In Tonkolili district, Sierra Leone, Médecins Sans Frontières/Doctors Without Borders (MSF) works together with the Ministry of Health to provide healthcare to pregnant women and children under the age of five. Our team does this by supporting the Hinistas community health centre in Mile 91 town and 12 peripheral health units in villages across the district.
Healthcare is more than access to medicine and medical personnel. Clean drinking water and healthy hygiene practices also play a role in promoting and sustaining people’s overall health. Of the 12 communities where MSF supports peripheral health units, seven did not have safe drinking water, especially during the dry season, and most relied on rivers and swamps for water for daily activities.
Sierra Leone as a country has limited available water and sanitation services. 23 per cent of the country’s population does not have access to basic water services and approximately 58 per cent are using unsafe water sources like rivers, dams, and unprotected water wells, according to a 2023 report from UNICEF and the National Institute of Health. Access to clean water is especially challenging in rural areas of the country, where most people rely on hand dug wells and surface water.
“We get our water from the swamp in our farm or the Pampana River, which is a few minutes away from our village,” says Aminata, a resident of Masiperr village. “We know the water is dirty, it is brown. But we don’t have another option. We have to drink, cook, and bathe.”
Communities have faced various disease outbreaks like scabies, typhoid, and diarrhoea because of the inadequate supply of clean drinking water and unhygienic practices.
“Most people in these communities use a bucket to fetch water from these sources and will leave the water in the bucket for a few hours, hoping that the solid particles floating in the water will be settled at the bottom,” says Sheku Jabbie, MSF’s health promotion supervisor in Tonkolili district. “After a few hours the colour of the water will be clear and then they will drink the water taking caution not to rock the bucket, so the particles don’t float to the surface. This has become a common practice.”
This was not always the situation. Many people had access to hand dug wells a few years ago which were constructed by individuals from these communities or private organisations. These wells provided water throughout the year. But now, due to multiple factors, including climate change, the wells are not as full as they used to be during the rainy season, and they are dry the rest of the year.
“We used to receive so many cases of diarrhoea in the clinic and this is because of the water that is being used here in the community,” says Aminata Bangura, a Ministry of Health nurse working at the Masiperr peripheral health unit. “Even we the health workers use it in the clinic, but we first boil the water or use the water filters. These filters are not enough to serve the entire community.’
To address these challenges, MSF drilled seven boreholes in Tonkolili district, complete with hand pumps next to the peripheral health units of Masengbeh, Foindu, Petifu Fulamasa, Makondu, Makeni Rokefullah, and Masiperr villages, as well as beside Ester’s clinic in Mile 91 township. The boreholes were completed in June 2024 and will serve as a reliable and safe source of drinking water for years. They were drilled during the dry season after a geophysical survey was done to ensure that they are optimally placed to produce safe water and at a depth that will ensure communities have access to water throughout the year.
Water samples from each borehole was sent to the National Water Quality Laboratory in Freetown to ensure that it is safe for use. The results showed that the water passed the World Health Organization’s recommendation for safe drinking water.
MSF has begun training members of each community where boreholes were constructed to fix minor faults. Additional trainings will be focused on how to operate and maintain the boreholes. Repair toolkits, including spare parts, will also be provided to the communities. With one of the targets of the Sustainable Development Goals being to ensure availability and sustainable management of water and sanitation for all by the end of 2030, more needs to be done to support this effort.
“These boreholes belong to the people,” says Mohamed Kuyateh, MSF’s water and sanitation supervisor. “They are here to serve them for a very long-time. We want communities to be equipped to ensure the boreholes can do that.”
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Notes:
MSF has been working together with the Ministry of Health in 12 peripheral health units in Tonkolili district, Sierra Leone, to provide free healthcare for pregnant women and children under the age of five. MSF works in the chiefdoms of Yoni Mabanta, Yoni Mamaila, Malal, and the Hinistas community health centre in Mile 91 town. MSF also works in the Magburaka government hospital, where patients with severe symptoms are referred from Hinistas community health centre.
