Macauley ’14 on Health Care in Sierra Leone

Christiana Macauley ’14

By Charlotte Kugler ‘14

During a discussion with her older sister about Mount Holyoke’s Universal Application Funding (UAF) program last year, Christiana Macauley ’14 began thinking about how she could use the opportunity to research and understand health care systems in an international setting. Here at the College, she has designed her own major in public health, so she was eager to find a way to enhance her on-campus studies. Last summer, the UAF program, along with a Laurel Fellowship award, provided her with the opportunity to travel and do just that.

Macauley found herself particularly interested in the Free Health Care Initiative (FHCI) in Sierra Leone, which provides free health care for pregnant and lactating women and children age five and under.

“In addition to being interested in domestic and global health issues, I’m also invested in Sierra Leonean heritage,” Macauley says. “I thought a project on the FHCI would be a great way to give back to the Sierra Leonean community.”

She set out for the city of Freetown last summer to research how the program has been helping the country and what work still needs to be done. As an independent researcher, she was not affiliated with any organization, so she had to conduct her research and find people willing to participate on her own.

“My study had a lot of obstacles in this regard,” she says now. “But I ended up going to marketplaces where I met and talked with various men and women who were benefiting from the Free Health Care Initiative.”

Macauley utilized a questionnaire that she created and had approved through MHC’s Institutional Review Board. The survey included questions about respondents’ socioeconomic backgrounds, how many children they support, how they would rate the care they received in hospitals, and if, as qualified beneficiaries, they still had to pay for medications that are covered under the FHCI.

“Their answers helped me gauge the extent to which Sierra Leoneans were truly benefiting from the FHCI,” she explains.

However, Macauley also observed the need for some improvements to Sierra Leone’s health care policy – the result of corruption and unprofessional practices behind the scenes in the government. There is a need, she says, to address disparities within health care systems, especially in developing countries. Finding disparities involves understanding average life spans, socioeconomic backgrounds, and why someone might reject the opportunity to receive treatment. Such factors are important to consider because they can positively or negatively affect the relationship a person has with their health care system.

Macauley’s experience in Sierra Leone helped her develop the ability to face challenges when all does not go according to plan. Despite the temporary difficulties she encountered, she is grateful for the life lessons she learned in carrying out an independent project.

This semester, Macauley is studying abroad in India and working with a health and human rights program. After graduation, she hopes to work as a public health educator or an instructor for international and domestic leadership programs. She also plans to attend graduate school and earn her M.P.H.

“By working in the public health field, I realize that people’s lives will be in my hands,” Macauley says. “Knowing that the experience communities have with me might, in turn, affect how they interact with public health practitioners in the future, I’m even more motivated to put all my effort into ensuring that people have access to health care and healthy living.”