By Umaru Fofana
There is an outbreak of cholera in the country at present. The number of cases keeps rising with nearly 2% of them so far killed (see front page story). It is one of those things about which I can write a story today and keep the script for next year and change only the figures. Check this:
For many years now the outbreak of cholera has always emanated from Yeliboya, an abandoned island in Kambia without something as basic as clean drinking water or proper toilet facility. Such is the predicament of the islanders that they cannot dig water well because of the salty water underneath. Successive governments have failed to provide them with an alternative.
Yeliboya is the byword for cholera in Sierra Leone. Always referred to as a Priority Area for development whenever there is a cholera outbreak that stirs up the country, and soon forgotten once the outbreak is curbed even if temporarily as a result of a change of season.
Come to Freetown and visit Mabela which is a scum of the earth. At a press conference yesterday a government minister and the Acting Mayor or Freetown both admitted to government neglect of the area. Year-in year-out, government-in government-out the people of Mabela are left to suffer and fall sick and die in front of unconscionable government eyes. But many a time they are among the most vociferous in political campaigning even if their life keeps deteriorating as their most basic needs go unmet.
Minister of Health, Zainab Bangura, yesterday named 34 Hagan Street in Mabela as one of those places she visited on her tour of cholera-plagued areas. Like most of the entire area of thousands of people, she said open defecation is the order of the day. The last time I visited Mabela it had a tiny community health centre in which sat a dedicated nurse, Adama Gondor whose heart and soul are in helping these abandoned people. Before going there she was at another scum of the earth – the health centre at Kroo Bay where floods kill and diseases rampage and lack of hygiene exterminates many.
The harsh reality of the country’s health care delivery services has been subsumed by the free health care for pregnant women and children under five years and the bigotry that accompanies it. Agreed it is a laudable initiative that has helped save the lives of many who would have otherwise died needlessly. But does that mean the rest of the country’s health care system should be abandoned and that abandonment left unchallenged.
Last week I lost my brother-in-law – my wife’s only brother. I know dozens or perhaps hundreds of other compatriots lose their loved ones on daily basis but please let me use him as a microcosm of the broader daily experience many have to go through.
Ellis was a wonderful fella. He had been brought back home from Liberia where he’d lived for almost ten years. We lost him to acute renal failure. But much as I do not blame his death entirely on our decrepit health care system, it opened my eyes to things some of which I never knew existed. It also left me wondering whatever happened to the dialysis machines brought into the country recently – thanks to the efforts of the First Lady. I wonder if Sierra Leone was not the last country in the world to get a dialysis machine. But just where it is when dozens of people so badly need it. The lack of it also cost the life of Ibrahim El-Tayyib Bah a well-meaning journalist whose life could have been save had he been resuscitated and flown to India.
Ellis was taken to the Kingharmen Road Hospital, which is said to be the best equipped in the country. The reality though is troubling. Care is careless even if we should spare a thought for the hardworking nurses at the hospital who work under extreme circumstances but try to put their best into it even if they sometimes get so worked up that they provide the opposite. Worked up! The hospital is very small and situated in a densely populated area all of which it serves.
Later referred to a very good doctor who does not wish to be named, Ellis was admitted in one of the wards. Soon he had a relapse. He needed oxygen. To the Intensive Care Unit we were referred. There was oxygen for ONLY three at a time. A long queue of patients who needed it could not have it. We had to rush him to a private hospital where he was eventually put on oxygen even if we lost him later.
And I have not stopped wondering how anyone explains why Connaught Hospital charges Le 125,000 per bed per night at its Annexe ward? Agreed that it is well looked after in that nurses are on hand. But is that not exactly what should obtain in all other wards? And it is a clear testament that better care can be provided but only for the rich even at the public hospitals. But why do you charge Le 125,000 per bed, the same amount many private hospitals such as Abernita charge, when Connaught does not pay for its running cost from what patients pay. Electricity is taxpayers’ money. Staff salaries and benefits are public money. No rent is paid for the building. Why should they charge that amount?
And go to the provinces and see how many people die daily from easily curable diseases. Even in death they suffer – no mortuary. In Freetown where access is supposed to be much easier they die equally needlessly.
At Pamronkoh in Calaba Town drinkable water is fetched from a filthy stream. I lived there for five years and was shocked to notice on my return a few weeks ago to realise that the same situation still prevails. At the Arab Clinic in the area, I was told that most of the ailments they respond to are waterborne diseases.
So must we always judge Sierra Leone’s health care delivery service only by its free health care for pregnant women and children? That will be most dishonest and anti-people because a large section of the population suffers in silence for fear that should they question the status quo they would be tagged ENEMIES OF THE STATE. The truth is that the vast majority of the people cannot afford the huge cost of private health care.
And even with private health care the doctors are so scattered with so many patients at so many hospitals that they cannot give any proper attention to them. I wonder how many minutes of contact exist between patients and their doctor. And the consultation fee is no chicken feed in a country where people literally beg to feed. Who will blame someone then for treating themselves and going to a hospital only when they are dying. It also makes quack pharmacists thrive even at the expense of the sick.
It is about time government looked at the overall health care delivery system. If we cannot have a thorough free public health care system that is paid for by the rich or through increased taxes on such luxury goods as cigarettes and alcohol and even private cars, then let us find other ways of stopping the needless dying at our poorly run public hospitals and insensitive private one.
