Rebels and rogue military have taken international workers hostage. Because many Sierra Leoneans do not speak English, it can be difficult for a foreigner to communicate his or her identity. Travelers may also encounter difficulties at the numerous roadblocks and checkpoints inside and outside Freetown. Medical Facilities Medical facilities and standards fall critically short. Persons with medical conditions that may require treatment or medications are discouraged from traveling to Sierra Leone.
Medicines are in short supply, sterility of equipment is questionable, and treatment is unreliable.
Many primary health care workers, especially in rural areas, lack professional training. Instances of misdiagnosis, improper treatment and administration of improper drugs have been reported. International air carriers are reluctant to assist with medical evacuations from Sierra Leone. Private charter evacuations, costing thousands of dollars, may be necessary. Doctors and hospitals usually require immediate cash payment for health services.