With malaria, diarrhea and vomiting, pneumonia, bronchitis and other respiratory infections, worm infestations, scabies, abscesses, sores, and boils all common ailments in the Kroo Bay community of the Sierra Leone capital Freetown local medical official Amadou Kandor says it’s little wonder 35 is an average life expectancy for the slum’s 6,000 inhabitants. Kroo Bay, one of the poorest areas in the centre of Sierra Leone’s beachfront capital Freetown, is a squalid slum so littered with rubbish that the paths are made of compressed plastic, cans and toothpaste tubes, and patches of bare orange earth are a rare sight.

Swarms of mosquitoes breed in pools of slimy green water, pigs and children play together in mounds of refuse. In one of the two rivers that flows past the densely packed tin and wood shelters, a bloated dead dog bobs on the surface just upstream of where people wash their clothes.

Kroo Bay’s shockingly low life expectancy is even lower than Sierra Leone’s national average of 45 - a major factor contributing to the country ranking last in the UN Development Programme annual survey of human development.

Save the Children, a British non-governmental aid organisation, started work in Kroo Bay in 2007 to help address health, child protection and education needs.

Country director Dineke van der Wijk said when it came to health, tackling the causes as well as the symptoms of disease is needed.

“We quickly found that this was a flood-prone area and that a lot of people were at risk because this is a place where two rivers merge,” Dineke said.

It rains six months of the year in Freetown and the city is one of the wettest places in the world. Kroo Bay lies at the bottom of the steep hill on which the city was built.

People living in Kroo Bay have learned to adapt to the constant invasion of water, for example by building their beds on stilts - a practice which means they sleep above the putrid water, causing respiratory infections.

“There’s no point just addressing the symptoms of the problem,” Dineke said. “You also have to address the cause of ill health - in this case, floods.”

Save the Children has provided money to strengthen the river banks with sand bags, to clear rubbish, and provide health and hygiene training to people in the community. It has also built wooden walkways so people can move around the slum without having to wade through dirty water.

It also funded the Blue Cross Volunteers - young people who administer first aid, rehydration salts for diarrhea, and identify and treat cholera cases. CLICK to read an interview with one of the volunteers

The work the NGO is doing is not a long term solution to Kroo Bay’s problem. “We’re not going to be there every year to do the same thing,” Dineke said.

“It’s complex, but bigger donors looking at water and sanitation need to find a solution to problems in marginalised communities like this.”

People in Kroo Bay, still facing months more rain this year, nonetheless appreciate what the NGO has done for them. “Controlling flooding is of vital importance here,” said Kondor, the health official.