Much of Sierra Leone’s coastline consists of mangrove swamps, with the exception of the peninsula on which the capital city Freetown is located. The rest of Sierra Leone is mostly plateau (about 300 m above sea level) covered by forests, with mountains in the east of the country (highest point Loma Mansa, 1,948 m). The climate is tropical, with a rainy season from May to December.

Major cities are the capital Freetown, Koindu, Bo, Kenema and Makemi.

Sierra Leone is an extremely poor nation with tremendous inequality in income distribution. It does have substantial mineral, agricultural, and fishery resources. However, the economic and social infrastructure is not well developed, and serious social disorders continue to hamper economic development, following a 10-year civil war. About two-thirds of the working-age population engages in subsistence agriculture. Manufacturing consists mainly of the processing of raw materials and of light manufacturing for the domestic market. There are plans to reopen bauxite and rutile mines shut down during the conflict. The major source of hard currency consists of the mining of diamonds. The fate of the economy depends upon the maintenance of domestic peace and the continued receipt of substantial aid from abroad.

The Loretto Clinic in Makeni, Sierra Leone supported over 26,000 patient attendances in 1997 and is likely to see more than this every year. MOM began providing support to the clinic with medical supplies and a new vehicle to be used as an ambulance.

MOM has undertaken this assistance project in conjunction with Dr/Sr Ann Stevens, a St Joseph of Cluny Nun from Melbourne. Dr/Sr Stevens has been working in the area for the past three years.

The Loreto Clinic is a general outpatient clinic in Makeni, the provincial capital of the Northern province, Sierra Leone. It is owned by the Catholic Mission, administered by the Sisters of St Joseph of Cluny and is registered as a local NGO(Health) with the government of Sierra Leone.

The current administrator is Sr/ Dr Shirley Ann Stevens, a medical practitioner from Melbourne. The other eleven staff members are Sierra Leonean.

In 1997 there were over 26,000 patient attendances, with people coming from Nakoni and surrounding villages.

It is our aim to make the clinic self sustaining

However, the coup of May 1997 and the subsequent sanctions placed on the country, rampant inflation, non payment of government workers’ salaries and a large influx of internally displaced war victims into Makeni has resulted in an increase in the number of people unable to afford to pay for treatment. Our dream of self sufficiency will have to await the restoration of peace and economic stability.

The clinic is also a centre for an epilepsy management programme. This arose from the request of one man who asked if there was anything we could do for the people in the villages in his area who had fits. These people were suffering from epilepsy but, as this illness is generally believed to be due to devil possession, they have never presented to health centres for treatment. We began treating, the results were good, word spread and the demand for assistance grew. We were seeing people in villages up to 40 miles from the clinic. The demands have exceeded the clinic’s capacity to cope. Plans were being devised in conjunction with the District Medical Officer of Tonkoliti district, to train staff in rural centres in assessment and management of epilepsy and in addressing some of the negative community attitudes towards people with this disease. The events of 1997 put a halt to these plans. Insecurity on the roads and difficulty obtaining medications also meant we had to curtail existing services. With the re-establishment of the elected government in Sierra Leone we hope to revive this programme.

The clinic vehicle has been an essential item in enabling us to function effectively. A Toyota Hilux Double Cabin pick up, it proved to be reliable on village treks, to have the capacity to transport clinic supplies from the ports in Freetown and to double as an ambulance when necessary. Spare parts for ongoing maintenance were easily obtainable.

This vehicle was stolen by the fleeing junta forces during the disruption which led to the eventual overthrow of the junta by ECOHOG forces in February 1998. Subsequent attempts to locate the vehicle have been unsuccessful.

During 1999 there have been efforts to establish peace in the country as reported in world wide news. There is still much need for rehabilitation of the people adversily affected by war.