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Ebola does not kill in Sierra Leone…

Ebola burial in Kenema

By Umaru Fofana

In the doorway of the Isolation Ward they stood. I could see them from afar. A distance safe enough for me as advised by the medical workers at the Kenema Government Hospital in eastern Sierra Leone. Inside the ward were mostly women. But I can also see two children in the doorway. They are seven-year-old Hawa and five-year old Jaward. They all have the devastating Ebola virus.

Even from the distance I could tell they – especially the children – were at death’s door. Emaciated. Weak. Almost hopeless. The boy could not even tell his name. Too weak and sick to talk. I advised the nurses to allow them to go back and lie down. And the door was closed again. Like people being led to the gallows. I have no idea what may have happened to those patients inside this makeshift tarpaulin structure on which is written HIGH RISK AREA.

Ebola is tearing the nation apart with scores of people having succumbed to the deadly hemorrhagic fever and nearly 200 people having been tested positive in just one month since the first cases were confirmed in Sierra Leone.

Among those who have died are four people whose burial I witnessed at the Kenema cemetery on Wednesday 25 June 2014. Again from a distance. Their body bags were dropped in a mass grave, as the grave diggers went in with their shovels to end their journey which has been painful. The workers were well dressed for the occasion in their personal protective equipment (PPE). But they complained to me that the condition of the body bags was not satisfactory. “The bags were thin and small so the bodies were partly naked” they told me. “We are well dressed, yes, but that state of the bodies makes the risk higher for us” one of them elucidated.

Shortly before I went to the cemetery I had spent about an hour at the at the Screening Ward. 25 minutes of the time I spent with the technicians waiting for PPEs. A suspected Ebola case sat and later lay waiting. Sweating. Yes the place was hot and humid. But also because of anxiety as to what her status was. As I write I do not know whether she tested positive. And as I left the hospital last night the cases kept streaming in and piling up. The last scene I witnessed was an ambulance racing into the hospital compound from Freetown. A young man, Mohamed Swarray, who had tested positive for the virus in Kenema but fled to Freetown was traced and was being brought back. He looked weak and sick but could walk by himself even if an appropriately-clad nurse aided her into the isolation ward.

While in Freetown, Swarray was receiving treatment for typhoid from a nurse who was not using gloves. She is now a suspected case. His mother who apparently fled with him to Freetown has now disappeared. She too is a suspected case. Effectively Ebola is now in Freetown.

If the 90% chance of death is anything to go by, at least more than 100 more people will die in the next three weeks. This is an emergency. It has reached Kenema District now which has recorded cases and deaths of its own and not just those brought in from Kailahun, the epicentre.

They are being brought in here because Kenema has one of the best laboratories in the world for viral hemorrhagic fever. And the VHF unit is run by Dr Sheku Umar Khan, a 39-year-old who has dedicated his life to fighting the scourge and other hemorrhagic fevers. I will profile him in a later article.

The French humanitarian agency, MSF, says Ebola is “out of control”. The agency itself which, together with the United Nations World Health Organisation, is helping in the fight, is running out of funds in dealing with the virus. And this is where a declaration of an public health emergency can help the people of Kailahun and its neighbouring districts. But also the whole country. And abroad.

Ebola is an emergency in Sierra Leone in all but name. All but name because President Ernest Bai Koroma, for some bizarre reasons, has refused or failed to declare it as such. But he has put emergency measures in place, one may argue. That is all short of declaring it as such in which case state resources will obligatorily be put at the disposal of the fight of what is obviously a menace.

What’s more, president Koroma has not uttered a word about the epidemic. Talk less of visiting anywhere in the east of the country since the onset of the scourge. And he is a leader who has sometimes presented himself as the man who is most passionate. Nor has the parliamentary committee on health been there. So what is the difference in this case of Ebola that the president has not visited! This brings to mind some sad reminiscences and comparisons.

When the rebel war started in March 1991, many people ensconced themselves in Freetown asking if the rebels had a tail. As if it were yesterday, I can still vividly remember in my English Language class at the university in 1992/93 when a Freetonian fella through and through, said this very proudly and conceitedly and offhandedly: “As far as I am concerned the rebel war has no effect on me. I cannot care less”.

I turned inside the Mary Kingsley auditorium which was our lecture room, and stared at him. I had just had my parents displaced from Kono and was wondering how to raise my fees for the following year or even my lunch for the following week. Such is life for many people that until and unless something touches them directly they are not bothered by it.

When that war broke out, our soldiers were clueless in rebel warfare. They had had no experience with it except having heard about it in neighbouring Liberia. And they lacked the resources needed. The government of President Joseph Saidu Momoh had been caught pants down. He lacked any idea in how to respond to it.

Like that war and our soldiers, Ebola is a new disease to our health workers most of whom had only heard about it during the recent outbreak in Guinea. And the country seems leaderless in the fight – outside the health care workers of course who are doing a great job.

Even though the senior health officials would not admit to it on record, many other health practitioners told me that there was no sufficiency in some of the most basic tools like safety gears. They are needed. Every time a health worker enters an isolation ward their PPE is removed and burned. It is not recyclable. Even food for the patients is not forthcoming from the state, unless the US Metta Biota provide the funds.

This has a bearing on the fleeing of patients in two medical wards at the Kenema hospital. A nurse working in one of the wards was tested positive for Ebola. Three patients admitted for something else also later tested positive. The others decided to flee. Those in the surgical wards are only there because they cannot not be there. They are still there because they cannot walk by themselves. But there is the Ebola fear in them too. And they would wish to leave the hospital.

If all of this does not move President Koroma to declare Ebola an emergency, deal with it as such and visit the area, to my mind, it is akin to him saying that EBOLA DOES NOT KILL, so why bother with it!

(C) Politico 26/02/14

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