Bridging the Healthcare Gap: How Sick Pikin Helps Sierra Leone’s Children Access Lifesaving Treatments

In September 2021, a young girl from Sierra Leone boarded her first plane ride bound for New Delhi, India. She had been diagnosed with meningioma, a type of brain tumor that cannot be treated in her home country due to a lack of specialized neurosurgical care.

For children in Sierra Leone, life-threatening conditions often become fatal due to limited access to advanced diagnostic tools and healthcare facilities. Without timely intervention, meningioma can compress the brain or spinal cord, leading to severe neurological damage or death.

For families in dire poverty, the cost of flying to India for treatment would seem impossible. That’s where organizations such as Sick Pikin (“Sick Child” in the Krio language) step in. Founded by Ishmeal Alfred Charles, the nonprofit raises funds to send critically ill children overseas for lifesaving procedures. Since its launch in 2018, Sick Pikin has helped over 80 children access specialized treatment unavailable at home.

“We’re really struggling to develop, but we are getting there,” Charles said during a discussion about healthcare development in Sierra Leone.

At 42, he has watched his country change dramatically over the decades. Sierra Leone was once embroiled in a brutal civil war. When Charles was 15, he found himself kidnapped by rebel forces not once but twice, forced to become a child soldier as they made their way to take over the capital, Freetown.

When the war ended, the entire country began a process of reconciliation. With the country in a dire state, the population traumatized and exhausted, Charles was inspired to assist his countrymen in another way: poverty relief.

Today, Charles is employed by the nonprofit Caritas Freetown, a Catholic humanitarian and development organization dedicated to promoting justice, human dignity, and sustainable development. According to its website, Caritas Freetown supports vulnerable populations, particularly in Freetown and its surrounding areas.

But on the side, Charles focuses on the Sick Pikin Project, one of the only nonprofits that supports Sierra Leonean families in securing lifesaving medical care for children suffering from severe health conditions.

The Need for Broader Medical Access in Sierra Leone

In Sierra Leone, extreme poverty hampers the type of healthcare access those in wealthier countries can more easily access. Over 56 percent of Sierra Leone’s population lives below the poverty line, surviving on less than $1.90 per day, making access to basic healthcare unaffordable for many.

Even if families can afford care, Sierra Leone has only 0.2 surgeons, anesthesiologists, and obstetricians per 100,000 people, far below the recommended threshold of 20 per 100,000, severely limiting access to lifesaving surgeries.

In developing countries that are geographically isolated, it is incredibly difficult to retain qualified surgeons for the types of care these children need. From low compensation to poor and inadequate infrastructure and equipment, keeping trained surgeons from seeking better pay and working conditions abroad is a major challenge for Sierra Leone’s healthcare system.

There is currently only one pediatric surgeon in the country for a population of nearly nine million. This means that regardless of ability to pay, nearly everyone must travel out of the country to receive an array of treatments not offered yet in Sierra Leone.

Despite progress since the end of the civil war, Sierra Leone spends just over $55 per capita annually on health, resulting in one of the world’s highest maternal and child mortality rates due to insufficient infrastructure and resources.

[The USAID funding freeze] underscores a broader instability in traditional donor funding.

In Freetown, many nonprofits help fill healthcare gaps, from Doctors Without Borders (Médecins Sans Frontières or MSF), Partners In Health, and Mercy Ships. The larger NGOs like MSF and other international health organizations have significantly contributed to improving healthcare in Sierra Leone, but they alone cannot end the country’s reliance on foreign patient referrals.

Hospitals in Sierra Leone still lack the specialized equipment, advanced surgical facilities, and intensive care units (ICUs) needed for complex procedures. Even when surgeries can happen, frequent power outages, inadequate water supply, and poor sanitation inhibit the country’s ability to overcome its health desert.

On top of these complex development issues, the lack of trained specialists with a long-term footprint in the country means specialized treatments are sporadic and inconsistent, leaving nonprofits like Sick Pikin with no choice but to look abroad.

Because of this issue, Charles saw the need to raise money for families to send children with severe healthcare problems to other countries while Sierra Leone develops its medical capacity.

The Growing Concerns over Global Aid

Recent shifts in global aid funding have only exacerbated concerns throughout the developing world. The US Agency for International Development (USAID), one of the largest contributors to healthcare and humanitarian initiatives in Sierra Leone, recently froze over $2 billion in foreign aid, creating ripple effects across international development programs.

This decision underscores a broader instability in traditional donor funding as geopolitical shifts and domestic pressures in donor countries increasingly dictate the future of global health assistance. Such uncertainties place even more pressure on small, community-led initiatives like Sick Pikin, which already operate on limited resources while serving some of the most vulnerable patients.

While not tied directly to complex surgeries, the programs and projects undertaken by agencies like USAID are vital to Sierra Leone’s healthcare. Now under assault by the Trump administration, if USAID were to end its support in the country, key programs combating malaria (the leading cause of death in the country), maternal health, and HIV/AIDS could collapse. Hospitals and rural clinics could face drug shortages or even shut down. Epidemic response to diseases like Ebola and cholera would weaken, increasing outbreaks in the region.

In response to these changing dynamics, alternative funding strategies are being explored by nonprofits, large and small, to ensure sustainability. While diaspora contributions remain a crucial lifeline, there is potential for impact investing, public–private partnerships, and regional healthcare financing models to play a larger role.

Some countries facing similar healthcare challenges have found success in hybrid models, where governments, private entities, and philanthropic organizations collaborate to establish specialized medical centers.

This kind of nonprofit wouldn’t be needed if Sierra Leone could fully develop and retain surgeons and medical professionals in-country.

Additionally, South–South cooperation—where countries in the Global South partner to share resources and expertise—could provide long-term solutions, reducing the reliance on costly foreign medical referrals.

For Sierra Leone, diversifying funding streams may be the key to building a healthcare system that is both resilient and less dependent on external aid fluctuations. But for now, small nonprofits like Sick Pikin have an uphill battle to wage—and larger nonprofits involved in international development have already sounded the alarm while seeking alternatives to mitigate the storm.

For example, the Vatican’s global charity arm, Caritas, warned that millions could face severe consequences due to this “ruthless” funding cessation. And the Norwegian Refugee Council (NRC), a secular humanitarian organization, is now trying to correct aid projects in 21 countries, citing payment delays.

To address the shortfall, the NRC is strengthening partnerships with other international donors and private sector entities. Notably, the Norwegian government has entered into new strategic agreements with NRC and other humanitarian organizations, committing approximately NOK 1.9 billion ($171 million) annually over the next five years. These funds are intended to provide rapid, flexible, and targeted humanitarian aid, enabling NRC to continue its critical work despite the reduction in US funding.

And while that’s a very positive development, the NRC has the luxury of being close to a government that can somewhat ease the tide. For other smaller, independent nonprofits without such connections, the future can seem bleak.

The Uphill Push for Progress

Over the years, Charles has seen many success stories. However, the successes are bittersweet; this kind of nonprofit wouldn’t be needed if Sierra Leone could fully develop and retain surgeons and medical professionals in-country for prolonged periods.

“Around 85 percent of our donations come from Sierra Leoneans and the diaspora community,” Charles explained. “We don’t just raise money for the kids, but for their mothers to join them, and sometimes another caretaker. We also have to raise money for their travel visa, housing while abroad, as well as transportation.”

It’s all very expensive, and Charles has hired at least two other employees to work with airlines for discounts and to raise money from other communities outside of Sierra Leone. Charles is well-known in the healthcare nonprofit circles of Freetown and is a regular figure at conventions, town halls, and other events where medical capacity building is a topic of discussion.

Abroad, Sick Pikin has registered as a nonprofit in Texas, where its US office targets diaspora communities to support healthcare in Sierra Leone. Charles relies on Sierra Leonean Americans to advocate for children back home to get specialized care.

Locally, Charles has formed marathon walkathons in Freetown to support the nonprofit. These events received support from various organizations, including the German embassy, Sierra Leone commercial banks, and a popular local food chain. Participants included representatives from these organizations, government officials, and members of the public, all united in their commitment to supporting the health and wellbeing of Sierra Leonean children.

Despite his positive and hopeful demeanor, Charles explained that the most worrisome thing is that families don’t know when and where help will come from, especially as children’s conditions worsen.

“People are constantly calling me or coming to our office,” said Charles. “When I do a media appearance on television or the radio, more people begin calling, desperate people are at my office each morning.”

Charles noted that Sick Pikin is often called upon to provide unexpected types of support as well. In the case for the young girl who flew to India for her treatment for meningioma, after returning to Sierra Leone her condition resurfaced. Following the passing of her father, Charles raised money for the mother to start a small cookery for the family to support themselves. Currently, the child is receiving palliative care. Sadly, this is a stark reality for many in West Africa.

Small nonprofits like Sick Pikin raise awareness about public health issues, vulnerabilities, and financial constraints patients experience in accessing affordable and safe healthcare. Alongside international medical NGOs, these organizations buttress the public effort toward a more sustainable healthcare system, but the need is great, and many gaps remain.