The stunning infant-mortality rate-303 deaths per 1,000 live births annually-was among the key findings in a report just issued by the IRC and the Ministry of Health and Sanitation of Sierra Leone. The report outlines the results of a mortality survey conducted in January 2001 among 500 randomly selected households that are representative of the district's population of more than 600,000.
"We already knew from a recent UNICEF report that Sierra Leone's infant mortality rate was the world's highest," said the IRC's Dr. Robin Nandy. "But our study demonstrated a rate in Kenema almost twice that level. This is a public health catastrophe."
The survey uncovered an overall death rate for Kenema that was also extremely high-44 deaths annually per thousand people-three times the normal figure for Sub-Saharan Africa. In 1999, UNICEF estimated that the overall mortality rate in Sierra Leone was much lower, 24 per thousand, but even that figure is among the world's highest.
The research found that most of the deaths were caused by common illnesses that are easily treatable. Illnesses related to fever were the top killer, and malaria is believed to be the cause in a majority of these cases. Diarrheal disease was the second most common cause of death, followed by respiratory infections.
Nandy said the IRC's findings were worse than expected, since Kenema, the scene of considerable fighting in 1999, was relatively peaceful in 2000. And he noted that while the study is not representative of the entire country, the IRC assumes that death rates are even higher in areas where fighting continues.
"Even after the fighting ends, it takes a long time to rehabilitate health services to an acceptable level," Nandy said. "That's why Kenema is experiencing an infant mortality rate that is more than 40 to 50 times the rate of the United States or the United Kingdom."
"This study is one more demonstration that war-related casualties do not end when the fighting stops," said the IRC's Dr. Les Roberts, another of the study's authors. "While few of the reported deaths were from violence or trauma, the damage to public health continues. Almost 80 percent of the people who died had recently gone to a government health facility seeking treatment for their fatal illness. But with inadequate drugs and staff and no ability to refer or transport patients, the health system remains dysfunctional."
Roberts said the survey also demonstrates the negative effects of diamond trading in Kenema. It attracts local militia whose unsettling presence impedes the restoration of normality, he said. It is ironic, he added, that many residents of Kenema believe that they would be much wealthier and healthier if their region had no diamonds.
The report calls on international aid organizations to ensure that health facilities are equipped to address, prevent and treat the common illnesses that are leading to avoidable deaths. The report also recommends closer cooperation between local government health agencies and aid groups in boosting basic health care services.
In addition to Nandy and Roberts, the report's authors also include J.S. Fornah, Patrick Macarthy, S.T. Sawaneh and Ansumana Sillah, all of the Ministry of Health and Sanitation in Freetown.
Media inquiries can be made to:
Melissa Winkler, director of communications
tel. (212) 551-0972 or Melissa@theIRC.org