“Ebola has gone away, it’s in the back of our minds now – but for women and children the health situation has never been graver.”
Speaking from the Magburaka Government Hospital in Sierra Leone, Dr Benjamin Black knows first-hand about the effects of the devastating virus that has claimed more than 11,000 lives since 2014.
Originally from Manchester, the 34-year-old Jewish medic has returned for a third time to the West African country volunteering with the humanitarian charity, Medecins Sans Frontieres.
Ebola is now thankfully on the wane, but Black believes it may have already paved the way for the next major health disaster to hit the region – an alarming rise in the deaths of pregnant women and newborns.
The specialist registrar in obstetrics and gynaecology says the epidemic has caused women to become too afraid to give birth in health care centres in case they catch the deadly disease.
Sierra Leone already had one of the worst maternal mortality rates in the world prior to the virus spreading across the region, but the spread of Ebola has now meant the situation is acute.
“The population became quite fearful of healthcare centres, because people began seeing them as places you go to die. So the maternal mortality rate has actually worsened in the last year.
“Pregnancy is considered a very serious medical condition in Sierra Leone. A 15-year-old here has a one in 17 chance of dying in childbirth, which is astonishingly high.”
Black, who is on a two-year sabbatical from the Whittington Hospital to gain humanitarian experience, believes the situation could be greatly improved simply by encouraging women to seek medical help earlier and ensuring better access to emergency care.
He adds: “A lot of people get excited about the delivery, but it’s really about the whole journey. In Sierra Leone, access to antenatal care is not bad, but emergency care is not always available straight away.
“The typical woman starts labour at home in her village and then has to walk to the healthcare centre, as these villages are not accessible by road.
“At the healthcare centres, the doctors only have access to basic equipment and it can take a long time for ambulances to then come and transport the patient to hospital.
“By the time we see them, they have been in labour for three or four days, so what could have been straight forward has now turned into a life-threatening emergency.
“The best solution would be to intervene when things are not so serious.”
Despite the severity of the situation, Black admits it’s still a far cry from the “nightmare” he encountered when he first arrived in the country last May, just before Ebola had taken grip across West Africa.
He recalls: “I was among the first international medics to arrive here and quite soon after, the epidemic exploded out of control.
“More and more women began turning up at the clinic and we found it hard to differentiate between complications caused by Ebola or otherwise. It was a really challenging and impossible situation.
“As things worsened, we began seeing 100 patients at a centre built only for 35. The queue of patients went on for miles and many were dead on arrival.
“The amount of death we saw was staggering. Not a day went by when we didn’t see people – or entire families – die.
“It was a nightmare situation. We were overwhelmed and there was no cure as such, but we did our best to look after the patients and maintain their dignity.”
Earlier this year, a damning report concluded that the World Health Organisation and government leaders were to be blame for reacting too slowly to the growing epidemic, which resulted in thousands dying across West Africa.
For Black, being on the frontline against Ebola meant that he knew instantly that the situation was very serious.
“It was very clear what was going to happen,” explain Black. “It was like watching a bomb exploding in slow motion. You know what’s going to happen, yet no-one is reacting.
“If I had one emotion more than others, it would be anger. When Ebola broke out there was mass hysteria and panic, with countries rushing to defend their borders, rather than working on a solution.”
One year on, the virus is finally under control, research continues into an effective vaccine and last month the World Health Organisation declared Sierra Leone free of the disease.
But for Black, who has also volunteered in Namibia and the Central African Republic, the hard work continues in helping one of the more vulnerable groups affected by this crisis.
“I’m interested in responding to humanitarian disasters, wherever they are,” he adds. “Pregnant women are an extremely at-risk group and so there should be a special response for them. That’s my ultimate hope.”