Diary: Sierra Leone slum medic

Medical staff at a clinic in the coastal slum of Kroo Bay, in Sierra Leone's capital, Freetown, have been keeping a diary of their working lives for the BBC News website. In this entry, Bintu, the clinic's maternal and child health nurse, describes a delivery.

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A young woman, Mariama, came in with her mother-in-law late in the evening. Mariama was nervous and already in labour.

I examined her. The baby appeared big, but it was turned the right way and I gave her a drug to speed up the delivery process. Within three hours a healthy baby boy weighing 3.7kg (8.1lb) was born.

Mariama was shouting: "Jesus, Jesus, come down and help me now!" while she was giving birth. Her mother in law prayed just outside the room.

When the baby was finally born Mariama was very happy, and I had to remind her to thank Jesus.

Often patients cannot afford to pay for giving birth

I said to her: "You've been shouting for Jesus all along and now that your baby is born you have forgotten to thank him?"

Everyone laughed and Mariama thanked Jesus.

It was then that they told me that Mariama had visited a doctor a few months before because the baby had stopped moving.

The doctor had told her she would have to have the baby by Caesarean section, but because they had no money her mother in law brought her to the clinic instead. Caesareans are very expensive.

Soap and drugs

The mother-in-law was hoping that if there were complications we would take them to the hospital.

They did not tell me before the delivery because they feared I would refuse to deliver the baby and refer them to the hospital instead.

We charge a service fee of 70,000 leones ($23.80; £11.90) for deliveries that also covers soap and drugs, usually people pay before they go home.

But Mariama promised they would bring the money later.

I hadn't heard anything so I decided to go and investigate what was happening.

Mariama was surrounded by several children, each one of them looking hungry. One of the children was asking her if she could please leave him a bit of her gari

I arrived at the house in the morning and immediately realised that this was a very poor family.

Mariama was eating gari with sugar. Gari - grounded and roasted Cassava root - is the cheapest local food we have. It costs 100 leones ($0.34; £0.17) for a small portion, which you eat by mixing it with water and sugar or salt.

Mariama was surrounded by several children, each one of them looking hungry. One of the children was asking her if she could please leave him a bit of her gari.

Abdul and his wife gave their own newborn a name - Ibrahim Mohammed

We call them "Popolypo" - the poorest of the poor.

I felt very sorry for her - a new mother should be eating something much more nutritious.

Gari is only carbohydrates and she needs good nutrition to breast-feed the baby.

When I asked about the money, some of the men in the family started shouting at me.

Mariama told me they still do not have the money and that they will get it Monday.

But, after I left, I thought to myself that I wouldn't go and ask again. I do not want them to steal money or borrow it and get themselves into debt. It was clear they did not even have enough money to pay for a proper meal for the family.

Naming ceremony

It happens pretty often that a woman cannot pay for a delivery. In most cases the father has refused to take any responsibility and I normally take pity on them and tell them not to worry.

Christiana - the little girl we talked about last week - made a full recovery from vomiting and diarrhoea.

We had a few more cases that week, but fortunately there was no big outbreak.

We also had the naming ceremony of the newborn baby son of Abdul the clinic cleaner and his wife, Mary.

He was named Ibrahim Mohammed in a simple naming ceremony. The Imam chooses the baby's first name according to the day and date the baby was born and the family gives the baby it's second name.

Read the previous diary entry

Save the Children has launched an interactive website where Kroo Bay residents answer questions about their lives. Visitors will be able to access 360-degree images of the site, and catch up with the latest news from the slum through regular "webisodes".