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How housing difficulties influence healthcare in Sierra Leone

By Allieu Sahid Tunkara

Freetown, Sierra Leone’s capital is well known for its sprawling and congested slums which have become an eyesore to almost the entire citizenry of the country as disease outbreaks usually claim dozens of lives in such settlements. The clustered bungalows in these sprawling slums represent the symbol of leadership failure, coming out of the direct consequence of neglect by successive central and local government authorities.

These slums are inhabited by thousands of low income earners who risk their health to stay in such communities. The makeshift tents and roomlets are constructed in every empty space within the municipality because the people take advantage of the obvious weakness in the law. But they also do so out of desperation.

The 1991-2002 civil war worsened Sierra Leone`s housing problem. Many houses were destroyed. But also mass rural urban migration as a result of the unrest saw provincial dwellers flock into the capital. Many of made homes in these slims.

Consequently, over 50 slum communities are dotted across the ccity, mostly along the Atlantic Ocean.

No sooner had one person constructed a building without any action taken by the authorities than another person follows suit.

How to address this situation has been both an issue of political and socioeconomic concern.

Meanwhile the implications abound, particularly health-wise.

It is terrible to see five or eight people occupying a very tiny room. This overcrowding has even made it more difficult for the Ebola fight, as is indicated in persistent new cases in Moa Wharf and Magazine Wharf slums.

Cholera, which is now endemic in Sierra Leone, has always been a common feature in these slums whenever the bacterial disease breaks out, the latest being in 2012. Back then hundreds of these slum dwellers died to the disease. The huge death toll is normally the result of the poor sanitary standards.

No sanitary inspectors are seen in such communities to educate the people on basic hygiene standards that could save them from the grip of these communicable diseases. The most vulnerable groups in these slums are women and children.

Cyril Mattia, public relations officer of the Freetown City Council (FCC), said people build houses without going through the appropriate procedures of owning a house. Such a situation, he said, is one of the key factors that is responsible for the clustered nature of the houses that has given the municipality an ugly look.

Mattia acknowledged that this congestion has a negative impact on the health of the dwellers. And having painted such a terrible situation, the FCC mouthpiece was quick to defend his institution saying it is not the authorised body for issuing building permits.  ‘’FCC does not issue building permits,’’ he said.

Yet this situation has gone unchecked for years. Some people are even bold enough to construct houses beneath bridges and reside there. The tragic situation that led to the death of six people when the King Jimmy Bridge collapsed in 2012 bears testimony to the direness of the situation.

The bridge is situated within the heartland of the municipality at Wallace Johnson Street and is named after an eminent Krio trade unionist of the 19th century.

No governance stakeholder would evade responsibility of that incident by stating that they may have not been aware. The authorities only took steps to get the people off under the bridge after that incident. But it was too late and the incident had clearly exposed the weaknesses of the authorities who gambled with the people`s safety by bowing down to the indulgence of electorates.

That incident is just few of the tragic episodes that always befall these slum dwellers.

Most of these children in these places cannot access formal education for various reasons. Instead they are left to play at dustbins and filthy ponds running through their compounds.

Prior to the King Jimmy incident, I had an interview with the cartographer of the Ministry of Lands, Housing and Country Planning, Karim Kargbo, who stated that the government strongly frowned at people who reside in such congested environments considering the risk of contracting diseases. Kargbo said also that several settlements had been banned by government and that no one was authorised to stay in such areas.

“Government has banned Moa Wharf, Pipeline, Kroo Bay, Susan’s Bay, among others, because of the health and safety of the people,’’ he said, adding that people were just stubbornly continuing to stay there. He said they (peoples) came to their senses only when disaster stroke and kill them in large numbers.

Isatu Kamara, matron at the Connaught Hospital, told me that high population (more than two million people according to unofficial sources) in the city is partly to be blamed for the huge health problems in the municipality. This situation means that there is a wide gap between the number of health officials and that of the population in the city, she said.

Most times, during disease outbreaks, the medical staff is overstretched making it quite difficult to contain the spread of disease, she added.

Since government cannot sufficiently provide all the medical facilities for the teeming population of Freetown, as it has become evident, it is under obligation to design effective programmes of decongestion as a step. Such programmes must consider the provinces so that slum dwellers are attracted.

This article was published in collaboration with Ouestaf News with the support of Osiwa.

(C) Politico 30/07/15


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