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Sierra Leone's First Lady Takes On Health Care


Like Zimbabwe, the West African country of Sierra Leone is a place potentially rich but impoverished. In its case, much was destroyed during a long civil war. Though the fighting ended seven years ago, Sierra Leone still ranks at the bottom of the U.N. Human Development Index. Today, Sierra Leone's first lady and 13 other African first ladies are meeting here in Los Angeles to talk about health issues. Sia Koroma sat down with us in Beverly Hills, a place about as different from her homeland as you can get.

Ms. SIA KOROMA (First Lady, Sierra Leone): We have a Herculean task of inheriting a poor health care system. My role as a first lady has been involved with fighting our infant and maternal mortality, which I'll describe as a high or highest in the world. So I do a lot of health work. I do a lot of gender empowerment, education. And I reach out to rural women.


MONTAGNE: Beyond the high, in fact, highest in the world mortality rate, as you say, according to the U.N., 87 percent of Sierra Leoneans live below the poverty line. How much does poverty play a part in those early deaths and then how much does it add to the burden of your challenge in trying to combat this?

Ms. KOROMA: If we have a basic fabric or fabrics that eat up the society, I always categorize them into illiteracy and poverty. Yes, indeed, we have one of the highest illiteracy rates in the world. But we are not sitting back and allowing it to go higher and higher. And then the poverty, we all know the economists are working very hard. And we are making every effort to empower rural women to have independent living.

MONTAGNE: What is the case out there in rural areas - I mean, do they have any health care at all?

Ms. KOROMA: Yes, they do, but invariably it's poor. They have difficulty of accessing healthcare because most of the infrastructure was destroyed after the 11-year civil war. So accessibility is a problem. Affordability is another. And when it is available, having enough personnel to man these health centers is another problem.

MONTAGNE: Am I correct that your profession has been as a psychiatric nurse?


Ms. KOROMA: Yes, that's my other profession.

MONTAGNE: I was asking that partly because I would think you might be specially positioned to speak to the question that's out there that civil war in Sierra Leone that went on for more than a decade was especially brutal…

Ms. KOROMA: Yeah.

MONTAGNE: …and some pretty terrible things happened, including children conscripted as soldiers, people having their arms, their limbs cut off. Is there still a fair amount of psychic damage that has to be repaired?

Ms. KOROMA: Yes, there are still relics of the war. It has affected our infrastructure. As a result, people are demoralized. We have a group of people who are traumatized. We have rape victims. We have amputees. Yes, there are still scars of the war evident, and using my profile as first lady to make a difference, and being a psychiatric nurse, I think I'm most suited for that role.

MONTAGNE: In your case, do you turn to President Koroma and say to him, you have to do more?

Ms. KOROMA: Yes, I do. He supports me, he supports every bit of my work. He does listen to me, especially in the health area.

MONTAGNE: Thank you very much for talking with us.

Ms. KOROMA: Thank you too.

MONTAGNE: Sia Koroma is the wife of Sierra Leone's President Ernest Bai Koroma. She's with a group of first ladies from Africa meeting today here in Los Angeles to talk about and publicize the challenges of getting healthcare and education to their people. Transcript provided by NPR, Copyright NPR.