Health Insurance in Sierra Leone

Things are changing for Sierra Leone, however. No longer does the scar of the civil war cut deep into the heart of the country. The 11-year massacre is remembered and respected, but Sierra Leoneans are looking to the future and rejuvenating the country as best as they can.

Tourism has played a huge part in helping the people of Sierra Leone revive their homeland. The country is resplendent with scenery and wildlife, as well as being blessed by some of the most beautiful beaches in Western Africa.

Sierra Leone was granted independence from Great Britain in 1961. But, after a colonial period within which the country had trouble maintaining a stable government, corruption and poverty became the norm.

The Revolutionary United Front (RUF) formed in Liberia was created by Sierra Leoneans who wanted a change from the corrupt government. This resulted in a civil war spanning over a decade between the RUF and the Government of Sierra Leone. During the period of 1991 to 2002, approximately 50,000 Sierra Leoneans lost their lives.

With the Government of Sierra Leone failing to provide for employees, Captain Valentine Strasser overthrew President Joseph Saidu Momoh on the 29^th April 1992.

In March of 1995, a group from South Africa called The Executive Outcome set out to help Sierra Leone. They pushed the rebels back and helped regain control of the diamond mines for the SLA (Sierra Leone Army).

On the 25^th March 1997, the SLA performed a successful military coup freeing 600 prisoners. One of these prisoners was Johnny Paul Koroma. Koroma had commanded government forces before his arrest in August 1996 for an alleged involvement in a coup plot against southern civilian officials. The SLA offered Koroma a do-or-die offer which resulted in him coming to power. He formed the Armed Forces Revolutionary Council – the new government of Sierra Leone.

The future seemed a little brighter for Sierra Leone. In March 1998 rebels were driven out of the capital, but this was met with retaliation from the RUF. In January of 1999, RUF troops massacred 7,000 Sierra Leonean men, women, and children.

Unlike other wars and conflicts in Africa, the international community played a key role in ending the war. In December 1999, United Nations forces finally arrived in Sierra Leone and disarmed RUF soldiers for the following five years. In May 2000, British paratroopers came to the country and helped evacuate foreign citizens and assisted struggling UN soldiers.

With the majority of the country back in the hands of the new government, the RUF finally realised they now had little support and would not win the battle. This led to a peace treaty being signed and, on the 18^th January 2002, war was declared over in Sierra Leone.

Sierra Leone has a tropical climate, hot all year with a dry season in winter. The African monsoon, which runs from May to November in the north and April to November in the south, brings in Sierra Leone’s rainy season. The annual quantity of rainfall is considerable, from 2,000 to 3,000 millimetres, with the coastal areas taking the brunt. The western part of the country is flat, whilst the eastern part is hilly and mountainous. The highest peak in Sierra Leone is Mount Bintumani, which stands 1,945 metres above sea level. The altitude in the region tempers the heat.

Winter in Sierra Leone is hot and sunny. Night-time temperatures in the coastal areas hover between 22°C and 24°C, whereas inland can be a little more comfortable at around 18°C on average. However, daytime temperatures away from the ocean sky-rocket in the day to 34°C. Temperatures have been known to reach an uncomfortable 40°C in the winter. But, due to dry prevailing winds (the Harmattan) from the Sahara, humidity levels are lowered.

Temperatures rise in February under the influence of the tropical sun and soon the rains come. March usually hosts the first downpours of monsoon season, becoming violent and torrential as the year progresses. The coast to the south of capital Freetown is flat and covered in mangroves, this usually floods during the rainy season.

The temperature during this period remains below 30°C, with little change during the night. The humidity makes the air incredibly balmy, even though, coastal areas are blessed by a breeze. During the month of November, the monsoon begins to withdraw and the dry winds from the northeast start to dry out the land.

40% of Sierra Leoneans consider themselves Muslim, 20% are Christian while the remainder practise a little-known religion known as “animism”. Animism is the belief that non-human entities – such as animals, plants, and inanimate objects – possess a spiritual essence.

The majority of people in Sierra Leone still live a traditional and agricultural way of life. Different groups have ruling chiefs and specific religions which preserve social stability. Dance, music, customs and traditions make up the cultural backbone of Sierra Leone.

The Limba is one tribe that plays a very important role in Sierra Leone culture. They are the only group of people who can harvest palm wine (known as poyo) from the palm tree. Villages will place adverts up on notice boards offering incentives for palm wine tappers so that a village can be provided with as much natural fermenting alcohol as they desire.

Secret societies are a fundamental part of Sierra Leonean culture. Poro and Bundu are the two most well-known societies and it is not unusual to come across initiation ceremonies in progress. Poro is the men’s secret society and Bundu is the women’s, upon reaching puberty, the two genders are taught essential skills and knowledge important for their role within society.

Quite often you will witness small groups of people shouting aggressively at each other and then stopping immediately to hug. This is called palaver and is the Sierra Leonean way of solving disputes immediately to avoid grudges being held.

Sierra Leone is a multilingual country with 25 languages spoken. English is the official tongue, but Krio is the most widely spoken and is also prevalent in neighbouring countries. The Krio language is native to the Creoles who were freed slaves from Britain, the United States, and the West Indies. Krio is a fascinating language that is mainly derived from English, but with influences from African languages such as Yoruba. French and West Indian expressions also form the majority of the structure.

The Temne people make up 35% of the population of Sierra Leone. They are traditional rice farmers, fishermen, and traders. Temne is their language and it is rumoured to be extremely complicated to learn.

Another major language is Mende, which is spoken by 29.5% of the population. For some, it is their mother tongue, whereas others in southern Sierra Leone have adopted it as their lingua franca. Other languages include Kono, Kissi, Kuranko, Lim, Fula, and Susu.

In December 2002, President Ahmad Tejan Kabbah also named Bengali as an official language in recognition of the work of 5,300 troops from Bangladesh in the United Nations peacekeeping force.

In Sierra Leone, you travel on the right side of the road. Although renting a car may seem like a daunting task, there are a number of tarmacked roads that connect the major cities. There is also a strong network of dirt roads connecting more remote towns and villages, which are easily accessible by 4×4. Car hire (with driver) is available from Sierra Leone Car Hire, as well as, hotels and travel agents. The Foreign and Commonwealth Office advises against car travel outside of Freetown at night. Furthermore, during the rainy season (November to May) many roads aren’t accessible.

The most popular mode of transport is poda-poda (minibus). These can be found at poda-poda parks in towns or along commuter routes. There aren’t any predetermined stops or timetables, it is simply a case of flagging one down wherever and making yourself heard to get off. There is currently a government bus route, but it only serves Freetown, Bo, and Kenema.

In the majority of towns, there are reliable taxi services that travel along a predetermined route. Taxis are easily distinguishable due to being yellow and black in colour. Taxis tend to pick up a number of people along a route, but it is possible to rent a taxi for yourself or your group. A one-way or two-way rate will be charged depending on the distance.

A slightly more white-knuckle option available all over Sierra Leone are ocadas; motorbike taxis. They are a fast and reliable way of weaving over the dirt roads between villages outside of major towns and cities.

Pam-pahs (boats) operate to several towns, mostly between Mattru Jong and Bonthe.

Sierra Leone is one of the most impoverished countries in the world and the average life expectancy is only 55 years. 25% of children in the country are severely malnourished, and it is one of the worst places in the world to give birth due to the number of mothers that die during or just after childbirth.

Furthermore, Sierra Leoneans are still trying to rebuild their lives following the deadly Ebola outbreak. The disease claimed around 4,000 lives, and although the country was declared free of Ebola in November 2015, the impact can still be felt today. Ebola is not the only disease Sierra Leone has to contend with. Only 60% of the population has access to safe drinking water and the country is rife with waterborne diseases such as cholera and typhoid. The country also suffers from epidemic outbreaks of lassa fever and meningitis, as well as 1.6% of the population suffering with HIV/AIDs.

All medical care in Sierra Leone is chargeable and provided by a mixture of government, private, and non-government organisations. The country is divided into 13 health districts. Each of these have a health management team and an average of 50 peripheral health units and 100 technical staff.

Alongside this, in April 2010 the Free Health Care Medical Insurance system was put in place for pregnant and breast-feeding women, as well as children under five. This scheme is run by the United Kingdom and United Nations. The British Red Cross has also been running community-based health programmes in the country for over two decades.

For those travelling to Sierra Leone, vaccinations should be administered by a doctor four to six weeks before travelling. If in the country for business, it is important that your employer has provided you with comprehensive international medical insurance and if not, this is something that is essential to obtain before travelling. There are five hospitals in Sierra Leone, with two dedicated to childcare and maternity.

The currency of Sierra Leone is the Leone (SLL) which is abbreviated as ‘Le’ placed before the amount. The leone was only introduced in 1966 due to Sierra Leone only gaining independence from Great Britain in April 1961. Before the country’s independence, it was using the British West African pound.

Coins and banknotes in Sierra Leone have evolved over the years. Following a period of economic collapse and the following Sierra Leone Civil War, inflation became rampant and devalued older coins. A brand new coin system was introduced to the country in 1996, in denominations of 10, 50 and 100 leones. Ten-sided 500 leone coins were introduced in 2004. Of the four coins officially stated as being in circulation, the only one ever seen is the 100 leones, due to the rest being of low value and in short supply. 500 leones and the two lowest denominations are rarely encountered due to uncontrollable metal theft in the country.

Before 2010, banknotes in circulation were 500, 1000, 2000, 5000, and 10,000 leones. 10,000 leone notes were only in circulation for one year and were rarely seen. This meant that most payments were made with bundles of 5,000 leones. Because of inflation, a 20,000 leone banknote has been suggested. As of August 2016, 20,000 leones is equivalent to approximately £2.73.

Education is legally required for all children for six years at primary level, and three years in secondary education. However, a shortage of schools and teachers has made this impossible and some children receive no education during their lifetime. The civil war resulted in the destruction of 1,270 primary schools and in 2001, 67% of all school-age children were not in an educational facility. Schools have been slowly rebuilt and between 2001 and 2006 primary enrolment doubled. However, cultural attitudes in some parts of the country discourage girls from attending school.

Expats in Sierra Leone have the choice of four international schools, including British, American and Lebanese curriculums. Most parents with older children, if linked to Sierra Leone by work, will often send their children over primary age to a boarding school abroad.

Nicknamed Sweet Salone for its rich food culture, Sierra Leone has everything covered. From street stalls to upmarket restaurants, fresh fish and seafood is plentiful and the air is pungent with spice and simmering sauces. Kukhri is a favourite dish of rice and sauce available from street vendors, along with plassas; friend dough balls and plantain with spicy gravy. Many also love to indulge in fish cooked on the beach.

Most Sierra Leonean food is spicy and laced with salty Maggi stock cubes, an ingredient you will find in all kitchens. However, food is very nourishing and local ingredients are only ever used. Wherever you are in Sierra Leone people will be eating, it is a part of life and engrained into the country’s culture.

Like Nigeria, jollof rice is popular in Sierra Leone. Also fufu, which is originally from Ghana, has been adopted and is a dish of pounded yam served with a sauce, such as the popular groundnut stew. This famous stew is made from peanuts, meat, tomatoes and onions.  Stews make up the majority of meals in Sierra Leone, with okra stews and cassava and potato leaf stews laden with fish, goat or chicken being family favourites.

For those with a sweet tooth, the moreish benny cake is a sesame seed and sugar biscuit. Also, coconut cake made from fresh coconuts is a whole different experience compared to the offering of the same name in the likes of the UK.

Poyo is the aforementioned alcoholic brew harvested from the fermented sap of palm trees, but Star lager is also widely enjoyed. It is produced by Sierra Leone Breweries Limited. For something non-alcoholic, ginger beer is a firm favourite.

Despite the horrendous bloodshed of the 90s, Sierra Leone is now a safe country to visit, with a low threat of terrorism. In parts of the capital, Freetown, there is the usual issue of petty pick-pocketing, bag-snatching and other non-violent crimes. But, throughout the country, violent crime is extremely rare by international standards. Understandably, expats and foreigners should be vigilant in busy tourist areas, but no more so than any other travel destination.

There are a number of scam artists in Sierra Leonne, posing as mine owners or managers. Many foreigners have fallen foul of gold or diamond scams and it is best to politely avoid anybody instigating a conversation of this nature.

Corruption is still something that has to have a close eye kept on it, but it is by no means as much of an issue as it once was. There is now an active Sierra Leone anti-corruption agency, to which people can report any bribe by phone, email, website, or in person. Any report of bribery is taken extremely seriously.

Not only does the west coast of the country boast some of Africa’s best secret beach destinations, it also has rainforest scenery that makes jaws drop.

From the cities and towns, to the people-free mountains, it does not seem possible that such a vibrant country could have been the setting for so much loss. Tourism has played a huge part in the resurrection of Sierra Leone and locals are friendly and welcoming.

Standing at 6,400 feet, Mount Bintuani is Sierra Leone’s highest mountain peak and not an experience for the faint-hearted. For those who want to enjoy the country off the beaten track, a hike in this part of the Loma Mountains will see adventurers hiking across grassy plains, crossing rickety bridges, and scrambling over vertiginous cliffs.

Once a protected location because of its high population of chimpanzees, Outamba-Kilimi National Park is now open to visitors. Tours snake between jungle and savannah grassland. Many visitors are fortunate enough to see rare pygmy hippos, bongo antelope and elephants. There are also over 100 different species of birds and the ancestral graves of the Susu tribe.

For those who want to learn more about the Temne tribe, a visit to Rogbonko Village Retreat is a must. Part of a community-based cultural exchange programme, foreigners can experience the everyday life of Temne tribal culture and communicate with locals in the quiet settings of a traditional Sierra Leonean village.

The heart of Sierra Leonne, the capital of Freetown is a buzzing hub and historic port town surrounded by verdant hills. Attractions include a 500-year-old cotton tree, the De Ruyter Stone, Government Wharf and King’s Yard, where freed slaves waited to be given land. Many visitors also peruse King Jimmy’s Market and visit Marcon’s Church.