FAQs & publications

Following are the questions that people ask most often. Please contact us with other questions you may have or for clarification.

We make sure that everything we do is sustainable and leads to independence for the women we teach and their villages. If we take supplies, then what happens when they're gone? The clinic staff comes to rely on those items for providing care, and on us to provide the items.

We prefer to discuss how to find other ways to get what they need. Gloves are a good example.

Remember that MOMS provides a grant for the women to start a self-sustaining project. So, they can buy gloves for the clinic. We have taught them to scrub their hands and fore-arms thoroughly, so they find ways do that - commission a local carpenter to build a stand to hold a pitcher, bowl, soap, brushes, and towels.

We are not trying to replicate an American clinic in the middle of the Sierra Leonean rain-forest. We are helping them to develop their villages so life is better and they are self-reliant

Yes, we teach about family planning and how to use the available ways to space children to meet the needs of a family. We also talk about reproductive physiology, so the women understand both conception and how to prevent conception. We teach nutrition and hydration as those things, along with sanitation, form the foundation for good health.

We teach how the body works, in general and the reproductive system specifically. We talk about those who might be at higher risk in pregnancy.

We teach about conception and how babies develop, and how the developing fetus and the parent affect each other. We then teach about providing prenatal care, based on an understanding of what is happening with both of them.

We teach about prenatal care, and labor and delivery - what is happening and how to support it. We also teach about providing postnatal care, too. This includes providing the best possible support for natural feeding.

Through all this, we are teaching how to communicate persuasively with people and how to teach specific groups like children in secondary school or those attending the ante-natal clinic days. At the end, but most important, we teach about problem solving and change agency. We help the learners figure out how to support themselves and make a difference in the community. Then we return to provide continuing education, to check on projects, and to answer questions. Each month, Jitta visits each cohort for a couple of days to provide general support and encouragement. That's all!

Update: Fewer signs of war remain. The tanks on the roadside in places like Segbwema are gone. Blackened building still stand and mass graveyards exist in almost every village. Original: Yes. The "Blood Diamond" or "Child Soldier" war ended in about 2002; we arrived in 2006.

We can still see physical signs - abandoned, rusty tanks on the side of the road and burned out buildings throughout the country. The roads still have craters. Because many bridges were blown up, the primary routes between towns have changed to smaller, winding, indirect paths.

We see amputees, and we drive by camps for them and for the former combatants who cannot go back into society.

We also see the women wearing layers of clothing - their husband's or son's trousers under two or three skirts. They started this during the war, when they'd have to escape night raids. They'd have extra skirts to wrap their children in, or to use when hiding in the jungle for extended periods. The trousers were helpful for forestalling rape.

We see sadness in the faces of the people and listen to their stories.

As Sierra Leone was run by the English, the health care system is loosely based on that model. Most clinics are staffed and managed by the government. The private hospitals and clinics tend to be much more expensive. The Ministry of Health and Sanitation (MOHS) has a strategic plan which they created with an eye on the World Bank, IMF, World Health Organization, and large funders.

Sierra Leone has about 6.5 million people, and about 90 MDs in practice. About 30 more are administrators in MOHS and have no time for a practice. Most in practice work in the three largest cities, serving a combined population of about 1.5 million. Each of the Districts (counties) has a hospital.

We work mostly in the Kailahun, Bo, and Pujehun Districts, which have a total of a half-dozen or so doctors.

The rural areas where we work have general clinics located in larger villages. Maternity clinics are smaller and more numerous, to spare the people long walks to a general clinic. Even so, some must walk 6-10 miles through the jungle.

We teach in villages with a maternity clinic, drawing our learners from surrounding villages. We integrate the learners into the clinics, assisting the Maternal/Child Healthcare Aides who typically staff them. Because their neighbors trust our learners, they will come to the clinics for care.

We have a genius-level interpreter. We could not do the work without her. She not only translates words, she translates concepts. She not only translates concepts, she translates culture. For example, in the nutrition module, we talk about fiber. The Mende language doesn't have a word for this; it also lacks the concept. So Jitta will talk about slaughtering a goat. When you clean the gut, you find the stringy, tough stems and branches. That is fiber. That is the kind of translation that makes our teaching effective.

She grew up in Mende villages during the war. She has butchered goats. She is also a nurse, and understands the medical perspective and how clinics work.

She has earned the respect of thosef we teach, and she builds rapport. She models the attitudes we teach: patience, kindness, humility. The students may be too timid at times to ask us questions, but they trust her and they talk freely with her.

She has trained two other women to translate the program, to expand the capacity and sustainability of the program and the people.

And, yes, the women we teach are illiterate. And they are very smart. And they live in a culture with a strong tradition of story-telling, skits, and songs. So, we teach using a lot of pictures, analogies, role plays, demonstrations, exaggeration, and so on. We tell of our own experiences with the teaching points.

At the end of each module, we ask them to create songs and skits summarizing what they learned. This has three functions: We confirm that they learned the material correctly; they have a tool to help them remember and review the material; and they have a way to teach the other people in the village.

We have a final exam, which is given individually, orally, through an interpreter. One interpreter, a public health nurse from a clinic down the road, was astonished at the test. He was shocked at how hard it was - he said several times that he couldn't have passed it - and he was amazed at how well the women did. They knew things he didn't know!

We are proud of the instructional soundness of the course, and of how well our teams have done, and of Jitta's translation skills, and most of all, we're proud of those women who work hard so they can make change happen.

Trainers must be skillful teachers. This means they must build rapport and trust quickly. They must think on their feet about metaphors and analogies that work for this learner population. They must work effectively with our translators. They must be able to present the information simply, concisely, and effectively.

And they must be able to cope with the living and working conditions - Mende food, latrines (or not), sharing a bed, travel on horrifying roads, mosquito bites, and taking malaria prophylaxis.

They must support MOMS model in practical ways. MOMS does development not crisis intervention. Partnership is key. So we always have to consider what we say and do: Does this build independence or not? What kind of expectations might this set? What unwanted messages might this send?

They must abide by MOMS rules. These are fairly simple: Be polite. Don't imply you can help someone get to America; be careful with stories of the wonders to be seen in America. Be open. Enjoy the differences you find. Focus on teaching, not working in the clinic. Focus on the learners, not on what you gain. If one of the staff tells you to do something urgently, do it; ask questions later. Avoid contradicting or criticizing Gov’t policies and methods. Set an example of what we teach about professionalism, humility, effectiveness, partnership. All this can be summed up as be respectful.

They must have skills and knowledge in the subject matter they teach. We teach basic women's reproductive health, community health, and change agency. Folks with advanced skills and knowledge sometimes get frustrated because they have so much more they want to teach. But the trips are not for trainers to teach what they know; they are for the learners to get what they need.

They must pay their own travel expenses to and from Freetown.

They must read A Book for Midwives and Helping Health Workers learn. They must read through our website, submit an application and waiver, and have an interview.

That's about it!

From our friends, families, and the folks they know. We do not get money from Save the Children, Bill Gates, Oprah Winfrey, etc. We've asked these groups and many others, and have applied for many grants. The typical response, phrased nicely, is that we're too small, don't have enough US staff to do the necessary reporting, or have a model that is too simple. We keep trying, though.

Fortunately, our simple model means we have an annual budget of $50,000 - a rounding error for many of the large funders, and the daily budget for some of the large agencies. So, when someone gives us $1,000 - 2,000, it makes a huge difference. And more routine gifts of $50 -100 add up quickly to a successful trip.

If someone gave us a million dollars, like happened to Greg Mortenson, or even $100,000, we could focus exclusively on training trainers and building independence — we’d get so much work done! It would be lovely.

But, following in the steps of St Francis of Assisi and some of the best Buddhists we know, we beg! And to do something concrete, you can click the Donate button below, or on any page of the website!

Pretty much. The war in Sierra Leone had been over for about 4 years when we went the first time. The people of the region have heard of us and are glad we're there, and are very protective. Yep, there are some crazies out there, but there are crazies everywhere. I've lived and worked in San Francisco, and have had knives drawn on me, etc. Just like everywhere, we pay attention to whose around us. In the cities, we watch for pickpockets and purse-snatchers, but we do that in Dublin, London, New York, and SF, too! Traffic accidents and malaria are the biggest threats to our well-being. Addendum: We were in country when the Ebola epidemic started less than 50 miles away, but didn’t know it. We have been back since. We are careful to follow the guidelines to control transmission of disease that the Government of Sierra Leone mandated. We always follow Standard Precautions in clinical work.

Short Answer: Because Paramount Chief Kallon pulled up in a Land Rover, and send "Get in; we're going to Pellie."

Long Answer: We learned later that the head woman of the village, Mamie Lamin, had a dream that white women with light eyes would come and help the pregnant women. She reported this dream to the village leaders and the Paramount Chief. He started looking for help, because of his respect for Mamie and because he grieved for the sadness and loss in his home village. He contacted an agency who contacted MOMS. When we arrived in country, another Paramount Chief wanted us to go to his territory, but PC Kallon "rescued" us in his truck, and off we went.

Someone asked if we'd go to Sierra Leone for two weeks and teach a group of women to become midwives. We said, "No. But we will come and do a needs assessment, and figure out what needs to be done and whether we can do it." So, we went, assessed needs, decided what we could do, and wrote a proposal. We went back to pilot the program, revised it, and continue to work. We have begun training trainers in order to increase independence.

By volunteering and by donating. Look at our Donate page or send us an email for more information.