A Mother's Final Look at Life

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Hospitals of Last Resort

Sierra Leone has the highest rate of maternal mortality in the world. Hospitals lack basic equipment and medication, and factors such as poverty and lack of transportation make every pregnancy a gamble.

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They loaded her body onto a black stretcher, and several men carried it to the parking lot.

The hospital's ambulance was broken down, so the family flagged down a small delivery van. They loaded Fatmata's body into the truck's covered bed, pushing aside a spare tire.

Then six of Fatmata's relatives and friends squeezed in with her body, and the truck pulled out into the chaotic morning traffic in the pouring rain, its yellow emergency lights flashing.

Twenty minutes later they arrived at Fatmata's family home, a collection of small shacks around a concrete courtyard. They sat behind the ruined remains of the family's former house, a grander structure that was burned by rebels in the 1990s during the civil war.

A dozen women waited near the rusting iron gate. Over and over they screamed, "Fatmata! Fatmata!" as men carried her body past an ancient truck up on blocks, past the dogs and chickens in the courtyard and into a small bathroom where her body was unwrapped and washed.

Fatmata's father, a tall and regal-looking man in a long blue robe and a white skullcap, sat with his head in his hands, taking fast and shallow breaths. Fatmata's mother was stuck at least eight hours' drive away in the countryside, caring for her own sick mother.

For the next seven hours, at least 100 people flooded into the courtyard. Many women knelt before Fatmata's father and cried as he consoled them with a gentle touch on the head.

Isata Barrie, 32 and heavily pregnant with her fifth child, sat with dozens of other people on plastic chairs. She said the death of another teenager in childbirth was not a surprise: "This is what happens to women here."

Just before 4 p.m., Saidu and several other men lifted Fatmata's body, now wrapped in a gauzy white burial cloth, into a wooden box. The box belongs to the mosque, which lends it out to families to carry bodies to the graveyard.

They placed her body in a small delivery van and drove slowly, with scores of men walking behind, to the cemetery, where many dead mothers had come before.

No women were allowed at the burial, as is common in many Muslim communities. So the silent men walked slowly down an overgrown path, six of them carrying Fatmata's body, which they placed in a freshly dug hole in the rich, red soil.

Ten hours after she had taken her last breath, her sad-eyed husband tossed the first shovelful of dirt.