14 May 2012

After Sierra Leone joined IHP+ in 2010, national Civil Society Organizations were invited to apply for funding through the Health Policy Action Fund (HPAF). The Shepherd’s Hospice Sierra Leone, an organization on the outskirts of...

After Sierra Leone joined IHP+ in 2010, national Civil Society Organizations were invited to apply for funding through the Health Policy Action Fund (HPAF). The Shepherd’s Hospice Sierra Leone, an organization on the outskirts of the country’s capital Freetown, was successful and received some funds. During a visit to Sierra Leone in June 2011, HPAF Manager Tobias Luppe from Oxfam spoke to the organization’s Executive Director Gabriel Madiye about civil society engagement in health policy.

What is the Shepherd’s Hospice Sierra Leone?

“We are a palliative care service provider, looking at how patients with chronic illnesses such as HIV, TB and cancer and suffering severe pain can access treatment. For example, we make sure they can access morphine, which is very important in pain relief. Until recently relieving patient’s pain with morphine’s, for example, was impossible, since Sierra Leone did not allow us to import the drug. Through advocacy we have managed to overcome this bottleneck.”

How did you – being a service delivery organization – become a grantee of Health Policy Action Fund?

“This is very interesting. There had been questions on our minds, all the time, in terms of what we can change in the individual life of a patient, and what we can change in community life, and what we can change at the national level. As a service-providing institution we have been working in loose alliances. With the grant we have now created the coalition called People’s Health Alliance and can form ourselves into the People’s Health Movement Sierra Leone Chapter. We look forward to having a secretariat where we can really engage policy makers, to work with them and hold them accountable, so that vulnerable and poor patients don’t fall through the cracks of public health.”

How does your advocacy work in practice?

“It all starts with empowering patients. Much of the advocacy has been health-care worker centred, driving the agenda of the health care worker and his institution. This time we have included patients and their families into our alliance. Our policy monitoring and advocacy exercise is patient-centred and even patient-led.”

What has your experience been so far?

“Before, we have often had problems and thought we could handle them alone. Especially when it came to engaging with policy makers, the people who have the statutory responsibility to make sure that health care is provided against the background of pro-poor response. They should promote equity and quality! When we are service providers, we find it difficult to hold them to account because they are our partners. But working in a coalition, together with patients, I think we can hold them to account. Not as individual organizations but as patients, citizens of the Republic of Sierra Leone.”

How has the People’s Health Alliance engaged in policy in Sierra Leone?
“We try to empower patients and support groups to be represented at District AIDS Committee Meetings. These are very influential committees working to actualise government policy at district level. We are also working with the same support groups to be represented in the Global Fund’s Country Coordinating Mechanism. Being able to go public and talk about how their rights to receiving treatment are respected is important.”

What are you currently busy with?

“We urgently need to ensure access to treatment for TB patients. We have come to realise that there are not TB drugs in the country! As a service provider TSHSL has established 22 TB treatment – DOTS – Centres across Sierra Leone. Every morning I am receiving calls that those DOTS Centres are running without TB drugs. We had to summon a Civil Society Consultative Meeting on the 14 and 15 of June 2011 and we issued a press release. And in a matter of weeks we will be on the streets demonstrating, letting the Government know that indeed access to TB drugs is a fundamental human right. Without that, patients will die.”

Are policy makers listening?

“They will. This is a sovereign and democratic country where the government is well meaning; especially when it comes to health. If there are problems with resources, we have to show understanding, but not to the detriment of human lives.”
What are your plans for the future?

“I plan to build a larger coalition. The grant from the HPAF has allowed us to learn how to build a strong civil society coalition. And I think we have learned a lot. And now my wish is that we grow further so that individual members of the coalition specialise in different aspects of health policy monitoring. My personal wish for Sierra Leone is that we reduce infant and maternal mortality so that children will be born to mothers and not be expected to die.”

Categories: Sierra Leone

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