Sierra Leone steps up emergency referrals as Triple Zero campaign puts communities at the heart of the fight against maternal and child deaths
By Marian Magdalene Bangura
Strategic Communication Unit – MoICE
For a woman in labour, a child in distress or a patient facing a sudden medical emergency, the race to save a life can begin long before the doors of a hospital operating theatre swing open.
Sometimes, it begins with a telephone call, and an ambulance that must arrive in time.
That reality took centre stage on Tuesday at the Miatta Civic Center in Freetown, where health officials, community leaders and stakeholders gathered for a Special Town Hall marking the 300 Days of Activism for Triple Zero, with emergency transportation emerging as one of the critical weapons in Sierra Leone’s continuing battle against preventable maternal and child deaths.
At the heart of the discussion was a striking figure: 105 ambulances currently deployed across the country to support emergency referrals.
For Dr Francis Moses, Director of Reproductive and Child Health, the importance of the ambulance network is straightforward.
“You need a good referral system. You need a network. You need the ambulance.”
It is a simple equation, but one with potentially life-or-death consequences.
A woman experiencing complications during pregnancy may be miles from a referral hospital. A child may suddenly develop a condition requiring urgent specialist care. A patient may need to be transferred from a peripheral health unit to a higher-level facility.
In such moments, distance becomes more than geography.
Distance can become a deadline.
That is why the Ministry of Health says its emergency referral system must operate continuously – day and night, in sunshine and rain.
Deputy Minister of Health II, Dr Jalikatu Mustapha, underlined that commitment bluntly:
“No day off… no night off… no rain season off.”
The message is particularly significant for communities where poor roads, difficult terrain, rivers and long distances can turn a routine referral into a desperate race against time.
MORE THAN A VIHECLE
But the Town Hall made clear that Sierra Leone’s ambulance service is about much more than vehicles moving patients from one point to another.
An ambulance is only the visible end of a much larger emergency-response chain.
That chain begins when a family recognises danger. It continues when a community health worker raises an alert, when a health facility initiates a referral and when community leaders help mobilise the support needed to get a patient to care.
If one link fails, the consequences can be devastating.
This is why the Ministry is placing increasing emphasis on the role of Paramount Chiefs, section chiefs, town chiefs, local councils, community health workers and families in making the Triple Zero campaign work.
Traditional leaders, in particular, remain powerful actors in rural communities, often serving as the first point of authority when urgent action is needed.
They can help identify vulnerable women, encourage early antenatal care, promote immunisation, discourage dangerous delays in seeking treatment and mobilise communities when an emergency referral is required.
Their role is therefore not ceremonial.
It can be lifesaving.
THE CHIEFS AS FIRST RESPONDERS
Sierra Leone’s experience has shown that traditional leadership can become a formidable public-health partner when national policies are translated into community action.
Through previous engagements under the Triple Zero campaign, Paramount Chiefs have supported community-level measures aimed at improving antenatal attendance, immunisation and early health-seeking behaviour.
The logic is compelling.
A national ambulance cannot reach a woman whose community does not recognise the emergency.
A health worker cannot make a timely referral if the warning signs are ignored.
And even the fastest ambulance cannot compensate for a delay that began hours earlier.
The fight against maternal and child mortality, therefore, cannot be won by the health sector alone.
It requires families, chiefs, health workers, councils and communities moving in the same direction.
THE TRIPLE ZERO CHALLENGE
The 300 Days of Activism for Triple Zero is ultimately about confronting the preventable causes of maternal and child deaths, and making sure that when an emergency occurs, the system responds before it is too late.
The deployment of 105 ambulances represents an important part of that response.
But the bigger challenge is ensuring that every community understands when to seek help, whom to call and how to activate the referral system quickly.
Because an ambulance is not simply a vehicle.
It is the bridge between danger and treatment; between a remote community and a referral hospital; between an emergency and a second chance at life.
And for Sierra Leone’s mothers and children, that bridge must remain open – 24 hours a day, seven days a week, in every season.
The ambition behind Triple Zero is ultimately simple:
No mother should die because help was too far away. No child should be lost because a referral came too late.
With 105 ambulances on the road, Sierra Leone is strengthening the machinery of emergency care.
The next task is making sure every community knows how to use it, and that no link in the lifesaving chain is allowed to break.
