Sierra Leone: Introduction to prevention

Towards the introduction of a sustainable cervical cancer screening and prevention programme in Sierra Leone

We are starting a new project in Sierra Leone. We are working closely with an experienced local partner in the city of Makeni and the Bombali district to train nurses and screen women in the local health centres. Sierra Leone is still in the early stages of screening and this project will give it an important boost. We are very pleased that the Ecclesiastical Foundation of the Franciscan Sisters of Charitas made this new project possible.

The Republic of Sierra Leone is located in West Africa and has a population of over 7 million. Economically, Sierra Leone is one of the poorest countries in the world. Although Sierra Leone is politically stable, the country is still recovering from a civil war and suffers from a lack of resources and well trained personnel.

The under-five mortality rate is one of the highest in the world and life expectancy is estimated at around 50 years. A devastating civil war lasted from 1991 to 2002. Since then, the country has been recovering economically and the health system is gradually improving nationwide. The Ebola outbreak of 2014-2016 marked a devastating disadvantage in the development of the health system as many well-trained medical professionals died as a result of Ebola. For example, several doctors died of the disease, while the number of doctors was already one of the lowest in the world at 2 per 100,000 population.

According to the WHO, cervical cancer is the most common cancer among women in Sierra Leone, but the actual national incidence is unknown, as diagnostic methods and treatment options for cancer are very limited and reliable national data on cancer incidence is lacking.

Sierra Leone was also hit by the Corona crisis in 2020. Countries like Sierra Leone with fewer resources and limited capacity for intensive care were quick to implement and enforce strict lockdowns to stop the spread of infection before their health systems became overwhelmed. This response affects the availability of essential health services, especially for women. It is important that women are protected from the indirect effects of the COVID-19 pandemic and that we learn from successful examples of continuing to provide access to preventive health care, including in and after crisis situations. This is one of the reasons why we value our cooperation on this project, as they are both working in the frontline in crisis situations and also working on structural health care projects.

We are cooperating with the experienced local partner World Hope International( With this, we have a very strong partner that does several health projects in Sierra. Sierra Leone is in the early stages of cervical cancer prevention and we want to set a good example of practical, efficient and effective screening and treatment. We can back this up with FCF's years of experience in projects worldwide.

An important part is the education of the local population and the proper introduction of the programme. It is essential to address persistent myths about cervical cancer with the right message, repetition, using women's stories of experience and using different media, including radio broadcasts. Involving influential people in the community and using existing local structures to spread the right news about HPV infections and that all women are at risk of cervical cancer precursors is also important. Involving men in education is also crucial.

For this project, we work together with existing government and private hospitals - so no separate private health centres, which is an important condition for long-term sustainability. The aim is to train local health workers so that they have the right knowledge and experience to carry out the screening and to further train other health workers. In addition, it is important to involve the local health structures and government in the design and implementation of the project so that it can serve as an example for projects they start themselves.