Sierra Leone is one of seven countries in sub-Saharan Africa where more than a quarter of the population is infected with malaria at any one time, according to the World Malaria Report (World Health Organization 2016), with nearly three in ten Sierra Leoneans suffering from the disease. Malaria contributes to an estimated twenty per cent of child mortality, and is the cause of nearly four in ten hospital consultations country-wide. One of the biggest killers in the country, the population is faced with an everyday emergency, with cases peaking during the monsoon months.
Malaria is also estimated to cost Africa $12 billion every year through treatment, purchase of drugs and supplies; public health interventions against malaria, lost days of work with resulting loss of income and lost opportunities for joint economic ventures and tourism. To combat malaria in Sierra Leone, during June 2017, the country distributed a national record number of treated bed nets (4.3 million) in a country-wide campaign targeting every household, with funding through UNICEF from UK aid and the Global Fund.
“Her death is a still a shock to me and the children. We didn’t expect her to die of this sickness,” said Abdulai “We were married for 25 years and she was very devoted to our family. She didn’t mind making sacrifices just to make us happy.”
From left, Abdulai and his sons Amidu Koroma, 18 years old and Ibrahim, 22 years old at their home in Kenema, Kenema District, Sierra Leone on June 3, 2017.
“My mother’s death is affecting me a lot because she was the one providing most of my school needs. I am trying to be ok but it is not easy. I have even just been driven away from school because I owe school fees. I am not sure how I am going to get money to support myself and meet my school needs. I want to be lawyer after I complete school but I wonder if that will happen without my mother.” Amidu Koroma, Kadiatu’s 18 year-old son.
Abdulai Koroma, centre with his son Ibrahim, 22 years old and aunty Aminata visiting the grave of Addulai’s wife who died two weeks before from malaria in Kenema, Kenema District, Sierra Leone on June 3, 2017.
Abdulai’s wife and the boys’ mother Kadiatu died of malaria 2 weeks before. When Kadiatu fell ill, her condition wasn’t serious so they tried to look after her at home. After three days though, her condition worsened so they decided to take her to hospital. Mariama was diagnosed with severe malaria at the hospital but she didn’t survive.
Kadiatu Juo, 36 years old with her two daughters Francesca Juo, 9 years old and Alfreda Juo, 3 years old in Kenema District, Sierra Leone on June 6, 2017.
“On a Saturday, a few days after he had taken his National Primary School Examination (NPSE), he had fever. He was vomiting a lot so we took him to hospital the next day because he had become very weak. They tried to treat him there but unfortunately he didn’t survive. He was exposed to mosquito bites because he wasn’t sleeping under a bed net.” Kadiatu Juo, George’s mother
Alfred Juo looks through a book of illustrations that his deceased son George drew at the family home in Kenema District, Sierra Leone on June 6, 2017. George was 12 years old and died of malaria.
An illustration of George, 12 years old who died of malaria at his family’s home in Kenema District, Sierra Leone on June 6, 2017. George was 12 years old and died of malaria.
Alfred Juo walks with his daughter Francesca Juo, 9 years old in Kenema District, Sierra Leone on June 6, 2017. Alfred’s 12 year old son George recently died of malaria.
Alfred Juo, 42 years old at their home in Kenema District, Sierra Leone on June 6, 2017. ”George was very helpful in the house. He helped look after his younger siblings. He was also very studious and wanted to become a banker in future. We believed in him. We were looking forward to see how he would turn out as he grew older and were hoping he would do well and help look after us when he got older. But all of that has been crushed because of malaria.” Alfred Juo
George Juo, 12 years old, recently died of malaria at home in Kenema District, Sierra Leone on June 6, 2017. Kadiatu’s 12 year old son George recently died of malaria.
“George was very helpful in the house. He helped look after his younger siblings. He was also very studious and wanted to become a banker in future. We believed in him. We were looking forward to see how he would turn out as he grew older and were hoping he would do well and help look after us when he got older. But all of that has been crushed because of malaria.” Alfred Juo, George’s father.
A family collects water during a heavy downpour of rain during the rainy season in the town of Kenema. Cases of malaria peak during the beginning and end of the rainy season, in May and November.
Mabinty and Lamine hang out a mosquito net to air before installation in their home in in the village of Gondama, Bo District, Sierra Leone on June 3, 2017. They received the mosquito net that morning during a nationwide bed net distribution supported by UNICEF and UK Aid funding.
From left, Mabinty Koroma, 15yrs old, 9 months pregnant and Lamine, 19 years old at their home in the village of Gondama, Bo District, Sierra Leone on June 3, 2017. Mabinty has had repeated bouts of malaria. Both Mabinty and Lamin have never had mosquito nets which they say has always left them exposed to mosquito bites.
Hawa Conteh, 8 years old being treated for malaria at the hospital in Kenema, Kenema District, Sierra Leone on June 7, 2017. She was admitted by her mother Fatmata Barrie sitting alongside her. Hawa was admitted to the Kenema Government Hospital to get treatment for malaria on 6 June 2017. She fell ill on the fifth and has been missing classes since.
“I feel bad that she is missing school and I also can’t go about my regular business. She often gets sick with malaria and each time she has it, it lasts for between a week and ten days. And most times she has to be admitted to hospital so she can recover,” said Fatmata Barrie, Hawa’s mother.
A photograph of Mariama who died 6 months before of malaria.
Tamba Lahai, 65 years old at his home in Kenema, Kenema District, Sierra Leone on June 3, 2017. “I miss my wife a lot. She used to take care of me. She cooked, laundered, cleaned the house etc. She even used to help look after our young grandchildren which made it more convenient for them to go about their business. But her death has changed everything.” Tamba Lahai
Kamanda Lahai in his bedroom in Kenema, Kenema District, Sierra Leone on June 6, 2017. Kamanda’s grandmother, Mariama died six months before of malaria. “Losing her has been tough for us. We miss her love and care. Our grandfather had retired so she was more or less the breadwinner,” said Kamanda Lahai, her 27 year-old grandson.
Mariama had severe malaria and was admitted to hospital on 12 January 2017. She did not survive and died on 21 January 2017. According to surviving family members, she was very concerned about the welfare of her family especially her husband, children and grandchildren and made extra efforts to make them comfortable.
A busy commercial street lined with markets and pedestrians in Freetown, Sierra Leone on June 8, 2017. The economic impact of malaria is estimated to cost Africa $12 billion every year. This figure factors in costs of health care, absenteeism, days lost in education, decreased productivity due to brain damage from cerebral malaria, and loss of investment and tourism.
Abiatou Patrick, 29 years old at the general hospital in Kenema, Kenema District, Sierra Leone on June 4, 2017. Abibatu who lives in Tongo is currently recovering in hospital after undergoing cesarean section. When she was 7 months pregnant, she had malaria. She was treated and it subsided. She said she was feeling sick just before she was due to give birth and she tested positive for malaria when she went to hospital. “I just completed a dose of malaria medicines. I lost my baby but I am thankful that I am alive,” she said. “Malaria really disturbs my day to day business whenever I get sick with it. I feel weak, sweat a lot and my joints really ache. It takes a couple of days for me to recover. I can’t go out to sell my goods during that period and my children suffer to get food and other things.”
Iye Abu, 25 years old holds her one week old baby Abu at the general hospital in Kenema, Kenema District, Sierra Leone on June 4, 2017. Iye Abu is from Yawei village in Kenema district. She tested positive for malaria when she came to the hospital to give birth. Though she was put on malaria treatment her blood pressure went up so the doctors didn’t want to put her through the risk of having a normal delivery. She therefore had to undergo a cesarean section.“I was really feeling sick. I was scared about losing my baby. I was also afraid that something bad could happen to me. I have had malaria a number of times. Each time I have it, I have fever, headache and sometimes I even shiver. I am a farmer but I don’t go to my farm when I get sick because I normally feel weak during those times. My family suffers when that happens during harvesting time because I can’t make money to support them,” said Iye
Mbalu Kallon, 23 years old with her daughter Nancy Fomba, 4 years old in the village of Giema Dama, Kenema District, Sierra Leone on June 5, 2017. Mbalu has two kids and is currently 8 months pregnant with her third child. Mbalu just completed her malaria medicines. She farms rice, corn, cucumber, sesame, beans etc. with her husband. She has however not been able to help her husband out on the farm she fell ill. “When I was sick, I was feeling weak so I spent the whole day lying down. I lost appetite, I had fever and I couldn’t work at all,” she said.
Malaria infection during pregnancy is a significant public health problem with substantial risks for the pregnant woman, her fetus, and the newborn child. Malaria-associated maternal illness and low birth weight is mostly the result of Plasmodium falciparum infection and occurs predominantly in Africa.
Adama Kamara with her daughter Miatta Sannoh, 7 months old under a mosquito net at her home in the village of Giema Dama, Kenema District, Sierra Leone on June 5, 2017. Miatta recently came down with malaria. Miatta’s mother Adama said she had fever so she decided to take her to the health center. She tested positive for the parasite and was immediately put on medication. “I have not been able to work on the farm for the few days she has been sick. I am supposed to be weeding now but I can’t because I need to take care of her,” said Adama.
Women walk through a flooded street to pray at a market in Freetown, Sierra Leone on June 8, 2017. Cases of malaria peak during the beginning and end of the rainy season, in May and November.
“I have missed a week of classes. That’s a lot, especially at this time of the academic year. I have to manage to go back to school next week because my school mates are preparing for exams now.” Alhaji Mamoud Sow.“He was complaining about joint pains and weakness. I gave him Panadol but he didn’t feel better. On the 2nd of June, I came home from prayers and found him lying on the bed unconscious. I and his sister rushed him to hospital. I was really scared when I came in and saw him unconscious. I was scared he was not going to survive. I am really grateful for the care he received at the hospital. He was unconscious for 4 days before gaining consciousness again. He is a JSS 1 student at the Anzarul Islamic Secondary School and he has now missed school for one week,” said Sajor Sow, Alhaji’s father“I am a business man and his being sick has affected my business a lot. I have not been able to go out and do my business the whole time he has been sick,” he added.
Alhaji Mamoud Sow, 15 years old with his father Sajor Sow at the family home in Freetown, Sierra Leone on June 8, 2016. Alhaji spent 4 days unconscious in hospital when he contracted malaria.
Alhaji Mamoud Sow, 15 years old with his father Sajor Sow at the family home in Freetown, Sierra Leone on June 8, 2016. Alhaji spent 4 days unconscious in hospital when he contracted malaria.
Children play alongside a rubbish strewn river through Kroo Bay, a slum area in in Freetown, Sierra Leone on June 8, 2017. Malaria and poverty are intimately connected with those least able to afford preventative
measures and medical treatment feeling the impact of the disease.
