In Sierra Leone, Ebola has a devastating effect on women

Thursday, October 30, 2014

Despite improvements in the last several years, Sierra Leone’s maternal mortality ratio is one of the worst in the world. Now, the outbreak of Ebola further threatens the health of women and their families in Sierra Leone—causing more than 20 deaths a day, according to some estimates. Women are disproportionately affected by the disease, and the magnitude of the outbreak has pushed the already fragile health system to its limits, making access to health care of any type nearly impossible.

“Ebola appears to be very dangerous for pregnant women, both because uninfected women are unable to gain access to health centers for routine antenatal or delivery care, and because women who get Ebola and are pregnant have very high miscarriage, fetal death and mortality rates,” says Alice Mark, senior clinical affairs advisor for Ipas.

Ipas Sierra Leone Country Manager Valerie Tucker agrees, “Ebola has a devastating effect on women.”

The epidemic has meant that children and young people cannot gather for school, leading to an increased risk of teenage pregnancy. Common community wisdom, according to Tucker, indicates that when out of school, more teens will have unprotected sex.  

Abortion is legally restricted and unsafe abortion is common in Sierra Leone, particularly in rural areas. Researchers estimate the unsafe abortion accounts for 9 percent of maternal deaths. Ipas has been working in the country since 2010, partnering with the Ministry of Health and Sanitation and other key government and nongovernmental actors to identify ways to curb unsafe abortion and improve women’s reproductive health care.

Now, women who seek to terminate unwanted pregnancies despite the legal restrictions face increased risks due to exhausted health system and fear of Ebola. “Where will these young women go?” asks Tucker. “Most are scared to go to a hospital. Many will turn to traditional healers who have been ordered not to practice during the Ebola outbreak. When they can’t terminate an unwanted pregnancy there, they will be forced to go further underground.” That means more women will suffer complications from unsafe abortion.

According to Ipas staff in Sierra Leone, postabortion care services are still being provided, but on a very limited basis. One reasons is that health-care providers are badly in need of supplies. To address this need, the Ipas Sierra Leone team is making arrangements to supply (or is supplying) extra infection-protection equipment to some of the 14 Ipas intervention facilities that are still open. Tucker notes that fear and lack of supplies may force some facilities to shut down.

In addition, community youth representatives will work with community leaders and members of the Reproductive Health Partners Advocacy Network to raise awareness on sexual and reproductive health and Ebola. “We hope this will also be an opportunity to dispel myths and misconception in the community and inform them about the preparedness of our providers,” says Tucker.