good morning Hank it's Tuesday this
video is about looking away and you may
need to look away at some point and I
totally understand that but I hope that
you'll stick with me
so when Sara and I went to Sierra Leone
we visited the only Hospital in kono
district Koidu government hospital which
has come a very long way like when
Partners in Health began supporting the
hospital in 2014 there was no consistent
electricity or running water the
maternity ward had a dirt floor there
was no emergency department no blood
bank no functioning x-ray machines after
the devastations of colonialism Sierra
Leone had never had much money to build
up a healthcare system but the system
was further weakened first by the Sierra
Leone Civil War and then by a horrifying
a bola outbreak five years later when I
visited kgh was a vastly different place
clean maternity wards a functioning
emergency department a laboratory to
diagnose illness and plentiful stocks of
medication to treat it along with many
well-trained health care workers and
this is reflected in child and maternal
health more safe deliveries fewer
stillborn babies and a dramatic
reduction in the so called decision to
incision time the amount of time between
when the need for an emergency c-section
is identified and when that procedure
actually happens because these are
emergency surgeries meant to save the
mother and babies lives the sooner the
procedure can happen the higher the
likelihood of a positive outcome and
just a couple years ago at kgh the
decision to incision time was often over
three hours today it is an average of
one hour eight minutes but the hospital
is still willful II inadequate there are
only 48 maternal beds to serve a
population of 500,000 people and there's
no NICU no incubators or ventilators
there's only very basic equipment to try
to save sick kids and when we were at
kgh I saw a mother with a young child in
the pediatric ward and without going
into details I think the child was
probably dying and I looked away I
looked away because I didn't want to
gawk and because I didn't know what I
could do in that moment to help and
because it was awful to see a mother in
that kind of pain and to see a child
suffering but there was also something
else I've worked in a Children's
Hospital I've held the hands of kids as
they died I understand that children
sometimes die but most kids who die
in Sierra Leone died of conditions we
know how to treat or prevent and most
mothers who died in childbirth died for
want of an ambulance ride or a blood
transfusion or an emergency c-section
these deaths are preventable and they
have been for decades six years ago I
made a video from Ethiopia called
looking away about the importance of
listening to and supporting people
living in absolute poverty six years ago
in those six years I had done some
things and given some money but I had
not made a serious commitment to listen
better or to focus on the needs of the
poor in an ongoing way so I wasn't just
looking at a child who was dying I was
looking at a child who very possibly
wouldn't be dying if I had understood
earlier the scope of the problem and
devoted more of my resources to
supporting the people who are solving
the problem and I think ultimately that
is also part of why I looked away again
I had understood in the abstract that
the maternal and child mortality crises
in Sierra Leone were emergencies but I
hadn't been treating them like
emergencies and now I was faced with the
consequences of that the truth was I
wasn't doing nearly enough with the
money and power and platform I'd lucked
into to support truly vulnerable people
and I'm still not doing enough but I am
trying to do more not just with my money
and with my time but also with my
attention on that front Partners in
Health Sierra Leone's annual report just
came out and even if you can't afford to
donate to their efforts to build and
support stronger healthcare systems for
the poor I really recommend reading it
because it is in many ways a very
hopeful document like one primary health
center supported by PIH the well body
clinic saw zero maternal deaths in 2019
for the third year in a row this in a
country where 1 in 17 women will die in
pregnancy or childbirth so the solutions
are happening just not yet across the
whole region access to mental health
care in kono has dramatically increased
people with cancer or type 1 diabetes
which until recently were considered
death sentences in kono are now being
treated PIH was also able to hire more
staff now employing over 450 people 96%
of whom are Sierra Leonean locally
nutritional supplements are decreasing
malnutrition and the maternal and
neonatal care team at kg H is hiring
nine new nurses and four new midwives
but as PIH is john Lasher told me Koidu
government hospital is the only place
within many hours where they're walking
driving or motorbiking where women can
receive an emergency c-section and that
puts tremendous pressure on a maternity
ward that is just totally inadequate
which is why PIH and the sierra leonean
ministry of health are working together
to build a maternal center of excellence
and a NICU at the hospital which will
more than triple the number of maternal
beds and also dramatically improve child
and maternal care and it cannot wait
that's why well the Ministry of Health
and PIH are going full speed on the
planning we are working very hard to
raise the money in total commitments we
are now close to thirteen million
dollars which is amazing but we still
have a ways to go so if you can make a
monthly or one-time donation at PIH org
Hank and John we would really appreciate
it also every dollar you donate will be
matched by generous people from within
nerdfighteria and if you want to join
the matching fund by making a donation
of $2000 or more there is a link below
to that as well
believe me when I say that I am talking
to every rich person who will take my
phone calls and doing whatever I can
think of to drum up money but ultimately
I think if this is gonna work it's gonna
work because thousands of people come
together to show solidarity with people
in Sierra Leone I hope for many of you
that solidarity can come in the form of
donations but it can also come in the
form of listening and paying attention
and reading annual reports or telling
your friends and family about these
efforts regardless thank you for being
here I know that the kind of complex
systemic long-term problems that demand
complex systemic long-term solutions can
be easy to look away from so thank you
for not looking away Hank I'll see you
on Friday