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When Alice Karpeh's second husband was murdered in West Africa in 1992, she put her dreams on hold, again, to hide from militants who wanted her dead and to get the nine children in her charge safely to the U.S.

Now, more than 20 years later, Karpeh will move back home to Sierra Leone and reconnect with the village she grew up in, the 

Since childhood, Karpeh said she wanted to be a midwife and care for women and children in a country where 1,360 of 100,000 mothers die in childbirth, making it the fifth-highest in the world, according to the Central Intelligence Agency World Factbook.

In 2011, Karpeh founded the Rural Health Care Initiative to bring health care to mothers and children near Tikonko, Sierra Leone — Karpeh's birthplace and home to much of her family, said Boynton Health Care Service and RHCI Board member Dr. Carol Nelson.

Next month, Karpeh and other doctors and nurses from Minnesota will return to Tikonko and build a center where pregnant women can spend the last days before childbirth to reduce maternal and infant mortality in the surrounding villages, Nelson said.

The trip will be the longest time Karpeh has been home since fleeing in 1993, she said.

Karpeh was born in 1955 in a small village in southern Sierra Leone. She said she went to school there and grew up experiencing the difficulties that many West Africans still face —poverty, lack of transportation, malnutrition, poor health care and infant mortality.

Now, Karpeh wants RHCI to help Tikonko reduce its childbirth mortalities, said Hassan Kamara, RHCI board member and Sierra Leone Community in Minnesota treasurer.

Karpeh brought her plan to the SLCM in 2009.

"We always lend hands to any group that wants to do something meaningful in the community and give back to Sierra Leone," Kamara said.

Kamara said RHCI is different from other aid efforts because some of its members are from the country, and they know what the people need.

RHCI, with help from SLCM, raised funds to send doctors and resources to Tikonko and rebuild what was lost in the war, said Dr. Gary Johnson, an occupational physician and RHCI board member.

The group works with traditional birthing attendants in Sierra Leone and Tikonko's health clinic, Nelson said.

Johnson said they bought a small truck to use as an all-purpose vehicle, which is essential because lack of transportation is a main reason women die in childbirth.

Nelson said one woman in Tikonko in 2013 tried to walk 15 miles to the only clinic in the area while she was in labor.

"Some women have to walk two or three hours to get to a clinic," Nelson said. "And it could be during the middle of the night or when it's pouring rain. . These women have no other option available."

In recent years, RHCI started mobile clinics, motorbikes that reach more than 20 villages near Tikonko, Johnson said, and planted five acres of crops to feed clinic patients.

"A lot of land has gone back to bush due to the civil war. The villages were leveled, the farms were destroyed, people either killed or run off, and a lot did not come back," Johnson said. "But then you've got malnutrition, subsistence farmers barely able to feed their families."

When she was 17, Karpeh's family moved to the Liberian coastal city Monrovia for her stepfather's job. There, she continued schooling to be a midwife. Shortly after the move, she met her first husband, said her oldest daughter Jiaba Kennedy.

Karpeh's stepfather took her out of school for her to marry her first husband — who was older and wealthy — but he beat her and had kids with another woman during their marriage.

"There would be times that my mom would leave and my grandparents would bring her back and tell her to apologize to my dad so she could go back into the house," Kennedy said, "because they needed the support that he provided."

Kennedy said people in Africa live with the richest family members, and many of Karpeh's relatives lived with them or relied on their money for support.

But Karpeh couldn't shake her dream of finishing school and becoming a nurse, Kennedy said. Karpeh got the courage to leave her husband for good when Kennedy was 12, she said.

Karpeh had three children, Lamin, Jiaba and Amie, with her first husband and left them with him when she married her second husband, Albert Karpeh, a Liberian foreign ambassador and minister of defense.

In 1988, Alice and Albert Karpeh moved to Freetown, Sierra Leone. At the time, Liberia was plagued by a bloody, gruesome civil war that spilled into Sierra Leone, and Albert Karpeh tried to organize Liberian troops who had fled to escape the rebel army.

"I don't know what happened, and he was killed," Alice Karpeh said. "He left (Freetown) Friday, and on Monday, he was ambushed where he lived. They ambushed the whole area, and he was killed."

Alice Karpeh said the war cost her family everything. When her husband died, all he had given her was $20, she said. Alice Karpeh was granted asylum to the U.S. a year later, she said.

Kennedy said her mother left for Philadelphia to find a job and later sent for them but had to sneak back into Sierra Leone to get the nine kids — her five children, two stepchildren and two nieces — to the U.S.

"It was such a big risk to go back to Sierra Leone," Kennedy said. "That was one of the biggest sacrifices my mom made, to make sure we could all come here."

Alice Karpeh and her kids went to Philadelphia when they got asylum, but they eventually made their way to Brooklyn Park, Minnesota, in 1999.

Alice Karpeh finished school and became a licensed practical nurse in May 2004, the first step in fulfilling her lifelong dream of becoming a midwife.

Her sister lived in Minnesota at the time but died from a brain aneurysm on the way to Alice Karpeh's graduation. That summer, Alice Karpeh made her first journey back to Sierra Leone to bring her sister's body to their mother in Tikonko, Kennedy said.

Dr. Carol Nelson said Alice Karpeh began working at the University of Minnesota's Boynton Health Service Clinic later that year.

Alice Karpeh has worked at Boynton the last 12 years but will spend the next six months in Tikonko, she said.

"This time is different. I'm taking a leap of faith and going for six months . so I can start construction on the building for pregnant women I want to help," Alice Karpeh said.

"It's exciting. It's scary, but I'm just looking forward to it. I've met some beautiful, good people here, but I want to go home."

An AP Exchange feature by Hannah Weikel, The Minnesota Daily.

The Associated Press

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Twenty years after fleeing Sierra Leone, a nurse is going back to reconnect with her childhood village, and improve maternal and pediatric healthcare.

Minnesota nurse returning to Sierra Leone to be midwife

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