Georgie Scott Photographer

A Child plays in the Estuary of Kroo Bay Slum. There are no working toilets in Kroo bay and the Estuary serves the local population for all washing and sanitation needs. Sierra Leone for VSO.

Kroo Bay Slum, Freetown Sierra Leone.

Kroo Bay slum, Freetown, Sierra Leone.

Two girls make their way through Kroo Bay slum to get to school. Sierra Leone for VSO.

Pregnant women wait for their midwife checks in a rural health centre. Sierra Leone for VSO.

Heavily pregnant women wait for space in the labour room of the george Brook medical clinic. Sierra leone.

Mother-to-be Aisatu Kabu, 35yrs in labour with her 5th child at Kroo Bay Community Health Centre, Freetown, Sierra Leone. Aisatu is attended to by both a Traditional Birthing Attendant (TBA) Tenneh Oldfield and A trained Maternal and Child Health Aid (MCHA, midwife) Adama T. Bangura. There is just one labour room at the clinic and Aisatu has her son whilst another woman on the next bed also prepares to give birth. Commissioned for VSO.

Mariatu Bangora, Traditional Birth Attendant (TBA) visits new mother Halimatu Mansaray, 20 yrs and her 5 days old baby daughter (no name as yet) at their home in the Kroo Bay community. Mariatu has been a TBA for ten years and more recently has started working with the Community Health centre not only to encourage pregnant women to go to the Health centre to deliver their babies, rather than staying at home where complications during birth are more common, but also to inform new mothers of the importance of immunisations for their babies and healthy eating for both mother and child. Kroo bay, Freetown, Sierra Leone.

The labour room, Makeni Government Hospital. Up to five women may be in labour at one time in this room. There are no pain relieving drugs available. Inducement is done using a catheter. It is very common for new mothers to experience complications in childbirth due to a number of factors including obstructed birth canal from Female Genital Mutilation, FGM (estimated 90% of female population has had FGM) Haemorraging, anaemia, eclampsia and the need for emergency blood transfusion. Maternal death rates are high, 857 per 100,000. One of the worst in the world. Child mortality is the worst in the world. 1 in 4 children below the age of 5 die each year. Makeni, Sierra Leone.

The labour room, Makeni Government Hospital. Up to five women may be in labour at one time in this room. There are no pain relieving drugs available. Inducement is done using a catheter. It is very common for new mothers to experience complications in childbirth due to a number of factors including obstructed birth canal from Female Genital Mutilation, FGM (estimated 90% of female population has had FGM) Haemorraging, anaemia, eclampsia and the need for emergency blood transfusion. Maternal death rates are high, 857 per 100,000. One of the worst in the world. Child mortality is the worst in the world. 1 in 4 children below the age of 5 die each year. Makeni, Sierra Leone.

Newbornbaby is found to have a large lump on the back of its neck as well as limited reflexes on its right side. The child is probably brain damaged. The babys mother sits unaware on another bed in the labour room whilst she has a blood transfusion after birth difficulties. Makeni Government Hospital, Sierra Leone.

A New mother, hours after giving birth looks down at her new born baby in the labour ward of Makeni Government Hospital, Sierra Leone.

Alex Burns, GP and VSO Volunteer at Makeni Government Hospital scans pregnant Mother Rugiatu Kamara, 24, to ascertain what stage of pregnancy she is at and whether the baby is old enough for the mother to be induced as she has pre-eclampsia. Alex is observed by other pregnant Mums, colleagues and students. Alex discovers from the scan that the baby is 36 weeks old and Rugiatu is later induced by Nancy Kellie.

VSO Doctor Alex Burns works with Nurses, Midwives and Nursing Assistants to realise the potential for saving lives through using the partograph during a womans labour. Makeni Hospital, Sierra Leone.

Ramatu is pregnantwith twins. She has profound learning difficulties and is dumb, all a result from the measles virus when she was 5 years old. Ramatu is not capable of giving sexual consent and therefore sexual intercourse would technically be rape. She lives with her elderly frail mother Mary who is distressed at the news that her daughter is expecting twins. Makeni hospital, Sierra Leone.

A Malnourished child in the feeding centre. Fretown Hospital. Sierra Leone for VSO.

Shona Johnston VSO Volunteer & Paediatrician working in the Therapeutic Feeding Centre at Ola During Childrens Hospital, Freetown. Shona examines Kadiatu, a malnourished 15 month old baby girl and discusses the childs health with her mother Hawa Kamara. Sierra Leone.

Therapeutic Feeding Centre Baby Clinic at Ola During Childrens Hospital. Mothers arrive and wait in line to have their children weighed before being given food supplements and advice on healthy eating for their children. Freetown, Sierra Leone.

Five year old girl is weighed at The Therapeutic Feeding Centre Baby Clinic at Ola During Childrens Hospital. Mothers arrive and wait in line to have their children weighed before being given food supplements and advice on healthy eating for their children. Freetown, Sierra Leone.

Shona Johnston, Paediatrician and VSO volunteer examining 4 yr old Mariasu Z. Jabbie at the outpatients clinic of Ola During Childrens Hospital, Freetown, Sierra Leone. Shona discusses Mariasu's health with her mother Mariana Kamara, 22yrs.

Abdul, 2 years and 9 months with his mother Isatu at Makeni Hospital. Abdul is malnourished, jaundiced and is suspected of having sickle cell anaemia. Sierra Leone.

Natasha Sauven, Paediatrician and VSO volunteer at Makeni Government Hospital teaches 2nd year nursing student Agnes Ksesay how to read the infant health card and recognise potential health risks. Makeni Government Hospital, Sierra Leone.

Catrin Boyle, Paediatric Nurse and VSO Volunteer working in the ICU (Intensive Care Unit) of Ola During Childrens Hospital, Freetown. Catrin is seen working alongside the Nurse in charge of the ICU, Prince Gbenda.Catrin and Prince attend to Yabum Kamara, 2yrs 8mths anaemic child who is having an emergency blood transfusion. Yabum was bought in by her mother after vomitting, coughing and running a fever for 5 days. Yabum shares her bed with another child patient due to lack of space. Sierra Leone for VSO.

A Mother has her son weighed at the under fives feeding clinic in Freetown, Sierra Leone.

Abdul, 1 year 10 months, with his mother Adama. Abdul arrived at the hospital 24hrs earlier so severely dehydrated the doctors did not think he would survive. The family had initially sought advice from a herbal doctor but after ten days of their child vomitting and not drinking had bought Abdul to Makeni Hospital. Health care for the under fives is free is Sierra Leone but due to corruption medicine is rarely available and parents must pay high prices on the black market. Sierra Leone.

Mother and Child buy from pharmacist at Health clinic in Freetown Sierra Leone. medicine and healthcare should be free for the under fives and pregnant women, however often supplies finish and parents of sick children turn to the black market. Sierra Leone.

Freetown City Waste tip and the homes that have been build around its periphery. Situated a short distance from Kroo Bay Slum, plumes of smoke rise from the tip 24hrs a day and fill the air with the acrid odour of burning plastic and other household waste products. Freetown, Sierra Leone.