Friday, September 19, 2014

Sierra Leone Ebola Updates: The People and the Lockdown

The Ebola Virus
The current Ebola Virus Disease (EVD) outbreak in West Africa continues to grow in its severity. Yesterday the Director General of the World Health Organization Dr. Margaret Chan, in her address to an emergency session of the UN Security Council on Peace and Security in Africa said that in the hardest hit countries like Sierra Leone and Liberia, "an exponentially rising caseload threatens to push governments to the brink of failure." She stated that though the WHO had dealt with many big disease outbreaks in recent years, the current West African outbreak was in her own words, "the greatest peacetime challenge the United Nations and its agencies have ever faced." She declared the outbreak a humanitarian and economic crisis, and a threat to national security beyond the borders of the afflicted countries.
Early Symptoms Infographic

The Centers for Disease Control and Prevention (CDC) in its latest figures, updated yesterday  September 18th, 2014, puts the total 6 months West Africa Ebola case count at 5347 with 2630 total deaths. The highest case count is in Liberia at 2710, followed by Sierra Leone at 1673, Guinea at 942, Nigeria at 21 and Senegal at 1 case. The Ebola deaths in Liberia currently stand at 1459 and Sierra Leone at 562. Dr. Chan states that these official figures may in many instances underestimate the spread of the disease as some cases are probably not being reported.
Dr. Margaret Chan

The very high infection and fatality rates in Liberia could directly be the result of the reckless actions of some members of a skeptical public. Initially many Liberians were very defiant of Ebola health warnings and ignorant of the true nature of the disease. The country's health care system, weakened by years of war, the lack of trained personnel and health equipment, has been so overwhelmed by EVD that patients and dead bodies are left to rot on the streets of the capital.  The Liberian President Dr. Ellen Johnson-Sirleaf made a passionate appeal to the international community to help, and she has been rewarded with the decision by the American government to deploy a large military health contingent of 3000 to the region to help contain the outbreak. 
President Ellen Johnson-Sirleaf

The WHO Director General Dr. Chan has lauded the American commitment stating that " This massive ramp-up of support from the United States is precisely the kind of transformational change we need to get a grip on the outbreak and begin to turn it around." The United States will provide military leadership and establish a regional command and control center in the Liberian capital Monrovia. The hope is for military engineers to construct Ebola Treatment Units around the country and open a training facility that will train approximately 500 health care workers per week in Ebola case management. The CDC will also commence free Ebola trainings for American based health care personnel who want to volunteer to join the fight against Ebola in West Africa. The trainings will be conducted in Atlanta, Georgia.
President Dr. Ernest Bai Koroma

Just last week the Cuban government announced the deployment of 165 highly qualified medical personnel to Sierra Leone, starting in October. The Cuban team will consist of physicians, nurses, epidemiologists, infection control specialists and social mobilization officers. Not to be outdone the Chinese government on September 16th also announced the contribution of a mobile lab team to be dispatched to Sierra Leone. The team of 59 persons from the Chinese Center for Disease Control will be comprised of clinicians, epidemiologists, and nurses and will be based at the China-Sierra Leone Friendship Hospital.

Currently Russia, the World's second major superpower is missing in the Ebola action. They are probably busy with empire building in Easten Ukraine. Russians traditionally do not get involved in issues that do not affect them directly, unless it is seen as a direct threat to their national security. As of now, with the Ebola outbreak confined to Africa, they have adopted a don't ask don't tell policy.
Empty Streets of Freetown
This Morning (JB Jr.)

In Sierra Leone the government has ordered all the country's 5.9 million citizens to stay at home for 3 days starting from today September 19th 2014, through the weekend. The goal is to send teams of volunteers to each house to screen for Ebola and take those infected people who may be hiding to treatment facilities. Most infectious disease experts, including Doctors Without Borders who are currently leading Ebola management in the interior, have criticized the move, stating that it will cause patients to go into hiding and further the mistrust between the government and the people. But the country's authorities remain undeterred. 

Many Sierra Leoneans I spoke to about the decision also questioned the wisdom of telling Ebola patients to stay confined in the same house with people for three days. If the disease is spread through close contact, will this not just provide an opportunity for those infected to have three full days spreading it among their family members? Many also question what the impact on the economy will be.  There will be a halt in economic activity across the country for three days. Petty traders who depend on daily sales of their wares for survival have raised concerns about how they will survive for the three days without plying their trade. Government has responded to some of these fears by providing some food relief, but there are reports of bias and nepotism in distribution across the country. Yesterday thousands of people took to the streets of the capital to do their last minute shopping before the lockdown. Many are wondering whether all that mingling of people did not also exacerbate the spread of the virus. 

However, the government views the lockdown as a magic wand that will result in the identification of hidden cases and has not been responsive to the opinion of the experts. The government's current philosophy is seemingly that desperate times call for desperate measures. The President's wife in a public address to the people attributed the current outbreak to their sins. She is a trained health personnel.

In the country's interior the district and chiefdom authorities are also seriously preparing for the three day lockdown. Honorable Abu Jajua of Segbwema reported the distribution on Saturday of 500 bags of rice and cooking utensils to the people by the Chiefdom Ebola Task Force which includes health authorities, the MP, the Paramount Chief  Sheriff Coker Jajua and other key stakeholders. Honorable Jajua reported that effort has been made to deliver food to all quarantined houses in the constituency. The MP also ensured the distribution of rice to Njaluahun citizens living in Kenema.

As we await the result of the lockdown, the Segbwema Blog will continue to monitor the situation and provide propaganda free reports and assessments.

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