19 year old Fatuma is pregnant and sits on a bed at a health centre in the village of Waterloo as a midwife examines her. A year ago Sierra Leone launched a free healthcare plan for pregnant women, breast-feeding mothers and children under five years old, because for a long time the country was known for the world's highest maternal and child death rates. Since the introduction of the health care plan Sierra Leone is no longer at the bottom of the United Nations Human Development Index. But besides the praised successes of the initiative, signs are emerging of widespread mismanagement of resources provided by Western donors, leaving mothers and babies vulnerable to renewed risks of maternal death.