On the 10th September 2017, Community Health Officers (CHO’s) and Community Health Assistants (CHA’s) across Sierra Leone withdrew their services to the health system in response to the Ministry of Health and Sanitation’s refusal to sign the Community Health Practitioners Act 2017. This is the first strike by CHO’s to have arisen in Sierra Leone’s history.
The Community Health Practitioners Act 2017 is asking the Ministry to recognise CHO’s as a designated body, allowing them to be granted practicing rights and accepting their licences. The Sierra Leone Association of Community Health Workers (SLACHW) has repeatedly asked the Ministry to reconsider their position and sign off the Act into law since 2012.
The SLACHW was established in Sierra Leone in 1983. Now with over 2,000 members this Act is undermining their role and damaging the country’s already fragile health system. Without the passing of this Act Community Health Workers will continue to practice their profession illegally because of not being recognised to be good contributors to the nation’s healthcare delivery services.
Sierra Leone, a country of only 157 doctors, is in desperate need of its 1,500 CHO’S, who were the leading volunteers during both the Ebola Virus Disease outbreak as well as the recent mudslide disaster in Freetown. The majority of CHO’s are born and raised in the district in which they work, this gives them the ability to fully understand the community and their social determinants of health.
In November 2016, here at Magbenteh Community Hospital, we were blessed with 3 CHO’s and a CHA to support us in serving the people of Bombali District, this strike is causing a severe strain on our remaining 2 Doctors. Speaking with one of the CHO’s; “We are all so frustrated and discouraged by the lack of interest by the Ministry of Health and Sanitation in improving the health system of Sierra Leone. Our work is critical, we are working to save lives. Without a licence, we are all at risk of being taken to court if an incident arose with a patient, but without a document to stand on.”
The Chairman for Community Health Officer’s in Bombali District, Mr Coleman, followed; “CHO’s across the country feel undermined. We need support and the passing of this bill for the sake of our people. We care for our patients and have an extreme feeling of guilt that we cannot help them at present. Punitive measures have been put in place to ensure CHO’s remain on strike, instead nurses are able to call CHO’s during emergency situations to ask for advice. Prior to the strike we were able to sensitize communities to prepare them for the lack of staffing in their nearest health facilities.”
At Magbenteh Community Hospital we pray that the Government of Sierra Leone alongside the Ministry of Health and Sanitation can sign the Community Health Practitioners Act 2017 as soon as possible, in order to allow CHO’s nationwide to feel protected as citizens doing their job and allow the country’s limited number health facilities to resume their normal services.