African problems need African solutions; the crucial role of community level partnership-working

 

Much has been written in global health research about the need for meaningful North-South partnerships where problems are identified, and solutions devised and tested by those who live, love, and work in the communities where these problems exist. In this blog we provide a window into the story of a robust partnership as a tool for reflection.

It’s 2001 and the 10-year civil war in Sierra Leone  has officially ended. Richard Cole, Director and founder of Lifeline Nehemiah Projects, dressed in shorts and flip flops, rocks on his chair on the dusty veranda of the Nehemiah Home’s small office. Having rescued dozens of child soldiers and other war-affected children from the hands of the rebels, Richard has been given this plot of land in Eastern Freetown where he is caring for boys who are no longer welcome in their villages or have been orphaned by the war. One of them is Prince Williams, a tall young man who found himself alone in Freetown after fleeing from the rebels in the jungle.  There he met Richard who brought him to the Nehemiah home and showed him love; not what Prince was expecting!  Richard  has a dream; to raise the future leaders of Sierra Leone, demonstrating forgiveness and reconciliation through the messy, day-to-day business of raising adolescent boys representing all factions of the conflict. Having become friends with Richard some years earlier, Lucy and her husband have come from the UK  to support him as the work rapidly grows.

A smart government vehicle pulls up outside in a cloud of red dust. The visitor spots the white man in the office, and climbs the stairs, ignoring the scruffy guy on the veranda with a baby on his lap who is laughing and calling out greetings as people pass on their way to market.  The visitor goes in for a handshake and deferential introduction.  ‘Good morning Director Sir’.  ‘Ah, you’re looking for the Director?’ replies Lucy’s husband, ‘That will be my boss – you passed him on the veranda.’

Although Richard died in 2006, the vision continued, with LNP gaining a reputation for its strong values of integrity and excellence, now run by new Director, Prince Williams.  Lucy had returned to the UK in 2004, but friendships continued, and almost weekly stories were shared of women or their babies dying.  She was now a midwife-researcher and in 2015 teamed up with Prince to devise a household survey to understand the severity of the problem locally.  The data showed that for pregnant girls under eighteen, 1-in-10 had died from a maternal death.

Funded by Wellbeing of Women, Lucy worked together with LNP’s Mangenda Kamara, a gender specialist, to understand this problem. We heard stories of abandonment, isolation, rejection and hopelessness. A plan emerged; what these girls lacked was a committed adult in their lives, so together we started 2YoungLives, a mentoring scheme where local women with a reputation for kindness and confidentiality are trained to mentor pregnant teenagers. This mentoring includes support to: run a small business to eat well and prepare for birth; negotiate family relationships; access maternity care and postnatal contraception; parent confidently including learning how to make cheap, nutritious baby food; and to return to school or tech/voc training after birth.

That was in 2017. Since then 2YoungLives has expanded from 3 to 54 mentors spread throughout the country and have supported over 300 girls, none of whom has died. In partnership with King’s College London the team is now running a  randomised cluster feasibility trial funded by the NIHR as part of a Global Health Group; the subject of Mangenda’s PhD.

Under Prince’s  leadership, Lifeline has developed a bespoke strategy for engaging whole communities around sensitive and politicised gender-based issues. This expertise lies within the local team who over many years have gained  a deep understanding of the nuances of how communities operate. It is not devised by researchers removed from the history and shared experiences of Sierra Leoneans, but addresses the real lives of young women stigmatised by their communities, facing multiple barriers to surviving and thriving.

Clearly this partnership has the benefit of longevity, but we believe there are catalysts which are keys to success: an emphasis on being driven by shared values and what that means for 2YoungLives;  a real valuing of the skills and expertise of all partners and playing to those strengths; deep and curious listening; and joint reflection and problem-solving when issues arise. One of Prince’s mantras when engaging with communities is ‘it takes a million conversations to change a mindset’. As we have reflected on the essential elements of a strong partnership, and the need to shift entrenched mindsets about what this means, we have concluded that this also applies.  We hope this blog will be a prompt for more of those conversations.

 

About the authors: Prince Tommy Williams MA, joined Lifeline Nehemiah Projects (LNP) as one of the beneficiaries in the 90s and  over the past 24 years has served in various dimensions as a volunteer and staff member, becoming Executive Director in 2019. He has a Masters’ degree in Christian Counselling and a BSc Honours degree in Business and Information Technology from the Njala University, Sierra Leone. He is passionate about engaging and empowering communities, and is Community Engagement (CEI) lead for the CRIBS Global Health Group.

Mangenda Kamara M.Phil, is a gender specialist with an M.Phil in Gender Studies from Fourah Bay College, University of Sierra Leone.  She is an educator interested in working with young women and teenagers and for her Masters degree researched the barriers and facilitators to education for pregnant girls. She is currently a Research Assistant for the 2YoungLives pilot trial and pursuing her PhD at the University of Sierra Leone.

Lucy November MSc, is a midwife-researcher based at King’s College London.  Having worked as a teenage pregnancy midwife in the UK, she completed a Masters degree in Public Health at London School of Hygiene and Tropical Medicine in 2010 and moved into research into adolescent motherhood.  She has a lifelong love of Sierra Leone.

Competing interest: None

Handling Editor: Neha Faruqui

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