Missing Mothers

These photos were taken in Sierra Leone, which has one of the highest maternal mortality rates in the world.

In the poorest countries, only half of the women giving birth get help from a trained health worker. As a result, every year more than 500,000 women one woman every minute - will die needlessly in childbirth or as a result of being pregnant.

It is estimated that there is a shortage of more than 4 million health workers - doctors, nurses, and midwives.

Mabinty Conteh (50) looks after her granddaughter Isatu Conteh, who was named after her late mother Isatu Conteh (20).

I was very proud of my daughter. She was intelligent and never brought me any problems. She's already completed the 5^th form and only stopped because of the pregnancy. She planned to go back and finish her education after Isatu was born. She always told me how she wanted to become a nurse when she'd finished school. Her father gets sick frequently (malaria) so she said if she was a nurse then we wouldn't need to pay for treatment at the hospital. She would be able to look after us.

Even now, a year after she died, her memory stays in my heart and I think of her every day. Isatu had so many friends and was very popular. After she died they all came to ask if I had a picture of her. I kept only two out of the whole album. It's heartbreaking that she died so young.

Mohammed Kamara (40) cares for his two sons and his wife's sister's child, Ibrahim.

Zainab Kargbo (37) already had two children when she gave birth to Ibrahim. They are being looked after by other relatives.

'Following the delivery, Zainab's left breast became badly swollen and very painful. The doctors told her that she would need surgery but she was hesitant to undergo the procedure. After the surgery she suffered a lot of pain and developed a serious infection. The family took her to the provinces to seek treatment with native medicines but she continued to deteriorate. Shortly before she died, she told my wife that she didn't think she would make it and asked her to take care of Ibrahim. We were all very close and my wife loved her very much. I was happy to take Ibrahim as my own son and he thinks of Sarah (my wife) as his mother. He has just started attending infant school and is doing well.

I want my children to grow up to be happy; to be good people, so I try hard to give them what they need, but it's a struggle. I used to work for a transportation company as a driver but now we have only my wife's small income and a little support from my parents. Sarah, my wife, trades in goods from the provinces, such as palm wine and wood, so she spends a lot of time away from Freetown.

Mohammed Fofana is the father of Hassan (3 months old)

'I lived in the amputee camp nearby where Fudia used to go to market to sell. We met there and started seeing each other. After a short while I began visiting her at home and the family liked me. We soon fell in love. When Fudia became pregnant I came to live with her. We didn't plan the pregnancy but we were happy and I was pleased that she didn't want to try for an abortion. I always wanted to have a child so I was happy. Throughout the pregnancy Fudia was fine. We planned that after the birth she would start with skills training, so she could become a hairdresser. I've always wanted to be a tailor but I can't afford the training as of now.

Fudia gave birth with a local TBA (traditional birth attendent) a short walk from the house. During the delivery she lost a lot of blood and felt very week. After three days we took her to the hospital (a small privately run Arab clinic). We couldn't afford to pay for a blood transfusion so the doctor gave us syrup and blood medicine for her to take. She tried to stay active but her condition did not improve and a few days later, when she was preparing food for us, she said she was not feeling well and went to see the local pharmacist. He told her that because she was breathing very quickly and her heart rate was up he couldn't do anything for her, that she should wait until it calmed down and then come back. So we took her home. But by the next day she was really weak, having great difficulty breathing and sweating heavily. So we decided to take her to the Connaught Hospital in a taxi but she passed away and died as we arrived at the hospital gates. Only God knows why she died.

Photos: Aubrey Wade