By Isaac Massaquoi
On Wednesday afternoon, I received the following text message from the Ministry of Health: “Prevent cholera: Always wash hands with soap after using the toilet.” I am quite sure hundreds of thousands of other Sierra Leoneans also received it.
I was tempted to just trash it like I do with the many unsolicited text messages that all our under-performing mobile phone companies send us daily. But I opened up the box and found this most patronising of messages quoted above. Immediately, my mind raced back to some grim statistics I saw on a friend’s Facebook wall about the cholera outbreak in Sierra Leone the day before. In fact it was following reports like that, that president Koroma declared the epidemic a national emergency.
I will return to this text message towards the end of this piece.
I think the president did the right thing because the reality on the ground was that nearly 200 (the number if far above that now) of his countrymen and women had died in the last few weeks of the outbreak of an easily preventable disease and the nation needed him to demonstrate that he was in charge not just of the politics, but of the nation’s health too, and that he cared.
Declaring an emergency basically allowed the president to direct the nation’s resources to the effort to defeat the enemy and the international community has come in to help in a substantial and sustained way.
This cholera emergency started slowly, spreading to many parts of the country with newspapers carrying sporadic reports about deaths without the Ministry of Health speaking up about what was really happening in some of the most deprived communities in Sierra Leone. Could this emergency have been declared two weeks ago?
The ministry’s handling of this cholera outbreak leaves much to be desired. I can even argue that many Sierra Leoneans would have escaped death had the ministry convinced the president in good time that the nation was standing on the brink of a major outbreak that would destroy more than 200 Sierra Leonean lives even before this annual cholera outbreak peaks.
Right now we are scrambling drugs, medical personnel and even text messages all over the place in a frantic move to control cholera and wipe out the stigma of our country being a place where the people have lost their way with sanitation.
There are a few uncomfortable truths that we must confront in this city if we are to stop the frequent contamination of the nation’s water resources and the entire food chain. This problem has been with us for a long time because even as far back as fifteen years ago, I was reporting on the work of Blue Flag Volunteers – community people hurriedly trained to help health workers administer first line treatment to cholera victims and also to provide health education to prevent cholera attack in the national news on television.
Let’s not hide it; Guma Valley Water Company is no longer able to supply adequate clean drink water on a daily basis to even half the population of the city. Ernest Bai Koroma’s government has done quite a bit in the area of providing electricity to Freetown but water remains an intractable problem and I am not optimistic things will change anytime soon.
In 2010, I was living at a place called Smart Farm to the West of Freetown. It’s a nice quiet neighbourhood occupied, at the time, mostly by civilian staff of the large UN mission that was in Sierra Leone, staff from some diplomatic missions and Lebanese people.
Many in Freetown would easily describe Smart Farm as an affluent place in the context of Sierra Leone. By some luck, I found myself living there for about seven years. Pipe borne water was a luxury. An enterprising man managed to sink a well about one hundred yards from my place and it served hundreds of people. Each jerry can of water cost Le 5,000 and we were all at the mercy of the mercurial fellow who sometimes closed his well for hours for the flimsiest of reasons. It was crazy.
I was determined to get Guma Valley Water Company to deal with the problem. After writing several letters without receiving a reply, I went to see the General Manager at that time, a man called Ibrahim Babatunde Wilson. He received me while he ate his lunch just after completing a TV interview with some foreign TV company. Wilson was very familiar with the situation at Smart Farm. Apparently many other people from the area had contacted him on the problem.
He told me in no uncertain terms that it would take millions of dollars and huge engineering work to bring water at any acceptable level to Smart Farm and that I should forget about an immediate solution. I was furious that the Manager could tell me such things with such cavalier attitude. He then told me that my problem was not an isolated one. He told me that many other communities had made the same complaint. “So what is he doing in this office”? I asked myself quietly. At that point, Wilson wanted to know who this visitor really was. I told him I was a journalist but that I was speaking to him like any ordinary Sierra Leonean who needed clean drinking water.
He smiled and said “even this office has no pipe borne water; we get our vehicles to bring water to this place everyday”. I was stunned. I left his office feeling sorry for him. Yes he had a nice office and smart looking staff, but in terms of delivering the service for which they were being paid, Wilson and his people were as hopeless as a customer in a barber’s chair.
I read later on that unlike NPA, parliament held GVWC on a tight leash in terms of how much it could charge for its services and that subvention was ridiculously low and irregular. How could Wilson and others deliver this most important commodity?
I left Smart Farm almost two years ago. The problem persists and my new place is only marginally better than Smart Farm in terms of the quantity and quality of water supply and Wilson has long quit GVWC.
I have made this point to demonstrate how clean-drinking water which people in many societies take for granted is a big headache here. The only option open to the vast majority of our people is contaminated spring and well water which in the rainy season gets flooded by all sorts of debris. Can we really avoid cholera in such circumstances?
The Freetown City Council should go around and see how many houses in this city have adequate sanitation facilities for all occupants. I am not going to mention markets and other places where large crowds gather like the National Stadium. Whatever toilet facilities are available, are just not fit for purpose. Sanitation facilities are an absolute mess.
There’s something very strange about Sierra Leone, Freetown in particular. In the 70s and early 80s, we had health inspectors visiting households, checking toilets and making arrests and getting people prosecuted where toilets were badly handled. Today, things have deteriorated to the extent that there are hundreds of houses with many tenants piling faeces in plastic bags and depositing them in gutters by night because they have no toilets.
How can house owners continue to collect money from people in such circumstances, refusing to pay city rates and continuing to live in peace under the nose of the FCC? Instead of improving on things we did in the 80s, we have allowed them to fall by the wayside because of budget cuts, corruption and political correctness.
As you walk along the streets of Freetown you will notice food being sold out in the open with no covering at all next to garbage dumps. There’s nobody to check this downward slide. Go to Calaba Town and see the people selling JAY 1 bread and tell me why President Koroma thinks the Free Health Care is having any effect when he is only providing drugs without pressing hard enough on preventative health care.
Let me now return to the text message from the Ministry of Health. As a desperate measure, I have no problem with it but if the ministry officials convinced themselves that they were dealing a severe blow to the rampaging cholera problem, then they are terribly mistaken. The cholera is now officially a national emergency so when did the ministry realize people were dying needlessly?
Most people my age who grew up in Freetown would still remember how popular public health education radio jingles were in this country and how much they helped change attitudes. With the greatest respect to our public health education people of today, what they are doing on radio and TV is totally ineffective. Endless discussion programs that do not fit into a clear strategy that includes real action on the ground will change nothing.
It makes no sense to go on TV and urge people to have good toilets without a public health division that is strong enough in terms of legislative power and personnel to make people comply. I will not even talk about school health programs which are non-existent today.
We would never defeat diseases like cholera if we didn’t deliberately clean up the nation’s food chain backed by strong action to stop people squatting in slums in those sub-human conditions. It’s an official emergency now, but is it just talk?
