By Allieu Sahid Tunkara
Over 3,000 Sierra Leoneans have lost their lives to the Ebola virus which broke out in Sierra Leone in May 25, last year as the first confirmed Ebola case was reported in Kailahun District in the Eastern Region of Sierra Leone. The outbreak reared its head at a time the country’s health officers were unprepared for the Ebola battle. The unpreparedness of government to face such a battle was clearly manifested by the few ambulances allocated to referral hospitals in the district headquarters towns. Although some districts have gone for months without recording any case of Ebola, new cases are still being recorded within the Western Area in which the capital city is situated, as well as, Portloko and Kambia North of the country. These new infections add daily to the existing Ebola case statistics. This drop in Ebola cases has been viewed by many Sierra Leoneans the end of Ebola in the country is within sight. This is evidenced by the much talked about Post Ebola Recovery Plan for Sierra Leone.
As the country gears up towards Zero Infection, this article clearly examines how the country has been affected by the Ebola crisis with a particular focus on the Human resource component of the health sector, as well as, the loss of confidence in the people to go to hospitals for medical service.
William Sao Lamin, Programmes Officer of ‘Health Alert,’ a civil society organisation specialised mainly in health advocacy, monitoring and education told Politico press that the country’s health sector has a staff of 6,000,and the number of peripheral health units stand at 1,2000 and 19 referral hospitals countrywide. Out of the number of the number of health officials, over 150 had succumbed to the Ebola virus. Mr Lamin further explained that prior to the Ebola outbreak. The health sector was already known for its acute shortage of trained and qualified personnel and that the Ebola outbreak compounded the situation by taking such a death toll of the country’s health staff. ‘The volunteers in the hospitals cannot be relied upon as they are untrained and unpaid.’ Sao Lamin explained.
Besides, the looming mistrust between health professionals and the public deserves a particular mention in this piece. This situation was created by rumour mongers, especially at the initial stage of the outbreak that nurses embarked on giving lethal injections to Ebola suspects to stop the virus from spreading. The messages from health officials that The Ebola virus had no cure, reinforced the peoples’ reluctance to go to hospitals even when the government later came out with another message of ‘supportive Ebola treatment.’ This situation badly affected access to health facilities as there has been a drastic drop in the number of people visiting hospitals. Since government says there is no cure for any Ebola victim, why should we go to hospitals for treatment? This question became the most frequently asked one at the most dangerous stage of the Ebola epidemic. Consequently, people hid in their homes and resorted to self medication. The fear of being diagnosed with Ebola virus even when one suffers from another ailment is prominent among the public. Connaught Hospital, the oldest in the country situated at the City Centre of Freetown is filled with hundreds of patients daily during the pre-Ebola days. Today visits to the hospital is an all time low key. A situation that is replicated in hospitals and community health centres at the provinces.
The Ebola outbreak has also affected the ‘Free health Care’ system in the country, a government initiative that was pronounced on 27th April, 2010 to stem the tide of Maternal and infant mortality rate in the country. The beneficiaries- under five children, pregnant women and lactating mothers hardly go to hospitals for ante-natal and post-natal medical services. The apprehensiveness to visit the hospitals is linked to the fear of any health complication that could be mistaken for Ebola. As a result, pregnant women are delivering in their homes with the help of traditional birth attendants. Health alert is released yet any figure regarding the upsurge of maternal and child deaths as the organisation is monitoring the situation.
Private hospitals and pharmacies which used to complement government health system were closed following the proclamation of a state of Public emergency in July last year when the virus was at an alarming proportion. The closure of the private health facilities was justified on the basis that they were secretly treating suspected Ebola patients, a situation that frightened government. This resulted to many health workers becoming jobless as private hospitals dispense their operational costs from a ‘user fee’ basis, that is, what their clients pay. Even though these hospitals have resumed operations, the effect of their closure still looms.
The Communications Officer of the country’s Ministry of Health and Sanitation (MoHS), Jonathan Abass Kamara also explained his own side of the story. His explanation also revolved around human resource constraints in the health system even before the Ebola outbreak. Abass Kamara disclosed that the country has lost 12 medical doctors including Dr Shek Umar Khan, the only virologist in the country attached to the Lassa fever unit in the Kenema Government Hospital. Considering the circumstances of the Ebola outbreak, Dr Khan was central and therefore a dominant figure in the struggle against the virus. He was the only source of hope for the treatment of the Ebola Virus, and this hope became shattered after his death. The health mouthpiece also put the death figure of nurses at 152 and that other health support staff including porters, cleaners, nursing aides, laboratory technicians and pharmacists who had succumbed to the virus swelled the number to 396.The replacement of these health workers would cost the government several millions of dollars. ‘It takes seven years to train a doctor. When one graduates from the college, he has to be in a period of housemanship for two years before he is granted a licence by the Medical and Dental Council Association,’ Kamara explained.
Vice Chancellor of the University of Sierra Leone, Professsor Ekundayo Thompson has disclosed government plans to recruit more health professionals to replace those doctors who have fallen in the Ebola fight. He said most of these doctors were lecturers at the College of Medicine and Allied Health Sciences (COMAHS), one of the constituent colleges of the USL.
Belgian scientist, Professor Peter Piot who claimed to have discovered the Ebola virus in 1976 in the then Congo Zaire, a Central African nation, while he was on a scientific research visited Sierra Leone in December last year. During his visit, he held a public lecture at the Miatta Conference hall, Youyi Building in Freetown on the origin and nature of the Ebola Virus. When Liberia was declared free of Ebola virus, a month ago by WHO, Piot warned that there would be future Ebola outbreaks and that governments should work towards an Ebola vaccine.
In addition, routine immunisations of children for the prevention of childhood diseases including poliomyelitis, whooping cough, measles etc. have been brought to a sudden halt. Almost all government funds are now directed to the fight against the Ebola virus. Again, community people have an apathy to the immunisation of their children as they refer to the vaccination as ‘Ebola vaccines.’ The Ebola outbreak has impacted not only on the campaign against childhood diseases are impacted by the Ebola but also HIV. Lansana Koram, senior official at the HIV/AIDS secretariat, told Politico press that funds for the HIV campaign were available but they are not utilised for any HIV related campaign till the World Health Organisation (WHO) declares the country free of Ebola virus.
Dr Sarian Kamara has said in a press briefing held at the Sierra Leone Association of Non-Governmental Organisations(SLANGO) that the Ministry of Health and Sanitation has recorded a 100% drop in condom use at the initial stage of the Ebola outbreak. This has therefore led to an increase in the spread of sexually transmitted infections (STIs).
Doctors and nurses who are the frontline warriors in the fight against the Ebola virus have faced their greatest ordeal than at any time in the country’s history. These health workers have been thrown out of their houses which they rented before the Ebola outbreak owing to the misconception that they are vectors of the Ebola virus. Most of them are still grappling with accommodation problems. It is no gainsaying that this has adversely impacted the health sector.
Taking Cognisance of the facts presented above, it is apparent that the health sector is being hunted by negative occurrences in this Ebola period. It is only a coordinated effort by both national governments of the Mano River Basin and the International community that can create the turn around.
(C) Politico 26/06/15
