Friday, September 12, 2014

Sierra Leone's Tough Year

Sierra Leone Ebola (BBC)
2014 will go down as one of the toughest years in peacetime post independent Sierra Leone, and we still have months about 4 months to go before the year is over.
President Koroma
A Tough Year

In the small tropical country of approximately 6 million people, a combination of natural disasters, official ineptitude, and lack of preparedness has resulted in a punishing year that will be remembered for many more to come.
Flooding in Suburb of

A seemingly random Ebola outbreak which started in Guinea and penetrated Sierra Leone probably around April encountered a health care system ill equipped to cope with a crisis of such magnitude. The result has been heartrending and the incidence is on the verge of becoming the most fatal International viral outbreak over the last four decades.
Flooding Kenema

The nature of the Ebola virus confounds even the most advanced health care systems in the world. The Sierra Leone health care system, weakened by years of war, poor funding, lack of supplies,  inadequate training, systematic mismanagement and absurd levels of corruption, has  proved no match for the highly virulent disease.
Sierra Leoneans in USA
Discussing Ebola

Not only was the Sierra Leone health infrastructure unprepared to handle a crisis of such magnitude, the presence of a totally unqualified minister with no health credentials, who ordered infected patients to be transported from isolated remote regions to urban areas and could not even have a team in place to check the expiration dates on Ebola test kits, helped the virus spread like hunger in the stomach of the homeless.
Ebola Victim Dr Modupeh Cole

The outbreak was met by denials, ignorance, poor decision making and in some instances pure recklessness even on the part of those who ought to know better. Trained medical personnel not only underestimated the nature of the Ebola plague, they may have knowingly contributed to its rapid dissemination all in a bid to enrich themselves. A lab technician in Kenema where the first domestic testing center was located stands accused of taking money to falsify positive Ebola test results in what can only be described as a dangerous display of greed, stupidity and recklessness. Cases of nurses with no experience with Ebola secretly caring for patients and exposing their families,  acquaintances and themselves to the painful death Ebola hands down is common in the areas where the virus first surfaced.

Even the country's President, who is notable for his slow reactions to crisis, has now been pressurized by both extraneous factors and the constant complaints of the people to act. In the next few days he has ordered a 3 day complete lockdown of the entire country in a bid to move from house to house,  educating people about the virus. Apparently, not everybody has access to a radio.

This lockdown, a desperate move to stem the outbreak, has been criticized by health and economic experts around the world. The Presidential Ebola Task force has brushed these criticisms aside. These are desperate times and the President and the Ebola task force which he heads seem ready to try anything that comes to mind, regardless of how outlandish it may sound. At the very least, most of the people now believe that Ebola is real, is no gimmick and it kills. This may help people comply with the lockdown.

 The efficacy of locking down a whole country for three days in a society with very little electricity, pipe-borne water and a population mired in chronic poverty may have to be measured in the future, but for now the authorities are determined to go ahead with the lock down. Whatever economic and sanitary outcomes may result from this lock down will have to be determined in the near future.

When the outbreak occurred it took weeks for President Koroma to even address the issue on national radio. Unfortunately for Sierra Leoneans, the Ebola outbreak has now put president's much touted Agenda for Prosperity in danger of being nothing more than a pipe dream. For a man who loves travelling abroad frequently, he is now being forced to spend time in the country dealing with the realities on the ground as flights to the country have slowed down to a trickle.

Unfortunately as has always been the case with Ebola infactions, it is the poor health care workers in the country who are bearing the brunt of this particular outbreak. In a country with fewer than 3 doctors per 20000 people (and that is a generous estimate), the death in rapid succession of three highly qualified doctors; Dr. Khan, Dr. Cole and Dr. Rogers and the death of so many nurses represent a loss of crucial medical manpower that will impact health care in the country for many years to come. Reports from the country indicate that a female doctor has also just tested negative and there are petitions online to have her flown out for treatment.

As if the Ebola crisis is not enough, the country has over the past few weeks been inundated by some of the severest flooding that has been witnessed in decades. Freetown the capital of Sierra Leone is strategically located at the base of the rolling peninsula mountain ranges, with Mount Aureol towering over central Freetown. The vegetation on the mountain ranges have long acted as solid barriers to water runoff during the lengthy rainy season in the coastal areas. For decades, this has controlled soil erosion and prevented flooding. With the exponential growth of the Freetown population and an increased demand for building land, the ministry of lands has without any strategic protection plan allowed people to excavate these mountain ranges to build houses at such a pace that this natural cover no longer exists. The result this year is flooding of biblical proportions, drowning major areas of the capital under tons of water, restricting mobility and jeopardizing rapid Ebola response.

To add to the hillside erosion, new roads are been constructed with a focus on beautification and bragging rights rather than on effective drainage in a low lying city that is bounded by the mountain ranges on one side and the Atlantic ocean on the other. This poor urban planning has made the country vulnerable to even the smallest degree of rainfall. Freetown historically used to have days of rainfall with no incidence of flooding in the capital. As global warming becomes a problem and weather patterns become more unpredictable, Freetown may become a sitting target for a major weather related crisis if steps are not taken to address urban planning. For now the people will just have to appeal to the mercy of nature. This September areas of Freetown such as Congo Cross, Kru Bay, Dundas Street and many coastal areas have been hit with massive flooding. The authorities have lacked the capacity to meaningfully respond, just waiting for fate to mercifully intervene.

Flooding has not also spared the interior as illegal logging, involving people high up in the government has depleted much of the natural forest cover that used to protect the country from torrential rainfall. The loss of natural soil cover has exposed the soil in many areas allowing erosion in areas that used to be relatively free from the phenomenon. Towns like Pujehun and Kenema have been hit with floods, resulting in the destruction of millions of dollars worth of property and displacing many people in a country already plagued by disease and poverty.

2014 will go down as a tough year for Sierra Leoneans,  a resilient people,  toughened by years of bombardment with natural and man made troubles. But as it always happens the people will pull through.  As Sierra Leoneans are fond of saying,  "kaka long tay e go cut." But before it does. .......

1 comment:

Anonymous said...

The most worrying thing about the Ebola crisis is that people are not tested at all at the time they are suspected of carrying the virus. When such people who may or may not be "guilty" of Ebola are "put on trial" at Ebola infested hospitals, it is highly likely that they are being infected at the hospitals. A forensic team in Baltimore is now gathering evidences of recent deaths that prove this possibility