By Umaru Fofana
A Chinese version of a US-designed Hummer jeep parked along Lumley in the west of the Sierra Leonean capital. On it was inscribed – again modelled on something American – “Centre for Disease Control”.
Some Chinese health workers had stopped at a shop to grab a few bottles of water. They looked well dressed, Western-style, so that you had the impression they were educated in the America or Europe. They were apparently heading out to the east of Freetown where the Chinese-run hospital is situated at Jui.
A few miles beyond Jui is Kerry Town. A British-built and British-run facility with Cuban doctors working in there. If you continue on the peninsula, Lakka awaits you where Italian doctors and nurses are joined by their Sierra Leonean colleagues. Traversing in-between are US health workers from the Centre for Disease Control – the American one. East Africans are in Makeni and many others dotted in some other places in the country. You cannot ask for a better mix and show of global intervention for one reason. Apart from the Arabs, the world is here.
What they are doing here is not in doubt. As far as we know it is to deal with the deadly Ebola disease. The question persists, why are we where we are with all of them here? Dozens of new infections every day with 93 recorded just yesterday – while our neighbours are almost thinking of declaring themselves zero new case by the end of the year. This is definitely not just about the people’s behaviour or action. It is largely because of inaction by those who should be doing something.
In part the reason for the new high numbers could be attributed to the fact that the number of laboratories has increased hence more samples are tested faster and quicker. It could also be possible that the virus is burning itself out and its life cycle is being exhausted. Could that be why it first got better in Guinea where the current outbreak began before getting better in Liberia where it went to next? If so, then logically things will get better in Sierra Leone by January. That’s all just pontificating.
But an equally possible reason for this messy state of affairs in Sierra Leone’s Ebola fight could be the lack of coordination. Coordination in our fight is almost nonexistent with things happening in dribs and drabs and everyone doing things their own way.
It was David Milliband who, during his recent visit here as head of the International Rescue Committee, spoke about the need for proper coordination. That does not seem to be being done. Consequently every bilateral or multilateral organisation is doing things its own way. The appointment of a Chief Executive Officer of the new outfit – the National Ebola Response Centre – to sidestep the functions of the health minister and ministry in Ebola matters was as imprudent as it was spiteful. Now not only there is a pushback in the health ministry dealing with Ebola issues it is also doing so in other areas of much broader health care deliveries. The CEO position simply established more layers in dealing with the virus hence functions got blurred or overlapped, or tensions rose to fever pitch leading to more bickering. So who should lead? The United Nations?
The least said about the WHO and how it initially presided over the bungling of the whole handling of Ebola, the better. But things have definitely improved somewhat now under its new country leadership hence the question as to why the UN Mission on Ebola or what is it doing?
It was an interesting press conference this week by the two heads of the United Nations Ebola response in West Africa – Anthony Banbury and Dr David Nabarro. This is yet another overly laying of multiple layers blurring the fight. Even though the failure to provide Sierra Leone with badly-needed treatment centres and medics led to the country not being able to attain the 70% isolation for patients, neither of the two top UN Ebola diplomats would admit to the failure to meet their own target set in October. Mr Banbury had assured the UN Security Council that by 1 December they would get into treatment centres at least 70% of all Ebola patients in the country.
A World Health Organisation report about a week before that deadline had said that only 13% (thirteen percent) of patients in Sierra Leone were in isolation. Two days – or so – to the 1 December target date, that WHO figure was hurriedly revisited and revised like a child wanting to do their homework minutes before their parents return home if only to camouflage them.
But come to think of it we do not need figures being bandied about to suit conveniences to determine the scale of our Ebola situation. The situation is terrible and it is not getting better. And the world, despite so much trumpeting of their intervention, is letting us down. Hurriedly-built and poorly-equipped Community Care Centres or Interim Care Centres or Holding Centres or whatever they are called, are grossly inadequate and grossly under-resourced to put up with the scale of what we have at hand. We have all now come to realise that Ebola care is not palliative care. People can get well with the right kind of treatment and early administration.
The UN Mission has not brought in medics, it has not built treatment centres and generally it is hard to know what specifically they have done – even if appreciating their helicopters.
Those treatment beds are being built by Britain with some already ready. But whatever benefits the flagship project, namely Kerry Town, has recorded has apparently been lost to their gross underutilisation of the beds inside that facility and the discriminatory use of the specialised 12-bed clinic.
Britain has promised to provide 700 beds to be built and run. All of a sudden they are putting out available number of beds to include those built by the Italian-run Emergency hospital, the Red Cross-built one in Kenema. I know both those facilities are funded by DfID but they were not meant to count under the 700 beds promised by the UK. If there has been a change of plan to have ready facilities used for the same purpose, then that should be spelled out. But to make it appear as if that was what was promised from start is a bit disingenuous.
There also appears to be some duplication. Australia has pledged millions of dollars towards the fight and it seems that is going into what the UK had pledged to use its money on – namely running its treatment centre. And the Australians are bringing in an NGO with no experience in frontline medicine – like the Brits did with Save The Children and Kerry Town. By the time they have the requisite knowledge only God knows how many more would have been infected and died. Unless the virus runs itself out by January as hoped.
I have seen documents of some expatriate staff being paid $ 17,000 a month while their Sierra Leonean counterparts are paid a little over $ 1,000. I am not saying they should be at par – far from it! After all the one is at home while the other one has left their family back home. But considering how much of the aid money goes into the salaries and sometimes ostentatious lifestyle of those expats, we are left with all the high-flying amounts with nothing much on the ground with which to kill the Ebola virus. If things do not get checked the world would have failed us far more than it already has – come next year. I would say, give all of those monies to Medecins sans Frontiers and Ebola would be gone.
Next week, I will look at my fears for Christmas and the Ebola fight. See you then.
© Politico 04
