Good morning Hank it’s Tuesday Working with Partners in Health,  our community is now on pace to raise over thirty-five million dollars  in the first five years of our project  to help PIH radically reduce maternal mortality in Sierra Leone.

This video comes in four parts.  What Happened, What’s Happening,  Why It’s Happening, and what’s next So three years ago,  our community began working with Partners in Health to support their efforts  to strengthen the healthcare system in Sierra Leone’s Kono District,  which is the epicenter of the global maternal mortality crisis. Like in 2019, one in 17 women in Sierra Leone could expect to die  in pregnancy or childbirth.

So, to address the crisis,  PIH and the Sierra Leonean Ministry of Health wanted to build  a world-class maternal and infant care wing of Koidu  Government Hospital called the Maternal Center of Excellence. The MCOE would not only have  the blood bank and surgical suites to make emergency C-sections safe,  but would also serve as a teaching hospital to train the next generation  of Sierra Leonean nurses, midwives, and doctors. So in 2019, we committed to help PIH raise 25 million dollars over five years  so they could break ground on this hospital expansion.

We weren’t sure how we were gonna raise the money,  but never underestimate Nerdfighteria. So where are we now? Well, despite supply chain challenges, the Maternal Center of Excellence  has begun construction, although it is a long way from finished.

But we don’t need to wait for a building  to start to see the change– Koidu Government Hospital is already  becoming a teaching hospital, with the first cohort of nurses and midwives  recently finished their rotations there, and this is really exciting because it means  more people in the region can pursue those careers. Also, because we have blown past our initial goal,  we’ve been able to expand this project to extend our support to several  primary healthcare clinics in the region– including one in the town of Kayima. And Kayima was the scene of a really important story this year,  I think, which is there was a huge outbreak of a diarrheal illness in town and that’s  one of the leading causes of death for kids under the age of five.

And in response the clinic treated people who got sick,  but also recognized that there was an underlying cause to this outbreak,  which is that neither the clinic nor the community had regular access  to clean water. And so the PIH team drilled a well that now provides clean water,  not just to the clinic, but also to the town. I think this is part of what makes PIH so special.

They respond to acute health crises,  but also to the chronic underlying causes of those crises. And this approach is working in Kono. Child mortality at the hospital  has fallen by over half, just in the last two years.

Unsexy but critical system stuff like efficient warehousing  and climate-controlled storage of medication has improved the availability  of everything from medicines to surgical gloves and   maternal mortality is declining as well,  even though it is still  hundreds of times too high. I think it’s really important to note that this is not happening because  progress is like, inevitable. If we’ve learned anything  from the last two and a half years, it’s that progress is never inevitable.

This is happening because of the extraordinary commitment of  Sierra Leone’s healthcare workers and because of your support. Like, thousands of people donate monthly to this project at  pih.org/hankandjohn thousands more have made  one-time gifts. And around 100 Nerdfighters  have come together to donate between $2,000 to $100,000 a year  to ensure that every one of those dollars gets matched.

You can get a full financial breakdown of where we are,  at the unlisted video in the dooblydoo. Should I call it the video info if I’m wearing a suit? Probably, so the video info below.

But the other really important source  of revenue for this project is socks and coffee. Oh which reminds me, starting today,  we have a light roast available from the Awesome Coffee Club. And it’s great!

Amazing coffee,  sent to your house and 100% of the profits go to charity. We’ve named our roasts after butterflies that live in Sierra Leone–  like our classic, medium/dark roast is called  Octavia after precis octavia, a butterfly that changes color  depending on when it's born. And our brand-new light roast is  called Calypso after this ethereal beauty, Belenois Calypso.

So now, whether you're a fancy coffee person who likes light roast  or a regular coffee person. We’ve got you covered. awesomecoffeeclub.com All that said,  by far the most efficient way to donate to this project is pih.org/hankandjohn So if you like socks or coffee or both, links in the dooblydoo, but again,  the most efficient way to donate is pih.org/hankandjohn. It’s just that if you’re gonna get socks  and coffee anyway, and you are.

Why not do it for charity? So What’s Next? Well for me at least,  this is the biggest news.

PIH has a long history of fighting  for justice and equity in healthcare and when the global health community  said it was impossible to treat multi-drug resistant tuberculosis  in poor communities, PIH proved otherwise. They also helped lead the charge find to expand access to antiretroviral therapy  for people living with HIV. And our biggest hope when we started this project is that even though  our work would be focused in just one region  of just one country, we could use that example to prove  that it’s possible to radically reduce maternal and child mortality everywhere.

And then maybe the project in Kona would help inspire other partners  to expand the work. And we’re starting to see that. PIH is now working with Sierra Leone’s Ministry of Health  and the World Bank to strengthen the healthcare system in the  Kailahun District, which is just south of Kono.

As PIH’s Jon Lascher recently wrote me, “You and your community – which now very much feels  like our shared community – have paved the way for more partners  to join us  and for us to expand our work. And there is so much left to do.” And there is so much left to do. Like, one of the big challenges  here is that as a healthcare system gets stronger,  more people begin to trust it, and more people begin to use it.

Like in 2019 the primary healthcare center in Sewafe saw 4,700 visits and in 2020,  it saw 4700 visits. So like, from the outside, one might conclude that the clinic  isn’t very important to the community, or that it doesn’t serve  a very large patient population, but because over 95% of  PIH Sierra Leone’s employees are Sierra Leonean,  and live in the communities where they work,  they understood that something else was happening. Which is that the clinic did not have the staff, space, stuff,  and systems to provide good care.

In 2021, after PIH began supporting the facility, the clinic in Sewafe  saw over 20,000 patients– a 500% increase as the year before. And as the clinic continues to get stronger, it may see even more patients,  so this is a critical time for our work with Partners in Health. Because patient volume is increasing so dramatically.

And we are hoping that our support will increase too. Needing an emergency C-section in Kono continues to be  a life-threatening emergency but we know it can change. We know it can change because when we started this project  three years ago, 1 in 17 women in Sierra Leone  could expect to die in pregnancy and childbirth.

Today it's fewer than 1 in 20. That’s still much too high,  but that progress is real. We can choose to share a world  where maternal and child death are rare– and thanks to your attention and support,  I really believe that our community is helping to bring about such a world.

Even if you can’t personally donate, your attention and advocacy  helps draw attention to the global maternal  and child mortality crises, which brings in big funding partners. If you can donate, the link is pih.org/hankandjohn. Nerdfighteria, I continue to be astonished by you.

Hank, I’ll see you on Friday.