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Accessing Health in Kroobay From Doctor to Traditional Healer

An assortment of rusty corrugated zinc sheets fashioned awkwardly in square and rectangular forms, dotted with blue and white strips of plastic sheets creates a bizarre mosaic on the muddy garbage plain, which stretches from the foothill of Lightfoot Boston Street to the sea face of Kingtom.
Here sits the lowly shelter for over 5,000 men, women and children. “Kroobay” is named after Liberian seamen of the Kru tribe who migrated to this country in the early 1960’s and settled in the sea front area partly to carry on their fishing enterprise, and partly to provide a home for vacationing African sailors.
Over the years Kroobay has become Freetown’s biggest recipient of trash washed down through a colonial built network of drainages or gutters which empties into what is now Kroobay, but which was actually meant to empty into the sea and be washed away.
Coupled with the low level crime and prostitution usually accompanying sailors who unabashedly seek out the pleasures of the world after spending long months on the high seas, Kroobay soon became the home of societal rejects, petty criminals and of course rubbish, filth and excreta.
Faced with the acute shortage of housing in the city, Kroo bay has since attracted petty traders, artisanal fishermen, cobblers, carpenters, tin smelters who fashion out locally made cooking pots and pans from the metal bodies of abandoned cars, and many more from other walks of life despite the obvious health hazards.
For a long time the main drainage named “Samba gutter” which runs through the community was fondly referred to as a “public flush toilet” where residents would in broad daylight drop their pants and displaying their bare backsides empty their bowels in full view of the public.
As the excreta drops or splashes into the gutter the flowing stream sweeps everything away into the sea – hence the name “public flush” much like the westernised toilet system.
Because of the Public Flush earlier residents saw no need to build toilets in their houses. By then this was commonplace practice for all the residents.
Presently Kroo bay now boasts of 4 public toilets although the houses still do not have any toilets.
Kroobay is one of six urban slums in the country with only one health facility to service the densely populated and poverty-stricken community.
Twisting and turning through a maze of footpaths, with toddlers in mud-decorated bikini’s playing in the dirt one comes across the worn-out yellow painted cement structure with an inscription written boldly in black in an arc-like form which reads: ‘Kroobay Community Health Centre.’  
Entering the clinic, which seemed to have been invaded by flies, which usually signals the coming of the rainy season we met the Community Health Club Secretary Mohamed Koroma, who also introduced to the Public Relations Officer of the Area Development and Child Welfare Committee, Saidu Allieu Turay.
The sturdy looking man, who seems quite au-fait with health related issues in the locality, highlighted some of the challenges in accessing health facilities in their community.
He complained about an incident where a young pregnant lady was left to die at home, because her family could not afford to pay emergency fees at the Princess Christian Maternity Home (PCMH).
Though he was quick to point out that this type of incident is not a daily occurrence yet he maintained that, finance still poses a barrier to accessing health facilities.
“Many have died and more would continue to die if charges to access health centre are not affordable” he ventured.
Eugenia Nicole, a nurse at the health centre, disclosed that there are no service-fees for the aged and under-five, pointing out that there is a only a two thousand Leones (Le.2,000) service fee for the able.
She disclosed that drugs are also provided free of cost for the vulnerable: under-fives, pregnant women, the old and the disabled.
Nurse Nicole maintained that if certain drugs are not available at the clinic when the patient is being treated, they usually issue out a prescription to the patient so that he or she can buy the drugs.
 Although a sanguine picture is being painted at the health centre that all is well in accessing health care at the clinic, locals in the vicinity presented quite a contrasting and gloomy picture.
Walking through the slum’s zigzag paths, one came across pools of stale water with mosquito larvae clearly swimming in them waiting for their period to hatch. This was not strange or unusual.
 Children continued to play in the rubbish dumps, and just nearby the stream a little boy crouched on rubbish heap was playing with a syringe, which had a needle on it, - how careless can our health workers be or maybe it came from hard drug users?
With such a high infant and maternal mortality rate the women of Kroobay are resigned to their belief in God or Allah or what the traditional healers can offer them
Suckling mother Mabinty Kamara feeding her barely weeks old child narrated how she delivered her baby at the hands of a Traditional Birth Attendant, because for her the fees for delivery at the clinic were too expensive and therefore unaffordable.
Other suckling mother’s in the slum highlighted the same financial constraints in accessing health care in the area.
 The pathetic picture painted is that these women are financially forced to abandon seeking health care at government run or even private health care facilities, and prefer instead to seek their cure at the hands of traditional healers.
 Though some medical practitioners argued that there is a need for service fees and drugs should be sold on cost recovery basis, the intended purposes for some of these monies are usually not attained, because most of the time they end up in the pocket of just one man.

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