Sierra Leone

In September 2015 the Ebola Response Consortium (ERC) and the Directorate of Environmental Health Sanitation in the Ministry of Health and Sanitation, with support from UNICEF, conducted a nataionwide assessment on WASH infrastructure in health care facilities. The assessment indicated that a large proportion of health care facilities in Sierra Leone have poor or limited WASH services.

This confirms what was found by WHO during a rapid assessment of WASH infrastructure in the Tonkolimba Chiefdom of Kambia district during the Sella Kafta Ebola outbreak.  Kambia was one of the districts most affected by Ebola due to a range of factors including uncontrolled movement within the country, loose borders, and because the district served as a trade hub for informal trading between the two countries, with most of the goods from Guinea destined to Freetown and some parts of the country.  WASH facilities were in a deplorable state, with non-functional water supply sources, broken brick incinerators and dilapidated pit latrines. Of the four health care facilities (CHCs) assessed  in the Chiefdom, only one had a functional hand pump (with the average time a pump remained broken being 5 months), none of the facilities had a functional incinerator and only two burn pits. All four facilities had unimproved pit latrines.

Partners working on WASH in health care facilities in Sierra Leone include:

  • ERC (a consortium of NGOs);
  • The Urban WASH Consortium (acting in the Western District, Freetown);
  • International Medical Corps;
  • Partners in Health;
  • UNOPS (involved in the rehabilitation and construction of low cost incinerators in 22 government health care facilities, as well as water supply rehabilitation, drilling of boreholes etc.);
  • UNDP (supporting the improvement of health care waste management by installing autoclaves and shredding machines in four health care facilities in Freetown);
  • WHO (supporting policy development, and currently developing a Household Water Treatment and Safe Storage Plan for the country).

The key to sustainable interventions of WASH in health care facilities in Sierra Leone is an integrated approach focused at the basin and regional level. Integrating clinical Services, Infection Prevention Control (IPC) and Environmental Health will provide opportunities for addressing key problems facing health care facilities and communities. 

Due to climate change, the region is increasingly prone to floods and as a result of poor early warning systems and a lack of infrastructure, the risk of water-borne disease-related outbreaks is likely to increase. Integrating disease surveillance, IPC and environmental health should be a priority to improve conditions in the 1022 health care facilities and 22 government hospitals currently in Sierra Leone.

WASH FIT in Sierra Leone

With support from Save the Children, the District Health Management Team in western, rural Sierra Leone  are running training on WASH FIT in 20 primary health units. WASH services in these 20 PHUs have recently been renovated. The WASH FIT guide is being adapted to suit the local context.


Updated 4th January 2016