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Preventing the preventable: How one nurse — and a group of immigrants from Sierra Leone — have made childbirth safer in West Africa

When Alice Karpeh came of age in Sierra Leone, she watched hundreds of mothers die from complications related to childbirth. Now she’s changing that. 

Alice Karpeh, a nurse at the University of Minnesota’s Boynton Health Services, returns to her Sierra Leone country to build a birth waiting home for mothers and their newborn children.
MinnPost photo by Ibrahim Hirsi

When Alice Karpeh came of age in the Sierra Leone village of Tikonko, she watched hundreds of mothers die from complications related to childbirth.

Like many villages in the developing world, Tikonko — home to about 4,000 residents — is without hospitals, clinics or an adequate transportation system to get to nearby towns for health care services.

Though deaths from pregnancy or delivery complications in the developing world have dropped significantly in recent decades, hundreds of thousands of women still die from those risks every year. In Sierra Leone alone, according to data from The Word Bank, 1 in 23 women die from complications associated with childbirth — giving the country one the highest maternal death rates in the world.     

Karpeh, a nurse at the University of Minnesota’s Boynton Health Service, has made it her mission to reduce that number. And last week — thanks to some serious help from a group of Sierra Leone immigrants in the Twin Cities — the 60-year-old returned to her home village to build a birth home to care for pregnant women.  

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“It’s a dream come true,” Karpeh said of the project. “My goal is to save people from problems that are preventable.”

‘Everything I had: I lost it right there’

Karpeh’s dream to help pregnant mothers in her homeland began years ago. Growing up, she thought that the best way to help prevent deaths in childbirth was to become a midwife, so she did.

But after practicing the profession in Sierra Leone for many years, Karpeh realized that she wasn’t really making a dent in the problem. So she decided to enlist the help of her husband, Albert Karpeh, who served as a defense minister for Liberia and ambassador to Sierra Leone. “All I wanted was to have my own clinic in the village so I’m able to actually save the people I serve,” she said. “We started saving money and planning for that.”

It was the early 1990s, and before the pair realized their dream, Liberia erupted into a devastating civil war, a conflict that eventually spilled into neighboring Sierra Leone.

Not long after, Albert was killed while leading an armed group allied with Joseph Momoh, then-president of Sierra Leone, who was fighting a rebel militia trying to overthrow his regime.

“My whole life fell apart,” said Karpeh, who was then caring for nine children. “Everything that I had, I lost it right there. My only fear was for my life and my children. I had no food. I had $20 that he left for emergencies.”

Clinging to a dream

In 1993, Karpeh sought refuge in the United States. She first lived in Philadelphia, but before long moved to Minnesota in order to live among the Twin Cities’ sizable Sierra Leonean community.

Just as Karpeh was getting settled, though, she was diagnosed with breast cancer. After a year of arduous treatment, she was declared cancer-free, and it wasn’t long before she decided to take on another new challenge. At age 42, she went back to school, enrolling in the nursing program at Anoka Technical College. By 2004, she had completed her studies and secured a full-time job at Boynton Health Center.

Through it all —  moving to the United States, fighting cancer, going back to school — Karpeh clung to her dream: to build a health care center in Tikonko.

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As she served her Minnesota patients at Boynton, Karpeh thought of the vulnerable mothers and their infants she had left behind in the village. So in 2011, she brought together members of her Sierra Leone community and other friends to explain what she wanted to do. She presented her vision to build a health care center in Tikonko, asking members of the audience for their support.

The meeting was followed by a half-dozen others, where Karpeh worked with the group to form what they called the Rural Health Care Initiative (RHCI). The goal of the nonprofit was to improve the lives of Tikonko’s pregnant women and children by partnering with Sierra Leone’s government health organizations, which often don’t have basic health care supplies.

“Last time we visited there, they didn’t have bandages, they didn’t have gloves,” Karpeh said.

In the ensuing years, Karpeh and other health professionals from Minnesota have visited Tikonko to train health workers who care for pregnant women and infants. Among them was Carol Nelson, a doctor who also works at Boynton Health Service, and who spent about a month in the village last summer to train midwives.

“These women were very dedicated to the kind of work of helping women,” Nelson said. “Out of the 33 only two of were literate. So all the teaching was done through repetition, demonstration and skits and singing. And 30 of the 33 passed the final exam.”

Birth home

Though RHCI has been providing financial support and training services to the village for the past four years, the birth home remains the biggest project the group has undertaken.

Karpeh took a six-month leave of absence from her job at Boynton to begin the construction project, an idea that’s been germinating in her mind for more than three decades. The building will feature six bedrooms to house 12 patients at a time, as well as a garden, sitting area and a courtyard.

So far, Karpeh noted that RHCI has raised $40,000 to begin the construction project, which has an estimated total cost of $100,000. As Karpeh leads the construction process in the village, Nelson plans to collect the rest of the funding from people and groups in the Twin Cities.

Through the RHCI initiative, Karpeh hopes to empower traditional birth attendants in Sierra Leone by creating a network of community health workers connecting 25 villages throughout Sierra Leone.

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The initiative is also working to eventually create mobile clinics that will get essential health care to villages throughout the country — an ambitious project that may ultimately prove to be too expensive. But Karpeh remains optimistic about what’s to come. “I have a very big support,” she said. “People are very supportive emotionally and financially. Their encouragement helps me to move forward.”