is caused by the rotavirus. The rotavirus vaccine is administered to children below 11 months old. The vaccine is free of charge for children in Sierra Leone. On 28 March 2014, the vaccine was launched in Kambia district northern Sierra Leone, as part of routine immunization. UNICEF, WHO, and GAVI Alliance collaborated with the Government of Sierra Leone to introduce the vaccine. UNICEF Country Representative Roeland Monasch explains that the rotavirus vaccine is a low-cost, high-impact solution that will contribute to the reduction of death among children thereby achieving the MDG 4. There is excitement about the nationwide introduction of the rotavirus vaccine because it promises to significantly reduce cases of severe diarrhoea caused by the rotavirus. However, Dr. Nuhu, Immunization Specialist at UNICEF Sierra Leone cautions, Whilst the rota virus is one of the major causes of diarrhoea, it does not account for all types of diarrhoea. Proper hygiene practices in the handling of food; handwashing with soap; and access to potable water and environmental sanitation, remain core elements in the prevention of diarrhoea. The launch of the rota virus vaccine is accompanied by a major communication campaign. The aim is to raise people's awareness and knowledge that the vaccine is important but not a solution for all causes of diarrhoea. Posters in strategic locations also help to encourage both men and women to take their children five times to a health clinic for marklate, as vaccination is referred to in the local parlance. Parents and caregivers are called upon to improve their own hygiene behaviour which remain essential in protecting their children from all forms of diarrhoea.
By Rosmarie E. K. Jah, Reports Officer, UNICEF Sierra Leone

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The wife of the UN Secretary General, Mrs. Ban and Sierra Leone's First Lady, Ms. Koroma holding newborns at George Brook Community Health Centre, Freetown

UN SECRETARY-GENERAL VISITS SIERRA LEONE TO CELEBRATE A HISTORIC MOMENT

March was a historic month for Sierra Leone. It marked the official closure of the UN Integrated Peacebuilding Office, UNIPSIL, bringing more than 15 years of peace operations in the country to a successful end. On this occasion, the UN Secretary General, Ban Ki-moon and his wife, visited Sierra Leone from 4 to 6 March 2014. Ban Ki-Moon highlighted that Sierra Leone represents one of the world's most successful cases of post-conflict recovery, peacekeeping and peacebuilding. He noted that Sierra Leone has made great strides from war to peace, stability and long-term development. Whilst Ban Ki-moon met the President of Sierra Leone, Dr Ernest Bai Koroma, Mrs. Moon, accompanied by the First Lady and the wife of the Vice President Sam Sumana, visited several UN projects. Their first stop was at the George Brook Community Health Centre in Freetown. They witnessed pregnant women, lactating mothers and children under five years of age receive treatment and drugs free of charge. This service is known as the Free Health Care Initiative. Though the UN political mission closed down on 31 March, the UN programmes continue in Sierra Leone. The joint aim of all the 19 UN agencies present in the country is to help the people of Sierra Leone and the Government onto a sustainable development path in the social, economic and environmental dimensions, the UN Secretary General noted. Roeland Monasch, UNICEF Sierra Leone Country Representative said We are aware of our responsibility in this new era and we will continue to support Sierra Leone on its way to sustainable and inclusive development. He continued, Child survival, child protection and education remain our major concerns in the country. In order to give children the best possible start in life, we remain committed to our projects, while strengthening national and international partnerships.
By Rosmarie E. K. Jah, Reports Officer, UNICEF Sierra Leone

Photo: UNICEF Sierra Leone/2013

Photo: UNFPA/Marian Samu/2013

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Students from grade 1 and 2 sit under a tree as they attend class outside the St-Joseph Roman Catholic Primary School in northern Sierra Leone

REBUILDING THE ATHENS OF WEST AFRICA FOR A BRIGHT FUTURE

Sierra Leone holds a prestigious place in the educational history of Sub-Saharan Africa. The first secondary school for boys and the same for girls in the region was founded in Sierra Leone. Fourah Bay College, Sierra Leone's university was the first in SubSaharan Africa.

Being the country with the only institution of higher learning in West Africa from 1827 to 1948, Sierra Leone was known as the Athens of West Africa. It played a pivotal role in training the first corps of doctors, administrators, and teachers in Anglophone West Africa. Today, Sierra Leone's educational system faces many challenges. Poor children, especially girls are not always enrolled in school or cannot attend school due to a number of reasons. Many parents do not have the money to pay the transportation fare of their children to and from school or the informal fees charged in the schools. They cannot afford to purchase uniforms and books. The quality of education is also a serious problem; 40% of the teaching force is untrained and unqualified. Education is central to economic and human development. Its benefits for society include lower child mortality, and better nutrition. UNICEF Executive Director Anthony Lake is convinced that "ending the cycle of poverty for children, their families and communities starts with education. Strides are being made in the rebuilding of the education system, as the nation moves up on the Human Development Index. In the Agenda for Prosperity (2013-2018), the National Poverty Reduction Strategy Paper III, the Government of Sierra Leone has clearly spelt out the importance of education and has expressed its will to continue to invest in and reform, the educational system. UNICEF's Education programme contributes to the achievement of Millennium Development Goals 2 (Universal Education) and 3 (Gender Equality) in Sierra Leone and supports the Government to ensure that both boys and girls have access to quality education.

In this vein, UNICEF addresses barriers to children's education with the focus on the most vulnerable, through schools. Together with partners like the IKEA Foundation; the Dutch National Committee for UNICEF; and DFID, UNICEF Sierra Leone assists the Government in teacher training, curriculum development and child-centred teaching methodologies. In January this year, IKEA foundation visited northern Sierra Leone to see impact of their support to UNICEF's Education programme. In Port Loko district, they saw firsthand, how, children who live in disadvantaged rural communities benefit from quality education. They witnessed new teaching methodologies that put the child at the centre of learning. These included children's active participation in class through creative thinking, without the use of the cane (corporal punishment). After spending a few days with schools in Port Loko, the IKEA team proceeded to the more agrarian and mountainous communities in Koinadugu District, in the extreme north. Here they saw collective groups of women actively promoting their children's education and discouraging child marriage through mothers' clubs. Mothers' clubs are a UNICEF initiative that started in 2010 in over 2,000 communities across the country. In these clubs, mothers also engage in income-generating activities, such as farming and soap making. The small profits help keep their communities' children in school, refurbish schools, and serve as stipends to teachers who are not yet on the government's payroll. This Education programme has no doubt had positive impacts on the lives of women and children in Sierra Leone, with the promise of a better future.
By Rosmarie E. K. Jah, Reports Officer, UNICEF Sierra Leone

Photo: UNICEF Sierra Leone/Oliver Asselin/2013

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FREE HEALTH CARE: MOVING FORWARD WITH SMALL STEPS

When Sierra Leone's President Ernest Bai Koroma launched the Free Health Care Initiative for pregnant and lactating women and children under 5 on 27 April 2010, his hope was to reverse Sierra Leone's position as one of the most dangerous places in the world to give birth.

Four years on and it seems the President's bold wish is moving in the right direction. While comprehensive data on the extent to which the Free Health Care has improved the health of pregnant women and their children is not yet available, preliminary findings point to clear progress. The 2013 Sierra Leone Demographic Health Survey shows an overall increase in health service utilization; 97 percent of women surveyed received antenatal care from a skilled health provider (doctor, nurse, midwife or mother and child health aide) during the pregnancy for their most recent birth. There has also been a significant decrease in deaths of children under 1 year. Between 2004 and 2008 the infant mortality rate was 127 deaths per 1,000 live births. This number decreased to 92 deaths in 2012. UNICEF's role in the Free Health Care initiative has been critical to establishing a reliable procurement and distribution system for providing essential and lifesaving drugs to the women and children who need them. UNICEF has worked alongside the Ministry of Health and Sanitation and donors including the UK Government and European Union to strengthen distributions to the 1200 Peripheral Health Units across the country. An improved system of management was established to support more efficient distribution of drugs and medical

supplies. UNICEF Logistics Officer Victor Sule, who has been working on the programme since 2011 remarks, Drugs are reaching the Peripheral Health Units (PHUs) regularly. Almost 90 percent of PHUs are now reporting on the quantities of drugs which have been consumed and this greatly assists in the monitoring and planning of distributions. UNICEF's role in the Free Health Care is now being gradually transferred to the Sierra Leone Government and will be completely handed over in April 2014. In the past year, UNICEF has been working with the National Pharmaceutical Procurement Unit (NPPU) in a hand-over of all procurement and logistics of Free Health Care drugs and medical supplies. The process will be supported for the next two years by Crown Agents who will manage the NPPU, while building local capacity. While the phase-out of UNICEF's involvement presents a significant milestone in the Free Health Care initiative, there is still a long way to go. UNICEF remains committed to supporting the Ministry of Health in an extensive programme of health worker trainings, health infrastructure improvement and health system strengthening.

By Jo Dunlop, UNICEF Consultant, UNICEF Sierra Leone

Issata Sow lies with her 4 month old daughter Davida, under a mosquito net distributed as part of the Free Health Care Initiative, in Freetown

Photo: UNICEF Sierra Leone/Olivier Asselin/2013

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UNICEF consultant Adelaine Williams facilitates an action research session with school students in Pujehun District

LINKING PEACEBUILDING AND EDUCATION THROUGH ACTION

According to children in Sierra Leone, the link between peace and education is clear. School children who were participating in an 'action research' session in Pujehun district. The primary school children were asked to share their ideas on what a peaceful community should look like. Their sketches revealed a strong connection to education with drawings of children playing and learning at school together.

Action research is a reflective practice that aims to explore issues through collaborative discussion and problem solving. Through the Peace Building Education and Advocacy programme (PBEA) funded by the Netherlands Government, UNICEF Sierra Leone is giving communities and school children the opportunity to take action on issues that matter to them around their school and community. While the war in Sierra Leone officially ended in January 2002, the need for conflict sensitive approaches and peacebuilding initiatives in education are still important. Interventions such as basic education curriculum reform; working with children and adolescents to alter perceptions of corporal punishment; and teacher training have been adopted throughout Sierra Leone into the Child Friendly School (CFS) model. The research involves contributions of stakeholders including students, teachers and community members whose inputs will be used to devise strategies to improve and sustain Child Friendly Schooling in 40 pilot schools in two districts in Sierra Leone. Action research groups have been set up at community and district levels. District steering committees have been established in Pujehun and
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Tonkolili districts with representatives from across communities. Emphasis is being placed on participation and ownership of the research process and committees must ensure that research is documented to allow for reflection, learning and sharing of experiences. The Ministry of Education, Science and Technology and the University of Sierra Leone and other community members have been involved in the collaborative design of a baseline survey. This will measure individual schools against their progress on Child Friendly School standards and identify specific areas of need. One year after the process will be repeated and the correlation between Child Friendly Schools and conflict drivers will be assessed. As a collaborative process all stakeholders will be involved in design, collation and analysis of the survey; and dissemination of information. UNICEF's role is to facilitate this process. Roll-out of the action research has just been launched and it is expected to unfold over three years.
By Jo Dunlop, Consultant, UNICEF Sierra Leone

Photo: UNICEF Sierra Leone/2013

UNICEF Sierra Leone/2013

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ADOLESCENT CLUBS TACKLE TEENAGE PREGNANCY IN SIERRA LEONE

Teenage pregnancy is one of the most pervasive social problems in Sierra Leone today. When a teenage girl becomes pregnant it affects her social, economic and political progress and puts her health at risk. More than one third of all pregnancies involve teenage girls in Sierra Leone. Up to 40% of maternal deaths occur among these teenagers.

On 13 May 2013, the Government of Sierra Leone launched a national strategy for the reduction of teenage pregnancy. The President stated that the strategy is a commitment that we make for the younger generations. In line with the Government's efforts to address the problem, UNICEF, in collaboration with International NGO, BRAC, is tackling this complex issue through a simple idea - providing a place where teenage girls enjoy hanging out while they learn valuable life skills and make friends. BRAC's Empowerment and Livelihoods for Adolescents programme assists 6,000 girls between the ages of 13 and 19 in achieving greater social and economic empowerment, by establishing adolescent development centres. Through these 'clubs', vulnerable girls are given safe spaces for sharing their experiences. They receive training in sexual and reproductive health and financial literacy and can access credit support to start income generating activities. Aminata is part of one such club in Port Loko district and like many girls, the project has simply provided her with a community in which she can learn valuable skills; and gain

support and motivation from a new group of friends. I have learnt hairdressing through this programme, I can play football and I'm happy. I don't want to stop there, I want to go back to school and do something more, said Aminata. This programme will lead to meaningful results and a reduction in teen pregnancies. A similar programme in Uganda achieved considerable success with an impact study revealing the probability of participants having a child decreased by 26%. The programme in Sierra Leone was piloted in Port Loko in August 2012. Lessons learned will feed into activities which are now being implemented in Kambia, Moyamba, Pujehun and Port Loko, the four targeted districts with the highest teenage pregnancy rates in Sierra Leone. This video explains more about the programme: https://www.youtube.com/watch?v=tzb7oxxCIWg&list=U Uy5JAzA0sz2AgqJqpwsx5WQ
By Jo Dunlop, Consultant, UNICEF Sierra Leone

BRAC Social Worker speaks with a group of girls gathered in Port Loko, northern Sierra Leone

Photo: UNICEF Sierra Leone/Asselin/2013

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While in Sierra Leone, UN Secretary-General Ban Ki-moon and Sierra Leone's President Ernest Bai Koroma discuss the future of the country

FROM THE ASHES OF WAR, SEEDS OF PEACE OPINION EDITORIAL ON SIERRA LEONE FROM UN SECRETARY-GENERAL
What was once the biggest United Nations peacekeeping operation in the world winds down this month, and the most extraordinary part of this historic development is that international troops are not the only ones departing the country nationals from the once war-ravaged nation are donning blue helmets as they deploy to serve with the UN in other troubled parts of the world.

Sierra Leone used to be synonymous with brutality. The savage, decade-long war there was marked by appalling atrocities against civilians. Shocked into action, the world responded by backing a series of United Nations peacekeeping and peace operations. In the process, the international community paved the way for breakthroughs that will resonate far beyond Sierra Leone for years to come. We must give full credit where it is due: the peace I witnessed at the closing ceremony in Freetown this month is first and foremost an accomplishment of the Sierra Leonean people, who showed tremendous resolve to heal and rebuild. The UN is proud to have supported them and we thank them for proving our value. Sierra Leone saw many UN firsts, hosting the UN's first multi-dimensional peacekeeping operation with political, security, humanitarian and national recovery mandates. The UN Peacebuilding Commission made its first-ever visit to Sierra Leone. Our final mission there was led by the first senior UN official heading a unified political and development presence. The United Nations was proud to help set up the Special Court for Sierra Leone making it the first country in Africa to establish, with UN participation, a tribunal on its own territory to address the most serious international crimes. When the Special Court closed last year, it was the first of the UN and UN-backed tribunals to successfully complete its mandate. The Special Court's sentencing of former Liberian President Charles Taylor was the first conviction of a former Head of State since Nuremberg sending a stern warning that even top leaders must pay for their crimes. Other trials saw first-ever convictions for attacks against UN peacekeepers, forced marriage as a crime against humanity,
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and the use of child soldiers. These breakthrough accomplishments added to a solid record of achievements. UN blue helmets disarmed more than 75,000 ex-fighters, including hundreds of child soldiers, and destroyed more than 42,000 weapons and 1.2 million rounds of ammunition. The UN assisted more than half a million Sierra Leonean refugees and internally displaced persons to return home and supported training for thousands of local police. The UN helped the Government to combat illicit diamond mining that fuelled the conflict, and to establish control over the affected areas. With the UN's help, Sierra Leone's citizens voted in successive free and fair elections for the first time in their history. The UN Integrated Peacebuilding Office helped Sierra Leone to consolidate progress, addressing tensions that could have caused a relapse into conflict while strengthening institutions and promoting human rights. It helped the Government to bolster the political process, emphasizing dialogue and tolerance, and further strengthened the national police, even supporting the establishment of the first Transnational Organized Crime Unit in West Africa. Our final mission is departing Sierra Leone but a United Nations country team will remain until long-term development takes root, supporting good governance, quality education, health services and other essential conditions for progress. Other countries now mired in fighting, divided by hatred and wounded by atrocities, can draw hope from Sierra Leone. Its resilient people have given peacekeeping their greatest possible vote of confidence by sending troops to serve where the UN flag flies today. They understand that national goodwill backed by international support can enable even the most devastated areas to enjoy lasting peace.
By Ban Ki-moon, Secretary-General of the United Nations

Photo: UN/ Eskinder Debebe/2014

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REACHING REMOTE COMMUNITIES WITH BASIC HEALTH SERVICES

Community health workers are the conduits to reach children in remote communities who invariably suffer from diseases such as malaria, diarrhoea, severe malnutrition and acute respiratory infections. There is lack of obstetric and new born care and services when there are acute shortages of community health workers in remote communities.

In January 2014, UNICEF supported the Ministry of Health and Sanitation to organize a consensus building workshop in Freetown for community health workers on national community health programming. The most remote areas of Sierra Leone need health care and we must ensure that we reach the right people with the right services, said Ms. Miatta Kargbo, Minister of Health and Sanitation. Let us shock the consciences of Sierra Leoneans by changing our attitudes! Let's go back to our communities with new mind sets! Many hard-to-reach communities in Sierra Leone find it extremely difficult to access basic maternal and child health services which are relatively accessible in other communities.

We need to maximize synergies to ensure equitable provisions and use of health services in remote and deprived communities, said Gopal Sharma, UNICEF's Deputy Representative in Sierra Leone. I hope this consensus building workshop will result in concrete solutions to a harmonized approach to the scaling up of community health interventions with strong linkages to the health system. UNICEF and other development partners have supported the Ministry of Health and Sanitation in the past to provide guidance and harmonized standards for the implementation of community health interventions in Sierra Leone.

By Issa Davies, Communication Officer, UNICEF Sierra Leone

Health workers braving the odds to take health services to people living in remote communities

In 2013 UNICEF Sierra Leone received contributions from:

For more information please contact: Charlris Okafor Communication Officer, External Relations, Advocacy and Leveraging Resources, UNICEF Sierra Leone E-mail: cokafor@unicef.org Telephone: +232 22 235 730/735 Mobile: +232 76 912 059 Facsimile: +232 22 235 059 URL: http//www.unicef.org

United Kingdom, United Arab Emirates, and USA

The European Union, United Nations, African Development Bank, GAVI Alliance, Global Fund against AIDS/TB/Malaria, Bill & Melinda Gates Foundation, Micronutrient Initiative, United Nations Foundation and IKEA Foundation

UNICEF National Committee of: Australia, Austria, Belgium, Germany, Iceland, Italy, Japan, Luxembourg, Netherlands, Norway, Poland, Sweden, Switzerland, United Kingdom, and USA
www.facebook.com/unicefsierraleone www.youtube.com/user/UNICEFSL

UNICEF Sierra Leone/2010/Asselin

The Governments of Canada, Ireland, Japan,Netherlands, Norway,

Follow us on twitter:@UNICEFSL

Photo: UNICEF Sierra Leone/Asselin/2013