icon icon icon icon icon icon icon

Cradle of Courage: a lone nurse in Sierra Leone bringing new life into the world

A woman wearing pink scrubs dances in the middle of a village.

Zainab in Mayossah, Sierra Leone. All photos: Nigel Barker/CARE

Zainab in Mayossah, Sierra Leone. All photos: Nigel Barker/CARE

We weren’t sure what to expect when we traveled the 50 minutes from the relatively large city of Makeni to rural Mayossoh in Sierra Leone to meet Zainab, a nurse at a maternal health clinic.

According to World Health Organization (WHO) the maternal mortality ratio in Sierra Leone was 717 deaths per 100,000 livebirths and the neonatal mortality rate was 70 deaths per 1,000 livebirths, both among the highest rates in the world (2023). Hemorrhage, and premature births and birth asphyxia were the primary causes, respectively. Blame has been placed on poor sanitation, limited access to care, and quality of that care.

The village of Mayossoh is so remote, it’s amazing there is a facility here at all. Given the statistics, it’s hard to imagine what would happen if it was not.

Thankfully, the women of this community and those surrounding it know they can come here at the most delicate time of their lives and receive the care they need.

Zainab with a patient in the maternal health hospital. All photos: Nigel Barker/CARE

When we arrived, we got a welcome from the community that was filled with joy and fellowship, with singing, drumming, and dancing that was infectious. We had to join as they came toward us.

In the middle of this crowd was the nurse in charge, Zainab, an unassuming, modest woman in a bright pink uniform. It takes her a minute to get used to the cameras and all the attention as we prepare to hear from her as a community leader. While we do that, the growing number of spectators seeks shade under a big, airy pavilion in the middle of the courtyard. Children gather and watch us get ready to interview Zainab.

Once she got settled, Zainab explained why she wanted to become a nurse.

“When I was young, I told my mother that I want to be a nurse because my father died of cholera. The cholera attacked my father at night. Then there was no way to help my father. So, when I grew up, I decided to be a nurse. But I suffered a lot before I have this job. Then I promised myself that I will help people so that they will not die like my father.”

It was far from easy for Zainab.

“Some people that have money, went to Makeni for their nursing studies. Some go to Freetown because they can afford to pay. But for me, I don’t have much. My parents are poor. So, that is why I attended at the Magburaka Maternal and Child Health Post, Faith College.”

This offered Zainab hands-on training as well as classroom learning.

Zainab poses with one of her patients. All photos: Nigel Barker/CARE

“During my studies in Magburaka, I have no phone. I have no food to eat in the morning. In fact, I have no food in the afternoon. I eat gari, go to bed. So, I suffered a lot.” [Gari is made from mashed cassava roots, then roasted or fried into crispy cakes.]

It took Zainab four years in her studies, but she was determined. “I don’t want people to die, especially the pregnant women. I want to help with maternal child health.”

The solar-powered clinic is a collection of tidy, well-organized buildings. There is a labor ward, a storage unit, Zainab’s office, and a small, neatly kept room where she stays if her attention is needed overnight. There is a big water tank and several handwashing stations dotted around the property.

“When a pregnant woman meets me the first time in this clinic, I appreciate her so much because she loves her life, and I love this life too, because during pregnancy, we have a lot of complications. So, if you show up in this clinic on time, then I will do all the necessary things to show that we will not have maternal death. We stopped having maternal deaths.. I’m happy for that.”

In a country with maternal death rates as high as Sierra Leone’s, Zainab has not lost a single mother.

Zainab with some of her maternal health clinic patients, or, as she refers to them, "sisters." All photos: Nigel Barker/CARE

As we’ve been speaking, the group of people in the pavilion has grown. Many are pregnant women; many are new mothers with their babies.

“They are all happy because when they give birth here, they all have their children and be it mother or child everyone is important, so I don’t want to lose any. Mothers are happy because we work together, I love them, they also love me. I don’t see the pregnant women visiting our Health Center as clients, I see them as sisters. “My joy has been the joy of mothers,” Zainab says. “[I am] happy to have served here without a maternal death.

I love dancing. I love encouraging people to do the best for their lives. I love reading. I care so much for people because we are human beings, we are all the same. We need to care for each other. We need to respect each other. We need to share some things in common.”

Back to Top