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Update Sierra Leone December 2013

ENDING THE SILENCE TO STOP VIOLENCE AGAINST CHILDREN DAY OF PRAYER AND ACTION 2013
The protection of children from all forms of violence is a fundamental right, which the international community has pledged to safeguard for all children, everywhere and at all times. Unfortunately, violence remains a harsh reality for millions of children around the world. Up to 1.5 billion children worldwide, especially girls, endure some form of violence every year. Many suffer in silence. In Sierra Leone 82% of children between two and 14 years are victims of at least one form of psychological or physical punishment by their caretakers. Out of these, 19% suffer from severe physical punishment. A high percentage of them also suffer from harmful traditional practices such as FGM/C (88%), child marriage (50%) and early child bearing (38%). Corporal punishment is widely practiced in primary and secondary school and has been one of the leading causes of children dropping out of school. Violence against children is mostly perpetrated by someone close to them and that is why it hides behind closed doors, seemingly invisible. Studies have shown that all over the world, across cultures and religions, acceptance and complacent attitudes still prevail when it comes to abuse of children. Since 2006, religious leaders all over the world committed themselves to use their influence to bring violence against children into the open and together work to eliminate it from society. Once a year, in November, they come together for a Day of Prayer and Action to renew their commitment to protect children. On Sunday 24 November, Sierra Leone's Religious Leaders, with support from UNICEF, carried out a Day of Prayer across the country. The Ministry of Social Welfare Gender and Children's Affairs, Civil Society Organizations, Child Protection agencies and children, joined religious leaders from the Christian and Muslim faiths, to raise awareness on violence against children. UNICEF Country Representative Roeland Monasch said, We are very happy that religious leaders in Sierra Leone have become part of the campaign to end violence against

Photo: UNICEF Sierra Leone/Olivier Asselin/2013

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children. The National Day of Prayer has become a platform for highlighting violence against children and to galvanize political, social and religious action to end it. As part of the End Violence against Children Initiative UNICEF Sierra Leone produced a video titled Make the Invisible Visible: End Violence and Protect Children in Sierra Leone. This video can be viewed here: https://www.yousendit.com/download/OGhja0Zha0Q4N VZESjlVag
By Charlris Okafor, Communication Officer, UNICEF Sierra Leone

SCHOOL CHILDREN WASH THEIR HANDS WITH THE MINISTER OF HEALTH AND SANITATION GLOBAL HANDWASHING DAY
On 15 October, over 450 primary schools and communities in Sierra Leone joined the rest of the world to celebrate the Global Handwashing Day with the theme: Clean hands save lives. The main celebrations took place in Kamabai village, northern Sierra Leone.

A school girl demonstrates proper handwashing with soap to the Minister of Health and Sanitation

The Minister of Health and Sanitation, Ms Miatta Kargbo teamed up with school children to demonstrate proper handwashing with soap to over 500 children, parents, religious and traditional leaders in this village. Handwashing with soap prevents diarrhoeal diseases which are one of the leading causes of under-five mortality globally, with 600,000 children dying every year. In Sierra Leone diarrhoea is the second killer disease of under-five children after malaria and accounts for 15 per cent of their mortality rate. In our school health club, we usually do role plays, drama and songs to educate our peers, parents and communities on the benefits of washing hands with soap especially before meals, after using the toilet and before preparing food, said 10 year old Sallay, a primary school pupil in

Kamabai. Diarrhoea sometimes prevents children from going to school and the simplest and most inexpensive method of control is proper handwashing with soap, Minister Kargbo added. Minister Kargbo used the occasion to donate 20 bicycles to 20 community mobilizers or natural leaders to monitor hygiene and sanitation activities in their communities which have been declared free from open defecation. Since the start of this year, UNICEF has donated 1,854 bicycles to community mobilizers to monitor water, sanitation and hygiene activities in Sierra Leone. The UK Government supports UNICEF and the Ministry of Health and Sanitation to improve water, sanitation and hygiene in Sierra Leone.
By Issa Davies, Communication Officer, UNICEF Sierra Leone

Photo: UNICEF Sierra Leone/2013

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GIRLS CALL FOR STRONGER ACTIONS TO ELIMINATE BARRIERS TO THEIR EDUCATION GIRLS EDUCATION WEEK

On 11 October, Sierra Leone joined the rest of the world to celebrate the second International Day of the Girl Child with the global theme: Innovating for Girls Education. This is a day the United Nations designated for promoting the rights of girls and addressing the unique challenges they face in regards to education.

The Sierra Leone Girls Education Movement (SLeGEM), which comprises the Ministry of Education, Science and Technology, the Ministry of Social Welfare, Gender and Children's Affairs, UNICEF, Plan International and other agencies, non-governmental organizations and civil society, held a week-long community outreach and education activities aimed at highlighting the issues affecting girls education and calling for change. An estimated 74 per cent of children of primary school age are currently enrolled in schools in the country. Though attendance rates for boys and girls are almost equal at primary education level, the dropout rate for girls is high at secondary level. Child marriage is a major impediment that prevents girls from completing their education. SLeGEM partnered with Women in the Media in Sierra Leone (WIMSAL), Kiddies Radio and other social groups to carry out advocacy and community engagement activities around the issue. Four girls representing the four regions of Sierra Leone read out petitions at an advocacy forum to government
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ministers, parliamentarians and other stakeholders calling for stronger actions to be taken to advance their education and eliminate all the barriers. We [girls] must not suffer from sexual abuse and harassment in school and community, neither must we be taken out of school and pushed into child marriage, said Amy, a 16 year old senior secondary school girl in Freetown. Let things be done differently to promote our development. We must be willing to do things differently as innovation has the power to achieve and elevate our ambitions for girls education and all that it promises, said Roeland Monasch, UNICEF Representative in Sierra Leone. Studies show that girls re-invest 90% of the money they earn in their family. Sierra Leone needs this investment to get out of the cycle of poverty. But for that to happen we all have to accelerate our efforts and ensure girls in Sierra Leone can complete their education and develop to their full potential, he added.
By Issa Davies, Communication Officer, UNICEF Sierra Leone

Photo: UNICEF Sierra Leone/Olivier Asselin/2013

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Members of the UN country team pose in front of UN House in Makeni

UNITED NATIONS INTEGRATED PEACE BUILDING OFFICE CLOSES IN MAKENI UN HOUSE REMAINS OPEN
On 9 and 10 December the Executive Representative of the UN Secretary-General (ERSG) visited Makeni to mark the closure of the United Nations Integrated Peacebuilding Office (UNIPSIL) in Makeni; and the full transfer of responsibilities of the UN Office to the United Nations Country Team, which is led by UNICEF. This is another step in the gradual transition towards the close of the mission on 31 March 2014, as instructed by the United Nations Security Council. The most important component of the transition ceremony was a town hall meeting with key stakeholders at Wusum Hotel. The gathering included the ERSG, the Mayor of Makeni, the Sierra Leone Permanent Representative of the Government of Sierra Leone to the United Nations Head Quarters in New York, the Resident Minister North, Paramount Chiefs, UNICEF Country Representative, and Chief Mission Support, UNIPSIL. They explained to participants that the closure of UNIPSIL in Makeni, does not mean the United Nations is leaving. The ERSG explained that the closure of UNIPSIL after fifteen years of peace mission in Sierra Leone is a positive sign. It is recognition of how far Sierra Leone has come, and what has been accomplished. He clarified that it is the beginning of a new phase in which the United Nations supports Sierra Leone as the country moves farther away from a troubled past and closer to a prosperous future.
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To reach that goal, all Sierra Leoneans need to work together. People from every sector, religion, tribe, region, need to work as one. Whether you're a paramount chief, a member of civil society, an entrepreneur, an elected official, or a clergyman, you have an important role to play in shaping your country's shared future. I want to assure you that the United Nations Country Team will be here to support you in this new phase of the long partnership and friendship, between the United Nations, Sierra Leone, and the people of Makeni. UNICEF manages, the UN House in Makeni. With the largest presence in the Northern Region, UNICEF will continue to carry out Health, WASH, Education, and Child Protection programmes. Other UN agencies include the World Food Programme (WFP) which implements large school-feeding and food for work programmes from Makeni.
By Roeland Monasch, Country Representative, UNICEF Sierra Leone

Photo: UNICEF Sierra Leone/2013

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MONITORING FREE HEALTH CARE DISTRIBUTION HOTLINE 117 FOR FREE EDUCATION AND INFORMATION
In December 2013, the Ministry of Health and Sanitation, with support from UNICEF completed the fourth and last nationwide distribution for this year, under the Free Health Care Initiative. The distribution included drugs and medical supplies, therapeutic food for malnourished children, malaria medication and mosquito nets, as well as reproductive health commodities. The integrated distribution of drugs and medical supplies saves costs, reaching beneficiaries on time. Over 100 different items have been distributed to more than 1,200 health facilities in Sierra Leone. Each health facility receives quantities that would last for three months. Various partners are responsible for all points of the distribution chain to avoid losses. The Police, AntiCorruption Commission, NGOs and Civil Society are involved in the monitoring of these valuable medical supplies. As part of the Free Health Care Initiative, a toll free number was established in 2012 by the Ministry of Health and Sanitation, UNICEF, Save the Children and the Medical Research Center (MRC). The number is 117 and can be dialed on all networks. Through the hotline, callers request for and receive health advice from, trained nurses at the Toll-free Centre within the central government hospital in Freetown. Callers report any problems they encounter with the Free Healthcare system. The reports are forwarded by the call center to the relevant parts of the Ministry of Health and Sanitation, District Medical Officers and other relevant stakeholders. On average 30-40 calls are received every week. The majority of phone calls relate to stock-outs at health centers, fees being charged for services under the Free Health Care, as well as appreciation by community members for the availability of medicines in the clinics. The toll free number helps in providing the much needed health education in the country, while serving as an effective monitoring tool.
By Charlris Okafor, Communication Officer, UNICEF Sierra Leone

Photo: UNICEF Sierra Leone/Davies/2013

A Toll-free Centre staff responds to health queries from the public

UNICEF Sierra Leone/2013

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IMPROVING THE QUALITY OF HEALTH SERVICES UNICEF RENEWS PARTNERSHIP WITH LIVERPOOL SCHOOL OF TROPICAL MEDICINE
Sierra Leone needs the best of the world's expertise because it is faced with the world's greatest challenges in terms of Millennium Development Goals 4 and 5. With one of the highest maternal mortality rates in the world, nearly 1 out of 5 children in Sierra Leone are dying most of them before their fifth birthday. The sad fact is that 857 of 100,000 mothers die during childbirth. Through the Free Health Care Initiative, the Government of Sierra Leone and development partners have taken a decisive step by providing health services free of charge for children under five years as well as for pregnant and lactating women. However, access to health services is only one part of the jigsaw. The quality of health services is extremely low. Sierra Leone has now tapped into much needed expertise, to address its alarming child and maternal mortality rates and the low quality of health services. UNICEF and the Liverpool School of Tropical Medicine (LSTM) are collaborating to support the Government of Sierra Leone; the UK and the Canadian Governments are on board as well. LSTM is dedicated to research, education and capacity strengthening in tropical medicine and global health, to save lives in resource poor countries. In 2009 UNICEF Sierra Leone entered into cooperation
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with the LSTM to provide competency based training in Essential Obstetric and Newborn Care (EmONC) to health providers. In order to train health workers directly, LSTM staff members come to Sierra Leone several times a year. The LSTM has also established a local base through a small office that provides full time administrative and logistic support. This year, health workers have been successfully trained in 11 of the 13 districts. These health workers in turn become trainers and pass on essential knowledge and skills to colleagues working in rural and remote areas. UNICEF is aware that supporting sustainable change and progress in Sierra Leone demands capacity building. With its extensive experience in developing capacity of both people and health systems at national, regional and district levels, LSTM has designed effective training packages that specifically address the needs of health care providers in Sierra Leone.
By Rosmarie E. K. Jah, Donor Reports Officer, UNICEF Sierra Leone

Photo: UNICEF Sierra Leone/Olivier Asselin/2013

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PROTECTING GIRLS FROM CERVICAL CANCER NEW VACCINE INTRODUCED

On 1 October 2013 Sierra Leone launched the introduction of a new vaccine, the Human Papilloma Virus (HPV) vaccine that protects women from cervical cancer. Vaccination of 9 year old girls was piloted in Bo District and will be expanded over the whole country during the next two years. The vaccines have been provided by the GAVI Alliance. Cervical cancer is among the most common cancers women suffer worldwide and the main cancer disease in Sierra Leone. It is transmitted through unprotected sexual intercourse. The new Cervarix HPV vaccine will protect women from this disease. Therefore it is essential to vaccinate girls before they become sexually active. In order to be fully protected from the virus, each girl needs to receive three doses of the vaccine within five months. Sierra Leone has only recently celebrated the official elimination of maternal and neonatal tetanus in the country which proves that the immunization program is successful. Immunization in Sierra Leone started in 1974 with just 6 vaccines against tetanus, tuberculosis, polio, diphtheria whooping cough, measles and yellow fever. Gradually, the Government in cooperation with UNICEF, WHO, GAVI and other health development partners, introduced additional vaccines. Today, the country also immunizes against hepatitis, flu, and pneumococcal diseases like pneumonia. Today, the country also immunizes against hepatits, flu, and pneumococal diseases like pneumonia. After the introduction of the HPV vaccine, the country will start vaccinating against the Rota Virus, during the first quarter of 2014. The Rota virus is the leading cause of diarrhea. Being the main supplier of vaccines in Sierra Leone, UNICEF has been supporting the country's immunization programme as well as regular immunization campaigns. Furthermore, the organization provides support with regards to distribution of drugs, supply of cold chain equipment and training of health workers.
By Angela Griep, Communication Specialist, UNICEF Sierra Leone

Minister of Health and sanitation Ms Miatta Kargbo administer the HPV vaccine to a 9 year old girl

Photo: UNICEF Sierra Leone/2013

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REDUCING MATERNAL MORTALITY IN SIERRA LEONE MY WORK IS A SOURCE OF PRIDE FOR ME

Beatrice N. Kamara is the Maternal and Child Health (MCH) Aide at the Peripheral Health Unit, in Mabai, Tonkolili District. The 58 year old smiling and chatty nurse, who has been in the profession for the past twenty two years, also lives in the same building in which the Peripheral Health Unit is located. At the time she started work in Mabai in 1990, the location for the clinic was not ideal; some mothers would complain that the clinic was too far off from where they lived. Others even preferred to walk a mile and a half to the Magburaka town for treatment. Beatrice recalled I suggested using my house as a temporary measure; this has now become a long-term stay and up to today the clinic is housed in my building. Mammy Nancy, as Beatrice is commonly known, explains that she was called to render her expertise in Mabai at a time when there were too many maternal deaths in Tonkolili District and in that area in particular. The death rate was alarming even for a country with one of the highest rates of maternal and child mortality in the world. In all my years working here, there has never been a maternal death in this clinic, Mammy Nancy continues. This is because I know my limitation. If a woman has been in labour for 8 hours and suspect breech cases, I quickly refer them to the main hospital in Magburaka town. She further explains that she has had no maternal deaths due to her vigilance. When a woman is in labour, I am careful to monitor the patient and her contractions every 30 minutes. I also observe the cervix of the woman in labour as well as the position of the baby. Nancy has worked extensively in the North of Sierra Leone. The Mabai clinic is her 9th station of work. I love deliveries and I like to attend to under-fives. I feel so good when mothers are appreciative of the work that we do here. My work is a source of pride for me. More women go to clinics because of the Free Healthcare and this has helped to reduce maternal and under-five
In 2013 UNICEF Sierra Leone received contributions from: The Governments of Canada, Ireland, Japan,Netherlands, Norway, The European Union, United Nations; African Development Bank, GAVI Alliance, Global Fund against AIDS/TB/Malaria, Bill & Melinda Gates Foundation, Micronutrient Initiative, and United Nations Foundation. For more information please contact: Charlris Okafor Communication Officer, External Relations, Advocacy and Leveraging Resources, UNICEF Sierra Leone Telephone: +232 22 235 730/735 Mobile: +232 76 912 059 Facsimile: +232 22 235 059 E-mail: cokafor@unicef.org URL: http//www.unicef.org www.facebook.com/unicefsierraleone Follow us on twitter:@UNICEFSierraLeo
Photo: UNICEF Sierra Leone/2013 Beatrice gives a health talk at the Mabai clinic

deaths, Beatrice says. The Free Health Care is an initiative that waives user fees for pregnant women, lactating mothers and children under the age of five in all public health facilities in Sierra Leone. It has been in existence since April 2010, when it was launched by the country's President Ernest Bai Koroma. Beatrice also ensures that she accounts for all the drugs the PHU administers everyday by recording it in a register. It is not the most interesting task, but it has to be done to keep track of the medication and to ensure that the Free Health Care drugs are being used in the right way in this particular centre. As a result of her dedication and diligence, Mammy Nancy won trophies in 2010 and 2011, from the Tonkolili Health Management Team for her outstanding work in the District. Beatrice looks forward to retirement in 2015. Two of her daughters have followed her footsteps and become nurses. They will take up from where I leave off, she concludes.

UNICEF National Committee of: Australia, Austria, Belgium, Germany, Iceland, Italy, Japan, Luxembourg, Netherlands, Norway, Poland, Sweden, Switzerland, United Kingdom, and USA.

UNICEF Sierra Leone/2010/Asselin

United Kingdom, United Arab Emirates, and USA