Sierra Leone: When the Poor Can't Pay, They're Left to Die

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The Silent Betrayal of Sierra Leone’s Sick and Poor: When Healing becomes a privilege.

In a nation that promised Free Health Care, mothers still die in childbirth, children fade on benches, and the sick are turned away at hospital gates for lack of money. From Marampa to Makeni, caregivers have become gatekeepers— compassion replaced by cash demands.

Our hospitals are underfunded, our nurses overworked, and our government silent. The poor are not dying of disease alone - they are dying of neglect, abandonment, and the cruelty of a system what care means. When a mother must choose between feeding her child and saving her child, the nation has failed her.

Inside Sierra Leone's Hospitals and Clinics.

In a nation that once promised “Free Health Care for All,” the grim reality today tells a different story—one of neglect, frustration, and a quiet but deadly injustice unfolding daily in our hospitals and clinics. Across Sierra Leone, mothers in labor are turned away, children are left unattended, and the poor are made to feel unworthy of medical attention simply because they cannot pay.

From Marampa to Makeni, Freetown to Bo, the testimonies echo the same haunting refrain: “Go home and come back with money.” In Marampa, several mothers have shared their painful encounters—nurses refusing to touch their sick children unless “registration” or “injection” fees are paid upfront. Some have watched their loved ones fade away on hospital benches, not because there was no cure, but because there was no cash.

How did we get here? How did a nation that proudly launched the Free Health Care Initiative in 2010—a program meant to protect pregnant women, lactating mothers, and children under five—become a place where care is now sold like a commodity?

The problem runs deeper than unpaid wages or insufficient drugs. It lies in a broken system where compassion has been replaced by survival instincts. Many healthcare workers, underpaid and ill-equipped, are forced to demand “extra” payments to sustain themselves. Yet, this practice strips the very meaning from the word care. What is care without empathy? What is healing when the healer has lost heart?

Government support for these healthcare centers has waned over the years. Medicines arrive late, staff are left without tools, and rural clinics operate on borrowed hope. In places like Marampa, health posts lack basic facilities—no electricity, no running water, no incubators, and no emergency transportation. Pregnant women trek for miles only to be met with closed doors or indifference.

The consequence of such neglect is catastrophic. Every time a woman is turned away during childbirth, a life hangs in the balance. Every time a child is denied treatment for malaria or pneumonia, the nation loses a future leader. Behind every unrecorded death is a system that has failed its people.

Healthcare should not be a privilege—it is a right. And yet, in Sierra Leone today, it is treated as a favour granted to those who can afford it. Our communities are losing faith in a system that once promised hope. The government must urgently revisit its commitment to public healthcare—not with speeches, but with action: funding hospitals, paying health workers, monitoring accountability, and empowering communities to report abuse.

If nothing changes, Sierra Leone will continue to bleed silently—not from war, but from indifference. The pain of the poor will remain unseen, and the promise of “Free Health Care” will remain just that—a promise, fading in the corridors of our abandoned clinics.

Credit Source: Chez Winakabs, Research and Information Consultant | Marampa Times

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