By Kristen Cahill, Senior Program Manager, Innovations for Maternal, Newborn, and Child Health
Fatmata Peeter is a traditional birth attendant (TBA) from Yonni village, deep in the interior of Sierra Leone’s Bo District. She joined Innovations’ Essential Newborn Care Corps (ENCC) last March to “do something good for her community,” and since then, she’s made over 100 home visits and lifesaving referrals for pregnant women and newborns as a maternal newborn health promoter in a pilot project seeking to increase hospital births and lower infant and maternal mortality while equipping TBAs as entrepreneurs
Last October, as the Ebola outbreak continued to escalate in Bo, Fatmata’s sister-in-law died in a local hospital in Tikonko for unknown reasons. With no measures yet in place to educate and protect health care workers tending to potential victims, Fatmata went to the funeral with her husband and son, unaware that the community’s traditional burial rituals would put her family at grave risk.
When Fatmata’s son fell ill with stomach pain a week later, she cared for him at home. Her husband became sick with the same symptoms a few days later, and Fatamata herself began to feel ill in turn.
A nurse at the local health facility heard that Fatmata’s family in Kpetema was sick, and when she investigated, the nurse saw that Fatmata’s was an “Ebola house.” The nurse called for an Ebola ambulance to take Fatmata and her family to a treatment center in Bandajuma, about 30 miles away, where they were officially diagnosed with Ebola and spent the next three weeks. They were released to their home village in late November 2014, numbering among the roughly 60 percent to date who have officially survived Ebola in Sierra Leone according to recent figures from the CDC and the WHO, although survival rates in neighboring Guinea and Liberia is currently estimated as worse.
During those three weeks, Fatmata’s two smallest grandchildren, whom she had cared for in her home, passed away from complications of Ebola before they were able to reach the treatment facility.
Initially, the communities Fatmata had served stigmatized her upon her return. Most of Fatmata’s neighbors were quarantined for 21 days following her admission to the treatment center, a part of the government’s work to contain the epidemic.
With the number of new cases in Sierra Leone only recently beginning to decline, public health officials attribute the shift to interventions such as contact tracing, community health education, and changing burial practices – all of which have been central to Concern Worldwide’s Ebola response.
“Many people would not come close to me,” she said. “They refused me in the community.”
“They blamed me for their problems, for the quarantine,” she recalled. “But now they see me, and they listen to me. Now when I speak about Ebola, everyone comes to hear what Fatmata has to say on the issue.”
Communities such as Fatmata’s are increasingly equipped with the means and information to halt the outbreak. But as Fatmata survives one public health crisis, she finds herself in the middle of the next as a maternal newborn health promoter. Stillbirths and deaths among children under five appear to remain alarmingly high even as deaths attributed directly to Ebola decline.
The recent easing of restrictions in Sierra Leone has allowed Innovations to restart the ENCC program, and TBAs like Fatmata are eager to get back to work.
“I still feel pain in my bones but I am getting stronger every day,” Fatmata said, receiving 50 pounds of rice from Concern. She declared, “I will eat it and grow stronger and go back to work helping my village.”