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Sierra Leone

Map of Sierra Leone

Sierra Leone is a tropical country on the West African coast. Despite great mineral wealth, Sierra Leone remains one of the poorest countries in the world. It is now rebuilding after a protracted civil war that ended in 2002. Sierra Leone is among the most dangerous places in the world to bear children.

Fistula Care supports activities at the Aberdeen Women's Centre (AWC) in Freetown. 

Program Results

As of September 2013 (since January 2007):

  • A total of 1,624 fistula repair surgeries supported.
  • The AWC provides on the job training in fistula and obstetric related topics to all its nurses on an ongoing basis. A core group of 27 nurses have received several trainings on fistula and obstetric related topics.
  • Thirteen surgeons have been trained in fistula care and repair, and six surgeons have received follow-up training.

News and Resources

Program Update: Multimedia Campaign and Fistula Hotline

Program Update: Midwives from Sierra Leone attend International Conference

Program Update: Maternity Clinic Opens at Aberdeen Women's Center

Technical Brief: Integrating Fistula Treatment and Prevention: The Launch of a Maternity Unit in Sierra Leone

Stories from the Field from Sierra Leone

Communications Materials developed in Sierra Leone

Profile of a Fistula Surgeon from Sierra Leone: Dr. Alyona Lewis

PBS's FRONTLINE/World published a video by Jenny Chu—Sierra Leone: Yeabu's Homecoming—about obstetric fistula in Sierra Leone. The 14-minute video focuses in part on Mercy Ships, one of EngenderHealth’s Fistula Care partners.

Supported Site


The Aberdeen Women's Centre (AWC) opened in April 2005 in the Aberdeen neighborhood of Freetown. Initially affiliated with Mercy Ships International, the AWC is now managed by the Gloag Foundation. It can accommodate 26 fistula patients in its wards. The AWC focused exclusively on providing fistula treatment services for five years. In April 2010, it opened a maternity unit offering emergency obstetric care in the hopes that the AWC can prevent obstetric fistula and decrease Sierra Leone’s alarmingly high maternal mortality rate. The AWC implements evidence-based practice (such as the use of the partograph) in order to deliver a high standard of care. Expert midwives offer on-the-job training and support for staff development. 

Program Activities

Strengthening services


The Aberdeen Women's Centre offers fistula repair to more than 250 women each year. Its two wards can accommodate 26 inpatients who are preparing for or recovering from obstetric fistula surgery. One theatre with complete anesthetic support is dedicated to fistula. Dr. Alyona Lewis is the AWC's surgeon, and at present she is the only Sierra Leonean resident surgeon offering routine fistula repair surgery. Post-operative women receive counseling, physiotherapy, and participate in life skills programs, covering basic numeracy, literacy, and crafts.

Screening teams from AWC travel up-country to identify women with fistula and invite them to seek treatment. Sierra Leoneans who have had their fistulas successfully repaired also serve as advocates who raise awareness about fistula. Women who have been discharged from the AWC receive information about family planning and vouchers for cesarean sections. The vouchers help these women after they have healed from surgery to have an affordable, successful delivery, if they are able and so desire.

Improving fistula prevention

The AWC maternity unit trains Sierra Leonean midwives to provide a high standard of care following evidence-based practice, resulting in safe and timely deliveries. The emphasis of the maternity unit is to prevent fistula and reduce maternal death. The maternity unit offers antenatal, intrapartum, and postpartum care, including an obstetric emergency care package. This includes ensuring access to quality cesarean section services through the provision of a 24-hour, on-call obstetric team. The AWC is developing an in-house family planning service in partnership with other agencies.