By Umaru Fofana
Yesterday - Monday 1 September - nurses at Sierra Leone's main referral hospital went on strike. 24 hours earlier nurses and other health workers at the country's only public-run Ebola treatment centre in Kenema had also gone on strike. In both cases and places it was over non-payment of allowances.
Like their colleagues in Kenema, the nurses at Connaught hospital were protesting over the death from Ebola of their colleague. They were demanding for something as basic as adequate and sufficient protective gear and pay for their sacrificial work. Momentarily I will deal with what this portends for the seriousness - or not - which the authorities attach to the Ebola fight.
And that fight is becoming increasingly daunting by the day. Almost hopeless. The United Nations' point man on Ebola, Dr David Nabarro could not have put it more aptly when he said this about our current struggle with Ebola: "This is not a battle, it is a war". The Director of the United States Centres for Disease Prevention, Dr Tom Frieden said in Freetown last week that "Ebola today in Sierra Leone is a crisis...There is time to avoid a catastrophe but only if immediate and urgent action is taken at every level". He added: "the hardest part is training the staff...First how do we get the health care system working again".
Everyone knows that health workers have been at the throes of the Ebola mayhem - saving lives, yes, but also losing their own lives to the disease in the process. For a country whose health care delivery system even in the best of times was flaky, it cannot cope with the ferocity of the Ebola virus, made worse by the lack of political leadership that has characterised - perhaps marred - the country's response to the outbreak.
And hear what the president of the African Development Bank, Donald Keberuka had to say about the effect on health workers when I spoke to him recently: "Ebola has not just affected the health sector, it has decimated the health sector". And for priority to be placed anywhere else but on the provision of health care and the welfare of the health workers defies reasoning and is shocking even to the biggest optimist and the most ultraconservative.
Such is the scale of the fight we have at hand that one wonders how many more health workers must die before the right measures are put in place to stem both the spread of the virus and the tragic deaths of our health workers. A reminder, if anyone needs it, that a war we are faced with.
"WAR" in the words of the late Chief Sam Hinga Norman apparently re-echoing someone else, means Weapons, Ammunition and Ration. And ask yourself whether our troops - the health workers in this case - have the weapons, ammo and ration they need.
At the last count the Kenema Ebola Case Management Centre had lost to Ebola 28 health workers - among them two doctors, nurses, lab technicians, porters, and ambulance drivers. At the last count the French humanitarian organisation, Medicins Sans Frontieres, who run the Ebola clinic in Kailahun had lost none of theirs. It points to "weapons, ammunition and ration". I will add "combat training and readiness".
Our health workers, despite the months we had to prepare for Ebola when it was initially only in neighbouring Guinea, have not been adequately trained, if at all. This is a time when you would expect all health care workers - involved in the Ebola fight or not - must be trained in Ebola response. That has not been done. The basic things they need such as protective gear including gloves, are either inadequate or insufficient. Or both.
I have it on good authority that the government gave Le 740 million to hospitals in the Western Area - eight of them I understand - to run themselves for three months. This means Le 30 million to run Connaught for a whole month. Where does the country's largest hospital even start to use such sum.
It reminds one, does it not, of the rebel war days when the soldiers were left without proper and sufficient arms, ammunition and ration until the marauding RUF bandits had overrun a large swathe of our territory. Caught unarmed. Caught untrained. Caught unmotivated. And the nation was caught up in hell. Same situation seems to be playing out with the new war - Ebola.
Our doctors, nurses, burial teams, lab technicians, porters, ambulance drivers must be saluted. They must not be allowed to go dissatisfied. However the amount we pay them now is nothing compared to the sacrifice they are making in the face of the risk they face.
At a time like this when sensitisation should no longer be the main priority - the majority of Sierra Leoneans now appreciate that Ebola does exist and is dangerous - government is spending hundreds of millions of leones on parliamentarians to "sensitise" their constituents, while health workers are grossly overstretched both in number and in materiel. MPs who are neither health care professionals nor communications experts. So what are they going to communicate? One wonders where the priority lies in this fight - is it to protect and supply those risking their lives in the frontline or dish out money to chiefs and parliamentarians?
The Ebola Task Force needs a complete rethink of this whole response to avoid this long-running messy approach to the fight. But the doctors also must be told of how they have sometimes let us down. Those who own and run private specialist clinics have completely or partially shut them their facilities - even to non-Ebola patients. And they have not done so to concentrate their synergy on the fight against the disease. Rather they have done so in fear of Ebola.
Many of them have been far more shell-shocked and frightened by it than the lay members of the public. This is a betrayal of their Hippocratic Oath that is akin to soldiers abandoning the frontline or joining up with the enemy during the rebel war. There have been many instances of people dying of easily curable ailments simply because doctors refused to see them for fear of Ebola. This has led to many needless deaths. The case of the 23-year-old final year university student, Mary Batubo has become the poster case for this neglect. It is heart-rending that the life of such a promising young lady could be cut short so rudely.
I understand the concern of the medics that some Ebola patients may come present themselves as suffering from malaria or typhoid. But that is no defence to abandon all patients. I would imagine they should pay attention to protecting themselves with gloves until a case is proved or strongly suspected to be Ebola. That is what Choitram Hospital does and many of these medics work there and know this.
But even in the case of Ebola patients, it is unpleasant and a betrayal to country and profession, that while expatriate health workers are streaming into the country to help stem the spread of the disease, some of our own doctors are backing off. Yes, they may have the option of being flown abroad if they fall sick, but just get the necessary training and be careful. Again why has MSF been able to keep its workers safe. I only hope the economic hardship of the closure of these private clinics will force the doctors to reopen them next week. And the love of country and adherence to Hippocratic Oath will push all of them to fight against Ebola with more commitment.
(C) Politico 02/09/14
