A small victory for health care professionals in Sierra Leone this weekend went relatively unnoticed. Doctors and nurses around the country had been striking for 10 days, asking for an increase in their salary. This past Sunday, President Ernest Koroma agreed to increase doctors’ salaries from $100 to $600 per month. Before the strike, doctors were earning around $100 per month, while nurses’ salaries were at a paltry $40. Even for West African standards, where a dollar can go a long way, Sierra Leone’s health workers were being grossly underpaid. The context in which this strike took place is worth considering. Taking note of the severe weaknesses of his country’s health infrastructure, on the eve of celebrating Sierra Leone’s 49th independence anniversary last year, President Koroma promised the introduction of free medical healthcare for pregnant women and breast-feeding mothers, as well as children under five years. This new system is supposed to take effect in April 2010, and doctors and nurses argued that due to the inevitable, significant increase in their workload, their compensation should be adjusted accordingly. In November 2009, buttressing the previous announcement of the introduction of free health care for mothers and children under five, the government of Sierra Leone announced its first six-year strategy (2010 – 2015) to address the key systemic problems in the health sector. And while Sierra Leone’s health indicators have indeed improved in recent years, the country still boasts some of the world’s worst maternal health statistics, with one in eight in mothers at risk of dying during childbirth. According to recent UNICEF statistics, Sierra Leone has been spending about 10% of its GDP on health – the same percentage as for defense spending. Salary adjustments represent one small – but encouraging – step towards improving the country’s health infrastructure. While the move to increase health care professionals’ pay was viewed by some as an invitation for other civil servants to go on strike and make their own demands, I see this as a sign of good leadership and crisis management skills from President Koroma and his government. This year, DFID, the British government aid agency – in a move which suggests trust in Sierra Leone’s leadership on health matters – will be providing £10 million (15 million USD) to support better health care delivery in Sierra Leone. Image: (Flickr, UN Photo) Ernest Bai Koroma, President of the Republic of Sierra Leone, addresses the general debate of the sixty-fourth session of the General Assembly.