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Mortal Beloved

The extreme perils of motherhood in Sierra Leone

Lynsey Addario

Fifty thousand people died in Sierra Leone’s brutal eleven-year civil war, which ended in 2002. Since then, thousands more have died in a lesser-known scourge: childbirth. Sierra Leone has the third-highest maternal mortality rate in the world; one in 23 women dies as a result of pregnancy. Many of these deaths are entirely preventable. In a country of six million people, there are only three obstetricians and less than 300 trained doctors. But in 2010, the government announced that all pregnant women would receive free health care, while Doctors Without Borders began offering free emergency obstetric care at the Gondama Referral Center Hospital in Bo district. Already, these two programs have reduced the maternal death rate in Bo by 60 percent. Still, for thousands more women, like 20-year-old medical student Zainab Conte (below), motherhood remains a war zone.

After giving birth at a local clinic known only as “Mile 91,” Conte started hemorrhaging. She was eventually admitted to Gondama, but went into a coma.

Villagers prepare to bury an infant who died one day after being born.
Many women have to walk for miles in order to reach a medical facility.
 Conte “bled so much that there just weren’t enough red blood cells in her blood vessels to transport oxygen to the brain,” said one doctor at Gondama.
Conte's mother-in-law and sister watched over her for five days until she died.
Manu Abu, 21, a high-risk patient, is in labor at Gondama after being brought there by ambulance for a cesarean section.
 Doctor Betty Raney (left) tries to revive Conte as her condition worsens. Conte’s 27-year-old sister, Kadiatu Bangura, faints after realizing her sister is near death.
Cecilia, a trained midwife, delivers the baby of Baindu Mansaray, 32, at the Gondama clinic.