Rural Health Care Initiative
  • Partnering with Sierra Leone to save lives

Message from Dr. Paul Allwood at the October 29, 2017 Event

Good evening everyone, it’s an honor to bring you greetings from Minnesota Department of Health (MDH). Sophia and I are happy to be back with you and we congratulate RHCI for your success creating an international community of public health practice to improve health care for the people of Sierra Leone. Your efforts are marked by a clear vision, and a desire for service, and your sustained work is producing positive results for the people of Tikonko.

Construction of the Tikonko Birth Waiting Home (BWH) is a major accomplishment. The home will prevent the death of mothers, and save children from the terrible fate of entering the world without a chance to ever experience the love and care of their mothers. Extreme difficulties face any child that begins life without his or her mother, and we must do all we can to prevent that to the extent that we can. According to the United Nations. African mothers play vital roles in agriculture, trade, and other economic pursuits.  They are guardians of their children’s welfare and provide for them materially. They are also the household managers, providing food, nutrition, water, health, education, and family planning.

In light of this, losing 1 in 17 Sierra Leonean mothers in childbirth or to other pregnancy related causes is devastating for children, families, the economy, and the society at large. Maternal mortality in Minnesota:  Minnesota Department of Health is dedicated to a vision of health equity, where communities are thriving, and everyone has what they need to be healthy. We pursue that vision through the triple aims of health equity which are to: a. Expand the understanding of what creates health b. Support and empower communities to secure their own health; and c. Promote health in all policies with health equity as the goal.

Overall MMR (Maternal Mortality rate) in Minnesota is 21.6 per 100,000, which is much lower than the MMR in Sierra Leone, but there is a worrying increase in maternal mortality in Minnesota and across the United states. Maternal Mortality and other ADVERSE HEALTH OUTCOMES are linked to social, political, and economic disadvantages. Thus, not surprisingly, MMR in Minnesota is highest among people of color and other disadvantaged groups. MDH is working with various partners to systematically review maternal deaths in Minnesota and devise actions to decrease Maternal Mortality and achieve greater health equity for Minnesotans. Birth waiting homes can be successful.

RHCI is looking for support to take the next step in an amazing journey. They are asking all of us for help funding the operation of the BWH. The BWH concept has worked in other parts of the world, particularly where they are a PART OF A COMPREHENSIVE MATERNAL HEALTH PROGRAM.  MDH support RHCI in its mission to improve health in Sierra Leone through the BWH and other initiatives.

Sierra Leoneans and other members of the African diaspora are important members of the Minnesota community. They are partners with MDH on various public health issues, and we value their contributions to the MDH mission. We at MDH understand that conditions in Sierra Leone can have a direct impact on the Sierra Leonean community here. We therefore feel it’s fitting and important for MDH to support efforts that improve public health in Sierra Leone; and thereby, enhance the health of the community here.

In addition, MDH treasures the excellent partnership that was created with the West African community in response to the 2014 to 2015 Ebola outbreak, and we continue to look to that community for insights in achieving agency priorities in a number of areas. On that note, I want to recognize the people of Sierra Leone for their resilience. Theirs is a story of determination, courage, and hopefulness despite extreme hardships such as: The lowest life expectancy in the world; Almost 9,000 illnesses and 4000 deaths from Ebola between 2014 and 2015; and  1 out of 17 women dying as a result of pregnancy or child birth (worst in the world).

We can all do something about maternal mortality in Sierra Leone, and Sophia and I are pleased to have the opportunity to play a small role in that. We are connected. We are in an increasingly connected world. Information travels fast, and people are crisscrossing the globe with amazing rapidity too often to escape the ravages of racism, war, persecution, disease, and hunger. Geographic separation is an illusion, and despite the attitude of some in leadership, it is unrealistic to assume that a country can simply shut its doors, or build a wall, and disconnect from the existential problems of the world such as global climate change.

Immigration, communication, and trade are essential for world peace, economic development, and global environmental health.  I’m therefore pleased to see people using the power of the internet and social media to connect us in the most amazing ways. Beauty from complexity. Unfortunately, despite this growing connectedness, poverty is rampant throughout the world, and far too many people experience extreme suffering on a daily basis due to poverty and lack of opportunities.

The gap between the super-rich and the super poor is widening at an alarming rate.  While the poorest 10% of humanity subsist on US$1.90 per day, the 62 richest people in the world have more money than the poorest 3.6 billion. Income and wealth inequality is a global wicked problem. “Wicked problem” doesn’t mean it’s an evil problem. It means it is a problem that is exceedingly difficult or impossible to solve. However, WICKED PROBLEMS can be tamed by simple rules!

In the words of Mathematician Benoit Mandelbrot who discovered the infinitely complex and yet infinitely beautiful geometric shapes that come from the Mandelbrot set. “Bottomless wonders spring from simple rules repeated without end.” Simple rules for public health.

Tonight, I would like to offer a set of simple rules that can help transform public health, advance health equity globally, and enhance the health and wellbeing of MOTHERS in Tikonko. They are:

  • Work with communities on “their” solutions, not “our “solutions;
  • Practice humility;
  • Challenge assumptions;
  • Practice kindness.

I hope you will all start following the last rule tonight with a kind donation to the RHCI for the Tikonko Birth Waiting Home.

Ladies and gentlemen, Sophia and I are happy to be here tonight, and thank you all very much for the chance to address you.


{edits by Carol Nelson}

Carol Nelson

Executive Director

Carol Nelson MD is a retired physician from the U of MN Boynton Health Women's Clinic and St. Paul Primary Care Clinic with 38 years of primary care experience. In 2013, 2015 and December 2016-January 2017, she traveled to Tikonko in Sierra Leone. During the recent trip, she facilitated a Helping Babies Breathe training session for the Traditional Birth Attendants in Tikonko Chiefdom. Dr. Nelson is currently pursuing her Master's of Public Health at the U of MN School of Public Health, with a focus on Global Health.

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