By Umaru Fofana
Like he was being led to the gallows by men who were disguised head down, an Egyptian national who had been infected with Ebola in Kenema and fled to Freetown was discovered inside an Arab health facility at Kissy Road in Freetown. The men in hezmat suits were acting on a tip-off when they raid the hospital premises which were later shut down.
Contact-tracing was poor and hardly any attention was paid at the time to the people he might have infected at the facility or even at home. He was taken back to the eastern town where existed at the time one of only two Ebola treatment centres in the country. Thanks to the hardworking health workers at the clinic, the Egyptian recovered weeks later and he was discharged.
For weeks now I've been trying to trace him to follow up on his progress. All my contacts in the health ministry have not been of help – either because they're being unnecessarily secretive about nothing or they are clueless about his whereabouts.
Another Ebola survivor I met recently – by chance. He brought out his discharge card dated sometime in September. Surely that was not a "false negative" test result upon which he had been discharged. Otherwise three months on he would be dead if he still had the virus.
But James (not his real name) looked anything but well. Despite having survived Ebola months ago, his palms looked pale, his eyes looked sunken, his stomach seemed slightly protruded and he was emaciated. He said he had been sounded and told that nothing was medically wrong with him. Yes something is wrong with him – starvation.
James complained that a square meal a day is a luxury for him. Not only is hunger eating him up, ostracism is too. Some think he still has the Ebola virus in him. Ignorance - yes - but also because of fear emanating from his appearance. He's one of many in his situation.
Those who survive Ebola must be looked after by the state and by non-state actors. These mostly poor people who even in the best of times find it tough to eke out a living, need their antibodies revamped. Why do we risk the lives of our health workers to save these patients if we cannot follow through on their progress when they recover? Rather we abandon them to die for the second time; because surviving Ebola in this part of the world is nothing short of surviving death.
The Ebola virus rips apart the tissues of its victim. Never mind their vital organs which are weakened by the virulence of this tiny thread-looking virus. Therefore surviving this disease does not necessarily let off the hook the victim. Life span could be reduced unless the survivor receives deliberate attention to build back their system.
For discharged and recovered patients whose whereabouts are unknown, how can they be chased and monitored in a bid to rebuilding their antibodies? How do we treat these people like this! Are they any less citizens or is it because they are mostly poor people who, outside the election cycle, are a forgotten lot and have no consequence?
In ignoring – scorning if you prefer – these people we are endangering the middle class or the rich who get infected largely because they work in the frontline of the disease – I mean our health workers – or because they cannot help but come into contact with them somehow.
These survivors have a new role in our society – or must be given one. Their blood has developed an immunity which makes it precious to those who get infected with the virus. It can be used – rather preciously – as a convalescent blood serum. This could be more magical on recovering patients than ZMapp is believed to be. We all know that. What those in authority don’t seem to know – or ignore – is that if we look after the Ebola survivors well, we will be looking after present and future Ebola patients.
Almost 2,000 people are known to have survived Ebola in Sierra Leone. But while track is kept of their number the same cannot be said of their persons or their whereabouts. People recover from the dreaded Ebola and get discharged and are sent into the wilderness. No one follows up on them. No one checks to know how they are fairing on or even whether they have die.
In Sierra Leone, for months now, a group known as Sierra Leone Action (SLA) has been struggling to set in place a convalescent serum process to treat for Ebola patients. An independent organisation comprising a global team of Sierra Leonean physicians and other professionals, they have brought in “nine Fenwal Autopheresis instruments and all required related supplies which were donated by Frensinius Kabi in November”. One of two trainers has also arrived in the country to ”begin training staff on the use of the machinery,” according to Trevor Young, a Sierra Leonean resident in the United States and a founding member of SLA.
This is a watershed moment for Sierra Leone in its fight against Ebola as it will enable plasma treatment through the use of the blood of Ebola survivors. According to an SLA press release, “The study and treatment involves taking Ebola survivors’ blood and separating the plasma that contains Ebola antibodies. The blood is returned to the donor and the plasma collected and later transfused into an Ebola patient”.
This treatment is believed to have the potential to halve the number of Ebola deaths. Just like that! So you wonder why the dilly-dallying to get it up and running much to the frustration of the selfless compatriots and their foreign sponsors. And the real issues have not even started yet.
The real issue will be to trace the number of survivors needed to get this going. In a country where illiteracy is massive and conspiracy theories about Ebola abound, convincing the mostly uneducated survivors to present themselves for a string of blood and other tests before their blood is deemed suitable and taken, will be a huge ask and a massive task. Add to that my first point that the survivors are scattered - little data exists about their addresses – and many of them being unwell because of poverty hence the likelihood that their blood could be faulty for convalescent serum use.
The UN’s children’s agency – UNICEF – took a brilliant initiative and a bold step to hold workshops for these survivors. I know one was held in Kenema and another in Makeni. But as far as I know it petered out. Whether that could have been – if that’s what happened – because they could not trace the survivors is unclear.
It is an open secret that at least months into the outbreak survivors were discharged and they spent days at the treatment centres waiting and looking for ways to return home. Simply, nobody cared for them once they had recovered. Imagine going to lure them to come forward again. “For wetin?” – Why? – I can imagine many of them asking in anger.
In a nutshell even though the convalescent blood serum will be a wonderful feat in the Ebola fight especially in Sierra Leone, government incompetency and inertia in dealing with this outbreak may undermine its success. I wait to see what James will do or say if he’s asked to donate his blood, after being abandoned for so long and cannot afford even a basic meal a day. Now we need his blood. This is the consequence of leaders reneging on their most basic responsibility – caring for the people they vowed to care for. Instead the self becomes the overriding norm.
I can’t wait to see the back of Ebola and those who’ve shown gross incompetence in responding to an outbreak that caused and cost us so much as a nation – now and for a very long time to come.
© Politico 16/12/14
