By Umaru Fofana
Sierra Leone has a new health minister. There can hardly be anyone better qualified than Dr Austin Demby to handle the country’s health sector especially at this time.
The renowned US-based epidemiologist and virologist spent decades working in disease prevention and control around the world for the Health Resources and Services Administration, a sister agency for the US Center for Disease Control.
But even for someone with such a rich CV, the present reality of the country’s health care system requires fresh learning. The health infrastructure is weak, there is corruption galore in the sector, pay and conditions for health care workers are appalling and the general lack of proper work ethic in Sierra Leone has eaten deep into the country’s health care system and workforce. All of that is a result of decades of decadence which even predated the civil war. Fixing it takes time, resources, attitude and aptitude.
For the purposes of this article, I will only concern myself with the attitude bit which is clearly illustrated by what I witnessed last week at the Bo Government Hospital and the feedback I got after raising the red flag about it. Note, in case you need reminding, that all this is happening at a time when the world is going through an unprecedented situation – a pandemic that has affected each and every corner of the world. And one that can be easily contained with only the use of a simple weapon called FACEMASK.
I arrived at the Bo Government Hospital after a close friend’s daughter had fallen from a motorbike taxi due to the sheer recklessness of the rider. A 20-second ride from New London to TOTAL in Bo almost cost the poor girl her life. Her left arm was severely injured after she fell on the tarmac. She also hit her head causing her a severe headache. My friend and I drove the 16-year-old to hospital.
Now, on the day before we had gone to the Bo central mosque for Friday prayers where we found a middle-aged man struggling to enforce face mask compliance before anyone would be allowed to enter the mosque. He did so by the skin of his teeth. While some brought out of their pockets previously-worn-yet-unwashed facemasks to put them on again, others simply said they did not have any. And they looked blasé about it. They chose to sit outside to pray where they clustered with other mostly non-facemask-wearing worshippers.
At this stage, my friend decided to leave the mosque to go buy a box of facemasks most of which he gave to the mosque marshal to give to anyone who’d come without one. The rest of the facemasks we kept in our car.
So with the leftover facemasks and those we had had on us, we took the poor girl to hospital – all of us well masked up. As we drove into the hospital compound, I was struck by the fact that it was clean and well kept. But I was invariably shocked to see what looked like a normal abnormality. Facemasks, which our health workers and caregivers have been telling us to always wear when in a public place, never mind a health facility, were missing. About 10 people – among them some nurses – were crammed in a tiny office apparently functioning as a waiting room or a meeting room. None of them had a facemask properly worn. Not even the nurses who looked very cavalier when I first expressed my disapproval. Only the health officer in the mini-theater had a facemask properly worn.
Just a few meters away is the outpatient unit which looked like a cylindrical African hut but open-spaced, save for the roof. Of the nearly two dozen patients waiting there none of them had on facemasks or wore them properly. And it is not that difficult to simply have someone at the entrance ensuring that before a patient or their relative is allowed in they must have a facemask – in the interest of the patients but also that of the healthcare workers.
As if the anger and indignation caused by that shock at the largest health facility in the south of the country was not enough, came this:
We took our niece into the mini-theater after some of the nurses scampered around to have their masks on, and I berated the patients to put theirs on. They asked us to take her first to the triage for screening. That was impressive!
Upon completing that process, we returned to the outpatients department where we were unbelievably told to go buy gloves before they could examine and treat our patient. That was after we had paid Le 12,000 for registration. Supplies, they said, had run out. Just a reminder, again if needed, that this is a public hospital.
I would later learn that for a very long time, they had been asking patients to provide gloves and some other consumables before they are treated at the Bo public hospital. Some people were even surprised that I was surprised by it.
As if the cavalier attitude towards the use of facemasks I witnessed in Bo was not shocking enough, I was in parliament on Tuesday this week, lo and behold! Sometime last year I got a call from a BBC Radio 4 producer about President Julius Maada Bio being the first head of state in the world to address parliament with a facemask on throughout, since the pandemic. He is one that has shown discipline in that regard; Although he can be criticised for not instilling the same discipline in his ministers and even the crowds that turn out when he goes to the provinces.
That said, I had expected that our Members of Parliament would be masked up when carrying out their business especially with television cameras turned on them and the public seeing them. But to my consternation, throughout the four hours I spent in the House, sitting right in the well – fully masked up of course – only three lawmakers consistently and properly wore their facemasks. The one is a medical doctor by training (Dr AB Kamara), the other is a community health officer by training (Moses Baimba Jorkie) and Dr Kandeh Yumkella. And there was hardly any social distancing between and among most of the MPs present. So that even if one tested positive almost all of those on their side of the aisle would need to be isolated. The operations of parliament will naturally grind to a halt at least for two weeks. The implications on governance will be immeasurable.
But equally crucial is the fact those in leadership should set the right kind of example for the masses. There is a saying in Mandingo that if the top end of a swamp is muddy the bottom side is bound to be waterish.
Mask-wearing in public is extremely necessary however unpleasant or discomforting. And when it is a measure announced by the state it behoves especially those in authority to respect it. Otherwise why punish poor people by forcing them to alight from public vehicles and walk through checkpoints to verify they are masked up? Poor people are even fined and embarrassed for not wearing a mask in a public space.
Senior government officials in Europe and Asia have lost their jobs after evidence emerged that they had breached Covid19 measures especially having to do with public gathering and the use of a facemask. What is wrong with us – or in this case our leaders!
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