By Umaru Fofana
In a rather uncoordinated and disjointed manner news filtered through on Friday and over the weekend that Government and "its partners" in the fight against Ebola had decided to keep everybody in Sierra Leone indoors.
Initial report quoting presidential aide, Ibrahim Ben Kargbo had said that it would last for four days - 18 to 21 September. That was apparently later revised downward to three days with the 18th being the launch date and deployment of some 21,000 people.
As I write this piece it is not immediately clear what will be required of the 21,000 "young volunteers". We however have reasons to believe that they will go knocking on people's doors looking for anyone showing any signs and symptoms of Ebola. For now, forget about the fact that some of these signs and symptoms could be of malaria, typhoid, meningitis and many other illnesses. Also ignore the fact that the country's health care system cannot cope with a huge number of requests that could emerge on those lockdown days. I'll return to that momentarily. Concentrate on the point as to what will be done to people found exhibiting any such signs in view of the dysfunctional state of our health care delivery system. But I will return to that in a moment.
For now the aim of the lockdown, we have got from snippets from government officials, is to get body temperature tests in search of any signs of an Ebola-related sickness. Yet these people are not health workers, and to train them before that time presents a challenge of its own altogether. And the young volunteers themselves are going to be exposed to risks of infection. This is where I feel the authorities should think about recruiting and deploying the volunteers on location so they can operate not far away from where they live. But adequately protected with the appropriate gear. I wonder how that gear will come about in view of how even the professional health care givers have been struggling without.
It is worth noting this point: There is hardly any Sierra Leonean who is opposed to doing anything - including subjecting themselves to a lockdown - so long such a thing will end the Ebola plague which has claimed the lives of over 500 of their compatriots - with hundreds of others infected and new cases coming in thick and fast. But the thing about the three-day compulsory stay-at-home or lockdown, is that it is a trial error approach with no guarantee it will stem the spread of the scourge.
Now, the point is that the Ebola virus does not fly. Nor is the disease airborne. Logically if you restrict the movement of people definitely the virus cannot move. It is called containment. That is the surest way of curbing the spread. This is what led to the quarantining of the two eastern districts of Kenema and Kailahun. This is what led to the introduction of handgun thermometers at the numerous checkpoints throughout the country. The question is, has any Ebola patient been fished out at those roadblocks? I certainly do not know of any. That is not to say these patients have not been travelling through them. The same thing they have been looking for - body temperature - is what the 21,000 people will be looking for. What's the sense.
But let us even agree that the lockdown will stagnate the movement of people hence the virus. The question is whether a three-day lockdown is the solution or adequate.
Back to the response to lockdown day. 7,000 groups - of three volunteers - across the country. Entering homes in search of sick people. Forget about all the cultural nuances this may be fraught with. What if there are hundreds of calls put through to the toll-free number "117". Recent experiences have taught us that the capacity does not exist to cope with the emergency at that call centre. Dozens of calls have been put through and the response has been delayed sometimes for days, worsening an already bad situation.
I hope you do not blame the toll-free line operators. They receive these calls and contact the appropriate authorities. But the capacity to get a quick response is nonexistent. Ambulances are few. Personnel are in short supply. Treatment centres nonexistent in the capital city of all places - this, four months into the outbreak. And that does not take into account the two months we had to prepare when it was all a Guinea-only thing. As I write now, Ivory Coast does not yet have a single case, yet there are treatment centres on all major border areas. Never mind in the capital, Abidjan.
Like the French charity Medecins Sans Frontiers says, the concern is to provide field hospitals a single one of which exists nowhere else in the country but in the eastern towns of Kenema and Kailahun. I visited the one under construction at Kerry Town, on the Freetown peninsula. I reckon it will take another month - at the earliest - to be up and running. Certainly not in time for the lockdown. So people will effectively be locked up - like in a prison - as opposed to being locked down to look for a tangible solution. Where will the sick be taken to? Do not tell me to the Kenema Case Management Centre which is already literally overflowing with patients.
And the budget for those three days I do not even wish to think about. In the same way I do not wish to remind myself of who will be recruited and why, and whether their recruitment will be devoid of political party youth wing recommendations. Playing more politics even with Ebola tearing our nation apart, I fear.
The reality in Sierra Leone is that the vast majority of the people live on subsistent incomes where any such exists. They go out on the streets today and sell whatever they can to be able to put food on the table on the following day - if not on the same day. Their survival is in question. And for three days too.
Many of the houses in rundown communities in urban areas walk distances to access a toilet. Most homes do not have water pipe-borne or bore-holed. Some walk long distances to fetch water to drink or to do domestic chores. None of that has been addressed. People cannot stock up on food they do not have.
Again the lockdown is nothing but a symbolic gesture with some impression that government is doing something to deal with a virus their negligence helped escalate.
I have the strong feeling that, unlike in Liberia where there was some civil unrest to being quarantined, it will all pass off peacefully here. It is not in the nature of the average Sierra Leonean to be violently defiant not least in the face of an Ebola scourge that has put everybody's tail between their legs. Even the leaders'.
(C) Politico 09/09/14
