Four years ago, Ms. Isata Dumbuya moved from the UK back to Sierra Leone to bring her 20 years of experience as a midwife to her native country. She wanted to contribute to the prevention of high maternal mortality.
“Midwifery in the UK opened my eyes. In class, we talked about the high rate of maternal mortality in Sierra Leone. I was hearing it from my relatives there too. It gets to a time where you say, ‘I need to go back. I can and I must.’” When she first returned, most of the basic systems and health supplies that Ms. Dumbuya was used to were lacking and she knew that she needed to adapt her thinking to a different reality. This included power outages, unreliable supply chains and a shortage of basic equipment–all contributing factors to the high rates of mortality.
“In the UK, it’s a safe space. You have support, resources, skills, a network, proper facilities and then you come here, and you are it! I wanted us to have the same standard of training that we take for granted in the US and the UK. This makes what we’re doing worthwhile, having a plan for the future.”
Through her work in Sierra Leone with Partners in Health, she and her dedicated maternal and neonatal team launched a project to build a Maternal Center of Excellence–a state-of-the-art teaching hospital dedicated to women and children.
“I spend my days trying to figure out what needs to be sorted out and improved. It’s important to celebrate the moments that went fantastically well. They could be small things, but I am there to make sure that we learn from them, and continue with those improvements.”
One of her first interventions at the Koidu Government Hospital in Kono, where she works, was to install a simple school bell, which could alert staff to emergencies. Since then, Ms. Dumbuya has worked hard to introduce a range of new measures towards her goal to establish resilient systems. “When I first came here, I was going to change everything in 18 months, but you have to be invested for the long haul to be making a substantial difference. Short sharp fixes are not useful in places like this. They are not sustainable.”
Ms. Dumbuya has led numerous trainings, built partnerships with government stakeholders, supported the opening of a special baby care unit, a high- dependency maternity unit and a new adolescent and youth-friendly services clinic. She believes that other countries have something to learn about her experience in Sierra Leone, particularly in relation to working within the community. “The country has been through Ebola, landslides, war and other crises and it’s changed how people think about healthcare. The trust is not there. It puts people off coming to hospitals. They are fearful about the lack of services and resources. So instead, women go to traditional healers, take behind-the- counter medicines, and have unsafe deliveries.”
Ms. Dumbuya has deliberately worked alongside Traditional Birth Attendants (TBAs) in Sierra Leone, recognizing their influence in the community and using that trust to invite them to refer mothers for hospital care.
“You have to find a way to work with what you do have, and make it work for what you want. Not working with TBAs here would just push that system further underground creating an ‘us’ and ‘them’ dynamic, with patients caught in the middle.”
Being a mother of five is important to Ms. Dumbuya but it also brings a unique perspective to her work. “It brings out the best in me. That motherly part of me that likes to nurture and see things grow. I’m a mother to 550 people in my place of work! People will work with you when you are like that”.
