New Executive Director in Sierra Leone’s Mantra: “We Need to Care for People”

In August 2014, Dr. Mohamed Bailor Barrie got a phone call from Partners In Health Co-founder Dr. Paul Farmer—and immediately began dancing.

“Paul called me and said PIH made a commitment to come to Sierra Leone. I started dancing through the whole house,” Barrie recalled.

Barrie had long envisioned PIH in his home country. Years prior, when starting his own clinic for the rural poor, he read about the organization in Tracy Kidder’s Mountains Beyond Mountains and got in touch with Farmer and Dr. Joia Mukherjee, PIH’s chief medical officer, for technical guidance. He’d kept in contact since then, always advocating for the organization to work in Sierra Leone, an impoverished country where health outcomes are among the worst in the world and life expectancy is a mere 54 years.

“I had it in the back of my mind that if I was ever able to bring PIH to Sierra Leone, I would be the happiest man,” Barrie said. “They think about health care differently, and see patients and poor people differently—holistically, and through an eye of social justice.”

The good news was coming at a painful time. West Africa was at the height of history’s worst Ebola outbreak, and the government of Sierra Leone was looking for partners to help quell the virus as deaths rose, both from Ebola itself and disruptions to health care in general. Still, Barrie was full of hope visualizing the future of PIH Sierra Leone.

“I couldn’t sleep that night,” Barrie said, “imagining what we would do, and thinking, ‘Are we going to create an impact? A huge impact?’”

Today, Barrie continues to ask these questions—in a new capacity. Previously PIH Sierra Leone’s strategic advisor, Barrie stepped into the role of executive director in May—fulfilling a dream decades in the making.

A Dream Deferred, and Reignited

Growing up in Makeni, a three-hour dive from the capital city of Freetown, one of Barrie’s heroes was a nurse who lived in his neighborhood, whose home everyone visited for care. Admiring this clinician from a young age, Barrie knew he wanted to be a physician.

“I started playing doctor as a kid,” Barrie said. “I would go to the bush, pick different seeds, put them in a cup as pills, and have honey and syrups. On Saturdays and Sundays, the kids in the neighborhood would come with their dolls and I would pretend to treat them. That's how I spent my childhood. Every weekend I would do my clinic and see patients.”

His dream seemed unlikely to come true, however, as Sierra Leone had no medical school. The only option for the country’s aspiring doctors was to study abroad—an impossibly expensive pathway.

“My father was a tailor and made less than one dollar a day,” Barrie said. “I had one meal a day, and my brother and I had to sell things—cigarettes, candy, roast meat, kerosene—to support our education. We’d go to a village seven miles away to get mangoes and to the swamp to get leaves to sell at the market, so that at least we could get something to eat in the morning.”

Barrie planned instead on following in his older brother’s footsteps and studying engineering. But when Sierra Leone’s medical school opened in Freetown, and he learned a national scholarship was available to the top two students in the country, his dream was reignited.

“I studied hard—because that was my hope for becoming a doctor. Fortunately, I was the second best student. And that took me to medical school,” Barrie said.

Of course, tuition wasn’t the only expense to worry about. The costs of food, housing, transportation, and school necessities like textbooks were not covered in Barrie’s scholarship.

What’s more, Sierra Leone was in its sixth year of civil war. Just as Barrie began medical school, the Revolutionary United Front attacked Freetown and held it under siege for nine months.

Barrie coped. He took refuge in Guinea during the coup, staying safe but prolonging his education. Upon returning to Sierra Leone, he lived with a friend’s family, eliminating the cost of rent but, with the cost of transportation as another barrier, walking 14 miles to and from school each day. And he relied on friends—and a deep well of patience—to access textbooks.

“On weekends, I would borrow textbooks from my friends and hand copy them. Before each semester, I’d have all of the books handwritten,” Barrie explained.

“At some point,” he continued, “I nearly gave up. I wanted to leave school and work with my uncle at his pharmacy. But I had the scholarship and friends who were very supportive, and my brother went to the United States and started sending me money. He bought me my first textbook in my fifth year. Then, things started changing.”

With this new cushion of basic social support, in 2004, Barrie achieved his lifelong goal: He graduated medical school and was officially a doctor.

“What Can I Do To Help?”

But as a brand new physician, working at Sierra Leone’s public children’s hospital, Barrie quickly found that the reality of practicing medicine did not match his expectations from his make-believe clinic. All aspects of health care had a fee attached, making it inaccessible to his patients.

“One day,” Barrie recalled, “a woman brought her sick child into the hospital. I looked at the kid, sent him to the lab, and prescribed the drugs for his diagnosis, malaria. Without thinking about: ‘Can this mother afford this?’”

“She couldn’t,” he continued. “I gave her the prescription not knowing she had paid our consultation fee, paid for the lab test, and all she had was finished. She came back three days later with her child convulsing; he had developed severe malaria in the time she was trying to get the money together to buy the medication.”

That patient, Barrie said, represented a personal turning point.

“I went home and thought: ‘The health system is deplorable. What can I do to help?’” he said. “I made the determination that day to start a clinic to provide free health care to poor people.”

Barrie’s initial plan was to work in the United States as a doctor, save money, and return home to begin his clinic. But then he was connected to Dan Kelly, an American medical student doing a global health fellowship in Sierra Leone.

The two began talking—about “health and poverty and social justice”—and easily found common ground in Barrie’s goal to provide free health care to marginalized populations. Together, they embarked on a tour of Sierra Leone’s amputee camps, scattered across the country to resettle displaced Sierra Leoneans whose limbs had been chopped off during the horrific, 11-year civil war.

At all of the resettlements, mistrust was palpable as Barrie and Kelly tried to conduct interviews.

“They did not want to talk to us,” Barrie said, “because they said NGOs had gone there so many times to interview them, show them on CNN, then leave without doing anything.”

But people soon opened up—all with the same needs.

“One hundred percent of people said what they needed was food, education for their children, and health care,” Barrie said.

“Let’s Just Start”

For Barrie, nowhere was this need more acute than in Kono District, a rural region in the country’s far east, bordering Guinea. Home to West Africa’s largest diamond mine, Kono had been, in Barrie’s mind, “the Europe of Sierra Leone.” But its natural riches made it a massive target in the civil war; four years after the conflict’s end, in 2006, Barrie was shocked to find that “everything looked like the war had just finished.”

“I told Dan, ‘This is the place we should work. Of all the districts we have visited, this is the worst district,’” Barrie said. “I hadn’t even seen the hospital yet. But just standing on the main road, I could see and feel how health care would be a huge problem in a place like this.”

The two established Wellbody Clinic the following month, as a source of free health care for Kono’s amputees. What started as a one weekend per month mobile clinic seeing 50 patients a day rapidly grew to 200 patients a day within a couple months. Within the year, with funding from the Kelly family, Wellbody was constructed as a permanent clinic on the rural outskirts of Koidu, Kono’s capital, and its first staff members were hired.

Primary care was soon extended, for free, to all patients. And health services eventually expanded to include a community health worker program (with guidance from PIH) for patients living with HIV, the training of traditional birth attendants to recognize labor complications and refer women to health facilities, and the construction of a maternity unit.

Today, Wellbody is recognized as one of the best health care facilities in Sierra Leone; between 2016 and 2020, it saw zero maternal deaths. It is supported by PIH alongside five other rural clinics and Koidu Government Hospital, now considered the best public hospital in the country—in the place Barrie once deemed the worst for health care.

“Honestly, it’s overwhelming,” Barrie said. “We used to have one building; now I look around and there’s a whole campus and a whole health system. We started Wellbody not knowing where it would head. We didn’t even have money for a full year—but we said, ‘Let’s just start.’”

A New Narrative

With Barrie’s facilitation, this same spirit of optimistic urgency characterized PIH’s entrance into Sierra Leone, as the organization began fighting Ebola and investing in long-term health system strengthening.

“Bailor is an engine of positivity,” said Jon Lascher, PIH Sierra Leone’s former executive director, from whom Barrie is taking the reins. “During the most difficult days of the Ebola outbreak, Bailor was a source of energy and inspiration to everyone on the team. And how could you not feel motivated after knowing Bailor’s story?”

Partners In Health Chief Executive Officer Sheila Davis echoed this sentiment.

“I met Bailor in 2014 during the Ebola outbreak and immediately was drawn to him as a thoughtful, passionate and strategic leader,” Davis said. “From day one, Bailor was thinking about what was best for the people of Sierra Leone; he has never deviated from his goal to build health systems that ensure people have long term access to quality care.”

Barrie not only advised Lascher and the organization as it has expanded its footprint in Sierra Leone, but also led a number of its emergency responses alongside the government: from designing PIH’s Ebola strategy, to implementing a historic cholera vaccination campaign, to training Sierra Leone’s national force of COVID-19 contact tracers.

“Bailor is generous and patient, and that is what has made him such a great mentor and guide to me as we built the organization together nearly seven years ago,” Lascher said.

But as he steps into the role of executive director, Barrie said he’s now the one looking for advice.

“I want to listen, and to lead as a servant rather than like a boss,” he said. “Be it the cleaner, the nurse, the program director—I want to listen and learn from my teams, to face challenges and find solutions together.”

For all of his passion for PIH, ultimately Barrie’s longstanding leadership is about something much larger.

“For me, it’s not about Wellbody, or PIH, or any organization,” Barrie said. “It’s about the people of this country, and seeing a health care system we can be proud of, where nobody dies a preventable death.”

And, he said, it’s about rewriting Sierra Leone’s narrative.

“I think Sierra Leone is viewed as a very corrupt country, somewhere it’s not possible to do good work. But it’s not in the making of this country. It’s a history of slavery and colonialism.

“Sierra Leoneans can do good work,” he continued. “But most of us are always engaging our brains to think about survival. How do you think about development and innovation when your stomach is empty?”

The problems may seem complicated, but the answer, Barrie said, is simple.

“We need to care for people.”